I am on a one year placement with Voluntary Services Overseas (VSO) here in Vanuatu, in South Pacific, 2000 km east of Australia between the Solomon Islands and Fiji. The country consists of 80 islands, 68 of which are uninhabited. The population is less than 200,000, consisting of mainly Melanesians with a few Polynesians. The weather is tropical; in the rainy season, which coincides with UK winter, temperatures reach 30-34 C and humidity of 85-90%.
I am based in Lolowai Bay Hospital in the northern Penama Province, made up of the islands of Ambae, Maewo and Pentecost. The bay is formed from an extinct volcanic crater, and has to be the most beautiful setting for a hospital anywhere in the world.
I am the only doctor in the Province, serving a population of 24,000 with the aid of a 31 bed hospital and 26 staff, including 14 nurses and a small operating theatre where I carry out minor operations, including closed reductions of fractures, incision and drainage of abscesses and the occasional Caesarean sections.
We have a small laboratory where we can do haematology, urinalysis, malaria slides, and stool examination - biochemistry has to be sent to the regional hospital. We have a small but useful x-ray department, but the range of drugs we can supply is quite limited, and we often run out of stocks.
Being the only doctor, I have to know something about every specialty. If there is anything that I am not sure about or beyond my capabilities, I can fly the patient to the regional hospital. However, the flights are expensive and we only have 4 flights a week. But we manage somehow.
Despite the wonderful scenery and climate, daily life isn’t that easy. The hospital generator has to be turned off every night in order to save money and, as there is no pollution here, drinking water is simply collected off the roofs and stored in tanks. Water for all other use is pumped from a nearby lake and hence has a lovely brown tinge to it. But when the pumps break down, all the water has to be collected in buckets.
Even though daily living may not be as easy as in the UK, there is a lot of job satisfaction that cannot be found back home. Here, I work for the benefit of the patient and not for a salary. Because of the limited resources, patients seem more grateful with whatever we can do for them. Yes, we do save lives, but we have lost a few.
This article was first published in the NASGP's NP Newsletter in 2001.
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