The development of paediatric surgery in Papua New Guinea.

Until 1993 complex surgery for children in Papua New Guinea (PNG) was usually conducted by general surgeons, or by overseas paediatric surgeons during ad hoc visits. There had been little coordination of these occasional international visits and no involvement in the surgical teaching program in the University Department of Surgery. Over eight years from July 1993 to July 2000, three Australian surgeons spent 33 weeks teaching paediatric surgery and paediatric urology, using lectures, tutorials and operative demonstration sessions. This paper is a report of the teaching and service provided by one surgeon (PAD) over 27 weeks in PNG and describes the development and training of the surgeon who will be the country's first qualified paediatric surgeon (MM). Other support given has been assistance with the publication of scientific papers, reviews of Masters' theses, the development of a proposal for investigation of the prevalence of renal tract anomalies and the development of protocols for the surgical management of anorectal anomalies and Hirschsprung's disease. In addition to this teaching, 311 children have had surgery during the 11 visits that form the basis of this report. The visits have been supported and funded by AusAID and the Royal Australasian College of Surgeons through the Medical Officer, Nursing and Allied Health Professional (MONAHP) and Pacific Islands Project (PIP) programs. An indication of the impact on the care of children with surgical diseases is evident from the improved skills and the changed referral patterns over the eight years.