Reflections on the Paediatric module by Dr Viola Kokiva

I am writing to express my utmost gratitude for the PIOA Paediatric Orthopaedics Module that I was a privileged to attend from the 13th to 18th of March 2023 in Apia, Samoa.

Dr Viola Koiva (right) with fellow PIOA trainees Dr Jacky Pahun (left) and Dr Agnes Auto (middle) enjoying a break in the course.

There were quite a number of new concepts taught that opened my eyes to how I should manage paediatric bone cases and I am greatly impressed and challenged to think beyond what I am used to seeing and practising in my country Papua New Guinea.

I am so pleased to learn that there is something we can offer to most of our patients whom we think nothing else can be done for. The most impressing concepts for me were:

– the cerebral palsy Gross Motor Function Classification System (GFMCS) that we can use to assess how as Orthopaedic surgeons, we can assist these children have a better quality of life when they grow up and become adults. It was interesting to see that they too can continue to be part of the productive work-force even if they’re GFMCS III. We surgeons play a role in helping the physicians manage cerebral palsy cases.

– the Osteomyelitis management emphasis on early diagnosis and drainage to save bone and reduce the unwise use of multiple antibiotics for long term therapy in osteomyelitis. This is so useful as I see a lot of these cases in my out-patient clinics and managing them is not always straight-forward.

– the calculation of LLD and the orthopaedic management options available for the children with LLD, how we can help save their limbs and prevent other skeletal deformities. This will lead to a better quality of life in the future and give them hope to find work and contribute to the country’s economic growth.

– the guided growth-plate arrest concept is also very useful and doable now that we have II in Port Moresby for those children with deformities from Blount Disease or Rickets condition.

– DDH screening is important early on and follow-up very useful so we can intervene early as surgeons and prevent major complications for the affected child’s development.

I look forward to more zoom classes and modules with PIOA that will help me expand my knowledge and skills in Orthopaedics so I can do better for my people around Papua New Guinea and the Pacific.

Editors note: PIOA is grateful to the Pacific Community and AO Alliance Foundation for their generous funding for this program.