Fiji has a total population of over 899,000 spread over more than 300 islands (WHO,2016). Life expectancy at birth is 73 for females and 67 for males (WHO,2016), and the infant mortality rate is 26 per 1000 live births (WHO,2018). However, significant improvements in health indicators have taken place over the past 10 years. Total health expenditure per capita is US$364. The demand for plastic and reconstructive services in Fiji remains high. There remains some untreated cleft lip and cleft palate cases and a high incidence of burn scars and contractures. Hand injuries are also common.
Interplast’s first program in Fiji was delivered in 1983 since then, has delivered almost 130 programs – primarily in Suva, Lautoka and Labasa, in close collaboration with local partner hospitals, universities and the Ministry of Health.
Historically, efforts to develop a sustainable local plastic surgical service in Fiji were hampered by emigration of local doctors, and the death of Fiji’s only qualified plastic and reconstructive surgeon in 2010 left the country with no local access to specialist reconstructive surgery services for a number of years. During this time, Interplast played a crucial role in providing plastic and reconstructive surgical services where they wouldn’t otherwise be accessible, while simultaneously training and supporting local personnel. This included regular visits to Suva, Lautoka and Labasa, and a small number of visits to Taveuni. A number of specialised visits to treat patients with hypospadias were delivered to Lautoka between 2009 and 2012.
The growth of the Fiji National University (FNU) Masters of Surgery Degree (MMED) has, however, led to the emergence of a new generation of local general surgeons and trainees with assigned sub-specialty interests. Interplast has been working closely with local surgeon, Dr Semesa Matanaicake, since he was a junior doctor, supporting his training to become a plastic surgeon like his late father. This has included a two-year training placement in Hobart and since returning to Fiji to re-establish the plastic and burns unit in Suva, Interplast has provided with mentoring support to Semesa and his junior peers.
Interplast has also delivered many training programs in Fiji, including those focusing on surgical skills, anaesthetics, nurse education, burns management and allied health training.
In recent years, Interplast has commenced formalising the training programs it delivers in Fiji. As Fiji is the ‘hub’ of medical training across the Pacific, Interplast has access to surgical trainees from many of the Pacific Islands who are studying through the Fiji National University and undertaking clinical rotation through the Colonial War Memorial Hospital in Suva. Interplast has delivered a number of plastic surgical skills workshops for these trainees, including three advanced applied reconstructive surgical skills workshops in Hobart in 2013, 2014 and 2017 and two clinical flap course in Apia in 2016 & Suva in 2019. Interplast has also been delivering training programs focused on developing the skills of Fijian physiotherapists around hand therapy, burns management and cleft management. Nurse education programs have also been delivered both at Colonial War Memorial Hospital (CWMH) in general plastics and burns as well as the School of Nursing at FNU.
Fiji is still some time away from having local capacity to fully meet the need for plastic and reconstructive surgery services and thus, medium-term support from Interplast is required to facilitate access to treatment for patients is anticipated, however, this need will reduce as more young surgeons are trained in plastic surgery.
Interplast plans to undertake a range of programs in and supporting our local partners in Fiji in the 2019/2020 financial year. This includes a number of surgical visits as well as training programs in physiotherapy, nurse education, speech therapy and plastic surgical skills. Interplast will also support a number of Fijian medical professionals to undertake further professional development and training in Australia. Unfortunately, due to fires which damaged the operating theatres, and subsequent re-building of facilities, Interplast will not be able to deliver a surgical program to Lautoka in this period.
For more details, keep an eye on our Upcoming Programs, or get in touch with us!