When one talks about the visiting the South Pacific, immediately thoughts progress to islands like Fiji and Vanuatu. Tourism meccas offering everything that a tourist can want for a holiday. Now, imagine visiting an island or group of islands that is culturally proud, unspoilt and unmasked, this is the Solomon Islands. The Solomon Islands is a group of 992 islands in the South Pacific, of the 992 only about 150 of the islands are inhabited.
The islands are divided into 9 provinces with The National Referral Hospital being located in Honiara.
In WW2 Solomon Islands played an integral part in the Allied Forces ability to protect the shores of Australia from invasion. Remains of Air force Bombers, tanks, artillery shells and mortars are scattered, buried by the ocean and covered by the thick jungle, some undiscovered even today.
Figure 1 WW2 Tanks: once covered by the jungle
Figure 2 Market Place
I have been a Registered Nurse and practicing in Emergency Departments for nearly 20yrs and an instructor of the TNCC program since 2006.
In my career I have lost count how many times that someone says,
“I don’t know how you do that as a job!” Many times I would not know how to answer, but the answer that we sometimes forget was reinforced while I visited the Solomon Islands, it’s caring for others, that’s how I do it.
In 2019 the Australian College of Emergency Nurses was approached and invited by Dr Trina Sale to visit The National Referral Hospital in Honiara and provide the TNCC education program to the nurses practicing in the Emergency Department and in the outer Province Health Care Facilities. This would be the first ever time that the TNCC education program had been provided for the nurses of the Solomon Islands. Running education programs and arranging education is no small task and it is not without challenges. Appreciation and respect must be paid to Dr Trina Sale and Evelyn Tamatafao who recognized, and supported this education for their colleagues. I feel privileged and honored to have been a member of the ACEN family and extend our umbrella and collaboration of Emergency Nursing education and resources now including the Solomon Islands.
The dedication to providing high level health care to their communities, the 12 attending Registered Nurses were selected not only from Honiara, but also the neighboring smaller provinces.
This visit was to be my first ever trip to the Solomon Islands and I did not know what to expect. I have provided education to so many nurses in so many different locations, but this was going to be on foreign ground for me.
Arriving into the Solomon Islands, I could see scatterings of huts, rolling mountainous terrain, and thick jungle like tree cover from the plane.
Emergency Nurses practice in such different environments, resourced, metropolitan, rural and remote. Recognition of barriers like language and understanding of terminology allowed for preparation of teaching resources and planning for lectures and clinical scenarios.
The anticipation and excitement of this adventure was building with only a few weeks left to prepare, Google searches conducted, I had myself ready for the Solomon Islands. Like any international travel, it’s not always what you see on Google. As I looked around while at the airport, and as we drove into the capital the full experience was being realised and pictures and articles cannot review accuratelywhat you see and experience with all your senses.
Solomon Islands is a destination and cultural experience that I would recommend for its cultural authenticity. Cultural exposure is what I would expect to experience anywhere that I ever travel, for work or for leisure.
Figure 3 Fisherman returning to Harbour
Figure 4 Hospital 4wd
As the education commenced the nurses attending were beaming and buzzing with excitement and enthusiasm of what myself and my colleague Liz were offering to them. Introducing ourselves at the start of the course we were met with smiles, wide eyes and so welcomed. Education needs interaction, so a discussion of “What the most common trauma seen at your hospital?” was soon initiated. In 20yrs of nursing I have not witnessed, let alone would classify it as a “common trauma” to have a patient speared by Swordfish.
We experienced a tour of the National Referral Hospital facilities and as we toured, I could not help but notice while there was patients present in the beds alongside them was multiple family members, no one was alone. The sense of community and culture was strong.
I have not ever been in a facility like this before, the ability to provide care and apply resource by the health care staff was inspirational. Healthcare in the Solomon Islands really is a family affair, but the support and service extends to involve the community as a whole. For example, Workmen and deliveries of food all coming from the outer community. No job in the community was meaningless and the community was proud of its region. This was seen one evening as I watched 3 elder females simply sweeping the street sides, all the while calling out, laughing, and smiling. The next morning when driving past this same area the transformation from their efforts was amazing.
It was evident that men in Honiara like their cars and trucks. Watching many of them utilizing whatever resource they could to wash and clean them at any opportunity possible, despite roads being dominantly unsealed.
Figure 5 Coconut delivery
In the mornings the men from the outer community and farms brought a coconut delivery to the kitchen of the hospital. Resources are provided everywhere from the communities as they may be required, or sold on the numerous roadside markets. The kitchen serving delicious fresh food each day consisting of mostly local fresh produce, and freshly baked cakes made onsite. (the Banana Cake was my favourite!)
Trauma occurs anywhere, but some places hold higher risk factors then others and the Solomon Islands is no different (Fig 8). It is through education that we as nurses have traditionally developed and skilled ourselves to be able to apply care and allocate resource for patients and to provide services in times of disaster or emergency. With resources and community focused care the response to these emergencies by the Solomon Island people was explained by Dr. Sale as she outlined the care and protocols that are in place within the Emergency Department of the National Referral Hospital.
Figure 6 Cargo ship Wrecked in bad weather in 2005
Infrastructure and development can be seen around Honiara as it prepares for the upcoming 2023 Pan Pacific Games. This is a very exciting time for the Solomon Islands. As the father and husband of an athletic and sporting family I may return with my family for this event as tourists and competitors.