General Surgery and Orthopaedics, Tupua Tamasese Meaole Hospital, Apia, Samoa

For my elective block undertook General Surgery and Orthopaedics in the Pacific nation of Samoa. I had never travelled to any of the pacific islands before and had no extensive knowledge or expectations on what my time there would be like.

Arriving into Samoa on New Years Eve I was met with a vast array of fairy lights, decorating the simple and open houses all the way from the airport to the capital, Apia.

The main thing that struck me on this journey was the sheer number of churches visible in the villages. I went onto learn that there were approximately 3-4 churches per village in the 300 or so villages across Samoa, and that around 98% of the population of the country were devout Christian. This would become more apparent seeing how God and faith played a major role in most clinicians as they went through their day to day tasks.

The pot holes on the road, wild dogs and pigs and fairly simple ways of living reminded me of Indigenous Australian communities I had visited in the Northern Territory. It would soon become clear that there are more similarities between the two cultures as I spent more time in the hospital.

Traditional medicine, strength in family bonds and unfortunately the high prevalence in the complications of preventable disease such as diabetes: bore a startling resemblance between Indigenous Australians and the Samoan culture, people and healthcare.

My surgical term gave me many opportunities to learn more about the healthcare system in Samoa, the common issues that are dealt with by the team.

It became clear the simple difficulties encountered when trying to deliver the best possible level of care in a developing nation, such as the scarcity of vital resources.

The work the surgical team did without the common supports and equipment seen in Australia were inspiring. The same surgeon doing amputations in diabetic patients, was assisting complicated gynaecological operations, urological emergencies and in one instance, major open bowel surgery for a 3 week old neonate.

When the theatre was prepping for the operation of the neonate I asked the surgeon who was not yet a consultant whether he would have any assistance from a paediatric specialist surgeon or if there was anyone with extensive paediatric experience in surgery.

He replied, “I look to my left, it is only me, I look to my right it is only me; there is no one but me to do this surgery”. This was a comical comment but reflected the breadth of practice that these clinicians were expected to have and the severe scarcity in the country of specialist clinicians.

The Samoan people are wonderful, welcoming and friendly. They endeavour to make you feel at home in their country and are keen you teach you the ways of their people.

An easy thing for myself to do was to buy and dress the same as the Samoan doctors, learn some basic language and to ensure I met all those around me.

It was an incredible place to learn about the healthcare and difference between Australia, and furthermore gave me the chance to travel and see most of the wonderful country.