Dr Tony Diprose is an anaesthetist at the Hawke's Bay Fallen Soldiers Memorial Hospital but he is not unfamiliar with slightly more distant venues of medical work.

Like extreme parts of the Pacific and recently the coast of West Africa where home, and his clinic, was aboard the 16,000 tonne ship Africa Mercy. For Dr Diprose such assignments are adventurous and challenging, and as a result of the work he carries out, very rewarding.

And there are likely to be more to come. Roger Moroney put five questions to Dr Diprose.

1: What originally sparked you to take on these assignments and how many overseas missions have you carried out now?


In the summer holidays between finishing my BSc and starting medical school I went to Calcutta, India, to stay with some Kiwi friends who were living there.

I did some voluntary work at a number of places, including Mother Teresa's charities and a free GP clinic on an inner-city footpath.

If ever you needed to understand the link between poverty and health, it was hard not to see it in such an extreme environment.

Like a lot of medical students I went overseas for my three-month elective in my final year at medical school and part of that was at a public hospital in Phnom Penh, Cambodia.

My wife and I helped in malnutrition feeding programmes, home care for disabled children as well as inpatient TB-treatment wards.

As a family we moved to Queensland for my last year of anaesthetic training and first year of specialist practice - the part of the job I loved the most was the surgical trips to remote areas, usually with a high proportion of indigenous patients.

In 2006 we moved to Port Vila, Vanuatu, where I worked for two years in the public hospital (my position was funded as part of the Australian Aide health package to Vanuatu).

We've been back to Vanuatu for a month to six weeks when I provided maternity cover for their local anaesthetist.


Since our return to Hawkes Bay I've been privileged to be a part of the NZ Medical Assistance Team - this is part of the Government's response mechanism to disaster, nationally and internationally.

I was asked to go to Vanuatu immediately post Cyclone Pam last year. Earlier this year I was part of the NZMAT clinical team who worked in theatre in Suva, Fiji, post cyclone Winston.

This trip to Benin with Mercy Ships is a part of my sabbatical that I'm taking from the HBDHB.

I've also been on a UK trauma training course dealing with mass casualty management and attended the American Society of Anaesthetists conference in the USA.

2: You have done several stints in Pacific regions but was this work in Africa more challenging, and did you carry out preparation research about what you were set to see and take on?

Some of the pathology seen in Africa was quite extreme and consequently some of the anaesthesia/surgery was really challenging (I don't usually ask theatre staff in Hastings to please go donate some of their own blood in the middle of surgery so I can transfuse it directly to the patient we're currently working on together!)

But the hospital set up on Mercy ships was very good, I always had an anaesthetic technician to help me, there are modern, serviced anaesthetic machines and colleagues to help.

I worked alongside anaesthetists from Australia, England, Scotland and the USA.

My work in the Pacific has all been in public or government hospitals, often with very basic equipment and drugs, and the nearest second specialist opinion or anaesthetic assistance is in another country.

I did talk to staff who have spent time with Mercy ships before, one of our DHB nurses has been out twice with them, an ophthalmologist from Rotorua and an anaesthetist from Auckland, so I had a reasonable idea what I was getting myself into.

3: There would have been many moments of gratitude from those you helped - how good and fulfilling was that at the end of another challenging shift?

There's no universal healthcare in Benin, people pay for their treatment.

Consequently, lots of people don't get treatment. Parents were very grateful that their children were getting surgery.

Ninety minutes in theatre freeing up burn contractures enabling a child to use their hand again ... that changes the trajectory of a life.

Removing large facial tumours, meaning a 30 year-old won't die of benign disease, it gives them back some hope, some dignity, it lets people re-engage with their community.

Yes people were appreciative, it was a privilege to be a small part of that ... even if it was via multiple translators' explanations of the conversations!

Mercy Ships has established an excellent reputation in West Africa, this is their third visit to Benin and they're in Cotonou for 10 months, people all over the city knew of the work being done by the organisation.

4: Would it be fair to say that we in New Zealand really have no idea just how basic and sparse things are for the people in those parts of the world?

It's easy to understand academically that things are tough for people elsewhere, its a bit more real when you're there - the patient is the same age as your own son or you're explaining why their wife has had a bad outcome in the delivery suite because there wasn't a midwife, doctor or medication available to help them.

I think people would be shocked to realise how tough healthcare is for local people in the places we go to for our winter Pacific holidays.

You don't have to go to West Africa to be confronted with overwhelming health needs.

Our health system is far from perfect, there are real difficulties and limitations. I do understand that.

But, having universal healthcare as a tenet of your society, that's a really good thing.
I work with some great people in the HBDHB who want the best for their patients.

I'm very grateful to have a supportive family who lets me go away, on occasion with only a few hours notice.

Without supportive colleagues in my anaesthetic department I wouldn't be in places like Fiji or Vanuatu helping our neighbours.

They are as much a part of what I've been able to be involved in as me being in those operating theatres.

5: What is next on the overseas "aid" agenda and will you be looking at another stint with Mercy Ships - and how long are those assignments?

Over December and January I'm taking the second half of my sabbatical.

As a family we're going to Samoa where I'm anaesthetising at the public hospital in Apia alongside one of the Samoan anaesthetists who did some of his training in our Hawkes Bay anaesthetic and ICU departments.

If my colleagues let me I'll be on call again for the NZMAT over the cyclone season from February to April.

Mercy Ships - maybe, I really enjoyed it I'm just not sure I'm getting a leave pass from my kids just yet. Medical specialists can go for as short as two weeks with Mercy Ships.

It's not just doctors - there are dentists, nurses, plumbers, carpenters, caterers, marine crew etc, etc, all a part of the team on the ship, all contributing to healthcare in a vulnerable part of the world.

Non medical positions are generally for longer than those of the specialists, but if people are interested I'd recommend they contact the organisation.