I’m back from two weeks in Malaita, one of the Solomon Islands’ 9 provinces. Malaita is one of the bigger, perhaps more developed provinces, having roads leading from Auki (the main town) both north and east, and a short way south. All the same, Auki is tiny, a few streets with a few shops and a small market and port. Kilu’ufi, Malaita’s main hospital (one of two) is attached to Auki. Quite a nice hospital.
While in Malaita I was able to travel both north and east (south has a lot of river crossings with no bridges and the wet season kicked in big time while I was there, so we couldn’t go that way), to conduct the survey about procurement in the clinics in the small villages. It was great to see how the majority of Solomon islanders actually live, which is very different to the life in the metropolis of Honiara (about 60,000 people). The villages are often quite close together, but then again, that’s just the ones I saw, which were along the road. There are lots of villages which are hours walk or canoe from the main road and I imagine, quite isolated. How the clinics in some of these villages manage to procure any stock at all is a small miracle.
The clinics are run by nurses or nurse aids. There are no trained doctors or pharmacists to spare for such small places. They are generally under supplied in both drugs and equipment. An average of 9 out of 19 of the most commonly used drugs were out of stock at the time of visiting the clinics I went to. These were such basic things as panadol, penicillin, magnesium…Also, it was frustrating to see that no one had, or even had heard of, Coartem, the new malaria medication. Coartem is set to replace chloroquine and fansidar as the primary treatment, is more effective with almost zero tolerance developed and fewer side effects. The problem is that no one has it. There’re loads of it in Honiara, but the process of rolling it out through the provinces is difficult and time consuming, and the Malaria Working Group in charge of this doesn’t seem to be getting through very well. I was surprised because Malaita is one of the more accessible provinces, so I figured it would have been introduced early in the program, but apparently not so. Many of the clinics were out of stock of chloroquine and fansidar, so couldn’t do anything for patients with malaria. Often having no panadol, they couldn’t even offer some analgesia.
Atoifi, the hospital in the east set overlooking the sea dotted with islands and a stunning mountain backdrop, had very limited stock. Two patient with TB had been admitted, but the doctors had to admit that they were just “taking up space”, because there was nothing to be done for them unless some TB kits could be procured. Atoifi is only accessible by boat supply is irregular and unreliable from Honiara.
I’d better go, will try to write again.
i’ll be home in just one week and am getting pretty excited.
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