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Working with Solomon Islands medical team is medicine in its purest form

Rural Clinical School conjoint Dr Jan Snow was hesitant to go on her first medical tour of the Solomon Islands back in 2013. Just back from her third tour, she now says that the experience is akin to practising medicine in its “purest form”. Dr Snow took time out to tell us more about her medical adventures in this amazing Pacific archipelago:

I've just returned from my third tour of the Marovo Lagoon in the Solomon Islands and am currently in transition -- transition from living in a tropical paradise surrounded by some of the poorest people I have known, working in the hottest, most humid conditions imaginable, to my busy, more complex life and my air-conditioned GP surgery in Port Macquarie.

To be completely honest, I was a reluctant participant in the first tour I joined in November 2013. I was volunteered by my friend, anaesthetist Grant Mills, who had shortly returned from his first tour. He assured me that I "would love it". I was nervous, feeling out of my depth regarding tropical medicine and not looking forward to sharing a cabin with someone unfamiliar. In addition, I don't dive and I dislike shellfish...

How does the Marovo Medical Foundation (MMF) work? For two weeks twice a year, a team consisting of 25 doctors, nurses, allied medical and non-medics travels from USA and Australia to provide medical services in the Marovo Lagoon of the Solomon Islands. This team provides free medical care for many hundreds of Solomon Islanders who otherwise have no access to a doctor.

MMF was founded in 2007 by Americans Dr Suzanne Daly and Allan Daly who were guests at Uepi Island Resort, and eco-resort run by Australians Jill and Grant Kelly. During their stay, the Dalys realised there was no medical provision in the area, with local Seghe Hospital a three-hour paddle away and having no electricity or running water.... and no doctor.

Over the next few years, MMF raised funds to solar-power the hospital, provide running water and mosquito screens, and provide medical services twice a year. The foundation joined forces with Solutions-pa-Marovo, a charitable organisation run by the Kelly's son, Jason, and built a state-of-the-art operating theatre at Seghe Hospital, with the first operation being performed in May 2013.

MMF consists of the surgical team which travels daily to Seghe Hospital, while the medical team travels to eight different villages chosen specifically to provide access to the greatest number of people in the Marovo. The villages are informed when the team is arriving and any person who arrives prior to 1pm will be seen by the team.

Services include triage, translation, medical consultations, dentistry, laboratory tests, dietician and lifestyle advice, eyeglasses provision, pharmaceuticals and data collection.

MMF privately fund-raises money to purchase all medicines, portable laboratory equipment, reading glasses, dental equipment, and petrol for the boats. Team members fund their own flights, accommodation, food and leisure activities eg diving. Many team members have done their own fundraising to aid the foundation and either bought or obtained donations of equipment, particularly surgical and anaesthetic equipment.

Medically, we see a pot-pourri of tropical medicine (malaria, fungal infections, yaws, parasitic infections), general infections (scabies, TB, STIs, abscesses), trauma (musculo-skeletal injuries, crocodile bites!), paediatrics (including congenital heart murmurs diagnosed by portable Echo and ECG), chronic illnesses and maternal medicine. The surgical team this year successfully performed 50 operations, including ruptured ectopic pregnancy, and in past tours have performed caesarian section, thyroidectomy, paediatric abscess drainage, and orthopoedic trauma.

Initially this was an all-American venture, but Australians now make up half, and this meeting of two related but different cultures adds intrigue and, sometimes, hilarity. It's totally aaaahh-some!

Port Macquarie has fielded large numbers of participants including anaesthetists Grant Mills, Iain Macleod and Anne Rasmussen, surgeon Nigel Peck, GPs Graham Carey, Gillian Macdowell, Jean Jagger, surgical nurse Bree Brown and several non medics (including Marie van Gend, and my architect husband Rob Snow who stepped outside his comfort zone to run the laboratory!).

The two weeks we spend working in the Solomon Islands is simultaneously exhausting and exhilarating: a juxtaposition of being completed drained yet feeling completely energised. It has been heartening to work with a wonderful group of self-selected people, all trying to give something to those who have little, and it has given me the chance to experience medicine in its purest form: a patient needing assistance and a doctor providing it. 

Watch this great video to learn more about MMF and their important work.

Dr Jan Snow has lived in Port Macquarie for 11 years, after completing her medical degree in South Africa and her specialist GP training in UK. She is a conjoint lecturer with the Rural Clinical School’s Port Macquarie Campus, teaching medical students in general practice.