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| February 2008

“One of the final frontiers” is the opening phrase in the Lonely Planet on Papua New Guinea, and this expression is right on the money. Lying just north of tropical Queensland, Australia, and bordering Indonesia, the 5.7 million population of PNG speak 867 languages, with an enormously diverse environment from idyllic tropical white sand beaches and dense tropical jungle, through to high mountains and active volcanoes. Our visit which was supported by AUSAID and Orthopaedic Outreach  was organised through the Royal Australian College of Surgeons and led by Professor David Wood.

The aims are to provide education in trauma care, and specialist orthopaedic surgical skills. The challenges are enormous, as populations of over half a million may not have a permanent specialist trauma/orthopaedic surgeon

In our two week visit, we travelled from Port Moresby, the capital, to Madang on the Eastern Coast, and then over to Rabaoul in East New Britain. At each location we taught courses on operative and non-operative fracture management attended by local health workers and doctors. In clinics, often with patients waiting for hours with no complaints we reviewed over 300 patients, subsequently operating on 105, training local surgeons in the process. Cases were diverse and certainly rewarding, although challenging as using a hand drill to plate long bones is tough!

Examples include forearm plating for defence injuries, tibial sequestrectomy, ankle fusions for neglected talar fractures, debridement of open fractures (open forearm with significant bone loss below), and multiple femoral malunions/non union.

Undoubtedly the educational component, as with all training is the key to health improvement, and I thank DonJoy for their valued support on this trip.

Orthopaedic Outreach is a registered charity supervised by Orthopaedic surgeons in Australia funding educational trips to developing countries throughout the Asia Pacific.

Commercial and private donors can contribute to this work through Orthopaedic Outreach with specific donations to the PNG account.



Richard Carey Smith, Lower Limb Reconstruction Fellow, University of British Columbia. PNG outreach visit undertaken whilst Tim Spalding's Knee Fellow at the University Hospitals of Coventry and Warwick.

For further information, or for those interested in donating to the
PNG tertiary healthcare mission please contact Linda Vivian, PA to Prof David Wood at or Richard Carey Smith at

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