The opportunity to work in the Solomon Islands came up through a strong relationship between the Royal Children's Hospital and the paediatric department at the National Referral Hospital, Solomon Islands. Part of this collaboration involves a paediatric registrar working for up to six months each year on their paediatric ward and nursery.

My daily work involved ward rounds in the children’s ward and nursery, attending deliveries of high risk newborns and patients in the emergency department. It was an experience that was challenging due to the vastly different etiology of medical problems compared with Australia as well as the limitation in resources in which to investigate and treat them. Children in the Solomon Islands suffer from diseases we rarely see in Australia. Tuberculosis, malnutrition and infectious diseases like malaria, rheumatic fever and bacterial meningitis are common. Due to distance and lack of basic public health measures children often present late to medical services.

The 20-bed nursery is repeatedly filled with up to 30 babies, accommodating premature and low birth weight neonates, and babies with respiratory distress and sepsis, without the modern technology that adorns newborn intensive care units. Rather than an incubator, an east-facing room is used, with the morning sun creating a cosy and humid room for the babies. There is no ICU or ventilators, and amenities like power and water can run out at any time. In a typical week there would be several very low birth weight babies, premature twins, a neonate with genetic problems or cardiac disease and a baby with sepsis in the acute area of the nursery alone.

Working in the Solomon Islands was extremely challenging in many ways. I quickly realized that my contribution was small compared with the significant learning and experience I gained from being in Solomon Islands.  The local doctors and nurses who worked in the hospital had years of experience in the field and worked under these difficult conditions for a long time. This emphasized to me the importance of working in a collaborative and culturally appropriate way rather than thinking that because of my background I somehow had all the answers. 

The position was made possible through the support of the Australian Aid Program's Australian Volunteers for International Development (AVID).

Read more about Shidan Tosif's experience in the Solomon Islands on the Global Health Gateway.