The paediatric ward is run by a paediatrician, an intern and nurses. Dr Thyna was the paediatrician on the ward during that week, and she has an incredible amount of knowledge. She made sure any ‘learning issues’ we had each day were distributed to each of us to talk about for a few minutes at ward round the next day.
The ward seems to always be reasonably busy with 10-15 patients plus nursery babies. The bible for paediatrics in Vanuatu is the WHO Hospital Care for Children. Dehydration is a huge problem, with diarrhoeal illnesses being really common, so a lot of care centred around that. On the other end of the spectrum, I learnt about overhydration – signs to look out for if the child has gotten too much fluid. This isn’t something I have ever really thought about, but important in this setting because of the severity of dehydration seen, malnutrition as a confounding factor, and the resource limitation.
Some of the cases on ward included; diarrhoeal illness/gastro, TB, meningitis, neonatal sepsis, malnutrition/growth faltering, pneumonia, congenital heart disease and epilepsy. It was a bit heartbreaking seeing some children who had poor prognoses because they lived in Vanuatu and couldn’t get suitable treatment. It was also sad to hear about how many babies and children died recently, but the team really learn from each and every case and improve their practice based on their experience. We really are lucky in Australia to have resources for sick children, as well as good public health resources – not just education programmes, but things for post-natal mums and their newborns, screening programmes and availability of healthy food and a varied diet.
Vanuatu Elective 