The bathrooms and toilets in the Nurses home were spectacularly renovated

A. Support from AusAID

The Twinning Project was boosted in the last year by an infusion of funds from AusAID. AusAID had allocated $135,000 to the expansion of the Twinning Programme. The funds were used in two ways.

• $ 35,000 to foster the Twinning Programme
• $100,000 to purchase new equipment for Vaiola hospital.

B. Training

Radiologist Dr Eddie Aka'uola spent three months working with Dr. Cliff Trottman, developing a special interest in Breast Scan procedures. Other Exchanges have been limited to a review by John Macdonald, as part of his visit / in-service programme for equipment shipped in September '98. However over the next few months, the funds will be used to bring several key personnel to SJOG for periods of from one to three months. Those recommended by John in his report were:

The Infection Control / CSSD Nurse

Dr. Akinesi, Medical Officer from the Outpatients / DEM departments.

Mrs Finu, RN Medical Ward

Mrs Simiki, Matron

C. Equipment

The equipment list was once again constructed from a wish list from all departments obtained during the Needs Assessment tour undertaken in July 1997. It was purchased, delivered and in-serviced by John Macdonald in September '98. David Quinney worked with John to decide priorities.

Items included 

• Blood gas analyser for Pathology ($12,000)
• Clare ventilators - 2 ($12,000 each)
• Dinamaps -2 ($7,500 each)
• Autoclaves, food trolleys, syringe drivers, Sonic-aids, IV Polls, Emergency Transfer trolleys for the Department of Emergency Medicine etc.

John also took a large quantity of donated goods with him, including items such as Thomas Splints, Wheel chairs, Scales for infants, a Compressor for engineering, an Operating Microscope for mastoid surgery etc. In all, two containers have been shipped over the last twelve months.

He noted in his report that the VaiolaHospital had improved markedly in several key areas. In particular, overall cleanliness and hygiene standards had lifted. He put this down primarily to the role of the infection control committee, and the introduction of such initiatives as an award system for the cleanest ward. A full time clinical educator had been appointed and was now well accepted. Several wards had introduced their own in-service training sessions. In general, pride of ward appearance, and improved morale was evident throughout the wards.

On a disappointing note, Mrs Finamoa Mailau (Aquinas Grad Dip in Education 1995) and Mr. Liuaki Tahaafe (CSSD twinning programme '97) have both tendered their resignation.

Dr. Taniela Palu is now the Medical Superintendent, and we have established a great relationship with him. With the resignation of the Health Minister, Mr Bill Tangi has now been appointed to that position. Bill was chief surgeon when the twinning programme was first established, so he is well aware of our potential role. We wish him well in his new appointment.

D. Tonga Health Sector Planning and Management Project:

The project was dealt a shattering blow when Daniel Slattery was unable to take up his post as team leader of the Health Sector Project in Nuku'alofa. Daniel had contributed enormously to our project over the previous 6 years. It was he who developed the programme, inspired others to be involved, liaised with AusAID, and fostered the twinning between the two hospitals. We greatly appreciate all he has done, and wish him well in his future endeavours.

The new team leader Dr Lynley Evans has expressed an enthusiasm to work with the twinning project. It is early days yet, but we hope to be able to build up a strong working relationship with Dr Evans.

Matching Grants

A new matching grant (#9817) has been awarded for $45,000 by the Rotary Foundation of Rotary International. The major donor in this grant has been the Rotary Club of St. Arnaud, which has put in $12,000. Other clubs are the Rotary Club of Nuku'alofa (D.9920) and Ballarat South, Charlton, Stawell and Maryborough, as well as our own club (D9780). President Allen Esmore of St.Arnaud had been very helpful in getting the funds together.

This grant is to purchase

• A laser for use in Ophthalmology
• Three hundred lenses for cataract surgery
• An automatic tourniquet for surgery
• A Respiratory Gas monitor
• Oxygen outlet requirements
• 11 Laryngeal masks for use in theatre.

FAIM (Rotary Australia World Community Service Volunteers)

A. Nurses' Home

Repairs to the Nurses' Home have almost been completed. Funding was via Matching Grant #7514 from the Foundation and the Rotary Clubs of Ballarat West and South, Torquay, Nuku'alofa (D9920) and Auckland (D9920). Extra equipment for the bathroom renovations has been supplied by Rotary D9920 in New Zealand.

Three teams have been involved

1. From Torquay Rotary Club, Rtns Geoff Dawson, Graham Price, Michael Reed and Malcolm Slater started the roof replacement.
2. From Albury NSW- Rtn. Alan Shadbolt and two specially selected top apprentices, Simon Towt from Seymour and Brett Cooper from Yackandanadah. Worked on the roof, and started work in the bathrooms.
3. From District 9920 (Auckland NZ). Consisted of Gary Willcocks (Leader/ Builder) Gavin Green (Engineer) Gordon Walker (Handyman), all from Howich Rotary Club and Peter and Rosemary Kennerley from HalfMoonBay Rotary Club. I have received a very detailed report from Stuart Thompson, the project coordinator who visited the site in Tonga in July, prior to sending the team out. He reports on the difficulties of working according to Tongan time, Tongan supply facilities, years of no maintenance and Tongan weather. However they managed to spectacularly refurbish the two shower blocks on the ground floor over the two weeks they were there. They were well supported by the maintenance staff of the hospital, in accordance with the FAIM principle of helping people to help themselves. They left plaques on the walls, indicating Rotary's role, encouraging the nurses to maintain the showers themselves.

District 9920 plans to send another team to complete the work in July this year. Judging by the enthusiasm in the report of the first team, they should have no difficulty getting the next team together.

Geoff Hedditch, Trevor Chapman and Stuart Thompson in New Zealand have worked tirelessly to coordinate these teams. Each team is composed of Volunteers, usually Rotarians, who give two weeks of their time to put something back into society. They not only do hard physical work, but by involving the local maintenance staff in their projects, ensure that their work will have long term benefits.

2. Dental Programmes

A third dental work party visited the Vaiola and Vava'u dental clinics in September '98. This team consisted of Dr David Goldsmith (team leader), Drs Ekke Martini and Scott Sherwell (all Ballarat dentists), Rod McLean (Infection control expert from RMIT), Ms Kara Burns (Science photography RMIT), Annette Harrison (dental nurse) and Chris Kettle (dental equipment repair technician).

A full report is available for anyone who would like more information at http://www.ballarat.net.au/rotary_west/ or by contacting David Goldsmith at dgold@netconnect.com.au

In summary, they

• Filmed an infection control training video , and are in the process of making it available throughout the Pacific.
• Did a DMFS survey of children's teeth using current W.H.O. criteria,
• delivered large amounts of donated equipment and materials,
• and repaired and serviced broken dental equipment.

David plans to take a fourth dental team to the dental department of the VaiolaHospital in September/October this year. Plans include

1. Taking a specialist facio-maxillary surgeon as a member to do complex work such as cleft lip/palate repairs, tumours, severe fractures, difficult impactions etc., which normally have to be sent to New Zealand
2. Ship out a reconditioned H.S.V.School Dental van. This would then become the focus of a future schools dental program. If possible try to sponsor the airfare for a dental therapist to accompany this van and to train and supervise dental auxiliaries in the effective application of fissure scalares.
3. Re-equip the Vava'u surgery.
4. Re-develop the dental laboratory at Vaiola
5. Investigate making health education videos suitable for TV in Tonga.
6. Do in-service training for the dentists.
7. Extend the DMF survey to other islands

C: Future teams

An application for a Carl Lewis Discovery Grant has been made to send a team led by PDG Henry Hudson to review the steam lines at Vaiola, and the water and plumbing at Vaiola. Depending on their findings, this may lead to further FAIM projects.

THE FUTURE

With an expansion of the twinning programme, the AusAID plan to assist the Tongan Health Sector, the new Matching Grant from the Rotary Foundation, and the continual commitment of FAIM, it looks as though we are on the verge of a very significant development of the project to revitalise the Vaiola Hospital.

The Dental programme running conjointly threatens to set a standard that the Twinning Programme may even now have difficulty staying with. We are building up better and better relations with the staff of Vaiola and other agencies such as the WHO and AusAID. We could not have imagined that we would be in a position to achieve so much, five years ago.

7 June 1999