The Andrew Dent Scholarship is offered each year to health sector students who need support to undertake volunteer work, electives or study trips that aid people in the Pacific Region. Rami Subhi, a fifth year medical student at The University of Melbourne, was the recipient of the Andrew Dent Scholarship in 2009. Rami spent four weeks at the National Referral Hospital in Honiara, Solomon Islands. His account of his time there is included below.
Neighbours, yet a world apart – Reflections from the Solomon Islands by Rami Subhi
Walking through the narrow concrete pathways of the National Referral Hospital in Honiara, the Solomon Islands - with the crashing waves of the Pacific Ocean not 20 metres away to the left, and the neat rows of old but well-maintained buildings of the medical and surgical wards to the right - I’m constantly met with beaming smiles revealing teeth tinged with red from years of beetle-nut chewing, and greetings of 'morning doctor'.
There’s an irony that immediately emerges between the gravity of the illnesses clearly visible in the patients wandering around the hospital, and their irrepressible and contagious joy. To the left a group of children are gathered, picking mangoes from the giant mango tree that shades the paediatric ward: a 30-bed ward that receives referrals from the rest of the country.
To some extent, the organisation of the ward reveals the Solomon’s way of life: communal, open and simple. Here, there’s little meaning to ‘privacy’, and ward rounds are a public event in which the entire ward – nurses, doctors, patients and their families, neighbouring patients, neighbouring patients’ families and friends – participates. I meet some happy and relatively healthy children, such as Luke – a 12 year old boy admitted for management of side effects of anti-leprosy treatment – who becomes known as the official ‘water-boy’ and ‘ward-sweeper’.
I also meet children who are much sicker than Luke. Edmund is 7 months old, and weighs only 4 kilos. I find out that 25 per cent of children admitted to this ward are severely malnourished and that in my first week three children die - two of whom die of potentially treatable conditions. In a country with high neonatal and infant mortality rates, death is seen as an inevitable fact. But while such complacency is understandable for mothers and families who are powerless to change the situation, it challenged my sense of equity and justice. Having had the privilege of growing up in a more fortunate country a mere three hours flight from the Solomons, I knew full well that most of these deaths are preventable with available and simple interventions.
The Solomon Islanders love Australia. They are NRL fanatics, keep abreast of Australian news and follow ‘Kevin 07’s’ every move. We also have much in common: the pidgin ‘hem alrite’ is the equivalent of the Australian ‘it’ll be alright mate’. But Australians know very little of the Pacific, let alone of the Solomon Islands. The global financial crisis was one demonstration of how inter-dependant our world has become; of how artificial geographical boundaries really are; and of how our well-being is intricately woven into the well-being of the global community. Engaging more closely with the Pacific, as well as being a humanitarian imperative, is clearly also in our interests.
From a medical perspective, there have been and continue to be admirable demonstrations of how such engagement can take place. The late A/Prof Andrew Dent AM was an Australian doctor, whose commitment to global health led him to work in less-resourced countries, including Cameroon and Papua New Guinea. He continued his involvement in the Pacific as Director of Emergency Medicine at St Vincent’s Hospital, Victoria, demonstrating that the values of compassion, equity and justice in medicine should not be contained within national borders. One of his many legacies is the Andrew Dent Scholarship, of the Pacific Health Fund, which aims to promote health system development and aid the people of the Pacific, and is offered to medical students on elective. During my stay in the Solomons, with support from the Pacific Health Fund, St Vincent’s Hospital, and the Centre for International Child Health, Melbourne, I was fortunate enough to be able to contribute to the ongoing development of a high dependency unit within the children’s ward.
Reflecting on my time in the Solomons, I was a little disheartened by the magnitude of the problems. But I was also grateful for and encouraged by the perseverance, hope and commitment of the local health-workers and patients.
The Children's Ward at the National Referral Hospital in Honiara, Solomon Islands