Old school in the New Hebrides: the Vanuatu experience

Resource limitations don’t Due to geographical and linguistic a good idea. The current Vila Central separation, the islands display an Hospital comprises several single- slow the medical staff – or amazing diversity of culture. Residents storey buildings with separate wings for the babies – at Vila Central speak more than 100 distinct languages medical, surgical, obstetric and paediatric Hospital. and there are many dialects. The offi cial patients. The hospital is in a particularly In August 2012, I travelled to Vanuatu languages are French, English and poor area with many slum dwellings for a week with funding provided by the Bislama (or Vanuatu pidgin English). nearby. There are always groups of people ANZCA Overseas Aid Trainee scholarship Most hospital staff spoke English, but for milling around and kids kick a football on under the supervision of Dr Matthew many patients Bislama was the common the open grassed area near the entrance. Howes, a staff specialist from the Mater tongue. It was interesting to discover Immediately it is evident that this is Mothers’ Hospital in Brisbane. that the term “anaesthetist” is not only a like no hospital I have worked in before. We were based at the Vila Central mouthful in English but also in Bislama. The two operating theatres are old and Hospital in Port Vila, the capital city While the surgeon is known as the patched up. Everything from the beds, on the island of Efate, providing relief “katem man” (the cutting man), there are lights, diathermy, drapes and gowns anaesthetic services during the Pacifi c several variations for “anaesthetist”. For appear to be from a bygone era and Society of Anaesthetists conference in Fiji. example, I could be called “dokta blong bring back fond childhood memories of Vanuatu is a south Pacifi c nation makem man i silip gud” (the doctor who watching M*A*S*H. There is a distinct lack comprising some 80 islands approximately makes you have a good sleep) or this of order and the meticulous sterility we 2400 kilometres east of Cairns. The islands could be expanded to “dokta we i stikim are accustomed to in western hospitals. are tropical and located in a region of man o i givim gas blong makem bodi i The anaesthetic machines seem more active tectonic plate movement known ded blong dokta i save katem” (loosely cluttered. The ampoules are hard to as the “Pacifi c ring of fi re”. Earthquakes translated as “the doctor who either sticks read and even harder to break; a fi le and volcanic activity are common and you [for example, spinal] or gives you gas beside the anaesthetic machine is used we experienced a quake measuring 5.1 so that look dead in order for you to be for this purpose. There are no colour- on the Richter scale during our stay. operated on”). coded drug stickers and multi-dosing of Vanuatu is country of contrasts; luxury The hospital at Port Vila was once drugs is common to avoid wasting scarce cruisers moor in the harbour while a few located on a small island in the harbour, resources. There are sharps everywhere, streets away families live in very humble a fi ve-minute boat ride from the mainland. no needleless injection systems. Sharps circumstances. Despite the poverty, it has Today the island is home to the Iririki bins are makeshift containers, such as been dubbed “the happiest country on resort, however, if you look carefully used water bottles or cardboard boxes. earth” and the national people (known you can see what remains of the former Many “single use” items are recycled, as Ni-Vanuatu or Ni-Van) greet you with hospital. More than 30 years ago it was including Hudson masks and oxygen a happy “hello” and a bright smile. decided to move the hospital to the tubing. The ward charts, drug charts and mainland, which by all accounts was anaesthetic records are bland and there

38 ANZCA Bulletin March 2013