The programme is currently restricted to The Cook Islands. Mairi Wallace – Gynaecologist, Shelley Solomon – physiotherapist and Tina Kusser – registered nurse, fly out a week earlier than the anaesthetist, Dr Michael Kalkoff. The first week is spent doing clinics. Patients have been screened prior to our arrival.
In Rarotonga patients are screened by the local Gynaecologist and general gynaecology problems either managed or deferred to the Gynaecology HSV. On Aitutaki, the next biggest island, patients are seen by a doctor and screened for Gynaecology or Urogynaecology. On the smaller islands we have realised that we have to have a far broader set of criteria for seeing patients as we are the only visiting specialist team and most islands do not have a doctor at all.
Once back in Rarotonga, usually a Friday, Tina, specialist Urology nurse, sets up the Urodynamics machine. For the last three years we have had a urodynamics machine at our disposal, which helps with accurate diagnosis and decision making around surgical options. This is only made possible by Rachelle Hodgson from Endoventure. Endoventure, not only loan us the machine at no cost, but they also donate all the catheters and other expensive consumables associated with performing Urodynamic studies. We have at times managed to run three clinics concurrently – besides a urogynaecology clinic also, physiotherapy and urodynamics. The clinic nurses and often a local doctor help with writing notes and doing the theatre bookings. The following week is spent operating. With the added workload in the wards and the specifics of rehabilitating patients with bladder issues, Tina spends her week working as a ward nurse. Shelley provides physiotherapy to all post operative patients and runs a clinic for those who can be managed conservatively. Over the years we have taught local nurses how to manage ring pessaries for pelvic organ prolapse. As a forgotten ring can cause major complications Tina and Shelley also spend this week checking on every patient in the country with a ring pessary in situ.
Putiputi Charitable Trust 