Pacific Island Child Cancer Regional Conference Country Update VANUATU Novotel Hotel, Nadi Dr Annette Garae 1- 2 December 2016 Registrar Vila Central Hospital Port Vila

DEMOGRAPHICS 82 islands within 12,189 km2 Population: estimated now to be 270, 926, (2009 census – 243,000) Growth rate: 2.14% Population < 14 years: 36.11% Capital: Port Vila - 45,000 (19% of the total population)

Health Services Health Budget – 1.3 – 1.5 billion Vatu 6 Hospitals National Referral Hospital – Vila Central Hospital Others on Santo, Tanna, Ambae, Sola, Norsup Health Indicators Infant Mortality – 25/ 1000

Medical Workforce Medical 3 Surgical 4 2 O&G 1 Paediatric Anesthetists Specialists Registrars Advance Training Medical Officer Interns Trainee Interns Medical 3   Surgical 4 2 O&G 1 Paediatric Anesthetists OP Pathologist Radiologist Emergency 12 7 15 District Hospitals GP Total Doctors 35

VCH National Referral Hospital – Based in Port Vila Service Delivery 150 beds build by the British more than 40 years Medical Ward - 40 beds Surgical - 40 beds Obstetrics – 40 beds Paediatrics – 20 beds Tb Ward – 10 beds Intensive Care – 2 beds Service Delivery Ward Services Emergency, General Outpatients, Special Clinics Referral Hospital Basic Imaging Services – Plain X Ray, US Basic Laboratory Services – Transfusion by Whole Blood or Packed cells

VCH – Paediatric 20 Paediatric beds + 6 beds SCN Staff – 3 Locums, 1 Registrars, 4 Interns 9 Paediatric Nurses, 6 nurses Average Paediatric admissions per month: 90 per month, 1000 per year Average SCN Admissions per month 15 - 20 per month , 180 - 200 per year VCH delivers 3000 babies per year

Paediatric Disease Burden Paediatric Services Special Care Nursery Infectious Diseases Pneumonia Gastroenteritis Meningitis Immunization Malnutrition – 30% High rate of EBF High fertility rate Family Situation Maternal Education Chronic Diseases Prematurity Birth Asphyxia Neonatal Sepsis Congenital Abnormalities

Paediatric Cancer in Vila Average of 5 cases a year ( both medical and surgical cases) No Audit Medical – Most commonly Hematology Surgical – Wilm’s Tumor , Osteosarcoma

Challenges Competing Health Priorities Resource Constraint - Human Resource – Nurses Specialists - Infrastructure and Services Laboratory Imaging Medications Limited Overseas Funding ‘LATE PRESENTERS’.....therefore most are palliative ...TLC..

Opportunities New Hospital new year Specialist Locums Paediatric Training for Doctors and Nurses Returning Local Specialists – Paediatric, Pathologist and Radiologist

TANKIU TUMAS