Indigenous ENT anaesthesia. Humanitarians at home

Abstract

Indigenous Australian children have rates of chronic suppurative otitis media (CSOM) that according to the World Health Organization (WHO) constitute a public health emergency [1, 2]. CSOM may result in permanent hearing impairment, learning difficulties [2, 3] and contribute to the cycle of illiteracy, unemployment, and poverty seen in Indigenous communities.Paediatric anaesthetists form a vital part of the Deadly Ears program, a program which seeks to provide ENT outreach services to remote Indigenous communities in Queensland. We examine the reasons for, and the benefits of, the creation of this particular service [4, 5] and the role performed by the paediatric anaesthetist. In particular, we focus on the cultural and environmental challenges, and identify specifically our modifications in anaesthetic technique to overcome these difficulties in a setting where anaesthesia is rarely performed. We demonstrate the role of the paediatric anaesthetist in a public health setting.We have focused on 22 cases conducted in Bamaga and Woorabinda on two outreach trips in 2008. Local ethics committee approval was obtained to review these charts. In particular, we focus on patient characteristics, surgical procedures and per‐operative complications.1 Coates HL, et al. Otitis media in Aboriginal children: tackling a major health problem. Med J Aust 2002; 177(4): 177–178.2 Rothstein J, Heazlewood R and Fraser M, Health of Aboriginal and Torres Strait Islander children in remote Far North Queensland: findings of the Paediatric Outreach Service. Med J Aust 2007; 186(10): 519–521.3 Morris PS. A systematic review of clinical research addressing the prevalence, aetiology, diagnosis, prognosis and therapy of otitis media in Australian Aboriginal children. J Paediatr Child Health 1998; 34(6): 487–497.4 Gruen RL, Weeramanthri TS and Bailie RS. Outreach and improved access to specialist services for indigenous people in remote Australia: the requirements for sustainability. J Epidemiol Community Health, 2002; 56(7): 517–521.5 Gruen RL et al. Specialist outreach to isolated and disadvantaged communities: a population‐based study. Lancet 2006; 368(9530): 130–138.