The team at this stage only visit The Cook Islands on a regular basis. It is hoped that in the future we can support teams doing similar work in other Pacific Island nations.
Air Rarotonga is the only airline flying to the various islands that make up The Cook Islands. All flights are to and from Rarotonga. Except for Aitutaki, the second biggest island and a major tourist attraction, all the other islands have only one or two flights a week. This means that a lot of the first week is spent travelling. After arriving in Rarotonga the team flies to an outer island. They do a clinic and the spend a few days until the next flight to Rarotonga and then fly from Rarotonga to the next island. As the Cook Islands Ministry of Health pay for the team’s accommodation this does not feel like an efficient use of resources.
When the team started visiting the outer islands, most patients had never seen a Gynaecologist (many had never been examined by a doctor). In retrospect it was realised that most of the women really wanted a check-up. Dr Wallace also realised that there was little awareness amongst clinic staff of either the risk of endometrial cancer amongst Pacific Islanders or the signs to look out for. From 2024 she has therefore broadened the clinical parameters, allowing patients on the outer islands to include some General Gynaecology problems. For this reason, the team borrows an ultrasound machine, generously lent to us by Sonosite. There is not the time or resources to provide routine cervical screening, infertility treatment, contraception or many other important Gynaecology services. Most of the islands have competent clinic staff able to provide basic primary health care including Family Planning and ante natal care. The criteria for patients to be seen by the team in clinic still needs to be refined, the major goal being to pick up, or even prevent the onset of, endometrial cancer as well as some serious quality of life issues, for example heavy periods.
A lot of time is spent every year asking for and arranging donations of equipment. As all companies need to know who they are donating to PSRH have always written letters of support. We are hoping that with the establishment of the Putiputi Trust we will be able to cut out the time-consuming step of getting a separate letter from PSRH for each donor. Through Endoventure, AMI have donated iStitch sutures for performing sacrospinous fixation and Endoventure have lent us the Urodynamics machine. We are grateful to Hallmark Surgical and Whitely Allcare for their donation of ring pessaries. Kensington Private Hospital lend us surgical instruments and have given us money and Botox. Johnson and Johnson donate sutures and have in the past made generous donations of incontinence tapes. Medical Aid Abroad provide both reusable instruments, theatre scrubs and consumables. Without these donations our mission would be impossible.
Putiputi Charitable Trust 