Pita Sovanivalu – new graduate

In his own words:

I’m currently working as acting Chief Medical officer in orthopaedics at Labasa Hospital (only divisional hospital in northern fiji serving a population of 150000).

Thanks to PIOA for what it has done for me in regards to :

Improve my theoretical orthopedic knowledge.

Taught me the importance of taking a proper history and examination.

Improve my surgical skills .

Continuous CME every Sunday.

Arranging individual mentoring with senior orthopaedic doctors from Australia/ NZ.

Provide a platform for discussion of cases and treatment plan.

Arranging for visitation of orthopedic team to our respective hospital to come and help in attending complex cases.

I hope and pray that PIOA will continue to do orthopaedic training in the Pacific.

Some comments from our students

Juvencio Dias (Timor Leste)

Juvencio Dias

During 2 weeks Module in Suva I have learnt a lot about Hip and Spine. The Module is very practical and made it easy to understand how to performed surgery from different surgical approaches to Hip and Spine.

I also was able to see different cases in the ward, and was guided by Senior Orthopaedic consultants and best lecturers from Australia and New Zealand. I’m Very Happy to attend this Module in Suva and my Gratitude  to PIOA and to CMWH (staff and Patients) as well.


Agnes Auto (Solomon Islands)

Agnes Auto

This learning experience has added value to my contribution in reducing Disability Advanced Life Years (DALY) in the Solomon Islands.

I feel more confident with the knowledge and skills learned, and am challenging myself to put these into practice the once I return home, to work with my Senior Colleagues .

I am thankful for the opportunity to grow with PIOA and grateful to the SPC for their support and enabling me to attend.

Tagio Tumas


Clay Siosi (Solomon Islands)

Clay Siosi Lewi

Spine – the learning I acquired through this training has broadened my understanding and management of spine pathologies or problems I see in my home country. It provide focused approach in identifying and managing my patients.

Hip – wealth of knowledge from the members of faculty. I learned about hip and pelvic trauma management. Their experience and expertise knowledge has opened up another level of understanding…

Best regards 


Deacon Teapa (Cook Islands)

I would to say thank you to PIOA and SPC for giving this valuable opportunity for being part of this organization. Coming back from nearly 12 years of academic hiatus I find the last 2 weeks on the PIOA modules has been fulfilling and enriching to my personal professional development. The course has provided me an opportunity to reinforce my knowledge and past experience, learn new things and especially

operative skills sets from some of the best orthopaedic surgeons in Australasia. I look forward towards the next modules in the coming months and years.

ATAWAI WOLO (Thank you very much)

PIOA meeting with Fiji National University 20 September 2022

In other developments for PIOA, we had a long-awaited meeting with FNU and major stakeholders in the Surgical & Orthopaedic department to address the urgent need to develop orthopedic care in Fiji. This meeting also helped address a lot of issues regarding training and it was a milestone for both PIOA and FNU. The future looks bright and looking forward to building quality orthopedic care in the Pacific, so watch this space.

Figure: sitting L- R Dr Josese Turagava (consultant Pediatric Surgeon CWM hospital) , Dr William May (acting Vice Chancellor/ Dean College of Medicine Nursing & Health Science for FNU), Dr Abhay Choudhari (Assistant Professor Surgery FNU), Dr Emosi Taloga (Orthopeadic Consultant CWM Hospital), Dr Basharat Munshi (FNU), Dr Timoci Qereqeretabua (Consultant Surgeon CWM Hospital, Dr Mai Ling (FNU) Dr Des Soares, Dr Pauliasi (Orthopeadic Consultant CWM hospital) , Standing: Dr L-R : Dr Semisi (CWM Hospital) , Dr Ilaitia Delasau (Consultant Surgeon CWM Hospital) / Photographer Dr Tu’uau Shaun Mauiliu

PIOA exit exam 19-23 September 2022, Suva, Fiji

The highlight of the module was the exit examination which was made up of 7 sections. There were 2 written papers, 2 clinical vivas where candidates had to examine patients and formulate a diagnosis and management plan.  There were 3 computer vivas (2 in operative surgery and 1 on investigation and diagnostic imaging).

Dr Richard Lander from Palmerston North New Zealand was the chief Examiner, and Dr John North from Brisbane Australia was his assistant. Two of our graduates Dr Stephen Kodovaru from Solomon Islands & Dr Tu’uau Shaun Mauiliu from Samoa, were invited as co-examiners during the weeklong examination process as part of succession planning for PIOA.

Dr Areta Samuelu & Dr Pita Sovanivalu successfully completed the final exam and will be eligible to graduate with a Master of Surgery (Orthopedics) from the National University of Samoa in Apia in April 2023.

Dr Areta Samuelu with new examiners and President Stephen Kodovaru and Director of Training Tua’au Shaun Mauiliu
Dr Pita Sovanivau with new examiners and President Stephen Kodovaru and Director of Training Tu’uau Shaun Mauiliu
Stephen, Pita, Richard Lander, John North Areta and Shaun

PIOA Hip module 17-24 September 2022, Suva, Fiji

The lectures for the hip modules were delivered by Dr Vaughan Poutawera & Dr Andrew Vane from Tauranga New Zealand, Dr Kaushik Hazratwalla from Townsville & Dr Des Soares from Brisbane Australia.

In this module, the students were taught a systematic approach to diagnosis and management of traumatic and degenerative conditions affecting the hip. This included clinical history taking and a thorough clinical examination with emphasis on a systematic approach to the management of osteomyelitis, septic arthritis and degenerative conditions such as osteoarthritis. In addition, there were focussed lectures and practicals on the management of trauma affecting the pelvis, acetabulum and femur.

Learning to ex-fix a pelvis

During the afternoon practical sessions, each student was given opportunity to deal with different conditions affecting the hip from the femur, hip joint and acetabulum. This was a very useful exercise to help them recognise and learn the up-to-date management of hip condition. One of the popular sessions was teaching cementing techniques to the trainees and this gave them options in dealing with difficult and complex cases.

Acetabular preparation for cementing
Ex-fix a femur

In the mornings ward rounds were continued as usual, making the students more confident in their orthopaedic history taking and examination. The module was also concluded with an end of block written examination.

Hip module group
The Tauranga team – Vaughan, Reshwin, Shaun and Deacon

PIOA Spine module (12-16 September 2022) – Suva, Fiji

The lectures for the Spine modules were delivered by Dr David Bartle from Tauranga New Zealand, Dr Ian Cheung & Dr Des Soares from Brisbane & Dr Michelle Atkinson from Sydney, Australia, and Dr James Tewa’ani from Solomon Islands.

In the Spine module students were taught a systematic approach to history taking, clinical examination and investigation with a focus on common spine orthopedic conditions. The practical sessions were aimed at common spine management options including cervical & lumbar spondylosis and stabilisation and internal fixation of spine trauma. Small group workshops focused on using Gardner Wells tongs/ halo traction using a model.

Condom model for practicing dura repair

A novel condom model was used to practice dural repair. Sawbones were used to demonstarte pedicle scre placement and laminectomy / spinal decompression. Other practical sessions looked at rehabilitation for spinal patients and other malignancies that affect the spine.

Each morning we commenced with a ward round seeing two patients and getting the students to present the history and clinical signs of the patients. Their management was then discussed and suggestions for improvement were made. This was a useful exercise as we were able to improve clinical skills. It was also helpful to try and elucidate clinical reasoning and decision making and help with developing these skills. The students enjoyed having expert advice on the management of elective conditions and trauma affecting the spine.

At the end of the module the students’ knowledge was tested with a written paper examination.

Dinner at end of Spine module

Congratulations to our new graduates

At the PIOA module held in Suva, Fiji, we celebrate the success of two of our trainees in their exit exam. We welcome Areta Samuelu (Apia, Samoa) and Pita Sovanivalu (Labasa, Fiji) as Fellows of PIOA. The examiners were Dr Richard Lander (New Zealand/Aotearoa), Dr John North (Australia), Dr Shaun Mauiliu (Samoa) and Dr Stephen Kodovaru (Solomon Islands).

From L to R Stephen Kodvaru, Pita Sovanilvalu, Richard Lander, John North, Areta Samuelu, Shaun Mauiliu

PIOA to restart modules – Suva, Fiji

After almost 3 years due to the COVID pandemic PIOA will hold the Spine and Hip module in Suva Fiji in co-operation wth the Fiji Ministry of Health and Medical Services and CWM Hospital, Suva. We are grateful to the Pacific Eye Institute which is kindly hosting us at their conference room. The module will be held between 12 – 24 September 2022.

We look forward to seeing trainees from Timor Leste, Papua New Guinea, Fiji, Solomon Islands, Samoa, Kiribati and Cook Islands.

PIOA assists Kundiawa Hospital with C arm digital xray

One of the common problems throughout developing world hospitals is the failure of II (C arm) machines. These are technologically sophisticated and used in the Operating theatre to do on table xray imaging of fractures in multiple planes. The devices fail in 3 main areas (bulb failure, motherboard or other electronic failure or damage to cable from rodents in base. Because the machine is large and heavy it is not possible to send it back for maintenance. Service personnel are also very expensive and hard to come by. The cost of the device is around US $80-100,000. PIOA worked in partnership with Australian Doctors for Africa to develop a low-cost C arm (it has been named C-Bones). We had assistance from Mick Caratti, a highly skilled engineer who did the detailed engineering design. Manufacture of the C arm was done by Alloytech in Bayswater, WA. The C arm device is purely mechanical and robust. The XR generator is a battery-operated unit that can provide 300 exposures per charge. It has been designed for veterinary use (portable) and is fully certified. The digital receiver is also wireless and communicated with a laptop via a router. It takes single shot static x rays which appear on the laptop within 2 seconds of image being taken. It is not a continuous image intensifier. The first prototype was installed in Kundiawa in PNG in June. A second is now installed in Hargeisa Hospital in Somaliland. This device can be delivered for USD $35000 (one third of the cost of a regular II). Installation is straightforward and detailed instructions are provided. Please contact PIO Pty Ltd (email des.soares@drdes.com.au) if you want more information about the C Bones.
X ray generator – can adjust kV and mAs
C Bones install at Kundiawa
C Bones install at Hargeisa Hospital, Somaliland

Reflections from Shaun Mauiliu, Director of Training

Talofa and good evening to all the faculty and students of PIOA

First I would like to thank Dr Des and Prof Nik and all our research committee for your hard work and teaching in the last couple of years.

I just want to share with everyone especially our trainees in the various pacific islands my own experiences.

Above is an article that just been published I know it’s not a much , but I thought it would worth to celebrate.

But first I thought it would best to start from my own experience going through the PIOA training program.

First of all I started like all of you guys, I was scared and had no idea about orthopedics even worse I had no idea about how to look after an orthopedic patient. But through the guidance and education that I have learnt from PIOA, this has given me the platform and courage to do the impossible. I was just like you, I was alone, working 100 hours a week, slaving like a dog to maintain a service, and at the same time neglecting my health and especially my family and the people that matter the most.

Yes we all have excuses and reasons not to do assignments and not to fill your logbooks , or that you are overwhelmed with patients, but i can bear testament to all the teaching and mentoring from PIOA, that you can make a positive change to the lives of our patients if you WORK HARD , HONEST, RESILIENT, HONEST & TAKE RESPONSIBILITY

During my years of training I worked alone and had a lot struggles and at times being treated like a nobody. But I stuck to my training in PIOA and to god be the glory for he has guided me to were I am now

My challenge to all the trainees please don’t not take advantage of the opportunity you have, take it and use it wisely please. Look after yourself and family first before your look after your patients.

The article I shared above is not much but testament to my mentors and especially to our PIOA faculty

We should all learn to celebrate our achievements when we can and we should all work together as a team

Once again a massive congratulations to Viola for passing your exams looking forward and to working with you in the future. You are a true testament of resilience.

Once again thank you Des and Prof Nik and our entire faculty for your ever ending support and mentoring

Just wanted to share with everyone in this forum even if you are alone in an island you can still do research and give the same level of care for your patients as you do in first world countries

Hope that this pandemic ends soon so we can all meet up and have a proper module😂😂😂

Kind regards