My recent visit to Fiji in November 2012 highlighted the ongoing opportunity of regular visits from Australian physicians to assist with the provision of specialist services and mentoring of Fijian medical officers and nurses.
I saw psychiatric outpatients at the Hope Clinic in Lautoka with Dr Susana Pene and staff nurse Misau. I met with the medical director, Dr Susana Maikalevu, of the Western Division Health Service and the manager of Lautoka Hospital. I also met with the consultant physician supervising Dr Susana Pene.
The nursing and medical staff at Lautoka Hospital and in the regional health district was very appreciative of my in-service training sessions on assessment and management of psychiatric and dementia conditions in older patients. More training is needed in this area because of the ageing population in Fiji.
I visited the dean, Professor Altaisaikhan Khasag, of the medical school of the University of Fiji in Lautoka. We discussed the medical course curriculum and the place of psychiatric education and training in the course. We discussed the University of Fiji inviting Australian psychiatrists and other physicians to contribute to the teaching program of the medical school when they visit the Western Division of Fiji. The dean was extremely supportive of the medical school being involved in various psychiatric meetings or conferences organised in Fiji for training of health professionals.
My discussions with the dean of the University of Fiji medical school point the way forward to stronger links between visiting Australian physicians and medical education and training in the Western Division.
I enjoyed this visit immensely and believe I made perhaps a small contribution to the provision of psychiatric services in the Western Division. A wide range of adult psychiatric patients was seen with the local medical and nursing staff in both outpatient and inpatient settings. I was able to assess the clinical work of Dr Pene and staff nurse Misau. Both are keen, hardworking and knowledgeable clinicians. In order to be even more effective in her role as chief nurse at the Hope Clinic in Lautoka, staff nurse Misau needs to be supported by an additional nurse or occupational therapist. I hope she can put forward a submission about additional support that meets with approval from her local managers.
During my stay I saw elderly patients at the Golden Age residential aged care facility with Dr Pene and staff nurse Misau and I provided an in-service training session for nurses on psychiatric and cognitive assessment in older patients. I reviewed all the inpatients at the Lautoka Hospital Stress Unit with Dr Susana Pene and the psychiatric nursing staff. I conducted an in-service training session for the unit nurses on assessment of common psycho-geriatric problems and I ran an in-service training session for Lautoka Hospital medical officers on the assessment, diagnosis, and management of common dementia syndromes.
Towards the end of my trip I visited a community health clinic in Ba where I was invited to be guest speaker at the Mental Health Celebration Day as part of the Non-Communicable Diseases Week activities. I spoke about advances being made in Fiji to reduce stigma about psychiatric illness, to educate the public, to establish postgraduate training courses in mental health to improve the quality of psychiatric treatment, and to decentralise mental health services to make them more accessible so as to allow faster and more effective treatment for patients.
I would like to thank Dr Peni Biukoto and St Giles Hospital for their support and the Fiji Department of Health offering to pay for my accommodation and for offering a living allowance payment for the period of my visit. I also extend my thanks to Mr Kishore Kapadia, a local businessman who paid for some of my accommodation at the Northern Club Lautoka. His support is much appreciated.
I wish to thank the Minister of Health, Dr Neil Sharma, and the Fiji Medical Council for facilitating the administrative aspects of my visit. Dr Shunil Sharma (physician Gold Coast) was most helpful in arranging the visit from the Australian end.
Finally, I would like to offer my sincere appreciation to Dr Susana Pene and staff nurse Misau for their help and hospitality during my visit.