Communications Problems

Unfortunatly, between Monday morning and Wednesday evening (16.09.02-18.09.02, GMT) accessing our website was sometimes not possible. The hosting provider changed the network provider, which resulted in some planned and also some unplanned outages. Those problems should be over by now. Mails should not have been dropped. Nevertheless, if you contacted us in the last few days by mail or form and did not receive an answer, please contact us again.

Unfortunately, you may still encounter problems when accessing our website. This might go on for another few days. Please be patient.

Currently Dr Oberli cannot receive and send e-mails at his private address. Please send a copy to the pathology address. If you do not know it, you can send urgent mails for Dr Oberli to the webmaster, they will be promptly forwarded.

Dr. Oberli's private e-mail access is OK again, copies to the hospital address are no longer necessary.

General News from Solomon Islands

Because the government has not paid the water bills and the Solomon Islands Electricity Authority does not have enough funds to buy diesel fuel, Honiara is without power and water again.

Electricity is back again, but about 60% of Honiara is still without water. Several city health clinics may have to be temporarily closed, if the water supply is not restored soon.

Honiara was without power again all day yesterday.

Last week the government has approved a 20% tariff increase which will hopefully show an effect in about three or four weeks. Meanwhile the Electricity Authority asks larger companies in town to make prepayments to have enough funds to buy diesel fuel.

Two volunteers from Switzerland, Marion Gebistorf (right) and Stephanie Hirs, successfully train young Solomon Islanders at the Point Cruz Yacht Club in Honiara for the Oceania Optimist Championship in Samoa coming October. Classes: Laser and Optimist. More pictures in the Picture Gallery.

Civil aviation, customs, and immigration officers have stopped working until their salary arrears are paid. As a result there are neither international nor national flights.

A student from Germany, who wanted to start working in the surgical department at NRH today, wasn't able to fly to Honiara and is presently stuck in Australia.

Civil aviation, customs and immigration officers have returned to work again this morning, and Solomon Airlines was able to resume national and international flights. But if their salary arrears are not paid until next Friday, the employees will stop working again.

The student from Germany was able to fly to Honiara last Thursday (between two sit in protests) and started working on Monday as planned.

Reason: non-renewal of insurance cover over Henderson Airport in Honiara.

Henderson Airport in Honiara is open again for national and international flights. The insurance problems have been resolved.

Solomon Islands Electricity Authorithy is currently converting its Lata power plant (Temotu Province) to allow the use of coconut oil instead of diesel fuel. If tests are successful, power plants in other provinces may later be converted, too. Lata has often had power problems due to delayed diesel shipments in the past.

Civil aviation, immigration, quarantine and meteorological officers are on strike since Wednesday evening, which means no national or international flights. They want their salaries and claims for harassment suffered during the ethnic tension, but the government has stopped paying compensation payments and therefore refuses to pay those claims. The employees consider this as unfair as others have received such payments before. On Thursday there were talks between the the employees and the government. The government offered a special duty allowance. After 5 o'clock in the evening a Solomon Airlines flight from Brisbane, Australia landed in Honiara anyway. There were no domestic flights. Today only domestic emergency flights were allowed in and out of Honiara. There were more talks, but the outcome is not yet known.

As of today 2 pm Solomon Airlines has been able to resume domestic flights again. The dispute over the public employees' demands had been referred to the Trade Disputes Panel. A preliminary hearing will take place next week.

Solomon Islands Electricity Authority has warned residents of Honiara that there may be unexpected blackouts over the Christmas and New Year period. Lack of funds does not allow to buy enough fuel for around-the-clock power generation.

Health Services

With drugs running low, the Minister of Health Augustine Taneko asks Solomon Islanders to take care of their health and keep their environment clean and tidy to prevent diseases from developing and spreading and to help control the number of mosquitoes.

Last week the Japanese Government has offered SBD 200,000 for buying much needed medicines.

According to Health Minister Augustine Taneko many specialist doctors in hospitals throughout the country are just waiting for the end of their contracts before leaving Solomon Islands. They just have had enough of the poor working conditions:

delayed payments

shortage of medicines

staff staying at home because their payments are delayed, too

frequent break-ins at doctors homes

armed persons entering hospital compounds seeking revenge against sick patients

The Minister says the Ministry of Health and Medical Services is trying hard to retain the doctors in the country and appeals to the public to show more respect for the health workers and sick.

Solomon Islands has accepted the Japanese offer to provide SBD 200,000 to buy essential medicines. The two governments have signed the corresponding contract yesterday.

Due to the continuing financial problems, health services at the Malu'u hospital (North Malaita) had to be ceased or reduced to a minimum. Even very sick persons no longer get injections, malaria drugs and diagnosis are no longer available, and in some instances pregnant women are advised to consult midwives in their villages.

Four fighter planes and a KC-130 tanker plane of the US Marine Corps landed in Honiara for a quick visit today and brought donations for the National Referral Hospital and schools in Honiara. US Marines had repaired a school in east Honiara in February this year.

About 10 days ago members of the Paramedical Association have stopped working because of the continuing delays in payment of their salary arrears. The lack of x-ray, laboratory, and pharmacy services severely affects the work in the hospital. Nurse Incharge Accident and Emergency Department at the National Referral Hospital in Honiara, John Kili, has urged the government to talk with the associations and unions and come to an agreement to end this situation as soon as pssible.

Today about 100 workers at the National Referral Hospital walked off their job in the afternoon to find other ways to support their families, since wages are still not being paid in time. Among them were workers from kitchen, laundry, transport, stores and supplies, security, carpentry, administration, and other services. A spokesman said they will have to continue to take the afternoon off until they get paid again. He appealed to the public to provide dinners for their relatives in the hospital until the situation normalizes again.

The United Nations Development Programme, Human Development Report, 2002, includes the following data on Solomon Islands:

• Human Development Index (HDI) rank: 121 of 173, behind Fiji ranked 72, but ahead of Vanuatu at 131. Other ranks: Norway 1, Canada 3, Australia 5, United States 6, United Kingdom 13, New Zealand 19. HDI is based on life expectancy, health care and education available, and the standard of living.
• Life expectancy: 68.3 years (Fiji: 69.1, Vanuatu: 68, Norway: 78.5)
• Only 34% of the population have access to adequate sanitation facilities (Fiji: 43%, Vanuatu 100%)
• 21% of the children are underweight for their age (Fiji: 8%, Vanuatu 20%)
• Average number of cigarettes consumed per adult per year: 638 (Fiji: 1107, Switzerland: 2871)
• Number of physicians per 100,000 people: 14 (Fiji: 48, Vanuatu: 12, Norway: 413)
• 80-94% of the population have access to essential drugs (Fiji and Norway: 95-100%)

Workers at the Kilu'ufi hospital have walked off their jobs because of non-payment of their salaries. Among them kitchen staff, laundry workers, carpenters, domestic workers and others. Consequently sick patients are without food.

The outpatient department is closed except for emergencies because there are no drugs and no workers.

Even more workers may walk off their jobs if salaries are not paid soon.

While paramedics and other workers have stopped working, doctors and nurses have continued to work during the last weeks, although they didn't get their salaries either. The Swiss Association "South Pacific Medical Projects" has paid 20 members of the operating theater personnel CHF 25 for buying essential food and paying for transportation (which costs them about CHF 0.80/day).

Similar support for the staff of the surgical departments is planned.

60 workers at Buala hospital have done what their colleagues at NRH in Honiara and Kilu'ufi in Malaita have done: they walked off their jobs because they did not get their salaries.

According to Dr Patrick Paia, Director of Provincial Health Services, the province will face a major health crises if wages are not paid soon. Other essential support services at the hospital have already disappeared.

A one-week workshop for health staff on how to care for and look after HIV/AIDS patients ended in Gizo (Western Province) today. It was supported by the Australian Rotary Volunteers.

Due to the reduced services available, the psychiatric patients at Kilu'ufi Hospital Malaita will have to return to their communities and families.

Patients will have to pay for various services at Kilu'ufi Hospital Malaita. According to Dr. Judson Leafasia, Director of Malaita Provincial Health Service, other hospitals and clinics in the country already charge fees.

Doctors and volunteers from Italy will be working in various communities on Guadalcanal during the next weeks.

The group consists of a surgeon, a gynecologist, a dermatologist, a neurologist, and two dentists. They will bring along the necessary equipment and drugs.

Dr. Gian Paulo Spina and his wife have already arrived, the other participants are expected next week. Dr. Spina is Director of the Department of Sugery at the Fatebene Fratelli Hospital in Milao.

Until the government provides enough medical supplies and drugs and starts paying salaries again, as of today, the Solomon Island Nurses Association's members work as follows:

• Nurses in hospitals will work from 0700 to 1500, only, there will be no afternoon or night shift
• Operating theater and eye department nurses in hospitals as well as nurses in Area Health Centers and Clinics work from 0800 to 1200 and are on standby for emergency cases at other times of the day

If the government still fails to provide adequate supplies and pay salaries within the next four weeks, the SINA members will stop performing any official duties from September 4, 2002.

Meanwhile the hospital lacks just about everything. Director of Malaita Provincial Health Services, Dr. Judson Leafasia, said: "We can use almost anything from canned food to toilet paper to aviation fuel and money. We are not on strike, we try to do our best, but we are simply hungry and cannot feed ourselves and our patients and cannot give our patients the best care because of lack of drugs and equipment."

Kilu'ufi Hospital and its National Psychiatric Unit is the second largest hospital in Solomon Islands.

Until the government provides enough medical supplies and drugs and starts paying salaries again, and support from x-ray, laboratory, and pharmacy services is available again, members of the Solomon Islands Medical Association (SIMA), which comprises all national doctors in the country, will provide fewer services:

• Sevices still provided: on-call duty, minimal ward rounds and inpatients care, attendence to medical and surgical emergencies as and when the need arises, as well as accident and emergency duties
• Services no longer provided: general outpatient's consultation, referral, follow-up and consultant's clinic and all elective surgery

The group of five Italian doctors and eight auxiliary team members have ended their mission. They have been working in the rural health clinics of Visale and Tetere and visited 10 villages in Guadalcanal. Together with local nurses they treated about 1,000 patients.

Church youth groups want to clean up the Central Hospital in Honiara on August 28. Further, they also want to raise funds for the hospital.

Yesterday the Ministry of Health and Medical Services received a SBD 213,669.06 check from the Japanese Embassy to buy essential basic medicines.

Various fund-raising acitivities will be launched to aid the two hospitals Kilu'ufi and Malu'u in Malaita province. The campaign will start with the performance of two popular musicians from Malaita, Billy Kako and Blind Tome.

As their demands have not been met, as of Thursday, September 5, health workers intend to reduce their working hours as follows:

• Nurses in hospitals from 0700 to 1200 only.
• Operating theater and eye department nurses in hospitals as well as nurses in Area Health Centers and Clinics on standby only.

The newly established Solomon Islands Copra Exporters Pty. Ltd., has donated one ton of rice and four cartons of fish to the National Referral Hospital to help feed its patients.

Due to lack of money and personnel, patients currently get only two meals a day, and according to Nursing Officer Thaddeus Siota most of the food served at the hospital comes from donations provided by churches and other groups around Honiara.

The Honiara City Clinic Mbokona was broken into and ransacked last night. The thieves carried of the refrigerator, some drugs and other items. The contents of the refrigerator, including some important drugs for infants and injections, were removed and scattered all over the floor. The clinic was renovated with Japanese money earlier this year.

As of yesterday many nurses did not show up for work, as they said they would. Honiara Health Clinics, except for two of them, have been closed. Many hospital wards were staffed by only one nurse or none at all. The operating theaters were said to be without staff, and in the labor ward some deliveries had to be taken care of by relatives, as no or too few nurses were present. Some nurses were on standby, and a few doctors were present at the hospital.

However, meanwhile there have been some talks again, and the Nurses Association promised to call their members back to work again and delay the strike until next Wednesday, if their salaries are paid by September 11.

The Ministry of Health hopes the first consignment of medicines will arrive soon, but it will not be enough to cover the needs of the country. Medicine shortage is more acute in provincial hospitals and so more patients from the provinces come to Honiara for treatment. The delivery delays seem to have been caused by transportation problems.

The pump supplying water to Lata, the capital of Temotu Province, broke down over last weekend. Spare parts for the pump will take anywhere between four and eight weeks until they arrive in Lata. And the only vehicle that could bring water to the hospital is out of order, too.

After having received a salary and expecting another outstanding one tomorrow, most nurses returned to work in hospitals and clinics today.

As of today, members of the Paramedical Association have resumed normal duties, after their salary arrears have been settled last week.

Dr. Christian Himmelberger (left) from Switzerland arrived a few days ago and will work as a volunteer registrar in the surgical department during the next six months. Philipp Honigmann, a student from Germany, arrived about a month ago, and is doing a four-month surgical elective.

As the department of internal medicine did not have a single working blood pressure monitor anymore, Dr Kumar (left) and Dr Elisabeth Wore are happy to receive one from Dr Himmelberger who brought it to Honiara. It was donated by his former employer, the hospital of Walenstadt. Another two monitors from Walenstadt are on the way to Honiara in a container shipment, which is expected to arrive towards the end of the year.

The Japanese Government has donated SBD 80,000 for the purchase of a generator and the improvement of the electrical installations at Sasamunga Hospital, Choiseul Province. The old generator broke down, severely affecting hospital operation.

Hospital services in Honiara are mostly back to normal, after health workers returned to work. However, there is still a shortage of drugs and supplies. New deliveries are expected towards the end of this month.

23 Solomon Islands medical students will complete their studies at the University of Papua New Guinea this year:

• 15 with a Bachelor's degree in surgery and medicine
• 3 with a Master's degree (2 in pediatrics und 1 in surgery)
• 5 with a Bachelor's degree in nursing (especially midwifery and pediatrics)

The students are looking forward to returning to Solomon Islands and serving their country.

The National Referral Hospital is so short of basic medicines and supplies that it had to ask private doctors and pharmacies for donations. What it did get will only last for a day or two. AusAid did provide about SBD 3 million to buy emergency supplies, but the Australian supplier kept the money without delivering anything because Solomon Islands owes it about SBD 10 million for goods shipped during the last three or four years.

The hospital should have 40 doctors, but currently only has 11 (including new doctors doing their residence).

The only pediatrician, an expatriate, went back overseas last Friday, and now the Children's Ward has only two practical doctors who will will stay for just a few months. About 30 to 35% of the hospital's admissions are children.

Parents from the Weathercoast (south coast) of Guadalcanal have come by boat to Honiara to get their one month old triplets vaccinated. The vessel MV Temotu was the first to visit their area since the start of the ethnic tension three years ago. The triplets were born in a village with the help of an elderly woman. The local clinic was closed because it had run out of medicines. Members of the Peace Monitoring Council team urged the parents to go to Honiara and have their children vaccinated. The triplets are said to be the first in Solomon Islands in several years. All three babies (two boys and a girl) are very healthy and will receive their vaccinations. Then the family will have to wait for a boat to take them back to their village again.

Currently three students from Switzerland are doing a two-month medical elective at the National Referral Hospital in Honiara: (from left to right) Salomé Bruneau (surgery), Andrea Martin and Simone Freiburghaus (both anesthesiology and gynecology).

Dr. Oberli writes: They have adapted well and work diligently and reliably.

Changing a vacuum dressing	Viewing slides for the Telepathology

Dr. Oberli writes: Christian Himmelberger is a truly valuable member of the team.

Later this week the Australian Air Force will airlift urgently needed medical supplies worth SBD one million to Honiara. The shipment has been organized by AusAid.

The Australian Government decided that shipping urgently needed drugs and medical supplies to Honiara with an Australian Air Force Hercules would be too expensive. A commercial flight will be used instead and the supplies will hopefully arrive at the end of next week.

Solomon Islands is planning two nationwide fund-raising events a year to support hospitals. The first is scheduled for October 31, 2002. Title: "Iumi Helpim Hospital Fund", theme: "Health for Prosperity".

Fund-raising for hospitals in Malaita has so far brought in SBD 12,000, of which SBD 8,000 have been used for services at Kilu'ufi Hospital.

Salomé Bruneau from Switzerland in the Female Surgical Ward	Theresa Naidoo from Australia in the Neonatal Ward.

Simone Freiburghaus from Switzerland in the Labour Ward

The long awaited emergency medical supplies and drugs finally arrived in Honiara and were officially handed over today by the Japanese Chargé d'Affaires and the Australian High Commissionar to the Solomon Islands Minister of Health and Medical Services at the National Medical Store.

Dr Bata instructs Andrea Martin, a student from Switzerland, in applying anesthesia

The following students will graduate at the end of this year if they pass their final exams successfully:

• 4 Bachelors of Medicine and Surgery
• 4 Bachelors of Dental Surgery
• 2 Radiographers (x-ray)
• 1 Pharmacist
• 1 Dietician
• 2 Nurses

5 will finish their postgraduate training and could start working as doctors in Solomon Islands in 2003.

Dr. Chester Kuma, who is currently working in Melbourne, Australia, will complete his Masters Degree in Surgery. Subject of his paper: Breast Cancer in Fiji.

Minister of Health and Medical Services, Benjamin Una, has urged all doctors who have completed their studies in Papua New Guinea and Fiji to return to Solomon Islands and serve their country, after their country has spent so much money for their training. He also mentioned that seven doctors are still in Papua New Guinea, although they have completed their training and should have returned to Solomon Islands.

At NRH 197 new cases of diabetes were recorded last year, another 97 new ones were recorded from January - October this year.

Gizo Hospital recorded 36 new cases, and Guadalcanal Province 12 new cases.

Theme of this year's World Diabetes Day (14.11.02): "Diabetes and Foot Care".

Philipp Honigmann, student from Germany, working on a cast	Andrea Martin, student from Switzerland, with nurse Janet in the operating theatre

Japan donates SBD 217,000 for the renovation of the malaria training and research institute it helped establish in Solomon Islands in 1987. Regrettably, the institute deteriorated during the ethnic tension and economic crisis.

Malaria is still a life-threatening disease in Solomon Islands and the number of cases increased during the last few years.

Dentists at the National Referral Hospital in Honiara can only treat emergency cases. Reason: Last Friday the compressor, essential for driving their instruments, was stolen. The thieves cut off a lock and carried the compressor away with a vehicle.

The head of the clinic, Dr. Cederic Alependava, has appealed to the public to look for the compressor and asked workshop owners not to buy a compressor from individuals.

Due to lack of space and resources National Referral Hospital can no longer treat persons who injured themselves while drunk. In an interview with the "Solomon Star" Dr Oberli said that the hospital simply cannot afford to spend the few resources left on such cases, but must concentrate on other cases which also need medical attention.

Dr Oberli also said that less violence within families and among rivals could help reduce the number of patients. Over the last weekend there were so many patients, that some had to be accommodated outside the wards.

Of the 30 positions for doctors presently only about a dozen are filled and the renovation of the old wards came to a standstill a year ago due to lack of money. Completing those renovations would provide enough room for the patients again.

One case of HIV/AIDS was recorded in Solomon Islands in 1994. Meanwhile 30,000 blood samples were taken and analyzed, and so far no new case has been detected.

Nevertheless, people have been warned to be very cautious about their sexual activities.

It's not easy for Philipp Honigmann to say goodbye to the little patients of his ward	(From left) Simone Freiburghaus, Andrea Martin and Salomé Bruneau also return home after eight weeks

Sabina Hofer, integrated in the operating team like an old friend (she was here in 1998 for several months), and...	... Bernadette Bucher, working as nurse in the ward,...	...take a relaxing bath in the Langa River on Sunday morning (01.12.02)

Both are working in the hospital since beginning of November.

Three nurses from Solomon Islands have completed a training program in first-aid and intensiv care at the Veterans General Hospital in Taipei. The program started September 1 and ended November 30. A year ago the Minister of Health of Solomon Islands had asked Taiwan to help with training personnel. The nurses association was also interested in such a cooperation.

Patients waiting for treatment in the outpatient department at NRH left in panic, when an announcement was made over the loudspeaker that 20 patients had to be discharged immediately to make room for a number of seriously injured from an accident scene.

However, the announcement was part of an emergency drill for nurses and doctors. A nurse in charge was disappointed when the drill had to be cancelled because police officers who should have taken part in the exercise didn't turn up.

A women's group for peace from west Honiara has donated SBD 3,000 to the White River Community Clinic in Honiara. The women kept the marketing area clean on a daily basis and collected fees for this service from market vendors.

The group was formed shortly after the Townsville Peace Agreement in 2001 to promote peaceful co-existence between women from Guadalcanal and Malaita.

Solomon Islands doctors doing their second (final) year of residency in Papua New Guinea have recently received a letter telling them the Government of Papua New Guinea will not pay them after December 31, and asking them to be home by January 1, 2003.

Seven Solomon Islands doctors are said to be finishing their qualification requirements, and have acknowledged the receipt of the letter.

Last Friday a fund-raising campaign by the Lata hospital for the nearly collapsing Temotu Provincial Health Services netted SBD 4,000.

The Lata hospital urgently needs money for maintenance and repair of leaky roofs, its water supply, the patient transport, and operation equipment.

The few staff members try hard to keep the hospital going. E.g. one registered nurse and one nurse aid have to take care of more than 100 outpatients every day.

In 2002/2003 Australia will provide about SBD 40 million to help improve delivery of essential health services in Solomon Islands. About 60% of the amount has been allocated for direct support of provincial health services.

A total amount of more than SBD 8,700,000 of Australian funds has been allocated to various health services. Recipients are hospitals and clinics, the National Psychiatric Unit, schools and training facilities, the Public Health Laboratory, and the National Medical Stores, as well as the Ministry of Health. Some allocations:

more than SBD 1,000,000 for the National Referral Hospital in Honiara

more than SBD 857,000 for the Kilu'ufi Hospital in the Malaita Province

more than SBD 688,000 for hospitals and clinics in the Western Province

more than SBD 341,000 for hospitals and clinics in the Makira-Ulawa Province

more than SBD 265,000 for hospitals and clinics in the Temotu Province

more than SBD 235,000 for hospitals and clinics in the Isabel Province

Media and Reports

There is a new page for books. Perhaps you find one you have not read yet.

The prize-worthy picture on the left by Christian Himmelberger was added to the picture gallery and is also available as a screen puzzle No 8. Pictures illustrating the corridor draining project can be found here.

Now you can search our web site. Enter the desired word (preferably in lowercase) into the window on the lower part of the home page and click on "Search". You will get a list of the pages containing the desired word.

Read the report of the Interplast Team from the Netherlands, which worked in Solomon Islands this spring.

Have you been in Solomon Islands and did you work there? If so, please fill in our new online questionnaire. You can help prospective visitors decide. Filling in the form takes about 10 to 15 minutes. The online questionnaire replaces the previous questionnaires which had to be downloaded.

Read the new Annual Review 2002 by Elisabeth and Hermann Oberli.

This year the management of Elektrizitätswerke Altdorf (Electric Power Company Altdorf), Switzerland, decided to forgo the usual promotional presents for the customers, and instead donate the money to Dr. Oberli's project. To help increase this amount further, an auction was set up at the Christmas party on November 29, 2002, where all members of the staff could bid. The very handsome amount was finally topped up to an even sum by the management.

After thanking his staff for their solidarity with a less privileged part of the world, CEO Reto Brunett said more ideas to support the project were born during this evening, and he hopes some of them can be realized later on.

Our thanks go to all those who contributed to this donation!

The first three questionnaires have been filled in and can be found here. If you spent some time in Solomon Islands, even if it was quite some time ago, send in your answers, too!

Projects

Some data can be found here.

The Swiss association "South Pacific Medical Projects" pays the costs of the continuing education of nurse and midwife Rebecca Manehanitai (left) and the training of nursing aid Pattison Taute. More details here.

"South Pacific Medical Projects" supports the training of three enthusiastic nurses. Details can be found here.

Here you can read more about two new small infrastructure projects.

Dr. Oberli writes:
Last week this container ship entered Honiara harbour. One of the containers is for us and presently going through customs clearance, which takes a few days but usually is a very smooth and unbureaucratic process.

Deceptive South Pacific idyll: directly in front of the hospital the ship slowly glides towards the harbour	Moored in Honiara harbour

Dr. Oberli writes:
Exactly three months after the container was shipped it was placed in our backyard.

loading in the harbour	unloading in the garden	Dr. Himmelberger unpacking

The first parcel Dr Himmelberger finds is from the hospital of Walenstadt, containing instruments he himself had collected before he left Switzerland.

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