How is surgery included in the Strategic Health Plans of the Pacific, Papua New Guinea and Timor-Leste?

Background: Papua New Guinea, Pacific Island nations, and Timor-Leste represent a range of island nations with populations ranging from a few thousand to 8 million. They perform on average about 25% of the Lancet Commission of Global Surgery's target 5000 per 100 000 population and their health workforce have significant deficits of trained surgeons and anaesthetists. This study was conducted to determine how the current national health plans of these nations have included surgery and anaesthesia.

How will increasing surgical volume affect mortality in the Pacific, Papua New Guinea and Timor Leste?

Background: Nine South Pacific nations, Papua New Guinea and Timor Leste, have collaborated to report and publish their surgical metrics as recommended by the Lancet Commission on Global Surgery (LCoGS). Currently, these countries experience about 750 postoperative deaths per year, representing 1% of crude mortality in the region. Given that more than 400 000 annual procedures are needed in the nine nations to reach the LCoGS target of 5000/100 000, we aimed to calculate the potential contribution of perioperative mortality to national mortality where these procedures are performed.

Amoebic Liver Abscesses in Fiji: Epidemiology, Clinical Presentation and Comparison of Percutaneous Aspiration and Percutaneous Catheter Drainage.

Background: Amoebic liver abscess (ALA) is a common clinical problem in tropical countries related to poor sanitation. The epidemiology and clinical presentation of ALA in Fiji has not been previously described. It is unclear whether percutaneous aspiration (PA) or percutaneous catheter drainage (PCD) has better outcomes.

Paediatric Osteomyelitis in Fiji.

Introduction: Osteomyelitis can lead to significant morbidity and long-term disability if early treatment is not initiated in a timely manner. For developing countries this can lead to a significant burden on the healthcare system. This study aims to describe the demographic variables, aetiology and outcomes of treatment and to calculate the incidence of paediatric osteomyelitis in Fiji.

Epidemiology of fatal and hospitalised injuries among youth in Fiji (TRIP 15).

Aim: To determine the burden and characteristics of fatal and hospitalised injuries among youth in Fiji.

Methods: We conducted a cross-sectional analysis of the Fiji Injury Surveillance in Hospitals database - a prospective population-based trauma registry - to examine the incidence and epidemiological characteristics associated with injury-related deaths and hospital admissions among youth aged 15-24 years. The study base was Viti Levu, Fiji, during the 12-month period concluding on 30 September 2006.

Driving following Kava Use and Road Traffic Injuries: A Population-Based Case-Control Study in Fiji (TRIP 14).

Objective: To investigate the association between kava use and the risk of four-wheeled motor vehicle crashes in Fiji. Kava is a traditional beverage commonly consumed in many Pacific Island Countries. Herbal anxiolytics containing smaller doses of kava are more widely available.

Sentinel Node Biopsy Alone versus Completion Axillary Node Dissection in Node Positive Breast Cancer: Systematic Review and Meta-Analysis.

Introduction. There has been recent interest in validity of completion axillary node dissection after a positive sentinel node. This systematic review aims to ascertain if sentinel lymph node dissection alone was noninferior to axillary lymph node dissection for breast cancer patients who have a positive sentinel node.

Driver sleepiness and risk of motor vehicle crash injuries: a population-based case control study in Fiji (TRIP 12).

Introduction: Published studies investigating the role of driver sleepiness in road crashes in low and middle-income countries have largely focused on heavy vehicles. We investigated the contribution of driver sleepiness to four-wheel motor vehicle crashes in Fiji, a middle-income Pacific Island country.

Method: The population-based case control study included 131 motor vehicles involved in crashes where at least one person died or was hospitalised (cases) and 752 motor vehicles identified in roadside surveys (controls).

Population-based characteristics of fatal and hospital admissions for poisoning in Fiji: TRIP Project-11.

This study investigated the incidence and characteristics of poisoning fatalities and hospital admissions among indigenous Fijians and Indians in Viti Levu, Fiji. Individuals with a mechanism of injury classified as poisoning were identified using the Fiji injury surveillance in hospitals system, a population-based registry established for 12 months in Viti Levu, and analysed using population-based denominators. The mean annual rates of fatalities and hospitalisations were 2.

Prevalence of sleepiness while driving four-wheel motor vehicles in Fiji: a population-based survey (TRIP 9).

Introduction: Sleepiness has been shown to be a risk factor for road crashes in high-income countries, but has received little attention in low- and middle-income countries. We examined the prevalence of sleepiness and sleep-related disorders among drivers of four-wheel motor vehicles in Fiji.

Method: Using a two-stage cluster sampling roadside survey conducted over 12 months, we recruited a representative sample of people driving four-wheel motor vehicles on the island of Viti Levu, Fiji.

A profile of injury in Fiji: findings from a population-based injury surveillance system (TRIP-10).

Background: Over 90% of injury deaths occur in low-and middle-income countries. However, the epidemiological profile of injuries in Pacific Islands has received little attention. We used a population-based-trauma registry to investigate the characteristics of all injuries in Viti Levu, Fiji.

Fatal and hospitalised childhood injuries in Fiji (TRIP Project-3).

Aim: Although childhood injury rates in low- and middle-income countries are known to be high, contemporary data on this topic from Pacific Island countries and territories are scant. We describe the epidemiology of childhood injuries resulting in death or hospital admission in Fiji using a population-based registry.

Methods: A cross-sectional analysis of the Fiji Injury Surveillance in Hospitals system investigated the characteristics associated with childhood injuries (<15 years) in Viti Levu, resulting in death or hospital admission (≥12 h) from October 2005 to September 2006.

The case for improving road safety in Pacific Islands: a population-based study from Fiji (TRIP 6).

Objective: To estimate the incidence and demographic characteristics associated with road traffic injuries (RTIs) resulting in deaths or hospital admission for 12 hours or more in Viti Levu, Fiji.

Methods: Analysis of the prospective population-based Fiji Injury Surveillance in Hospitals database (October 2005 - September 2006).

Results: Of the 374 RTI cases identified (17% of all injuries), 72% were males and one third were aged 15-29 years.

Three phases of the Pacific Islands Project (1995-2010).

The Pacific Islands Project (PIP), funded by AusAid and managed by the Royal Australasian College of Surgeons (RACS), has progressed through three phases from 1995 to 2010. During this time, it has sent over 520 teams to 11 Pacific Island Countries, providing over 60,000 consultations and some 16,000 procedures. In addition to this delivery of specialist medical and surgical services that were not previously available in-country, the project has contributed as a partner in capacity building with the Fiji School of Medicine and Ministries of Health of the individual nations.

Hospitalised and fatal head injuries in Viti Levu, Fiji: findings from an island-wide trauma registry (TRIP 4).

Background: Globally, head injury is a substantial cause of mortality and morbidity. A disproportionately greater burden is borne by low- and middle-income countries. The incidence and characteristics of fatal and hospitalised head injuries in Fiji are unknown.

Characteristics of fatal and hospital admissions for burns in Fiji: a population-based study (TRIP Project-2).

Background: Over 95% of burn deaths are estimated to occur in low-and-middle-income countries. However, the epidemiology of burn-related injuries in Pacific Island Countries is unclear. This study investigated the incidence and demographic characteristics associated with fatal and hospitalised burns in Fiji.

A case report: simple and effective external fixator for finger fractures.

A case report on a very simple and very effective technique of achieving finger fracture fixation. This cost effective and yet simple tool and technique of immobilization is cheap and can be readily used in the South Pacific. This procedure provides us with an alternative to amputation of the digit.