Vanuatu now has its very first ni-Vanuatu pathologist, Dr Crystal Garae from Ambae.

Ms Garae completed her studies last year from the University of Papua New Guinea (UPNG).

She will begin doing histapathology (study of changes in tissue caused by disease) work this week after all the equipment needed for this important service arrived in Vanuatu.

ACCF (Australian Cervical Cancer Foundation) raised the $40,000 AUD (around Vt3.3 million) needed for the equipment from a major fundraiser in Brisbane at which the Brisbane Sullivan Nicolaides Laboratory, a long term supporter of Vanuatu, was the major sponsor.

Professor Ian Frazer, was the special guest on the evening.

His Frazer Family Foundation has been a generous supporter of Vanuatu, donating five years of the Qiagen Care HPV cervical screening and HPV vaccination for Vanuatu.

They also helped to sponsor a two-month histology tissue processing training for laboratory scientist, Mr. Dexter Takau in the histopathology department in Tonga under pathologist Dr. Eka Buadromo.

On July 13 and 14, Takau and Dr Garae were able to trial the first ever tissue processing runs (with post mortem tissues) using the new equipment funded by ACCF.

This has been described as a start to a huge medical leap for Vanuatu.

ACCF Vanuatu representative , Dr Margaret McAdam said: “This is a watershed moment in medical history for Vanuatu.

“From this day forward, Vanuatu will be able to diagnose cancers and many medical conditions within the country, avoiding delays in diagnosis due to lack of an available pathologist and removing the need to send samples overseas or alternatively having no testing at all if patients could not afford to do this.

“This represents a giant leap forward for Vanuatu in terms of the future health of its people.

“Doctors, without a histological diagnosis, have their hands tied behind their backs in terms of instituting early correctly targeted treatments. Now this will be possible.”

Dr Crystal Garae said her first tasks starting off since January this year was to report on blood films, bone marrow aspirates and few fine needle aspirates. Blood films and bone marrow aspirates help to diagnose disease in the blood and bone while fine needle aspirates on lumps or swellings felt on skin surfaces such as lymph node swelling, breast and thyroid lumps helps to guide the treating doctors as to what kind of disease the patient may have.

This also helps them make important decisions on whether or not to operate on these swellings.

In April and June there were four autopsies done on forensic or police cases.

Autopsies can also be done on sudden death or collapse cases of unknown or undetermined causes upon the request of the doctors or the family members of a deceased patient.

“The ability for cause of death to be ascertained will allow peace of mind for family members in the case of a sudden unexpected death and also enable preventive health advice to be given to the families to help protect their own future health.”

The workload is challenging – seeing as there is also the overall laboratory quality management services that are under her responsibility on top of the clinical laboratory diagnoses that needs to be made on a regular basis.

The team of staff at the Vila Central Hospital Laboratory are supportive and helpful in improving the quality standard of the laboratory services by participating in audits that happen on a six month basis.

Pacific Paramedical Training Centre based in Wellington, New Zealand, is facilitating the audits which will help steer the Vanuatu laboratory towards accreditation in the long run.

Clearly there is a lot of external expert support in helping Dr Crystal Garae become established as Vanuatu’s first pathologist and especially in the setting up of the country’s first ever histopathology laboratory.

Sullivan Nicolaides Lab CEO, Drs Michael Harrison and Dr David Papadimos said “We will remain available to assist Crystal with second opinions and any assistance she needs.”

Dr McAdam said, “Vanuatu is lucky to have such generous benefactors in Sullivan Nicolaides and Prof Ian Frazer. They, and the dedicated team at Ministry of Health, Len Tarivonda and Apisai Tokon, the doctors and nurses at the forefront of service delivery, and Nina Emzin, support cytologist at Sullivan Nicolaides, have made the dream of a cervical cancer free Vanuatu one step closer.

“Though I cannot miss this opportunity to seek help from the visiting medical delegations in Vanuatu this week.

“The hospital urgently needs a new diathermy LLetz machine as we have a backlog of women to treat and need another Lletz machine.

“The one available currently is being prioritized for general surgical cases and women have to just wait until another LLetz machine becomes available.

“If anyone can donate please visit www.ACCF.org.au to make a tax deductible donation to ACCF. Be sure to note its for the Vanuatu Project on your donation.

“We need to raise $25000 AUD so need doctors to dig deep to help these women.”

The local community can donate direct to Hope for Health Vanuatu (www.HopeforHealthVanuatu.com) which is a local Port Vila charity working in unison with ACCF.

Dr Crystal Garae said she is grateful to God for the blessings and opportunity to contribute in a small way to the wellbeing and health improvement of the people of Vanuatu.

The team of people she also acknowledges are mentor Dr. Yakep Angue, Obstetrician and Gynaecologist based in Melbourne, the pathologist supervisors (in PNG, Fiji and Australia), laboratory scientists, lecturers and the staff at the UPNG Medical Faculty and the Port Moresby General Hospital for the knowledge, training and skills obtained during her 5 years of study.

Furthermore, she acknowledges the Vanuatu Government and the Australian Government especially through the Ministry of Health for granting her the scholarship sponsored by Australian Aid, under DFAT (Formerly AusAid).

“I am also very thankful to the Australian Cervical Cancer Foundation, through Dr. Margaret McAdam and Prof Ian Fraser’s strong advocacy for having gone the extra miles to help set up the country’s first histopathology laboratory.

“Thanks also to our volunteer Cuban cytologist Dr. Yaneidy Esteves.”

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