Fiji Report - Lautoka
FEBRUARY 2006

CASELOAD
The workload consists of a wide variety of orthopaedic trauma. This is predominantly related to motor vehicle and workplace accidents. In a one week period inpatients were seen with the following: serious spinal injuries, total knee and hip dislocations, and a number of mal-united paediatric upper limb fractures. Skeletal traction is the mainstay treatment for many fractures who would receive internal fixation in Australia. Those patients remain hospital bound for the 6 - 12 week duration of their treatment.

Large Outpatient fracture clinics (> 100 per clinic) are held 2 x week, and well as daily ward rounds of more than 60 inpatients. The theatre staff have a reasonable understanding of Orthopaedics. The treatment options for fractures are limited by the miss match of Orthopaedic stock in the plates and screw kits. There is one drill, few K wires and a very limited supply of surgical sets.

Swabs are reused and washed after each case. No joint replacement surgery occurs. The post injury/operative fracture treatment is impaired by the poor quality Plaster of Paris which does not easily set, as well as an underutilisation of the well trained Physiotherapy Staff.

Fiji has massive problem with diabetes. This is seen with the Orthopaedic ward being ½ filled with Diabetes related wounds and various levels of amputations of the lower and occasionally upper limbs. There are a few Red Cross donated Prosthetics for amputees and wheelchairs, they are not government funded.

OUTREACH VISITS
The visits by Orthopaedic Outreach have included:
David Chew (Victoria) - ORTHOPAEDIC SURGEON
Robin Vie Bold (Victoria) - ORTHOPAEDIC SURGEON
Stuart Myers (NSW) - HAND & WRIST SURGEON, ORTHOPAEDICS

From Prince of Wales Hospital (POW) Sydney:
Stuart & Emilie Myers - HAND & PLASTICS PHYSIOTHERAPISTS
They have now returned three times since January 2005.

In 2006 the POW team included six staff:
Stuart & Emilie Myers - HAND & PLASTICS PHYSIOTHERAPISTS
Jenny Barrie - CO-DIRECTOR OF NURSING & SURGICAL PROGRAMME, POW
Sarah Armstrong - THEATRE NURSE
Agus Kadir - ORTHOPAEDIC REGISTRAR
Richard Connelly - ANAETHETIST






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