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Video by Perry Briggs
As classrooms go, the Western Province of the Solomon Islands must be among the most beautiful in the world, with coral-fringed islands, world-class diving and active volcanoes.
Final-year medical students from Bond University have been coming here most years since 2013, working in remote hospitals and testing their skills before graduating and taking the first step of their careers as interns.
For many it’s a transformative experience because while the Solomons is rich in natural beauty, healthcare is a scarce luxury.
Paradise, but with challenges
“The developmental profile of the Solomons is more consistent with many of the countries in Sub-Saharan Africa,” says Professor Peter Jones, who along with colleague Professor Peter Fink established the program.
“It can be quite confronting that a three-hour flight from Brisbane, at least 40 babies per 1000 die in the neonatal period, compared to about four in Australia.
“But given the few resources they have available it’s remarkable the Solomon Islands is able to deliver any sort of healthcare at all.”
Local patients often trek through jungle or undertake arduous boat journeys to reach hospitals which sometimes lack basic medications such as painkillers and antibiotics.
Common health problems include the high neonatal mortality rate, malnutrition, rheumatic fever and cervical cancer.
Compounding the situation, The Solomons is considered the second-most disaster-prone country in the world due to cyclones, earthquakes, tsunamis and flooding.
Covid-19 paused the Bond placements program in 2020 but in 2023, 22 medical students returned and spent six weeks in the country, first at the National Referral Hospital in the capital Honiara followed by four weeks in the Western Province at either Gizo Hospital or Helena Goldie Hospital in Munda.
Practising medicine at the coalface
Professor Jones says the lack of diagnostic tools - such as blood tests and scans - force students to focus on basic clinical skills like physical examinations, patient assessments, and basic medical interventions.
“There's some astonishing life stories that the students are getting to experience just by being there,” he says.
"Sometimes they may think, how can we allow people not to have the kind of access to healthcare that we take for granted?
“But if they're able to do the basics of medicine really well and work together as a team, they will genuinely over the course of their placement save a few lives.”
Yathurshika Ketheesa and five fellow Bond medical students worked at Gizo Hospital, a short boat ride from the island where John F Kennedy was shipwrecked during World War II.
The students flew into a spectacular airport on an island only slightly wider than the runway before being ferried to Gizo, the capital of the Western Province with a population of about 7000 people.
“Gizo is on a very remote island. There’s lots of markets, little stores here and there. It’s like a little tropical getaway –
very peaceful, very serene,” Ms Ketheesa says.
Another student, Claudia Nguyen, says she was struck by the welcoming and positive spirit of the locals despite their challenges.
“The whole community is very embracing of the medical students,” she says.
“Whenever you walk along the streets you get the biggest smiles from the happiest people.”
Professor Jones, who is the clinical lead for capstone and elective rotations at Bond, says up to 90 percent of residents in the Western Province live in villages of less than 200 people on 11 main islands.
Transport difficulties and drug shortages
“To get treatment at one of the two hospital they probably need to use an outboard motorboat and that might require 80 litres of petrol,” he says.
“Paying for that might be a family’s entire savings.
“And sometimes if patient is diagnosed with something like cervical cancer, they’ll be given a box of Panadol for the boat ride home because there’s very little that can be done for them.”
Bond medical student Ruveen De Alwis typically started his day in the accident and emergency department of Gizo Hospital under the supervision of local doctors before visiting wards and clinics in the afternoon to speak with patients.
“The Solomon Islands is really under-resourced, so having to practise in this context has really opened our eyes to the fundamentals of medicine,” he says.
“It has given us a new perspective on the ways in which we learn, and the ways in which we practise medicine.”
Claudia Nguyen agrees.
“You become a lot more cognisant of how you handle things under pressure, and of how you want to be as a future healthcare professional,” she says.
Expanding to India and South Africa
This year, 47 Bond students will travel to the Solomon Islands, with plans to extend the program beyond medicine to students from other disciplines.
Meanwhile, Bond University is expanding its international placements program for medical students to hospitals in India, Taiwan and South Africa.
“If you are privileged to attend this placement (in the Solomons) then I really don’t think you would regret it,” Ms Nguyen says.