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Solomon Islands

Written by Angus Ritchie, 2002

Gizo Hospital, Western Province, Solomon Islands

The Solomon Islands is a group of over 900 islands off the eastern tip of Papua New Guinea. Known as the "Happy Isles", the locals are friendly and laid back.

Elective Experience

I spent 8 weeks at Gizo Hospital – 52 beds and the major referral hospital for the Western Province (60,000 people). They have wards for maternity, females, males, children and isolation ward for TB patients. The work was broad and multidisciplinary.

The surgical experience was especially good. The operating theatre is basic – you scrub up with ordinary soap and wear thongs in theatre. Abscesses are abundant and sometimes massive – we drained 500ml from a boy’s shoulder and the largest so far is 2 litres from a thigh (under high pressure). Diabetes is very common and poorly controlled. I saw many diabetic foot infections and had the chance to clean them. Sometimes this failed and we amputated.

Ketamine anaesthesia is the most common GA used, especially for children, abscesses and closed fracture reduction. Leg fractures were very common and usually due to a collision playing soccer – the most popular local sport.

Sick babies are common and my most rewarding experiences came from managing these cases (under Dr Divvy, a paediatrician). We had one very premature infant with cord sepsis and weighing 800g. She was tiny, and her weight fell to under 500g before she recovered. Managing her nutrition and medications and charting her recovery was a supremely satisfying experience. Her miraculous improvement set a new record for the smallest baby to survive in Gizo.

Patients requiring a blood transfusion must approach their kin, or ‘wantoks’ to donate, as there is no blood bank. One patient, a jovial old Gilbertese man with a broad toothless smile, was a long-term patient suffering chronic renal failure, poorly controlled diabetes and a carbuncle the size of a soccer ball on his back. He needed regular transfusions but had no 'wantoks' around to donate. In the end I gave him a unit of my own blood, for which he was immensely grateful.

Afternoons were spent mostly in the outpatients department – a place where anything can and does turn up. The cases ranged from severe meningitis, miscarriages strokes and trauma to hernias, diabetes, osteoarthritis and this local curiosity called yaws, a skin infection presenting mostly in kids with large, raw and painless ulcers.

We also saw tragic cases: a drowned child; a young mother with rheumatic heart disease who died suddenly, before our eyes; a man whose wife had a stroke at 32 related to her rheumatic heart disease and his son suffered from schizophrenia, a difficult illness for which there is scarce resources available locally.

If I were to write about all the wonderful patients I treated, all the tragedies and miracles and the funny anecdotes from working there, I would be here all day – as my diary proves. Though I can’t claim that it was a life changing experience, my elective reminded me of all the reasons why I wanted to be a doctor and the lessons I have learned, the faces of all those special patients shall be with me for life.

Life Outside the Hospital

Even though the medical experience is fantastic, there are many other reasons to choose Gizo for an elective. For me, every weekend was a little adventure. Most often Saturday’s were spent on various small, uninhabited islands around Gizo on daytrips – diving, snorkeling, fishing or just chilling out. The water is remarkably clear and warm and the reef in some places is truly sensational.

I walked the length of Gizo Island once with a visiting biologist. He was an avid birdwatcher and we were counting Gizo white-eyes – a rare species found only on Gizo. We passed through villages and coconut plantations and at the other end was Seraghe, a truly idyllic village with the clichéd palm-fringed, white sandy beaches and turquoise water.

I was invited to a village on a neighbouring island for another weekend. After a harrowing 2 hour trip across rough seas during which the 10m dugout canoe loaded with 15 people, powered by a 15hp outboard was swamped twice (no life jackets), I arrived at a small collection of leaf huts clustered on black volcanic cliffs above the sea. The locals took me swimming in secluded waterfalls, showed me ancient skull huts and lead me up the local mountain; they told me I was the first white man to climb that peak.