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Diary of a travelling Ipswich doctor: Day 6

A LEADING Ipswich doctor has been selected to teach the latest treatment and surgery techniques in the Pacific Islands - and he's keeping a diary of his experiences.

Ipswich hospital's Director of Orthopaedics Dr Angus Moxon set off for Samoa on Saturday for an eight day trip volunteering for the Pacific Island Orthopaedics Association.

He is one of four in the state who will be training registrars from Samoa, Fiji, Tonga, Vanuatu and Solomon Islands in the latest surgical techniques for orthopaedics.

It's an area of expertise in high demand throughout the region with farming accidents, poor health standards and diabetes leaving patients in need of specialised care.

This is the first time Dr Moxon has set off overseas to share his knowledge and experience and he's giving people at home a unique insight into the trip.

 

Doctor's diary - Day 6

My last full day in Samoa.

I have had a wonderful experience with some amazing people. The way the local surgeons adapt to their environment astounds me.

We did the ward rounds again this morning, followed by some lectures on hindfoot trauma, ankle instability and infection in the ankle joint.

'The way the local surgeons adapt to their environment astounds me'.
'The way the local surgeons adapt to their environment astounds me'. Angus Moxon

 

Doctor's diary - Day 5

A lovely dinner last night to celebrate the Pacific Islands Orthopaedic Association.  

There was plenty of discussion about the future of Orthopaedics in the region.   

Back to work this morning with the ward rounds and lectures on foot and ankle trauma and forefoot conditions we encounter.  

A great practical session this afternoon where the trainees practiced internal fixation of difficult foot fractures.   

Angus

Doctor's diary - Day 4

Day four in Samoa started with a mini thunder storm. Luckily it didn't last too long, and on the walk to the hospital, we remained dry.

Ward rounds today involved an elderly lady with a fractured femur around an old partial hip replacement.

This was followed by seeing a young man with a Tibial fracture, sustained in a motor vehicle accident.

A practical session on fixing ankle fractures on synthetic bones.
A practical session on fixing ankle fractures on synthetic bones. Angus Moxon

We then had some talks on Ankle and Distal tibial fractures and a practical session on fixing ankle fractures on synthetic bones.

We also found time to visit the diabetic foot clinic to see how the Samoans manage such a massive problem in their community.

Looking forward to our PIOA dinner tonight with the health minister and minister for education.

Angus

 

A practical session on fixing ankle fractures on synthetic bones.
A practical session on fixing ankle fractures on synthetic bones. Angus Moxon

 

Doctor's diary - Day 3

We had a busy day today in Samoa.

A hospital wide meeting to start the day, talking about the Pacific Islands Orthopaedic Association.

Members of the local health board and the University of Samoa were present to discuss the issues facing the program.

There was a lot of encouragement for the recognition of the program and interest from the other medical specialities in the hospital as to how to train their own colleagues to improve the health service in Samoa.

Day 3 in Samoa
Day 3 in Samoa Angus Moxon

We then proceeded to our ward rounds, seeing an elderly lady with a neck of femur fracture, and the lady next to her, with a proximal humerus fracture being supported by the most colourful sling I have ever seen.

Again we discussed management plans considering the limited amount of equipment available.

Day 3 in Samoa - photos show the winners of the best 'ankle ex fix construct' competition.
Day 3 in Samoa - photos show the winners of the best 'ankle ex fix construct' competition. Angus Moxon

The tutorial room followed with lectures by Dr Des Soares, Dr Nick Shortt and myself on common foot and ankle conditions.

The afternoon was spent discussing high energy trauma cases and their management which culminated with a practical session on External Fixation. 

It was a long day but a great deal was achieved, and again, it was a great pleasure to be involved with such an amazing group of people.

Angus

 

Doctor's diary - Day 2

Another beautiful day in Samoa.


We started our day on the wards again.

It was the paediatric ward this time.

We saw a nine-year-old boy with an infected knee from the outer islands that the local surgeons were struggling to get on top of.

The other case was a six-year-old boy who had been hit by a car at the side of the road.

He had multiple injuries, one of which was a femur fracture for which he was being treating in traction in a hospital bed for eight weeks.

DAY TWO: Time spent in the tutorial room talking about diabetes and the resulting foot and ankle complications.
DAY TWO: Time spent in the tutorial room talking about diabetes and the resulting foot and ankle complications. Angus Moxon

They have great difficulty putting a Hip spica cast on, due to the heat and humidity in the region.

There is also no available equipment to perform internal fixation.

The rest of the day was spent on the tutorial room.

DAY TWO: Time spent in the tutorial room talking about diabetes and the resulting foot and ankle complications.
DAY TWO: Time spent in the tutorial room talking about diabetes and the resulting foot and ankle complications. Angus Moxon

We spent the day doing talks on diabetes and the resulting complications in the foot and ankle - 50% of hospital beds are taken up here in Apia by diabetic foot complications.

There are more than 600 surgeries performed on diabetic feet here, which is a great deal of their operating.

Angus

 

Doctor's diary - Day 1

We have 11 training surgeons who are incredibly bright and enthusiastic to learn.

The day started on the surgical wards with one of the local Samoan trainee surgeons taking us to a couple of patient's bedsides, and going through the history and examination findings.

We then discussed the surgery performed and likely outcomes.

I have added some photos of how we viewed the X-rays, with a view of Apia and the Pacific behind.

After the case studies, Dr Des Soares (founder of the PIOA) started us off with an excellent lecture and practical session, concentrating on history taking in foot and ankle cases

I then gave an interactive lecture on Foot and Ankle examination, which was well received.

I followed with a demonstration of the examination technique and then the trainee surgeons practiced on each other with our guidance.

Interestingly, the group discovered some pathologies within their colleagues feet, mostly due to previous rugby injuries.

The Trainees then sat a written exam form their previous Spinal module, this allowed Dr Nick Shortt and myself an opportunity to explore the local region a little.

Angus

Doctor's diary - Day 3

Topics:  health, ipswich, orthopaedics, pacific islands



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