Next module – Apia Samoa

The next module in the PIOA program will be held at TTM Hospital in Apia, Samoa. We will welcome 3 new trainees (one from Fiji and 2 from PNG). This module will cover Introductory topics, Research, Spine and Hand and will run from 23 March to 10 April 2020.

A highlight during the module (and the reason for the module being delayed from February to April) is the graduation ceremony at the National University of Samoa for 4 of our PIOA graduates who successfully completed their exit examination in August 2019.

PIOA represented at the NZOA ASM

Dr. Reshwin Rajan from Solomon Islands presented a paper at the New Zealand Orthopaedic Association. Here is his report:

Stephen Kodvaru, Andy Vane and Reshwin Rajan

NZOA Pacific Ambassador Program was initiated by NZOA and Orthopacifix Charitable trust in 2018. Dr Raymond Saulep(PNG), was the first candidate. This year I was fortunate enough to be selected as the second Pacific Ambassador to NZOA. This program involved a week of observership at Tauranga Hospital and attending the NZOA ASM. This year the NZOA ASM was held at Dunedin, NZ, from 29th September to 2nd October.

On the final day of the conference, I also presented my paper on “Epidemiology of Soccer Related Fractures in Solomon Islands”. It was well received by the audience and I received a lot of positive remarks. It was indeed an honor representing PIOA at the NZOA 69th ASM. In summary, it was a great learning experience for me. During my six days attachment at Tauranga Hospital, I was involved in a total of 12 surgeries (mostly trauma and a few elective cases).

Vaughan Poutawera, Reshwin Rajan and Areta Samuelu

I would like to thank Orthopacifix Charitable Trust for meeting my travel expenses, not forgetting Mr Vane and Poutawera(VP) for accommodating me at Tauranga. Lastly but not the least, it was a great joy meeting my Brother Dr Areta and PIOA President Dr Stephen Kodovaru. Thanks again for making my stay in NZ a memorable experience.

AOA ASM 2019 Canberra

Des Soares, Areta Samuelu and Raymond Saulep at the Outreach session

The Australian Orthopaedic Association Annual Scientific Meeting was held in Canberra this year. Dr. Areta Samuelu (Apia, Samoa) and Dr. Raymond Saulep (Kundiawa, PNG) represented PIOA. Raymond also attended the Australian Orthopaedic Registrars Association conference and presented on Spine TB. Areta presented at the Outreach section. It was good to also meet up with Dr. Eka Wiratnaya one of our PIOA orthopaedic friends from Bali, Indonesia.

Areta Samuelu, Raymond Saulep, Eka Wiratnaya and Des Soares at the President’s Reception

Report on Module 2, Kundiawa, PNG Highlands

New graduates L to R Mark Rokobuli, James Tewa’ani, Shaun Mauiliu, Alex Munamua

Module 2 was held at the Sir Joseph Nombri Memorial Kundiawa General Hospital in Kundiawa, Simbu Province in the Papua New Guinea Highlands(PNG) from July 29th to August 16th, 2019. There were 15 trainees in the Knee module and 13 trainees attended the Foot & Ankle module. They are Dr. Alex Munamua, Dr. Reshwin Rajan and Dr. Clay Siosi from Solomon Islands, Dr. Pita Sovanivalu from Fiji, Dr. Johnny Hedson from Pohnpei, Federated States of Micronesia, Dr. Naseri Aiotato from American Samoa, Dr. Juvencio Dias from Timor Leste and Dr. Haynes Rasin from Buka (autonomous region of Bougainville), Dr. Viola Kokiva, from Kavieng, Dr. Raymond Saulep and Dr. Bohu Urakoko from Kundiawa, Dr. Felix Diaku and Dr Kevin Lapu from Rabaul, Dr. Stevens James from Lae and Dr. Anthony Nasai from Wabag (all from PNG).

The lectures were delivered by Dr. Nik Friederich from Switzerland, Dr. James Aoina, Dr. Hamish Leslie, Dr. Soots Leilua and Dr. Tim Chuang from New Zealand, Dr, Dr Daryl Teague. Kaushik Hazratwalla and Dr. Des Soares from Australia.

Back L to R: Areta Samuelu, Shaun Mauiliu, Des Soares, Mark Rokobuli, James tewa’ani, Alex Munamua. Front row: L to R Andreas Loefler, Peter Cundy, Richard Lander, Sud Rao

In addition, the second ever exit examination was held with the following PIOA trainees presenting – Shaun Mauiliu, Areta Samuelu (both from Samoa), Mark Rokobuli(Fiji) , Alex Munamua and James Tewa’ani (both from Solomon Islands). They were examined by Dr. Richard Lander and Dr. Sud Rao from New Zealand and Dr. Peter Cundy and Dr. Andreas Loefler from Australia.

Nik teaching knee arthroscopy on a knee model Viola Kokiva,, Raymond Saulep and Pita in background watching
Nik and Des demonstrating TKR technique on sawbones

In the Knee module students were taught a systematic approach to history taking, clinical examination and investigation with a focus on common knee conditions. The practical sessions were aimed at common knee management options including external fixation and internal fixation for supracondylar and tibial plateau fractures. Small group workshops on knee arthroscopy using a model, ACL reconstruction and high tibial osteotomy using sawbones were completed by all students. The surgical technique for knee arthroplasty using sawbones and discussion of the removal of infected implants was also covered.

Tim Chuang, Pita Sovanivalu, Viola Kokiva and Johnny Hedson

In the foot and ankle module, the students were taught a systematic approach to diagnosis and management of  lower limb  conditions. This included clinical history taking and a thorough clinical examination with emphasis on a systematic approach to the management of conditions affecting the foot and ankle. This included the management of soft tissues and closed and open fractures. In addition, there were focussed lectures and practicals on the management of foot trauma with the small group workshops on ankle fractures and forefoot and hindfoot injuries.

Overall the 3-week module was intense, and it was obvious the students were stimulated to learn. The students are now already reading ahead to prepare for the next module on Introductory topics, Spine and Research to be held in Apia, Samoa commencing on 23 March 2020.

Morning tea

Our thanks to the staff and patients of the Kundiawa General Hospital, Simbu for the use of the Conference room and for allowing us to conduct the course there. Our special thanks to the CEO and Director of Medical Services of  Kundiawa Hospital who made us welcome and provided transport to and from Mt Hagen and many other forms of assistance.

Bohu Urakoko, Naseri Aiotato, Raymond Saulep
Daryl Teague and Nik Friederich

Thank you to Kongo coffee who generously provided coffee for morning tea each day as well as a gift pack of coffee for all students and lecturers. Thank you also to the 3 women’s church groups who provided nutritious food for the duration of the course and made us feel at home.

Back L to R Des Soares, Anthony Nasai, Naseri Aiotato, Reshwin Rajan, Felix Diaku, Haynes Rasin, Johnny Hedson, Steven James, Juvencio Dias, Viola Kokiva, Pita Sovanivalu, Raymond Saulep Front L to R Shaun Mauiliu, Areta Samuelu, Mark Rokobuli, Daryl Teague, Nik Friederich, Kosh Hazratwalla, James Tewa’ani, Alex Munamua, Kevin Lapu and Clay Siosi. (Bohu Urakoko not in picture)

Finally, this module would not have been possible without the generous financial support from Wyss Medical Foundation, AO Alliance Foundation and South Pacific Projects.

Congratulations Dr. Clay Siosi

Congratulations! Dr. Clay Siosi, a PIOA trainee from Solomon Islands has been selected by the American Association for Hand Surgery (AAHS) /HSE International Reverse Surgery Fellowship review taskforce as the 2020 recipient! The International Reverse Surgery Fellowship was created by the AAHS to sponsor an international hand surgeon’s visits with AAHS member surgeons at their institutions. The goal is to provide expert, hands-on experience so that Clay can return home to improve local care and educate others.

PIOA exit exam 2019

Back row : Candidates (L to R) Areta Samuelu (Samoa), Shaun Mauiliu (Samoa), Des Soares (Director of Training), Mark Rokobuli (Fiji) James Tewa’ani (Solomon Islands) Alex Munamua (Solomon Isldands,
Examiners (front row L to R) Andreas Loefler and Peter Cundy (Australia) Richard Lander and Sud Rao (New Zealand)

We are pleased to report that 4 out of our 5 final year candidates successfully completed the final exit examination. This was run by independent examiners from Australia and New Zealand. We are grateful to Dr Richard Lander (Chief Examiner) and Dr Sud Rao from New Zealand and Dr Peter Cundy and Dr Andreas Loefler from Australia. The exam followed a similar format to the FRACS examination with 2 written papers, 2 clinical vivas and 3 computer based vivas. Candidates were tested on 45 different scenarios. We are proud of the teamwork and cameraderie shown by our final year candidates as they supported their colleague who was unsuccessful.

Next modules – Knee, Foot & Ankle, Kundiawa, PNG

The next modules commence on Monday 28 July in Kundiawa, PNG highlands. We are grateful to the Sir Joseph Nombri Memorial Hospital which will host us for the next 3 weeks. The topics to be covered include Knee , Foot & Ankle. We will have 16 trainees do the modules. In addition we will do our second ever exit exam. We have 5 candidates presenting for their final exam. They are Shaun Mauili and Areta Samuelu from Samoa, Mark Rokobuli from Fiji , Alex Munamua and James Tewa’ani from Solomon Islands.

First ever TENS nail performed in Samoa

Dr Shaun Mauiliu, PIOA final year trainee performed the first ever TENS nail in Samoa. Shaun learned the technique in 2018 at the PIOA Paediatric module. He has recently received a new NET brand TENS set supplied by Narang Medical Ltd. from India which provides cost effective implants for less developed countries.

The fracture was redcued closed and the surgery took 30 minutes. Well done Shaun and team. Very proud of you.