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Meeting William Tell, Switzerland's Hero

If you go to any country in the world each of them have their own loved and respected hero who had done a great deed, which freed people from their disadvantaged situations. In the Solomon Islands our hero was Sir Jacob Vouza, a scout from the Island of Guadalcanal who helped the allied forces win the Second World War during the battle of Guadalcanal. In the United States of America there were people like George Washington, Stalin in Russia and the list goes on.

Wilhelm tell monument
Wilhelm Tell with his son carrying his crossbow monument in his memory in Altdorf, Switzerland

Here in Switzerland was a man they called William Tell (Wilhelm Tell) who was allegedly believed to have resided here in this small town of Altdorf, Switzerland. His successful assassination of a government head resulted in him being seen as a terrorist but later a hero. My first three weeks of hospital attachment was in Uri Hospital in Altdorf; home of Wilhelm Tell.

I was invited by the Chief Orthopaedic Surgeon, Dr Remigi Joller who came five times to the Solomon Islands with Dr Oberli and thus is a familiar face to our country. His experience in the Solomon Islands was during the ethnic tension and even had his own encounter with the militants at gun point.

He brought his family twice and has ever since had close ties with the Solomons in providing and facilitating tools and equipments for the hospitals in the Solomons. I was welcome from start to end, "Solomon doctors wanting to do specialist attachments are always welcome at Uri Hospital, the door is always open" says Mr. Walter Baer, the Hospital Deputy Director , "it is always good to meet people from different cultures and learn from them".

Dr Joller and Dr Munamua in front of the Hospital
Dr Joller and Dr Munamua in front of Uri Hospital

The Uri cantonal (provincial) Hospital is well staffed both in the wards and the theatre but the workload is not as busy as Number 9 though they do have very high standards of care in diagnostics, surgical techniques and patient care. Teamwork is but one of the main key factors encouraged very much during my time in the hospital. Every morning at 7.45am and 4.45pm is surgical handover of patients by both general surgeons and orthopaedic surgeons. This allows the whole team to be aware of new patients and progressive reports. There is also a doctors' X-ray session for all patients who had done some radiological study which I believe helps in auditing each department or even gives first hand report from the radiologists. In the National Referral Hospital so many doctors write orders for X-rays for patients for reasons that are not justified thus I believe with such a system though difficult to run every day can be adopted in a more feasible level.

Language barrier was the main obstacle I encountered from day one but I was fortunate to have nearly all the members of the surgical team (General Surgery and Orthopaedics) speaking English. In Switzerland mostly, people speak German or French. For the first time I could understand how tourists or visiting doctors who came to the Solomon Islands to work must have felt, like our own Cuban anesthetist Dr Blanco, at the National Referral Hospital for more than a year to date, keep it up Doc.

Dr Joller with the Surgical Team
Dr Joller (sitting centre) with the Surgical Team

The first thing Dr Oberli bought me was a new Swiss watch and told me that now I have to follow Swiss Time, this was really funny but Dr Oberli knew about Solomon Time so I did not comment on the issue. Time is one which is not fully respected in the Solomons. It is not that we do not want to, but it is part of the culture of our people because of the nature we live in, which is very traditional. I guess the only way for us to adopt such a culture is to adopt it in areas seen as a great need for strict time management. This is just my own view. In Honiara and especially in disciplines which require efficiency such strict timeliness is very important for the benefit of our patients and the level of care. One cannot elaborate further the privileges of meeting experienced both general surgeons (Dr Gallus Burri, Head of department and Dr Stefan Oderbolz) here in Uri Hospital along with the bone doctors. All three surgeons; including Dr Marcel Ziswiler and Dr Alexander Kerber, two other qualified orthopaedic surgeons were so elevating, teaching me pertinent tips and tricks during surgery especially in the field of arthroscopy (surgery using a camera to see joints without big openings to the joint) which I got to assist in. The type of patient and pathology seen here is different from the Solomons where trauma and infection is seen more and also the age distribution is in the very young and middle aged. In Switzerland it is the later golden age that needs a new hip or new knee joint because of degenerative conditions and seldom do we have a bone infection. Dr Ziswiler mentioned to me that the last bone infection he saw in the hospital was like 7 or more years ago. That however is not the picture in the Solomon Islands. Another thing I learnt was the surgical drift from open surgery to minimal invasive surgery like arthroscopy.

Patients now will choose to go to a surgeon who can do minimal invasive techniques rather than traditional open surgery. For the many elective surgical cases like female sterilization, elective appendectomy, knee ligament reconstruction, and the list goes on. These are now done with minimal invasive methods however there are still some cases which will require open surgery. For me I guess this is the direction on how surgery in the Solomon Islands should move towards as we try and develop and improve patient care and outcome. It may not be today or in 2 years time but if we are to develop, we have to drive and plan towards such modern methods.

For Solomon Orthopaedics, one of our heroes is Dr Oberli who set up the department and is still helping us to move on. Others like the generous Stryker Company (Australia) who donated a brand new arthroscopic machine. Synthes Company, who continues to supply (free) plates and screws and is also heavily involved in the training of doctors in Australia and Switzerland. Australian Orthopaedic Association through its Orthopaedic Outreach Project which continues to send consultants to do work at least four times a year and of course the Swiss foundations only to name a few. Solomon Islands has been blessed to have all these good hearted people and institutions every year who only expect gratitude and our appreciation whether in training or equipment; I believe it isn't doctors benefiting from these things but the patients we treat in our clinics and operations. Heroes in disguise you all are to us and we appreciate all your help.

I will now be going to another hospital in Interlaken (between two lakes) and I think it will be a greater learning experience just like the three weeks I had in Uri Hospital, Aldorf.

To the Uri Spital staff especially the surgical team Drs Burri, Oderbolz, Ziswiler, Kerber and my good friend Dr Joller, thank you and I hope I return one day or even have a visit from any of you to the shores of Solomon Islands. Thumbs up to Dr Andrea and her team for making me feel at home. To my family and colleagues at home, I miss you all but am well and fine.

Remember the adopted Oberli's Fracture Clinic Motto; Life is Motion and Motion is Life.

Danke (thank you) and God bless
Dr Alex Bradley Munamua, Uri Spital, Switzerland

© March 2010, Dr Alex Bradley Munamua

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