DocTours Newsletter December 2015

Hello Everyone,

We have just returned from a site inspection of Fiji which is becoming one of our most popular destinations for volunteers.  Our travels were a long way from the five-star resorts and we continue to see an acute demand for medical and healthcare assistance.  We have shared some of our insights with you below.  Please let us know if you have any questions or would like more information – we are always happy to help!

Best wishes for the holiday season! 

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Volunteer Nursing in Fiji

Nurses in Fiji are trained in general nursing only and this year will see the first nurses graduating with a bachelor’s degree.   They are particularly in need of nurses with experience in specialist areas (including surgery, ICU, coronary care, psych, paeds, oncology and palliative care).

Many are involved in public health programs to visit remote villages to provide advice on hygiene, HIV and family planning.  They see many patients presenting late with NCD’s because of a preference to rely on traditional medicine and a lack of money.  The outcome of this is a large number of diabetes-related amputations (now more than 1 every 12 hours in Fiji where the total population is less than 900,000).

There is also a growing number of teenage pregnancies (we have heard various reasons for this trend).   Therefore there is an increasing demand for midwives and nurses who specialise in paediatric, post-natal, maternal child and women’s health.   There are groups of nurses who predominantly travel on outreach programs into the remote villages.  Their focus is on reproductive health and NCD screening as well as hygiene and home inspections and raising awareness of modern medicine.  They also have the schools programs where they conduct physical examinations and immunization programs during the school terms.  Volunteers are often invited to join one of these outreach programs and this is often one of the highlights of their experience.

There has been growing awareness of the importance of healthy living in Fiji for a while.  However the increased awareness has not been effective in changing the levels of stress, alcohol and kava abuse, smoking, eating junk food and physical or activity stemming the increase in NCD’s.  One clinic on the west coast of the main island initiated an NCD Intervention Project three years ago and the results are promising.  The NCD Intervention Project involved recruiting local health care workers to help educate and involve their community in wellness programs, healthy eating, Zumba classes and volleyball tournaments.  The approach was respectful, inclusive and designed to enhance skills and build confidence.  The women were encouraged to grow their own vegetables (which become a hobby) and were taught the basics of more healthy cooking (by reducing salt and adding herbs).  These women were empowered through education, engagement and taking responsibility and therefore this seems to be quite sustainable.

Medical Volunteering in Fiji

The scenic Coral Coast running between Nadi and Suva is famous for many tourist resorts however unfortunately it experiences a large proportion of road accidents along its beautiful, winding roads.  We attended a morning handover meeting at one of the hospitals and the list of cases was interesting.  There was a drunk who wandered onto the road the previous night and had been hit by a vehicle.  Another patient died when the hospital ran out of medication.  The shortage of medical supplies and basic equipment (eg everyone seems to be asking us for pulse oxymeters) was prevalent however not unusual in developing countries.   We humbly presented the hospital with a large box filled with hygiene kits, scissors and stationery which was very graciously accepted.

Elsewhere, specialists are highly valued including ED consultants, anaesthetists, radiologists, pathologists and cardiologists.  They are keen for specialists to mentor and transfer knowledge to the local staff who are keen to learn.

Volunteer Dentists in Fiji

We see lots of holiday snaps of happy smiling children in Fiji with pearly white teeth.  One of the contributing factors for this is that children up to the age of 15 receive free dental care in Fiji.  In addition, Colgate generously donates a new toothbrush and toothpaste for every child every year.  After that, dental care comes at a cost which many people cannot afford and therefore patients ultimately present at the hospital Outpatients Department with pain.   The dental teams are kept busy on a daily basis just addressing the cause of pain and therefore extraction is often the only resolution by that stage.

Fiji welcomes volunteer dentists.  This provides an opportunity to offer patients free dental care to help prevent and treat conditions earlier.  The local staff have willingly offered to communicate the pending arrival of volunteers by using the ‘coconut wireless’.   Any specialist skills are also welcomed and they will screen and book in relevant patients in advance.  Whilst the hospitals in Suva and Lautoka have the largest dental clinics, the greatest need is on the more remote islands and in their outreach programs.