Winning Hearts and Changing Lives - the FST in Vanuatu
By Lieutenant Colonel Darryl Tong RNZAMC
LTCOL Tong is a Territorial Force officer, and a maxillo-facial surgeon.
Exercise Pacific Partnership 2011 (ExPP11) was an excellent experience for members of the Forward Surgical team (FST) comprising 17 personnel drawn from the regular force, territorial force and the civilian volunteer health service (CVHS).
LTCOL Tong examines a young patient.
The FST included two surgeons, an anaesthetist, two anaesthetic technicians, a radiographer, two diagnostic lab technicians and nursing staff covering the operating theatre, recovery ward and surgical wards.
The NZDF provided the only surgical capability for the second phase of ExPP11 in Vanuatu in support of a US Navy MEDCAP involving service personnel from the US military and Australian Defence Force (ADF) whose main focus was to provide primary care and health surveillance for the people on Espiritu Santo.
When not operating, the consultant specialists were conducting out-patient screening clinics alongside US and ADF medical teams. A small dental team stayed on from the Tonga phase of ExPP11 and provided sterling service to the local population and supported the dental teams made up of US, Canadian, French and Australian personnel.
The FST was fortunate to work alongside the dedicated local hospital staff and had many dealings with an AUSAID surgeon, Dr Fred Merchant who is a retired general surgeon from Chicago originally but now residing in Fiji.
Life changing surgeries ranging from hernia repairs to removal of large growths and draining of infections allowed the FST to exercise as a cohesive unit and accomplish its primary mission of being able to deploy and conduct real-time surgery in a humanitarian aid role overseas.
Three surgeries in particular have literally changed the lives of the patients involved and highlights the necessity of a FST capability for NZDF deployments overseas, and the great fortune of having dedicated health professionals willing to serve on such missions with the NZDF. The first involved a 17 year old man from the more remote regions in the North of the island who presented with a two month old crush injury of his left hand. As with most of the local population he did not complain. The thumb and index finger were crushed with bone exposed and dead tissue. The hand was completely useless in its current state. The index finger was removed but as much of the thumb was preserved in order to give as much functional grip as possible for the future. Despite reassurances and explanations through interpreters, the young man was petrified that he was going to lose his hand. The look of relief along with a huge smile that followed once he saw that he had most of his hand left was priceless. For a man who lives off the land, the prospects of only having one functional hand was bleak, but after surgery and some limited rehabilitation, this young man would be able to gain the use of both hands once again and continue on with his life as before.
A 16 year old woman presented to the out-patient screening clinic and was referred to the FST from one of the US Navy doctors. Due to traumatic piercing of her ears and probable infection, large growths of scar tissue (keloids) had disfigured both ears to the extent that this young woman hid most of her face with her hair and was obviously shy and reclusive due to her loss of self-image. The keloids were removed and the ear lobes reconstructed and once again the priceless look of disbelief followed by joy was evident after surgery. The surgery itself was relatively minor but the end result was the rebuilding of self confidence and self-esteem – so important for a 16 year old woman to have.
Perhaps the most life changing surgery was performed on an Australian tourist who sustained injuries to his upper legs including a life threatening injury to his right femoral artery. Due to the quick actions of the AUSAID surgeon who was in the immediate vicinity when this occurred, the tourist was prevented from bleeding to death and was taken to the local emergency department at Luganville hospital where the specialist team from the FST was able to assess and prepare him for surgery with minimal delay.
His femoral artery was repaired and although the patient was stable it became evident that the patient’s leg was at risk and required specialist vascular intervention in Australia. The patient was evacuated by military helicopter to Port Vila and subsequently flown to Australia. The true spirit of Pacific Partnership was manifested during this medical evacuation as it involved US, Australian, New Zealand and French military personnel working together in close cooperation.