ANZCA Bulletin June 2012 - final.pdf - Australian and New Zealand ...

nurse anaesthetists. ATLASS is buildingon these achievements.After arrival, Dr Vreede looked afterour team. We collected a hire car andheaded towards our hotel. The roads werechaotic and crowded with tooting cars,buses, motor scooters, pedestrians anddogs, competing with each other for rightof way over the narrow and rough roads.We left our bags at our accommodationand made our way to Dili’s hospital tofind a large crowd of almost 500 patientswaiting to be seen by the ear, nose andthroat team from Australia.Communication is difficult in Timor.The official languages are Portugueseand Tetum though few people speakPortuguese. Many people also speakBahasa Indonesian. There are manyCuban-trained doctors who speakSpanish, and some Chinese doctors whospeak only Mandarin. An interpreterhelped us with the patients at the ear,nose and throat clinic.Mr Samento Faus Correia, the localco-ordinator and interpreter for RACS,wore a bright red Mao cap, which gavehim an appropriate air of authority. Hecontrolled the crowd and organised thepatients efficiently so Dr Curotta couldsee as many as possible. I became an“acting ear, nose and throat registrar”making notes and writing prescriptions.Australian volunteer and ear-care nurseJulie Sousness was able to triage patientswith the help of a surgical registrartrained in Fiji who worked at the hospital.There was a high incidence ofchronic ear infection and associatedcomplications. There were also patientswith chronic sinusitis, various untreatedcongenital abnormalities, sensorineuraldeafness, vocal cord problems andallergic rhinitis. Several patients hadoropharyngeal cancers caused bychewing betel nut, and one patient hadjuvenile nasopharyngeal angiofibromacausing severe epistaxis.We managed to see 280 of the patientsand identified 65 that would benefit fromsurgery. Unfortunately, we could notsee the rest. Prioritisation is difficult.We chose to concentrate on ear surgeryand gave priority to younger patients,those with bilateral tympanic membraneperforations, and those needingmastoidectomies.(continued next page)“ Several patients hadoropharyngeal cancerscaused by chewingbetel nut.”From top left: A view of Dili Harbour; Dr JaneMcDonald (left) puts a patient to sleep with thehelp of local Ear Care Nurse Julie Sousnessacting as interpreter; Halothane vapouriser;Dr John Curotta reviews a patient on the wardpost-operatively.35