Paediatric Neurology team visit Honiara, 15th - 21st September 2024

Janis Brown, Nurse Practitioner, and Dr Rob Smith Paediatric Neurologist, from the John Hunter Children’s Hospital in Newcastle Australia, spent five busy days at the National Referral Hospital in Honiara before continuing to Fiji Isles for a further two weeks. This is part of a longstanding and joyful collaboration with Pacific neighbours.  This was our first invitation to visit Solomon Islands. We were hosted and guided by Drs Deborah Airau and Hicks Bule with kindly oversight from Dr Titus Nasi.  

Each day began with a Continuous Professional Development (CPD) session. As usual, paroxysmal events including Epileptic seizures and seizure mimics were a main focus. Janis’s now famous talk, with an ever-increasing collection of interesting videos, was well received and stimulated thoughtful discussion. An added bonus for the visiting duo was the beach view from the doctors room. In clinic we work on a teaching model of initial case presentations by our junior colleagues, additional questioning for the family if necessary and then joint examination and planning.  

We saw a total of 50 new patients during the week including several inpatients and quite a few unscheduled visitors – including a 22 year old with Temporal Lobe Epilepsy. As usual, Epilepsy and Cerebral Palsy were prominent. Major challenges included the treatment of irritability, high tone and nutrition in children with Neurological disability and medication choices and manipulation in Epilepsy, as well as Emergency seizure management. 

 By Friday we were following more of the histories in Pijin, but still had little chance when people spoke fast!
We met children from nearly all Provinces and, as in Fiji, were frequently humbled when we heard how long it had taken some families to travel to Honiara.  Phenobarbitone is the most frequently prescribed medication for Epilepsy and there is an experienced local approach to prescription and dose adjustment. We gained new insights ourselves. Other medications are available but supply can be sometimes erratic. This is very frustrating for all and a continuing major contributor to the Epilepsy Treatment Gap. (see: WHO Intersectoral global action plan on epilepsy and other neurological disorders https://www.who.int/publications/i/item/9789240076624 ).

There was opportunity for more CPD over lunch. Much learning also comes from informal discussion at these times.  We had a wonderful session with Radiology colleagues in the new state-of- the-art CT suite, learned about local patterns of neurological disease and together reviewed images of the children we had seen in clinic. For us, the visiting team, this was a busy but extremely fulfilling time. We often feel as if we are privileged to learn more than we teach. We hope our hard-working Solomon Islands Paediatric colleagues also learned something along the way. 

Tagio tumas. 
Lukim iu.
Janis Brown / Rob Smith 

A happy lunchtime gathering with the team!

Janis giving her seizures and seizure mimics talk

Dr Deborah, Janis NP, Dr Rob, a mother and child and Dr Hicks on our last day in the clinic.