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Elective Experience - Helena Goldie, Solomon Islands;

Elective Report by Sarah Wells
The hospital overlooks a tranquil lagoon, the surroundings are incredibly beautiful; turquoise sea, islands covered with rainforest. It was established in 1903 by the Australian Methodist ission and is now administered by the United Church of Papua New Guinea and the Solomon Islands. It has 50 beds, serves a population of about 25,000 and is staffed by 2 doctors, qualified nurses and nurse-aids. The day always started with 'Lotu'-a short service.

About 900 operations are performed a year including draining of abscesses, appendectomy, repair of trauma (numerous lacerations from bush knives) and tubal ligation. I had many opportunities to practise local anaesthesia and ring blocks. Ketamine was used as a general anaesthetic. About half of the patients died of cerebral malaria. The nurses often clerk the patient and start the treatment protocol before calling the doctor.

I went on four three-day tours to remote villages. We used aluminium canoe with an outboard motor and passed many unspoilt tropical scenes to give immunisations, see patients with medical problems and repeat prescriptions for anithypertensives and hypoglycaemics.

The hospital has a commitment to Christian mission - preaching the gospel and community projects; a very high percentage of the population attend church. The people are always very friendly and generous. Although financially very poor; the abundance or natural resource means there is no evere deprivation. Most live by fishing, subsistence farming and growing their own fruit and vegetables.

Westernisation is creeping in, the advent of cinema is causing an increase in violence, smoking and drinking; tuna is fished from the local waters, tinned and sold at extortionate prices and logging is also a problem.
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