One of our most prolific and well-regarded volunteer general surgeons, Dr. Larry Falk from the Ukiah (California) Valley Medical Center, has returned from a month-long assignment on Christmas Island in Kiribati, located in an isolated region along the equator in the Central Pacific.
“Dr. Larry’s dedication to the people of Kiribati led him to volunteer for an entire month, available for elective and emergency surgery while there,” said Carlton Smith, president of Pacific Islands Medical Aid, Inc. (PIMA).
Below are Dr. Larry’s observations:
An invitation from Dr. Teraira and Carlton Smith motivated me to accept an assignment as a volunteer general surgeon at Ronton Hospital on Christmas Island from November 17 Through December 16. Their surgeon from Cuba, Dr. Miguel, had taken an absence from the island, leaving the general surgical services uncovered. I leapt at the opportunity to help since I know from past experience how vital these services can be and how rewarding it is from a professional and personal point of view.
I have been on some one and two week excursions in the past, but this was my first try at four weeks. I wasn’t disappointed and had a productive trip.
The general surgical work comes in spurts and the complexity and nature of the cases is difficult to predict. There are cases of chronic and acute appendicitis, gallbladder disease, hernias and others. There is a disturbingly high incidence of diabetic foot infections, which frequently lead to amputations. At one point I accompanied Dr. Teraira in his capacity as Chief Medical Officer of the Line Islands to a fishing boat to examine the remains of a fisherman who had become despondent and, sadly had committed suicide. It was a somber excursion, to say the least.
I had occasion to rub shoulders with other aid workers on the Island. There was a group from the World Health Organization working to survey the effects and minimize blindness related to trachoma, an infection of the eyes. I went with them on a boat across the lagoon to Poland and participated in their clinics. I learned a lot about trachoma and felt a true sense of collaboration with the WHO team.
There was also a contractor from Australia, Simon Troman, whose company was working under a grant from New Zealand to improve the electrical services on the Island. Right now there are four separate generators, with different electrical standards and without interconnections among them. The goal is to standardize the grid, interconnect the generators and build new transmission lines. This will have important implications for Ronton Hospital, which currently suffers from periodic power interruptions.
There are obvious consequences of the current El Niño phenomenon affecting the people and their hospital. Complicated by sea level rise, the changes in the prevailing wind patterns are causing excessive rain, flooding and interruption of transportation and other services on the island. This is yet another of the challenging problems the people of the island face on a daily basis.
The new desalinization plant installed with support and funding from Pacific Islands Medical Aid is working to provide fresh water to the hospital. Taaren, the Clinical Engineer and Director of Facilities at the hospital, has been working through some technical details to ensure a steady supply of clean, healthy water.
We are working with the help of PIMA and Ukiah Valley Medical Center to bring Taaren to Ukiah, California, for a one-month work/study program with our Chief of Bioengineering, Jack Smiley. Jack and Computer Engineer John Reilly were on a recent PIMA team and have established a close personal and professional relationship with Taaren, which should yield important benefits to the program at Ronton Hospital into the future.
With the new Head Nurse at Ronton Hospital, Tomató, we were able to help with organizing and in making an inventory of medical supplies and equipment at the hospital. PIMA has plans to help install some new shelving and to streamline the supply and equipment procurement process to make it more efficient and useful to the doctors working at the hospital.
Overall, one gets the sense of growth and progress in the air at Ronton Hospital and on Christmas Island in general. Nevertheless, there remain major difficult issues that will need ongoing attention from the local people and professionals on the island their partners, of which Pacific Island Medical Aid stands out as a long-term and trusted example.