Australian Sai Medical Services Unit - Voluntary Medical Camp in rural Fiji (Viti Levu)
A Collaborative Service Activity Of the Sai Medical Unit Of Australia & Sathya Sai Service Organisation Of Fiji
Free medical services were provided over the period 13th July to 18th July 2008 in the rural areas of Viti Levu by volunteers from Australia, Fiji and New Zealand as a service project of the Sri Sathya Sai Service Organisation. The team members comprised of:
8 General Physicians,
4 dentists,
2 dental prosthetists,
3 O&G specialists,
1 Geriatrician,
1 paediatrician,
2 ophthalmologists,
1 neurosurgeon,
1 optometrist,
5 pharmacists,
1 physiotherapist,
2 nurses,
6 volunteers
Some members of the local heath authority team also extended their help. Assistance was provided by a large number of the local Sai members, school members, and members of the Red Cross. 41, First Year medical students from the Medical Faculty of the University of Fiji and a tutor, accompanied the team for 6 days. They were great assistance in scribing, and as translators. In return they learned clinical and communication skills. This was a great community effort.
An Inaugural Combined Medical Conference of the University of Fiji and the Sathya Sai Service Organisation of Fiji was organised at the University on 12th July to launch this service project. This event was a great success.
The Team was supported for meals and local management by lot of Sai Devotees from each district, school staff and community members.
Sai Youth from Fiji were all the time with team - Ashwin Chand, Avinesh Kumar, Kaushik Ram, Pratin Lal, Shiva Karan and looked after all the needs of team members, set up and ran the camps efficiently.
All the members of central council of Sathya Sai Service Organisation of Fiji - Dr Narendra Reddy, Mohanlal, Arvind Sewram, John Chand, Dr Saras Nandan were always present to assist in various ways.
Services were provided at following locations:
Location of Camps
13th July 08 Tavua College, Tavua
14th July 08 Tavua College, Tavua
15th July 08 Penang Sangam High School, Raki Raki
16th July 08 Nacaci Hindu School, Toge, Ba
17th July 08 Loma Indian School, Sigatoka
18th July 08 Cuvu High School, Sigatoka
Each camp site was set up with various stations: Registration, Triage, Nurses station, General Clinic (including geriatrician, paediatrician and physiotherapy), Dental clinic, Eye clinic, Women's health clinic, and pharmacy. Patient education DVDs were played on TV screens at the registration area where attendees were seated in the shade, thus imparting education, on prevention and management of some common conditions, while they were waiting. Some DVDs of Sai Service projects were also played.
Medical Services offered during the camps included a full patient consultation, basic physical examination, diagnostic facilities such as screening for diabetes with finger prick tests for most patients over 40 years, blood pressure and ECG tests in appropriate patients. Free medications were dispensed through our pharmacy which had a comprehensive range of drugs.
Dental department services included extractions, fillings, palliative, preventive advice, repairs, additions to existing dentures and provision of partial dentures.
Eye services provided a comprehensive check up and giving out of free prescription glasses and eye drops.
Women's health clinic provided a full gynaecological assessment and Pap smear check ups for eligible patients for screening. Patients requiring further follow up and management were referred via referral letters to the relevant departments in the base hospitals. One of the gynaecologist provided surgical treatment to one of the patients at CWM later on. Physiotherapy was provided by the physiotherapist to the referred patients.
Statistics of the attendees:
Day 1 = 416
Day 2 = 735
Day 3 = 496
Day 4 = 473
Day 5 = 517
Day 6 = 627
Ethnic distribution Indian- 1889; Fijian - 1385
Male- 1262; Female - 2012; Total = 3274
Free Wheelchairs for the Needy
General Medical clinic:
Majority of attendees presented at the general clinic.
Many patients had multiple consultations that included medical, dental, eye and gynaecological assessments. Some of the problems encountered at the camps were as follows:
Common Conditions presented and treated:
Diabetes, obesity, Diabetic neuropathy, Goitre
Hypertension, IHD, CVA
Musculoskeletal pain, Back, neck and legs. Knee pain, OA knees
Diabetes, hypertension and ischaemic heart disease no doubt contributes to the greatest morbidity of the Fiji population not only in terms of shortening the life span significantly but also adding to the health burden in terms of requiring secondary level care. Although patients seem to have a pretty good follow up of these diseases via the local health centres and hospitals, control of the hypertension and diabetes seemed to be quite poor as reflected in the routine check ups. Compliance, lack of proper understanding and running out of medications seem to be important reasons behind the poor control of these conditions.
Chronic pain was the commonest problem encountered at the consultations. Significant number of these patients had pain in multiple areas suggesting fibro myalgia type of symptoms. Some of the other reasons for musculoskeletal pains included, poorly treated /untreated old injuries, occupation related, such as heavy physical labour in cane cutting areas, poor postures, degenerative diseases and rheumatoid arthritis. While many cases of chest pain were musculoskeletal in nature, in the presence of risk factors, ischaemic heart disease was difficult to exclude without further assessments.
Dental clinic:
The Dental Team made certain that all consumables, materials and instruments were provided and that local resources were not affected at all. Local help was sought in providing portable equipment including an autoclave, compressor, portable dental chairs and dental units with suction.
Womens Health:
A total of 421 women were seen during the camps ( 43 and 91 at Tavua College on July 13/14, 60 at Penang Sangam School, 80 in Ba, 70 in Loma, and 77 at Cuvu College, Sigatoka. Of the women seen 403 had pap smears and these will be processed free by in Sydney.
Serious gynaecological pathology was identified in several women - 3 with gynaecological cancer, 2 with large pelvic masses, 3 with serious urinary incontinence and 2 with genital prolapse. All of these patients were referred either to CWM Hospital in Suva or to Lautoka Hospital. One of the team members saw 2 of the patients in consultation with local gynaecologists in Suva. One of the women seen with the NZ Sai Medical group in Labasa was also reviewed in Suva.
Pharmacy:
The total number of prescriptions dispensed was 3434.
Medications were acquired from MOH, Makans, and Chandulal, local pharmaceutical suppliers, on consignment bases and left over supplies were returned to appropriate suppliers. Purchase of medication from private suppliers was funded by voluntary donation from donors in Fiji and Australia.
Nurses Station:
The following activities were conducted at the nursing station:
Blood pressure checks
Random blood sugar level monitoring
Urinalysis
ECG
Wound dressings
The patients had their blood pressure (B/P) and blood sugar level (BSL) checked prior to being consulted by the medical officers. This assisted the medical officers with their initial assessment process of the patients. The patients were sent to the nursing station for B/P and BSL checks following triage. B/P and BSL were checked for those patients who met the criteria, for example, those who had a history of hypertension or diabetes, were 40 years or above and presented with any symptoms. Most of the patients expected their B/P and BSL checked anyway, however, once the explanation was provided about the criteria they were satisfied and appreciated the care and service being implemented. On the last day of the camp we were very low on our stock to carry out BSL and as a consequence perhaps one or two patients were unable to get their BSL checked.
The patients who required ECG were mostly referred by the medical officers.
Urinalysis was also done for those patients who had high BSL readings. There were a few wound dressings to be attended to as well. The types of wounds included: ulcer, boils, open infected wounds, osteomyelitis and others. Some patients were referred to local hospitals for a follow up with wound dressings/wound management.
Informal education to patients who were well received by them and their family members.
Make the Difference
Combined Medical Conference ~
Sai Medical Unit, Australia
Sathya Sai Service Organisation, Fiji
University of Fiji
The Inaugural Combined Medical Conference of the Sai Medical Unit of Australia, University of Fiji and the Sathya Sai Service Organisations of Fiji.
The Inaugural Combined Medical Conference of the University Of Fiji and the Sathya Sai Service Organisations of Fiji was held on July 12, 2008 at the Saweni, Lautoka campus of the University of Fiji. The conference was opened by His Excellency the High Commissioner for the Government of India. The Dean of the University of Fiji Medical School, the Vice Chancellor of the University and the Chairman of the Sathya Sai Service Organisation all participated in the opening ceremony. At the opening there was a lamp lighting ceremony followed by students from the UOF leading in Christian, Muslim and Hindu prayers.
Indian High Commissioner with Camp Organisers at Symposium
The theme for the conference Make a Difference was the brain-child of our medical team leader Dr Gunu Naker.
The convenor of the Australia and Zone 3 Sai Medical Unit, Dr Nadana Chandran, introduced the participants to the Sai Medical Unit mission statement:
• To discover and follow Sathya Sai Baba’s teachings, directives and example for the provision of health care.
• To search out, identify and serve in areas of need.
• To create and encourage opportunity for service of health professionals
The mission statement and the conference theme established the appropriate framework for the rest of the day which included excellent presentations from several of the medical team members and some invited speakers. The invited speakers included the Director of Curative Services from the Fiji Ministry of Health, Dr Ami Chand and a senior physician from the Colonial War Memorial Hospital, Dr Gyaneshwar Rao. A Sydney orthodontist Dr Christine Underhill, Dr Shanta Muller from the University of Fiji and Dr Namrita Mesuria, a young dentist from Fiji were the other 3 invited speakers.
All the presentations at the conference were of a high standard and very well received.
Two presentations are being highlighted in this report because of their relevance for future conference themes. Dr Ami Chand stated that the Ministry of Health has identified a triple health burden for the country : Non communicable diseases ,NCD (diabetes and cardiovascular disease), communicable diseases, (dengue and typhoid) and psycho-social health problems (suicide, mva, domestic violence and sports injuries). He said the major challenge facing the Ministry of Health in providing health care was lack of resources (workforce, infrastructure, equipment, supplies). The public was more demanding of tertiary level services and because of the resource constraints this was difficult to satisfy.
Dr Chand acknowledged the role of service organisations in delivering health care and saw value in developing partnerships with groups such as the Sai Medical Unit.
Dr Gyaneshwar Rao told the conference that 82% of deaths in Fiji were due to NCD, 10 % due to CD and maternal and perinatal causes 8% due to injuries and poisoning. He argued that the provision of health care should not always be constrained by lack of resources. Much can be done within existing resources by exercising common sense and good medical practice.
Dr Mesuria impressed with her plea for good quality research to guide health care decisions.
Dr Saras Nandan and Dr John Fatiaki, general practitioners from Nadi and Suva, chaired sessions as did Dr Margaret Cornelius from the Ministry of Health.
The Dean of the Medical School at the University of Fiji and the Vice Chancellor supported the inaugural medical conference and told it was a valuable experience it was for the students. Both expressed hope that such collaborations would be further developed in the future. Apart from the 43 medical students, staff from the university, the Ministry of Health, and Lautoka Hospital, there were also several general practitioners and non medical people who attended. The conference did not charge a registration fee, and the excellent catering was provided by courtesy of a generous donor. The conference numbers varied during the day from about 130 participants at the opening to 75 during the plenary sessions.
Conclusion
All the members of the team who served through the Sri Sathya Sai Service Organisation thoroughly enjoyed the opportunity provided with the support of Ministry of Health in enabling us to carry out the voluntary Sai MediCare services in Viti Levu, Fiji.
This team served the patients in rural areas with a variety of problems and managed to complement the good work already done by Ministry of Health professionals. All the team members, Sai brothers and sisters in Fiji and lot of members from the local communities put their best efforts filled with love in this project. For most of the members this was a personal spiritual transformation. This Community spirit Makes the Difference. Having made collaboration with University of Fiji and their medical faculty we hope we can contribute towards facilitating educational work in years to come. Dean of medical Faculty Dr Umanand Prasad, the University of Fiji staff and the students made a great contribution towards the conference. Their efforts are highly appreciated. Each evening we had opportunity to have sathsang with local Sai families and this was bonding. Their hospitality full of love was highly appreciated. Last day of the camp concluded with celebration of Gurupurnima. Thus meeting all the objectives of this project.
Video of the 2008 Medical Camp
A full DVD of the camp can be ordered for $5 (p&p) from the Sai Medical unit. See the DVD Media Page for more information.
Medical Camp Photo Album
A photo album with snaps from the Medical Camps at various locations along with one or two photos of the Conference is available for viewing. You may view the 2008 Medical Camp Photo Album
