NS03 EXPERIENCES IN JAVA

Over the last four years we have spent three periods of a month or more doing voluntary work in Indonesia, mainly at the principal public hospital in Bandung, the capital of the West Java province. There are in Indonesia a similar number of neurosurgeons to Australia for over 10 times the population, a situation like much of the developing world. Three large training centres are attempting to redress the balance. At Bandung there are usually 40 or more training residents for a unit with about 60 neurosurgical beds. Our air fares are subsidised by the US based Foundation for International Education in Neurological Surgery, and accommodation by the local unit. There is a vast amount of neurosurgical material, half or more of it trauma. Road conditions are not the best, and seat belt and helmet laws basic and often not observed. In the absence of folate supplements in pregnancy, neural tube defects are common and often quite gross. Tumours are usually very large before coming to treatment, and vascular work is in its infancy, although more progressed in the private system. Examples of all these pathologies will be presented. Rehabilitation is at a level similar to Sydney 40 years ago. On our last visit, in May–June 2006, we spent a week in Jogjakarta some days after the earthquake there, dealing mainly with a large backlog of spinal injuries. There is one spinal unit in Indonesia, several hours flight away in the capital, Jakarta. We have found the people uniformly very pleasant and friendly, and appreciative of our efforts. We are always well looked after and feel perfectly safe. We can thoroughly recommend this kind of work in our region, for any age but perhaps more so for those winding down towards retirement.