Dr Stuart Myers

Donations / Book Project

We received many generous donations including:

- Fiji Airways with a freight allowance,- This is our biggest ongoing challenge.

- Rosie’s travel for transport, and

- Pattinson Medical for Thermoplastic.

- Used splints to recycle from Bondi Junction Hand Therapy practice and from the NSW Public Hospital Hand Therapy departments. 

These splints were incredibly useful in demonstrating the various splint styles made from different materials. This enabled us to run teaching sessions with the Physiotherapy department and to have staff practice with the materials.  We were able to assist the local therapists with their treatments with the correct materials. 

- Hand Surgery Orthopaedic sets, Battery powered  drills  and some external fixateurs organised by Graham Hextell at Orthopaedic Outreach.


- We would like to thank everyone for these donations as without them our weeks work would be much more difficult. 

- It was encouraging seeing the local staff working and learning together with our team.  
Our team returns on 11th April  2015, and hopefully we can take all your donations again then! 


- Donations can be made directly to Orthopaedic Outreach and are tax deductible.

- Emilie ran a series of lectures for Physiotherapists in Sydney, and the money raised was donated to Orthoapedic Outreach.

- In 2006 Stuart organised for Qantas to provide 25 networked computers for the hospital.

- We have left many hand surgery kits, and purchased some chairs for hip fractures among other things.

- Ausmedic annually provides us with sheets of thermoplastic. 

We are able to make the hand splints for our patients, and leave the rest which enables the local Physiotherapy department to make splints all year.  

Other projects:


School Book donation Project Henry and Anna Myers


- Henry (age 8) and Anna (age 6)  have gathered books from their Sydney primary school and donated them to:

                 - Lautoka Hospital Paediatric ward and to

                 - Lautoka Primary school. 

This is an ongoing project.  The aim is to create and supply a large mobile library for the children to read. Currently we have 17 boxes of books in our home waiting to get them transported to Lautoka.

Lectures were delivered by Henry to his school requesting donations    and then later reporting back on the results of the project.

 

 

 

Lautoka


Time zone GMT +12 hours     ( 2hrs ahead of Sydney)
Lautoka is the second largest city of Fiji and the second largest in the South Pacific.

                


It is in the west of the island of Viti Levu, 24 kilometres north of Nadi, and is the second port of entry in Fiji, after Suva.


Lying in the heart of Fiji's sugar cane growing region, it is known as the Sugar City.



Covering an area of 16 square kilometres, it had a population of 52,220 at the 2007 census, the most recent to date.
The main Lautoka Sugar Mill is the city's biggest employer by far. Built for the Colonial Sugar Refining Company (Fiji) (CSR)  by workers from India and the Solomon Islands between 1899 and 1903, it hires some 1,300 employees today.

Other industries include timber milling, garment manufacturing, distillery, brewery, jewellery, blending, steelworks, fishing, hatchery, domestic items, paints, and construction.

Fish being sold on the side of the road.


Lautoka is the only city in Fiji's Western Division,and is the industrial hub of Fiji which contains more than 50 percent of the nation's population.
Since 1970, the population of Lautoka has grown rapidly, and in the last twenty years it has also changed dramatically in structure. In the early 1970s the population was estimated to be about 12,000, the vast majority of inhabitants being Indian, as would be expected considering the early growth of the city was entirely associated with the sugar industry. Almost all of the present Indian inhabitants are descendants of the early Girmityas. In 1986 the population was 39,000 and in 1996 almost 43,000, but it is not clear exactly how the boundaries of the urban area were defined at either of these censuses. In 2005 the population including the suburban zones was probably about 50,000, occupying a total area of about 16 km². The population of Lautoka including the rural districts is around 80,000. But much of the recent growth of the city itself has been due to indigenous Fijians moving into the urban area.

 
The local markets sell all kinds of fresh fruit and vegetables and local produce.


   
The roads have improved greatly since we have been going to Fiji and particularly in the last 12 months a huge investment of money has come from China.


    
The cars and buses have not changed at all and the air conditioning in the buses is very effective.



   
Unfortunately the drivers have not improved at all and now the roads are better cars are going faster and the road toll is increasing.  Driving at night is a particular hazard and is to be avoided.



 
There are still no book stores in Lautoka so book donations are particularly treasured at the Hospital and also by the local schools
 
The region is known as lying in the valley of the “Sleeping Giant” due to the shape of the local mountain range.



   
The countryside is often lush but there is much less rainfall in the western division compared with Suva.



      
Fiji is a particularly religious country. The are many different religions co-existing in harmony. Swearing and Bad language is greatly frowned upon.



 
The view from the hospital below. Many of the houses have bars on all the windows and doors and crime is an issue for the locals. We have never had any issues at all in 16 visits to Fiji.

      

Sport is played everywhere. The Fijians mostly play Rugby and the Indians play Football.




Last Updated on 14 / 5 / 2015

Lautoka Hospital, Fiji

Orthopaedic Outreach Hand Surgery team Report: 2005- ongoing

General
 Fiji has a total population of 849,000 spread over more than 300 islands.
Life expectancy at birth is 66 for females and 73 for males, and the infant mortality rate is 15 per 1000 live births.
However, significant improvements in health indicators have taken place over the past 10 years.
Total health expenditure per capita is US$165. The demand for Hand Surgery  services in Fiji remains high.
Hand injuries are very common. 


Dr Stuart Myers (Orthopaedic Hand Surgeon) and Emilie Myers (Hand Physiotherapist) have spent the last decade working as volunteers
with Orthopaedic Outreach in Fiji.  They have taken bi-annual trips to Lautoka Hospital.  This has involved 16 trips to date, with a large team.


The team of Australian volunteers includes:
Hand Surgeon,
Orthopaedic fellow,
Registrars,
Residents,
Nurses,
Anaesthetists,
Physiotherapists,
Medical & Physiotherapy students.
Radiographers & Ultrasonographers.
 
To date more than 100 Australians have been able to participate.

Background:

Lautoka is in Western Fiji.  Travel is from Sydney to Nadi with Fiji Airways.  Lautoka is a  ½ hour taxi ride west.
Lautoka is known as the “Sugar city” for its Sugar industry. The population is 60,000.  
The hospital services the western half of the Fijian population.  
The eastern half of Fiji is primarily serviced by Suva Colonial War Memorial Hospital (CWMH),
and Labasa Hospital the North Island.
 
Lautoka Hospital Facitities:
Lautoka hospital has 375 beds and in 2014-5, is being refurbished.  
There is an ICU, 2 full operating theatres, and 1 minor ops theatre.  
The Physiotherapy department has 10 full time staff, a well equipped gym and hydrotherapy pool (usually empty of water).  
There are no other Allied Health services.  There is a disabled school adjacent to the hospital.

Medicine, Nursing and Allied Health are taught at the University of the South Pacific (USP) based in Suva, and now with a campus in Lautoka.
 
Caseload:
The workload consists of a variety of adult and paediatric Orthopaedic trauma and elective conditions.  
There are many relating to motor vehicle and  workplace  accidents and mal-united paediatric fractures.  
These are all complicated by the significant Diabetic problem which faces the whole Fijian  population.
Skeletal traction is the mainstay treatment for many fractures which would receive internal fixation in Australia.  
Large Orthopaedic outpatient clinics are held twice a week (>100 per clinic).  
There are daily ward rounds of >60 adult and paediatric Orthopaedic patients.

The treatment options for fractures are limited by the miss match of Orthopaedic stock in the plates and screws kits.
There are few drills and a very limited supply of surgical disposables.  
The post injury/ operative fracture management is impaired by poor quality Plaster of Paris which does not easily set.  
There is also an underutilisation of the well trained Physiotherapy Staff.

The Diabetic problem relates to poor wound healing and a large volume of lower limb amputations.  
There are only a few wheelchairs and no formal prosthetic service.

Impact of Orthopaedic Outreach:
On our first visit, the problem of infection was pressing.  
At that time, the trauma and diabetic cases were in the same ward.  
Subsequently the wards were separated, making a big difference to cross infection rates.
Our team did a full audit of patient notes with the aim to identify key problems.  
The findings were that there are significant delays to treatment and infection.  
More repeat surgery is done in the attempt to salvage cases.  
Emilie did work-site assessments to investigate the local work safety in the Sugar and Wood-chip mill.  
While there are some work safety measures in place, they are not enforced.
Teaching, practical workshops and case reviews occur on every visit to Lautoka.  
Extra Surgery and Physiotherapy workshops have been run in Suva at the University and Hospital over the years as well.
The team takes hundreds of kilos of donations each visit, which are then all donated to the hospital.  
Fiji Airways kindly provides us with free airfreight on our flights to take the gear with us.  
We have been able to provide the hospital with a crutches lending pool.  
The 300 pairs of crutches are loaned out and returned.  
Previously cases requiring crutches had to get into the town, (often non-weight-bearing) to buy a local heavy wooden crutches.  
We have given the operating theatres a printer so cases can be typed and copies printed off for files.
All cases are documented and photographed digitally.
The files are submitted to the hospital for review, as well as to Orthopaedic Outreach and AusAid.
Key Achievements Since 2005, We have undertaken 16 visits to Fiji.
Close to 320 operations have been performed and almost 2000 consultations provided.
Training programmes directed at registrars, medical students, physiotherapists and nurses have also been a feature.  


Hazards:
Dengue Fever, Sugary tea!!.

Rewards:
Meeting fellow Fijian colleagues, and their extended families.  
We have staff gatherings each trip and we have developed good friendships with many of the hospital staff.  
We appreciate the large caseload the local staff face daily and admire them for their constant work.  
We have a system of emailing and discussing cases together, as well as a Facebook page: “Hand Physiotherapy Forum Australia & Fiji”.

Local Needs:
We take enough of our supplies to cover cases seen in the week.  And we  supplement the local surgical resources and orthopaedic disposables.
They need good quality Plaster of Paris and thermoplastic splinting material.
Teaching and continuing education support through online access to journals, and lectures would be very helpful.  
Emilie has compiled a teaching manual “Hand Physiotherapy Fiji” for all central and regional Physiotherapy staff.  
It contains practical hand protocols and patient hand-outs.  Stuart’s website holds a library of lectures online which are Fiji specific.

 
Donations:
Donations can be made directly to Orthopaedic Outreach and are tax deductible.
Emilie ran a series of lectures for Physiotherapists in Sydney, and the money raised was donated to Orthoapedic Outreach.
In 2006 Stuart organised for Qantas to provide 25 networked computers for the hospital.
We have left many hand surgery kits, and purchased some chairs for hip fractures among other things.
Ausmedic annually provides us with sheets of thermoplastic.  
We are able to make the hand splints for our patients, and leave the rest which enables the local Physiotherapy department to make splints all year.
 
Other projects:
School Book donation Project Henry and Anna Myers
Henry and Anna have gathered books from their Sydney primary school and donated them to the Lautoka Hospital Paediatric ward
and to Lautoka Primary school.  This is an ongoing project.  The aim is to create and supply a large mobile library for the children to read.

Plan:
The plan for the next decade is to continue to compliment the Pacific region training programme with appropriate teaching for Orthopaedic,
Nursing and Physiotherapy.  Regular bi-annual visits by the Hand team will then be able to supplement the local Orthopaedic, Surgical
and Rehabilitation interventions. We endeavour to support ongoing teaching to all staff, and offering treatment and follow up to local patients.
We hope cement local partnerships with various organisations eg Fiji Airways, to ensure a smooth transport process for all of our donations.
Our team will continue to provide case support throughout the year and to communicate with other visiting teams and local staff.

 
 
Cane train


  DOnations  Operating theater  Children donating boks  crutches  Aluminium crutches