Doctor hopes specialist skills can stay in Sāmoa

Children in Sāmoa needing complex surgery can wait years for treatment, with some families having to travel overseas because the country does not have a paediatric surgeon.

Dr Martin Vaigafa, a surgical registrar at Tupua Tamasese Meaole Hospital in Apia, wants that to change.

He is completing postgraduate training through Fiji National University with the goal of specialising in paediatric surgery and hopes ongoing partnerships with visiting specialists can help build a local service.

“Sāmoa doesn't have a paediatric surgeon, but also, we don't have the facilities and resources for managing post-operative, especially an intensive care unit for paediatrics alone,” he tells PMN News.

Vaigafa says some children can wait years for visiting surgeons, while others needing urgent treatment need to travel overseas.

“If they can wait for the visit, then good, but if not, then we usually send them either to New Zealand or to India.”

Dr Stephen Adams in surgery. Photo/Supplied

A six-member team from the Royal Australasian College of Surgeons spent a week in Apia earlier this month, assessing more than 50 children and performing 26 operations.

The procedures included bowel reconstructions, tumour surgery and stoma closures.

Vaigafa says the visits are also a chance for local doctors to gain hands-on experience with complex cases.

Listen to Dr Martin Vaigafa's full interview below.

“I've learned a lot, knowledge-wise and skills-wise, and also managed to do quite a few complicated cases for patients who have been waiting for the opportunity,” he says.

One of the children treated was an 18-month-old boy with Hirschsprung disease, a condition that can cause blockage in the bowel.

Dr Stephen Adams, Head of Paediatric Surgery at Waikato Hospital, said the team had been able to undergo pull-through surgery, allowing him to pass stool normally.

“These are children who may have been waiting one, two or even three years for procedures,” he said in a statement.

“We were able to complete his pull-through surgery, which means he can now pass stool normally. It's a really meaningful outcome and has the potential to completely change his quality of life.”

Adams says the visiting team also brought equipment and medicines where possible.

Tupua Tamasese Meaole Hospital in Sāmoa. Photo/File

“At one point we didn't even have ibuprofen available,” Adams says. “We brought as much equipment and medication as we could so we didn't draw on local supplies.”

The partnership continues after the visiting teams leave Sāmoa, with specialists checking on patients and advising local clinicians when difficult cases arise.

Adams says building local skills is central to the programme.

“It's not about us coming in and making decisions. We're working alongside local teams, supporting them and helping them build confidence to manage more complex cases.”

Vaigafa says local clinicians can carry out minor paediatric operations but opportunities to build experience in more complex surgery are limited without a specialist based in Sāmoa.

Dr Stephen Adams led a team of surgeons to Sāmoa to assess children and perform operations in Apia. Photo/Supplied

He hopes the ongoing relationship will create more training opportunities and help develop a paediatric surgery workforce in the country.

“Hopefully in the next five, 10 years, we'll have our own surgeon and we'll be able to do some of these complicated cases and be able to keep the skills and knowledge within our country.”

PMN News has put questions to the Ministry of Health.