The manager of the emergency department at Solomon Islands' main hospital says a severe shortage of doctors is stopping the unit from properly functioning.
Dr Kenton Sare says there should be nine doctors rostered on for each shift but his department has to make do with only two.
He says at a conservative estimate, the emergency department treats more than 150 patients every day but other parts of the National Referral Hospital in the capital Honiara are also under extreme pressure.
KENTON SARE: I think elsewhere, you will have the luxury of having more than one hospital within the area. So people can actually have a lot more choice or they have to go to a specific children's or women's place. At the moment we don't have that - everyone comes here.
ANNELL HUSBAND: And with you saying that this hospital was built by the British originally, what was its capacity originally?
KS: I'm not sure its capacity then.
AH: I guess it's not equipped to deal with the population?
KS: No. As you rightly mention, figures have shown that we probably have one of the highest birth rates in the world. It has dropped a bit, but it's still quite high, which also means that I think our figures from our labour ward, the numbers of beds that we have only in the National Referral Hospital can fit one school in a month.
AH: How can you possibly cater for those women giving birth here when you've got to deal with the ill people, as well?
KS: I think if you take the opportunity to go and see the labour ward, they have about one to three birthing suites. At the moment they have closed down one birthing suite to try and keep mothers who have given birth while waiting to go to the post-natal ward. So that's the kind of load that they are carrying. And you have mothers giving birth in the first aid room, you have mothers giving birth in the corridor. At times it does happen like that. So this labour ward, it needs some attention, maybe a bigger space, but that's something that we have to work on. We roster at least two doctors here at any one shift or at least in the morning shift. At night shift we have only two doctors - one usually sits here and one, basically, is on the other side.
AH: So the four of you cover those two shifts that you described earlier. Gosh, so what if one of you is sick?
KS: That means the other three have to carry the load for the four.
AH: Right. And what was that like during the recent dengue outbreak? It must have been really difficult.
KS: I think that's one of the reasons why it has gone back to the team which look after the outbreak, and it has gone through the ministry, and we have a bit of help from the Australian team. I think there's a New Zealand team, as well, that came in during the outbreak. The little bit of time that they spent here actually gave us a bit of a breather.
AH: Yes, but just week to week. Normally, without the dengue, would you not be fairly exhausted?
KS: (Laughs) I can smile, I can laugh, but the exhaustion is there.
