Dr Donald Pitchford is an orthopod based on the Gold Coast who has led a variety of teams into the Northern Provincial Hospital which is located on the island of Espiritu Santo, the largest island within Vanuatu. Although the island itself only has a population of 40,000 the hospital based in Luganville provides services to almost 65% of the overall Vanuatu population, or 156,000 people.

Anecdotally, the majority of visiting teams support Port Vila. The majority of resources are also allocated to Port Vila, leaving Espiritu Santo under serviced and under supplied. There is limited ability to recognise or treat orthopaedic trauma and other orthopaedic disease in Santo, leading to a significant amount of non-union or mal-united fractures after delayed presentations.

Vanuatu has benefited recently from surgeons completing fellowship training in Australia with great outcomes. As the medical staff progress with new skills and techniques, they increase their ability to provide surgical treatment options for a wider range of patients. One limitation is that the surgeons themselves are not alone in the perioperative team, as so the upskilling of perioperative nursing staff was also seen as essential.

In line with the successes of perioperative nursing training elsewhere throughout the pacific, Vanuatu hosted the Introductory Perioperative Nursing Program in Port Vila. A strength in Vanuatu is certainly a very dedicated and progressive School of Nursing attached to the Vila Central Hospital in Port Vila. With creative leadership, the staff within the School of Nursing fulfil a role in providing nursing graduates a range of opportunities through varied experiences in undergraduate years.

Challenges in Vanuatu are consistent with those seen in many other pacific island countries. The lack of a reliable supply chain for basic requirements such as surgical gloves, anaesthetic drugs, material to wrap trays in for sterilisation – each of these limitations places staff under pressure and patients at risk. Replacement stock for orthopaedic surgical implants used in the correction of trauma seems fanciful, as they continue to rely on donations from various international NGO’s.