Covid-19 may have cancelled medical rotations from New Zealand to the Pacific this year, but it has not ruined the plans of gastroenterology trainers.
Dr Folototo Levai, Head of Medicine from Samoa is being taught a new skill by Dr Mai Ling Perman whilst ANZGITA nurse Karen Kempin (Dunedin) assists, and Dr David Motumanoa (Tonga) observes over shoulder. Photo: Supplied / Dr Chris Hair
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Every year, The Australian and New Zealand Gastroenterology International Training Association (ANZGITA) visit Fiji to do voluntary training and teaching to Pacific students and doctors in the region.
Prior to 2007, there was no specialist training in the South Pacific islands, and doctors who decided to complete their training abroad were often reluctant to return home, according to ANZGITA.
Australia-based gastroenterologist Dr Chris Hair said because of border restrictions to the Pacific, the team of volunteer trainers had to conduct their services virtually.
"The things that worked well this year have been backed onto what we've been doing in this field for a few years now and that's online webinars and case-based learning.
"We were able to have regular monthly catch ups, talk about cases and clinical scenarios and do some online learning together.
"It meant that access to education, ideas and abilities were still available during a pandemic, so doctors and students were able to continue their work/study, and it was important we maintained that communication because there is no other program like this in the Pacific," Dr Hair said.
However, there were some challenges with the distance learning for both parties.
"Having to deliver a regional-based skill training was difficult.
"What that entails are the volunteers from Australia and New Zealand would travel to Fiji around July-August for four weeks, working with trainees from around the Pacific, who have also gathered in Fiji and deliver endoscopy," Dr Hair said.
"It has been difficult to represent and replicate online, but we've adopted some of the simple digital technology to deliver tele-mentoring from afar.
"The idea is that I can be here in Australia and I can watch a virtual endoscopy happening in Samoa and then be able to give feedback during the procedure," he explained.
"It's not the same hands-on teaching, but adopting those technologies has allowed the isolation to not be so isolated."
Dr. Sereana Ledua Natuman, Head of Medical Unit department, Vila Central hospital is being mentored through a skill in gastroscopy by Dr Ian Turner, ANZGITA volunteer, gastroenterologist from Sydney. Photo: Supplied / Dr Chris Hair
Dr Mai Ling Perman from Fiji is an internal medicine physician and gastroenterologist. She started off as a trainee in 2008, when ANZGITA was established, and is now one of the trainers in the program.
Perman said the program has been life-changing for patients in the Pacific.
"Before ANZGITA got involved, patients who had gastrointestinal disorders couldn't be handled medically in Fiji, so they would end up having to go abroad for surgery or diagnosis and treatment. Also, only a handful of doctors were able to do diagnostic endoscopy and they were really confined to gastropathy, so very basic skills such as looking at the stomach, oesophagus and upper small bowel.
She said in the past decade, with the support from ANZGITA, progress had been made.
"We're able to treat bleeding in conditions like peptic ulcer, which is very common in Fiji and other Pacific Island countries," she shared.
"We're able to intervene early to avoid patients having to undergo surgery and it reduces the need for hospital stay."
Perman said that having the knowledge and experience of overseas specialists has improved diagnosis and management of gastrointestinal (GI) conditions in Fiji and the Pacific island nations.
"Their support has enabled students and doctors in the Pacific to detect early diagnosis and intervention of certain GI conditions. E.g. polypectomy to prevent colon cancer.
"The endoscopy services in other Pacific island countries have found that after doctors and nurses from those countries attended the Suva training centre, it has improved their diagnostic capabilities and their interventions, which has helped reduce their reliance on sending patients abroad."
Hair was pleased the annual program was able to go ahead this year.
"The way we've developed this program, it's about capacity building, training in country and education. We don't physically necessarily go across to the Pacific and do X number of surgery cases and then leave - what we do is we educate and train, and it means the health practitioners in the Pacific are able to continue to do their endoscopy work during lockdown," he said.
"The strength of the program was definitely highlighted this year and it meant Pacific patients still had access to services."