Sydney nurse Graham Hextell has seen the difference orthopaedic surgery training and services can make to people in under-developed nations.

The University of Notre Dame Australia School of Nursing lecturer has travelled to several South Pacific countries, including the Cook Islands, the Solomon Islands and Tonga, in his role as manager with international charity Orthopaedic Outreach.

There, Graham and his team have witnessed road traffic trauma, workplace injuries and multiple fractures, as people trying to harvest coconuts and mangoes fall from trees, along with explosives’ injuries.

“Some fishermen use home-made bombs as a method to fish,” he said.

“As with any explosive, there are risks, and we have experienced an individual who had the bomb detonate while in his hand.”

Orthopaedic Outreach has also targeted children born with congenital deformity Talipes Equinas known as Club Foot, which is treated with corrective surgery and sometimes bars and bracing.

As a specialist operating theatre nurse working primarily in orthopaedic theatres, Graham’s role with Orthopaedic Outreach involves liaising with hospital administrators and surgeons throughout the Pacific to identify their specific needs and then match those needs with the organisation’s team of volunteers.

“When I travel, the intention is to essentially become redundant – to promote self-sustainability amongst the nursing staff,” he said.

“Much of the surgery we perform would not normally be attempted in these countries, purely through lack of training and experience, and lack of equipment.

“My role is to ensure the local surgeons are actively involved in the planning and treatment for each surgical patient, and to support the local nursing staff through guidance and education regarding their practises, the procedures they are involved in, as well as resource management to the best of their abilities.”

On his last trip to Tonga, Graham said the Australian team saw 120 patients during their first day on the ground and went on to perform 30 surgical procedures in four days.

Graham said Outreach, which has helped establish orthopaedic surgical training programs in Fiji, PNG and Bali, has faced challenges ranging from poor sterilisation equipment, supplies being held up in transit or customs, and a lack of instrumentation and equipment.

But he said he loved making a difference in the countries.

“On a recent team visit to Tonga, we saw a seven-year-old boy who had a fractured arm,” he said.

“This had happened some time ago, and attempts had been made to fix it unsuccessfully.

“His arm was quite deformed…he had tears rolling down his face, waiting to be seen, no doubt afraid of us as a reminder of the pain from his previous surgeries.

“We operated on him two days later with a great result.

“Yes, he was still afraid of us and no doubt his arm was painful afterwards but hopefully he will be able to use his arm fully when the plaster comes off, and also remember the kind team from Australia who fixed his arm.”