With a possible career in Anaesthetics or general practice in mind, I wanted to plan my elective to give me a broad medical and surgical experience, but in a different setting with its own challenges.
The Solomon Islands is a large archipelago in the pacific, north-east of Australia. The country has had a turbulent history, having been occupied by the Japanese during WW2, and with a recent civil war in the early 2000s. The archipelago consists of ~900 islands, with a total population of around 653, 000 (2017), but with an especially young population this is rapidly increasing. The capital is Honiara, with the next biggest provincial centre, Gizo, 230 miles away.
Gizo hospital, serving around 140,000 people, is a 60-bed facility which was built in 2012 by the Japanese. The previous hospital was nearly destroyed in the April 2007 Tsunami which devastated the islands. 4 doctors work in the hospital, 3 local and 1 on rotation for 9 weeks at a time from Sydney. They are supported by a team of roughly 60 nurses and healthcare assistants, many of whom are able to do far more than their UK counterparts.
I spent the majority of my time in the Accident and Emergency department, helping the Australian Doctor. There were a huge variety of presentations, including a large number of minor cases such as UTIs and unknown pregnancies, due to reduced resources, a reduced level of health education, and the lack of primary care system. At the more serious end of the scale, there were lots of presentations of Malaria and dengue, along with cases of pneumonia, heart failure (particularly due to rheumatic heart disease) and traumatic sport and occupational injuries.
What impressed me most, was how the 2 main local doctors succeeded in being incredible “jack-of-all trades”. From deliveries, Caesarean sections, removing ectopic pregnancies, amputations, debridements, running outpatients, paediatrics and the medical wards, this broad based training and practice is very different to the UK, but is ideally suited to the environment they work in.
Overall I am really glad I chose the Solomon Islands for my elective, as it has given me a diverse sense of medicine in a rural, developing community and am really grateful to Trauma Care for supporting me financially.