CESAREANS TO CROCODILE BITES: CASE DIVERSITY AND WORKFORCE ANALYSIS IN A PROVINCIAL HOSPITAL IN SOLOMON ISLANDS dylan_bush@brown.edu

295-04

CESAREANS TO CROCODILE BITES: CASE DIVERSITY AND WORKFORCE ANALYSIS IN A PROVINCIAL HOSPITAL IN SOLOMON ISLANDS

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United States

Oral or Poster

Solomon Islands spans nearly 1,000 islands and has one tertiary care center, making provincial hospitals essential for delivering surgical care. Gizo Hospital, a 90-bed provincial hospital, has two operating theatres, two anesthetic machines, and a single surgeon serving both Choiseul and Western provinces, which are home to 131,000 people across 9,312 square kilometers. We analyzed the operative caseload and workforce utilization to identify gaps in workforce and specialty training.

Researchers conducted a retrospective review of a prospectively maintained surgical logbooks (2020-2022). Descriptive analysis was applied to diagnoses, procedures, and anesthesia modalities. Staff roles and team size was further analyzed by case type.

A total of 2,043 operations were performed across 106 unique procedures in 14 subspecialties. The most common diagnostic categories were gynecological/obstetric (N=677, 33.1%) and infections (N=475, 23.3%). Female sterilization (N=238, 35.3%) and obstructed labor (N=87, 12.9%) were the most frequent gynecological/obstetric cases, while diabetic ulcers/sepsis (N=208, 43.8%) were the most common infectious diagnoses. Common procedures included tubal ligation (N=240, 11.8%), cesarean section (N=220, 10.8%), mass/foreign body excision (N=181, 8.9%), and debridement (N=173, 8.5%). Local anesthesia was most commonly used (N=948, 46.4%), followed by spinal (N=500, 24.5%). Surgeons frequently operated alone across multiple subspecialties: Infection (n=43), Dermatology (n=28), Surgical Wounds (n=17), Urology (n=6), ENT (n=3) Hematology (n=1).

Surgical outreach missions contributed to caseload variability. Our data demonstrate the broad scope of practice of a rural surgeon in Solomon Islands. Future research should explore integration of subspecialty training for rural surgeons in Solomon Islands through telehealth and remote consultation.