Local enthusiasm sees a sound future of orthopaedic surgery as an individual specialty in the Solomon Islands with an increase in training orthopaedic registrars. The launch of the Pacific Islands Orthopaedic Association (PIOA) – a Solomon Islands-based group led by local head of the orthopaedic surgery department Dr Patrick Houasia no doubt has influenced this growth. Patrick together with Des Soares from Brisbane completed an enormous amount of planning and will reap the rewards of delivering a successful training program open to all pacific island countries.

The foundation trainees are Dr Alex Munamua, Dr George Kabwere and Dr Stephen Kodovaru (Solomon Islands), Dr Shaun Mauiliu (Samoa) and Dr Kolini Vaea (Tonga).

The program consists of twelve modules each lasting two weeks held three times a year for four years. While Orthopaedic Outreach is not a primary financial sponsor of this training program, the concept aligns with the same goals, and upon request, individual team members, such as Drs Nicole Williams, Peter Cundy and Paul Hitchen attending Honiara to deliver training are supported.

Clinical practices continue to improve through simple measures such as the deployment of alcohol-based hand rub in preventing the transmission of pathogens.

Osteomyelitis both acute and chronic continue to plague the children.

Appropriate use of external fixation is evident with sites varied from lower limb to pelvis.

Orthopaedic joint replacement surgery remains a consideration given a definite patient need yet logistical and financial constraints remain as obstacles. Dr Houasia has been fortunate enough to experience short term arthroplasty fellowship at the invitation of the Taiwanese. Joint replacement surgery has been initiated under strict control conditions, although this has been outside of Outreach contributions (through Taiwanese teams).

Talipes equinovarus (club foot) is being increasingly well managed through early identification and treatment programs in line with the Ponseti technique for correction. The local database is maintained by registrar Dr Stephen Kodovaru.