Vector Issue 2 - 2006

Lending a Hand: the Aid Issue
page 2
Article photo courtesy of Tonya Littlejohn
nomadic herding practices coexist with an
increasingly youthful population. The outcome
of these major structural changes is
that services do not always reach the most
vulnerable groups.
In my brief time there, I was involved
in work aimed at adolescent development
and well-being. Up to 55% of Mongolia’s
Dr Moore is a Plastics and Craniofacial
Surgeon in Adelaide, South Australia.
His medical school days were spent
at the University of Otago, New Zealand,
following which he came to Adelaide to
undertake his fellowship, having earlier
completed his training in Plastic and Reconstructive
Surgery.
He has a longstanding involvement in
developing world healthcare through his
involvement with the Overseas Specialist
Surgical Association of Australia (OS-
SAA)
Dr Moore, how did you first get
Q: involved in developing world
medicine?
A:
A few years ago I met a doctor from
the NT, Dr John Hargreaves, who
had set up the organization that was to become
OSSAA, which coordinated surgical
trips to locations in East Timor and Indonesia
that were extremely disadvantaged.
He convinced me to go along on one of
these visits for a fortnight to East Timor in
2000 immediately post-independence. After
going on that first trip I haven’t looked
back.
How often do you go overseas and
Q: what do you do?
We travel four to six times a year.
A:
Herders in Mongolia
Next week I am going to East
Timor which will be the nineteenth time I
have made that trip. What is done on these
trips varies according to the skill set of the
surgeons on that particular expedition. My
area is Plastics and Craniofacial surgery so
the main conditions that I deal with are
cleft lips and palates, and burns. I also
come across a variety of other conditions
such as other congenital abnormalities of
the head and neck as well as tumours involving
these regions.
Looking at the OSSAA mission
Q: statement it says that one of your
aims is to provide local training in services.
Lessons from a frozen Capital
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population are under the age of 24, many
of which live remotely or outside traditional
care structures such as family or
community. It was in the midst of this
complex and dynamic situation that I discovered
that despite my desire to contribute
to broader social and political change,
ultimately it was the small scale, targeted
programs that proved most effective at
addressing the immediate needs of Mongolian
people. For instance, delivering life
skills training to abandoned teenage girls
and outreach services to women in isolation
fostered independence and had a sustained
and tangible impact.
Sustainable assistance also involves giving
a voice to the disempowered. In many
communities, the most vulnerable populations
often do not have a say in the decisions
that affect them the most. It is vital
to create avenues for collaboration and
Interview with: Dr Mark Moore
Moving towards local sustainability
A: and independence is one of the ultimate
goals of our organization. When
I first moved to Adelaide the hospital I
worked at had an arrangement with the
Malaysian government whereby we trained
many of their Plastics trainees. At that
time Malaysia had no home grown surgeons
in that area, so we helped them develop
that capacity. They are now at the
point where many of these surgeons are
conducting their own outreach services to
places in Malaysia that are less advantaged
like Sarawak. I consider that a real success
story.
Similarly whenever we operate in any
of these sites we try to get some of the local
staff, both doctor and nursing, involved
so that their skills are built up. We still
have a long way to go but are slowly getting
there. The signs though are so promising
that AusAid is starting to look at our
operation as a potential model to replicate
elsewhere in the region.
Do you think that doctors in the
Q: developed world have an obligation
to assist those in the developing world?
A:
I think every doctor, and indeed
every person, if they choose to
can contribute to the health of those in
the developing world. This contribution
can be made in countless ways, many of
which don’t involve actually travelling to
these sites to practice medicine because
that is not always going to work for an
individual person. It could be through
fundraising, assistance with running organizations
like OSSAA or by covering the
clinical responsibilities of your colleagues
who do go overseas. Something that I am
against however is a phenomenon that I
call “medico-eco tourism” where doctors,
often the more junior ones, head to third
world countries on one-off visits and undertake
operations without adequate follow-up
and in some cases the necessary
Article photos courtesy of Dr Mark Moore
build meaningful partnerships between
marginalised populations and the Government.
In this spirit, the creation of a national
level young people’s forum gave the
country’s silent majority the opportunity to
articulate their own concerns to policymakers
and institutions. It has since become a
powerful medium for representation, giving
users the confidence to speak out and
decision-makers the choice to listen.
From such experiences in Mongolia
and elsewhere, I have observed the benefits
that aid and technical assistance can
accrue to the most vulnerable populations.
Certainly, the delivery of aid is a complex
and difficult undertaking. Nevertheless, in
places where the Government cannot, appropriately
targeted aid continues to provide
services and programs to those who
face the greatest burden of poverty and ill
health.
by Tonya Littlejohn
expertise. One of OSSAA’s principles is
to try and send the same surgeons back to
the same sites so that some degree of continuity
of care exists, along with the opportunity
to build an ongoing relationship
with the site which provides a whole range
of attendant benefits in terms of training
and ease of providing services.
I also think the medical schools should
play their part in this area as well, such as
through bilateral exchanges with medical
schools in developing countries. Organisations
such as your IHN are a good way of
starting and increasing this involvement.
A:
Is there a patient or experience that
Q: stands out for you?
If I had to choose one it is probably
the case of a young married
woman who was severely burned to the
face and chest while in her late teens. The
burns were such that she couldn’t close
her eyes and had difficulty putting food
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