The Foundation was set with the objective of providing free cardio-surgical and related treatment currently unavailable to the underprivileged people of Fiji. Since 2006, Fiji has benefitted tremendously through annual visits by the medical team from New Zealand facilitated by Friends of Fiji Heart Foundation (FOFHF).
Our Achievements
The 10th mission carried at Colonial War Memorial Hospital (CWMH) this year was particularly challenging due to a number of complex cases. Fortunately, the Foundation had the benefit of highly experienced and dedicated Team of Medical Specialists.
In line with the established practice, a team of Cardiologist visited the three major hospitals at Suva, Lautoka and Labasa for pre assessment. A total of 145 patients were reviewed in clinics between the three centres; 47 patients shortlisted to be re-assessed by the surgical team prior to surgery at CWMH. During re-assessment by the surgical team on 10th September, 26 patients were deemed clinically suitable to be operated on. However due to acuity of these patients, only 24 patients were able to be operated on within the time available.
The Pacemaker Team also attended to a total of 195 patients and completed 24 implants and replacements. The Paediatric Team assessed a number of patients and 15 children received heart surgeries.
The following activities were undertaken by Friends of Fiji Heart Foundation (FOFHF) during the Mission 2015; relevant detailed reports are attached in the Appendix.
Mission Dates
9th September to 26th September 2015 (including dates for Paediatric team)
Where
This year main surgical team was based at Colonial War Memorial Hospital (CWMH) in Suva, due to ongoing renovations at Lautoka Hospital Theatres. Pre mission screening was done by the visiting Cardiologist from New Zealand at CWMH, Labasa and Lautoka Hospital. Below is a breakdown of the services provided by FOFHF at different centres around Fiji.
| Location | Services | Dates |
| CWMH | Pre visit screening | 17th to 19th August |
| Dental Clinic | 10th to 14th September | |
| Adult Surgical Team | 10th to 20th September | |
| Pacemaker Team | 14th to 19th September | |
| Paediatrics Surgical Team | 18th to 27th September | |
| Lautoka Hospital | Pre visit screening | 17th to 19th August |
| Pacemaker Clinic | 10th to 13th September | |
| Labasa Hospital | Pre visit screening | 19th to 21th August |
See Appendix A for detailed summary of the team.
Summary of Procedures done
- During our mission over 355 patients benefitted.
- 145 patients were seen in pre-assessment clinics (for adult open heart surgery) in Suva, Lautoka and Labasa.
- Additional 195 patients were seen by the pacemaker team.
- All Cardiac Patients were carefully dentally assessed and treated in the Dental Unit at CWMH by Dr Ross Pellow.
- Further 57 paediatric patients were reviewed by paediatric team of which 15 patients were opearated upon.
- The team also had a New Zealand based Physiotherapist who worked with the local team providing relevant procedural support to post-operative patients and at the same time training the local physio staff.
Appendix B and Appendix C further outline a detailed list of all the procedures done by FOFHF during this visit.
Mission Outcomes
- 2015 was the most challenging year for the Medical Team.
- Nature of few cases were relatively more complex requiring special attention limiting time to attend to more treatments
- Overall, there were two significant untoward events noted during adult surgery. This occurred during immediate post -op period.
- Upskilling of local doctors and ward nurses in care and management of post cardiac patients through attachments with the visiting team
Logistics
- This year’s export to Fiji for medical supplies/equipment by sea accounted for was 16 tons (57.5cbm) packed in 2 containers. Import volume from Fiji to Auckland packed in 1 container for return of equipment/medical supplies was 8 tons (28cbm). Therefore the total export/import comprising 3 containers totalled to 24 tons (85.5cbm).
- Approximately 98% of equipment/supplies were sent by sea-freight and balance of 2% was sent by airfreight. These were mainly loan equipment plus the pharmaceuticals. The airfreight volume was low in volume but very substantial in value due to the nature of equipment and supplies. Most of the consignment(s) were taken as a check-in/ hand carry by our medical team.
- Airfreight cost – zero. Some Medical supplies were received late and not enough time to prepare customs documentations however, we managed to do the same in rush. It is difficult to work on a critical minimum time frame as the details should be received at least 3 days before the departure.
- No items were short-landed.
- Local devanning of the containers were done by Pacific Agencies. Ministry of Health facilitated with the clearance through FPO. Import and clearance of the supplies were received as scheduled and there were no delays with customs clearance as all the documentation were done well in advance to facilitate clearance on time. We received support from Pacific Agencies team in de-vanning (import) and re-packing (export) of the container. The operation was flawless.
- Total cost of sea-freight/handling would be about $3k. (If these items were to be airfreighted the cost would increase to $32k to $35k).
- The returning cargo safely arrived in vessel Capitaine Wallis on 12th October, 2015. The same was de-vanned and now in the warehouse.
- Marine Insurance claim – zero.
Acknowledgement
Heartfelt thanks and gratitude to the following individuals, organisations for once again supporting Mission 2015.
- Dr Parma Nand (Mission Chief, Founder & Trustee of the organisation)
- Dr Adam El-Gamel (Cardiovascular surgeon)
- Finucane & Dr. Wright and the the New Zealand Paediatric Heart Team
- Ministry of Health, Fiji Islands
- Staff and Administrations for their dedication and hard work – CWMH & Lautoka and Labasa Hospital.
- Friends of Fiji Heart Foundation – Fiji Chapter trustees, Executive members
- All medical team members of the mission 2015
- All the medical companies and their reps for continued support and generous donations.
- Our Sponsors for their generous support.
APENDIX A: Summary of Teams
Total of 94 medical staff and volunteers travelled to Fiji during this year’s mission. The below shows a breakdown of our staff and volunteers for mission 2015.
| Designation | Adult | Paediatrics | Pacemaker | Total |
| Cardiac Surgeon | 3 | 1 | ||
| Cardiologist | 3 | 1 | 1 | |
| Surgical Assistant | 1 | |||
| Dentist | 1 | 0 | ||
| Registrar | 2 | 1 | ||
| Nurse Practitioner | 1 | |||
| Anaesthetist /Intensivist | 6 | 3 | ||
| Perfusionist | 3 | 2 | ||
| Anaesthetics Techs | 3 | 2 | ||
| Physiotherapist | 1 | 0 | ||
| Theatre Nurses | 6 | 2 | 1 | |
| ICU Nurses | 12 | 7 | ||
| Ward Nurses | 14 | 6 | ||
| Pacemaker Technician | 0 | 3 | ||
| Others* | 3 | 5 | ||
| Total | 57 | 32 | 5 | 94* |
*Others in the table refers to Medical company reps and Medical students who devote their time helping during the mission in any way possible.
*The above total excludes 2 trustees and 1 mission executive traveling with the team.
APENDIX B: Dental Assessments
| Types of assessments done | No. of Teeth | No. of Patients |
| Dental Examination | 26 | |
| Scale and Polish | 21 | |
| Filling | 22 | |
| Extractions | 55 | |
| Total No. of Patients assessed | 26 |
- Any teeth that were infected were removed.
- Any teeth that were at risk of getting infected in the near or medium term were also removed.
- Any gum infection and inflammation was treated by very thorough scaling and polishing.
- Any areas of decay were filled.
- All treatment was performed under antibiotic cover.
- All patients were made aware of the connection between oral infection and its implication on an artificial heart valve.
- All patients were made aware of the importance of regular dental care for the years ahead, and the importance of antibiotic cover for any future treatment.
APENDIX C: Analysis of surgeries performed
| Types of cases operated: | Number |
| MVR , AVR, & Tricuspid Annuloplasty | 20 |
| AVR, MVR & Tricuspid Repair (Redo) | 2 |
| Removal of Sternal wires | 1 |
| Thymectomy | 1 |
| Totals | 24 |
Pacemaker Implants
| Type of case operated | Number |
| New Pacemaker Implants | 18 |
| Unit Replacement | 4 |
| Resiting Pacemaker +/- Lead replacement | 2 |
| Patients Checks * | 171 |
| Totals | 195 |
* Checks include device follow-up + post procedure checks + screening of new referrals
Paediatric Surgery
| Type of case | Number |
| Tetralogy of Fallot | 5 |
| VSD | 3 |
| Sub-Aortic Stenosis | 1 |
| PDA | 1 |
| ASD | 2 |
| Mitral Valve repair | 2 |
| RVOT Aneurysm repair (Redo) | 1 |
| Totals | 15 |
