Westmead Private Doctors head to the Solomon Islands for Prevention of Oral Cancer Australian Oral Maxillofacial Surgeon, Dr Ann Collins, and upper Gastrointestinal and Colorectal surgeon, Dr Gary McKay, recently returned from a surgical visit to Honiara and Gizo hospital. Their mission was to operate on any condition arising in the digestive tract requiring surgery. Oral and GIT cancer appears to be on the rise in the Solomon Islands, and one factor may be the increased exposure to certain known carcinogens. Dr Collins was particularly struck by the amount of alcohol, tobacco and betel nut use in the Solomon Islands. Betel nut is a mild stimulant and commonly available in the Solomons, with street side stalls selling betel nut as far as the eye can see. Chewing betel nut is also a social pastime as a means to extend friendship, and can be found in many, if not most, large gatherings. It stains the teeth red and the roads in the Solomon Islands are peppered with red spit splats, the product of excess salivation caused by chewing the mix of betel nut, betel leaf, lime powder made from coral. The mix is tucked between the gums and cheek, keeping its irritating carcinogenic contents in contact with the buccal mucosa. In fact, betel nut use is so common, and the staining from spit so destructive and unsightly, that the Solomon’s Ministry for Health has campaigned heavily to highlight to the community the devastating health and social impact of betel nut chewing. Prominent signs now read “No Alcohol, No Tobacco & No Betel Nut” at the main entrance to most hospitals and public venues. A Healthy Community Visit On a recent visit to Peel Health Campus, Danny Sims, Chief Executive Officer of Ramsay Health Care Australia, and Kate Munnings, Chief Operating Officer, met with staff from Peel’s local Aboriginal Health and Wellbeing Centre Nidjalla Waangan Mia. 18 The Ramsay Way 2016 | 03 Oral cancer is one of the most common cancers in the Solomon Islands. Dr Collins adds that “betel nut chewing combined with tobacco use have a synergistic effect and are the leading cause of oral mouth cancer”. Whilst tobacco use is mostly seen amongst men, women chew betel nut in a higher proportion than tobacco use, also making them at risk of oral cancer. The vast majority (83%) of patients with oral buccal cancers in the Solomon Islands chew betel nut, compared with only 17% of buccal cancer patients who do not. The buccal mucosa is the most affected by cancer, as this is where the betel nut tends to sit and carcinogens pool. Those who don’t smoke or drink or consume betel nut, such as many Seventh Day Adventist communities, have negligible rates of oral cancer highlighting the importance of these agents as carcinogens, and the role of preventative measures. Other possible risk factors for oral and pharyngeal cancer also include Human Papilloma virus (HPV), particularly serotypes 16, 18, 6 and 11. This virus also increases the risk of anal and cervical cancers, is sexually transmitted and quite common in some areas of the Solomon Islands. Although routine vaccination against the HPV serotypes 16, 18, 6 and 11 is now routinely given in Australia free of cost to high school boys and girls, this is not the case in the Solomons where the vaccine is unobtainable or unaffordable. Dr Collins said, “My main focus as an OMF surgeon has been diagnosing oral cancer and ensuring appropriate multi-disciplinary management. This requires major lengthy surgery with reconstruction and sometimes a team of specialist surgeons and specialists in medical and radiation ongcology. The individual cost for such surgery is quite high. However, education and preventative health strategies aimed at reducing the exposure of people to these known carcinogens to prevent cancer in the first place would be much more effective”. The Ministry for Health has done a lot already to address this issue, but there is still much more than can be done with public education at the grass roots level. Dr Collins plans to return to National Referral Hospital, Honiara, in the future to facilitate the teaching of oral maxilla-facial techniques to local surgeons, and hopes that ongoing preventative strategies will reduce the need for such surgery in the future. Mt Wilga Supports Lymphoedema Health Promotion and Initiatives Mt Wilga continues its strong alliance with the Australasian Lymphology Association (ALA) with sponsorship and support of their 2016 Asia Pacific Lymphology Conference in Darwin. The conference which also integrated the 6th International Lymphoedema Framework Conference drew over 350 national and international delegates and 30 trade exhibitors. Dr Helen Mackie, Mt Wilga’s Lymphoedema Specialist was on hand to present the prize for the Best Oral Presentation from Australia/NZ to Ben Singh for his presentation on “Acute inflammatory response to low, moderate and high-load resistance exercise in women with breast-cancer related Lymphoedema.” Pictured above is Helen (right) presenting the award for Best Oral Presentation from outside Australia/NZ to Anna Kennedy for “Empowering patients and health professionals: the collaboration to launch a unique national lymphoedema magazine”. Peninsula Donation A lifesaving echocardiogram machine is now for bound for Timor, thanks to Peninsula Cardiology and GE Healthcare, which will be used to diagnose heart conditions. This donation will support Guido Valadares National Hospital in Dili to establish its first cardiac care ward. Many thanks to Greg Hyland and his colleagues at GE Healthcare for refurbishing the device free of charge; we look forward to seeing it put to work at the national hospital very soon. COMMUNITY NEWS L to R: Kerry Cabassi, George Walley, Kay Williams, Kim Wilkinson, Danny Sims, Katie Bennell & Kate Munnings. The Aboriginal Health and Wellbeing Centre was set up in 2010. Since its inception the centre and Peel Health Campus have developed a highly effective working relationship and provided mutual support with the aim of meeting the health needs of the whole community. The centre provides local and regional Aboriginal people with accessible and culturally secure primary health care, recently winning the WA Health Excellence Award for ‘Achieving Better Health Outcomes for Aboriginal People’. Nidjalla Waangan Mia and Peel Health Campus work together throughout the year to create awareness and promote activities to improve the health and wellbeing of Aboriginal people, such as ‘Close the Gap’, Harmony Day, NAIDOC and Mental Health Awareness Week. George Walley, Regional Communications Manager of Aboriginal Health Services said that it had been a real privilege to meet both Danny and Kate. “We’ve always had a great relationship with Peel, but since Ramsay took over in 2013 our relationship has gone from strength to strength. Being able to meet the CEO and Chief Operating Officer for Ramsay Health Care Australia was a real opportunity for us to strengthen our bond”, continued George. George, a member of the hospital’s Community Board of Advice has also helped Peel Health Campus to develop its Reconciliation Action Plan (RAP). “It is fantastic to have George as a member of the hospital’s Community Board of Advice” said Diane Barr, Director of Clinical Services and executive sponsor of RAP at the hospital. “Our Reconciliation Action Plan has been developed with an enormous amount of input from George and his team. They provide us with continuous counsel, advice and support”, she added.
The Ramsay Way - 03 - 2016
To see the actual publication please follow the link above