Interplast is an amazing charity that sends medical teams to various countries across the Asia Pacific region to provide life changing surgery to patients otherwise unable to afford or access the surgery.
Dr Graham Sellars from the SAN Clinic in Wahroonga is one of Sydney’s best Plastic, Cosmetic and Reconstructive Surgeons who also volunteers a lot of his time for Interplast. We were lucky enough to have Dr Sellars write about his latest trip to Tonga as part of the Interplast team.
I recently went to Tonga in February 2017 with Interplast. This has been my third trip to Tonga.
I’m usually able to schedule an Interplast trip every alternate year. I initially started working with them in 2005. I was invited by a surgical mentor to do a trip in the Soloman Islands which opened the door to my involvement with Interplast.
There is always an element of the unknown when embarking on your first Interplast trip, in working without the facilities and support that one has in Australia; and I’m very conscious to perform surgery that will leave an improvement rather than creating a problem after you’ve left. Therefore we tend to use simpler procedures with a well known outcome.
On the first day of my last trip to Tonga, bad weather forced us to be diverted to Samoa for 12 hours before returning to Tonga. This set back our plans by a day and the 100 people who had were arriving for us to see at the clinic were unfortunately delayed by a day. This meant that we lost half a day of operating.
Typically of the 100 patients we would see, half of them would require an operation, and normally we would be able to do that within the following week. Unfortunately this time we couldn’t get to all of the cases, and the less urgent cases would have to wait for the following Interplast trip.
The typical cases range from cleft lips and palates in young children which are typically the more urgent cases. Unfortunately, burn contractures are very common due to the method of cooking in many developing countries. Hands, arms and feet tend to be affected, and these require releasing and skin grafts to allow normal growth to occur. As well as this we see a large range of various tumours, mostly benign but troublesome. One that stands out in particular on the last trip was a lady who had a large 20kg tumour on her left thigh, which was restricting her ability to walk. This required both surgeons and anaesthetists to remove safely.
The Tongan people are delightful, very happy and polite, and always smiling. They are ever grateful and one can’t help but see the glaring contrast between western society and a more simple life in the Pacific Islands. It certainly helps clarify what is important in life.
The local doctors are limited in number and generally have to treat a whole range of conditions, so specialisation is unusual. You quickly realise that the excellent skills of training in Australia and New Zealand go a lot further in such countries.
The surgeons in Tonga do very well with what they have and the training that they have had. Some of them have had opportunity to spend time in Australia training. Most surgeons spend some time training in Fiji which is the only medical school in the Pacific Islands. One of the strengths of Interplast is the ability to train the local staff and get them to go through cases themselves. It is very rewarding to return to see doctors that you have worked with previously, and growing in their own expertise. The long term goal in Interplast is to train yourself out of a job so that the local doctors can become self-sufficient.
Different countries vary in the equipment that they have. We take all our own equipment so that we are self-sufficient and not draining the resources of the countries that we visit. The facilities in the hospital are limited and they manage extremely well with what they have.
On this recent trip it was interesting to note the development within Nuku’alofa, the capital of Tonga, with increasing development within the centre of town. The hospital itself now has its own CT scanner.
For the cost of bringing one person from Tonga to Australia for treatment, we can treat 50 patients in their own home town with their family support which makes it a very effective program.
Interplast trips are extremely rewarding on a clinical and personal level. Having seen a child with a cleft lip in the clinic with an anxious and nervous mother, to seeing them in recovery having had their lip repaired, with the mother crying and thanking us in broken English. There is no greater job satisfaction.
Graham Sellars
If you’d like more information or to donate to the extremely worthwhile charity Interplast, check out their website here.