Mr Colin Hills, Australian High Commissioner in Tonga; Ms Kirsten Hawke, First Secretary AusAID,The Hon. Dr Viliami Tangi (Minister of Health), Mr John Ferguson (CEO St Johns)

The Twinning Program

Another three year agreement has just been signed (May 2005) by the Vaiola Hospital/Tongan Ministry of Health, the Australian High Commission, and St John of God Hospital, Ballarat Vic. This provides funding for medical and dental health professional envoys to work at Vaiola/St John of God Hospital.

As for the last two exchanges, there will be 8 envoys per year from Vaiola, and four from St John of God Hospital.  Funding is sufficient for their airfares, a small stipend for incidental expenses, and accommodation (four weeks for envoys to Ballarat, two weeks to Tonga). There will be at least one dental exchange either way each year, depending on the capacity of David Goldsmith's team to support the envoy.

David will submit a separate report, but it would be appropriate at this stage to recognise the enormous respect that his team has achieved through their role in development of the dental department at Vaiola, and more recently on the island of 'Eua. His success has in turn contributed to enthusiasm of AusAID and the Ministry of Health for Tonga for our twinning program

Funding by AusAID has been increased to $110,000 to allow for inflation.

A team from St John of God Hospital went to Tonga in May to witness the signing, and to inspect progress since the last agreement. The team included Mr John Fogarty (CEO), Lee-Anne Bellis (Marketing & PR Manager, & Administrator of the Twinning Program), Maureen Waddington (Mission Leader) and myself.

A twinning team from St John of God Hospital was there at the time, and they also witnessed the signing. They were Mr John Macdonald (ICU Nursing), Ms Cheryl Pretty (A&E Nursing), and Marianne Crowe (Surgical Nursing).

The signing of the document was a very formal affair, with all senior members of the Ministry of Health, the Australian High Commission and the twinning program present. It was in turn witnessed by national TV and newspapers.

The success of the twinning program established by the Rotary Club of Ballarat West in 1993 has been quietly winning supporters over the last twelve years.  The Ministry of Health for Tonga has become much more sophisticated over this time, even extending to the building of a new and very modern hospital at Vaiola.

The appointment of Mr Bill Tangi as Minister is indicative of the relationships which have cemented the role of the twinning program. Bill was a senior registrar/junior consultant in 1992 when we were first invited there. He was very aware of the parlous state of the health system at that time. He was foremost in those calling for reform at the time. Since his appointment as Minister of Health at the turn of the century, he has been in a position to drive this sophistication.

The Tongan health system is on the cusp of a major revolution, and the twinning program is seen as a significant resource for these developments. I expect that there may be further expansion of the Twinning Program over the life of this agreement.

Exchanges for 2004-5

St John of GodHospital to Vaiola

As noted above, St John of God Hospital sent a team who also witnessed the signing of the triennial twinning agreement.

·        Mr John Macdonald (I believe on his 11^th trip) has built up an enormous amount of respect at Vaiola, and especially amongst nurse educators. Inter alia, he was invited to be guest lecturer at the ICU course at Vaiola. He has been invited back in October to complete this years ICU nurse education.

·        Ms Cheryl Pretty , on her third trip, has also been invited back later in the year, with funding by the WHO, to further the Accident & Emergency education program.

·        Ms Marianne Crowe's role as a surgical nurse was seized upon by the surgeons and nurses in the surgical wards. They were quite desperate for information, especially on the appropriate use of surgical dressings. Marianne's knowledge and experience will be vital in the development of the new hospital.  Thank you Marianne, we hope that you will be able to continue your involvement, and come back again next year, if not before.

Vaiola to St John of GodHospital

·        Dr. 'Akanesi Makakaufaki - Medical Superintendent, Support & Domestic Services. "Nesi" had visited on the Twinning Program in 1999-2000, as an A&E physician. On this occasion she was very targeted in her approach, as she knew exactly what St John of God Hospital had to offer, and where to go to get the information she needed in her new, very demanding role as director of support services at VaiolaHospital. She spoke movingly at our Rotary Club when she addressed it during her visit this year. She has become a very great supporter of the Twinning Program.

·        Ms. Lisita Holani - Medical Records

·        Ms. Piuela Tu'akalau - Intensive Care Unit Mr.

·        ' Ofeina Fe'ao - Maintenance Services

Each of these members of this exchange will be vitally involved in the development of the new hospital. St John of God Hospital will look to providing them with all reasonable support in their leadership roles.

Matching Grants

Matching Grant #52394 was finally completed and submitted to the Foundation in May this year. I undertook the delivery/in-service of a Shikani Optical stylet for difficult intubations in Anaesthesia whilst attending Vaiola for the signing of the new Twinning Program agreement. This completed the expenditure of $16,109 provided by the grant.

The main initial purposes behind applying for the grant were

• To purchase eye instruments recommended by Dr Michael Toohey.
• To set up a dental surgery on the island of 'Eua

• To set up a dental prosthetics laboratory in the clinic at Vaiola
• To ship and disburse a large quantity of dental and medical donated goods to the hospital at Vaiola.

Funding was applied for, and was provided by

• the Rotary Clubs of Ballarat West, Ballarat, Mt.Gambier West (District 9780) and Frankston North (District 9820),
• Districts 9780 and 9810.
• The donated funds were matched by the Foundation of Rotary International, which gave us a total of US$11,948. (Aus$15,530, using the official exchange rate at that time of 1.3).

When this was actually converted to Aus$, it came to $16,109, due to currency movements. This represented a windfall of Aus$579. We were also pleasantly surprised when the slit lamps and ophthalmic instruments were donated by various sources.

We were able to get the container landed for $605 less than was originally quoted.

However, the cost of the dental prosthetics laboratory was significantly greater than we had been advised, in spite of significant donations to the project from outside the Foundation. (The plumber, Lloyd Grey (RAWCS volunteer on the dental project) supplied and installed air-conditioning in the two dental facilities for less than the price of one in Australia)

Our windfalls more than balanced out these extra costs. The hospital advised that they desperately needed a device to assist with difficult intubations in anaesthesia. I rounded off the Matching grant with the purchase of the Shikani Optical Stylet which I took and in-serviced in May this year.

The future.

We desperately need funds to get a container to Tonga in time for David Goldsmith's September visit, and to fund his redevelopment of the Ha'apai clinic. I hope to get a Matching grant organised, and will be looking for keen donors. I have spoken to several groups so far, but have not got any firm commitments.

I expect that with the building of the new hospital at Vaiola, there may be increased pressure for a greater role of the twinning program. I understand that this might be favourably looked at by the whole St John of God Healthcare system, which has much greater resources than just the Ballarat locus. This would be a very significant development to our original twinning program.

John Oswald
Vaiola Hospital Project Coordinator
The Rotary Club of Ballarat West D9780.

29 May 2005