A Surgeon’s Quest to Reduce Breast Cancer in Tonga
The Greg Urwin Awards are a joint initiative of the Australian Government-funded Pacific Leadership Program (PLP) and the Pacific Islands Forum Secretariat (PIFS). The Awards were established in 2008 to honour the memory and legacy of the former Secretary General of PIFS, the late Mr. Greg Urwin.
Dr. Kolini Vaea was a member of the 2013 Greg Urwin Awards cohort, and this is story was captured during an exit interview at the PLP office in September 2013.
Applications are now open for the 2016 Greg Urwin Awards- visit: http://www.plp.org.fj/opportunities/greg-urwin-awards to download the application package.
As a father, Dr Kolini Vaea could not bear to watch young children visit their mothers who were dying of cancer at the Vaiola Hospital in Tonga’s capital Nuku’alofa. As a surgeon, he knew one way to help prevent these situations was to conduct breast cancer screening.
The opportunity to take action came in 2011. As part of his Masters studies at the Fiji School of Medicine and with funding from the Australian High Commission in Tonga, Dr. Vaea and his colleagues conducted a screening campaign.
“We held the program on the main island and the response we got was great. 700 women volunteered to attend during community outreach sessions we conducted,” said Dr. Vaea.
The screening process was simple. Respondents answered a questionnaire and underwent a clinical examination and if there was a need, an ultrasound scan and biopsy were performed.
The high response rate from women was encouraging. According to Dr. Vaea, most women in Tonga would initially opt for herbal treatment and seeing a doctor was their last resort, “When they do come in they often have late stage breast cancer and there are very few treatment options. We send patients abroad for chemotherapy and if they cannot afford that, then there is not much we can do.”
Upon completion of the screening program, Dr. Vaea presented his findings and graduated with his Masters degree. Meanwhile, women kept coming for screening at the hospital, “The community outreach was effective, they knew where to get seen. We had an average of four new diagnoses every month, that is a lot for a country like Tonga and I realized that screening had to be taken out to the communities making it accessible for everyone and not just those who could afford to come to the capital.”
Being able to scan the patients and perform surgery within days of diagnosis was essential for the program but posed a limitation for Dr Vaea, “Surgery was not a problem for me, it was the ultrasound scan procedure for which I needed training. If I knew to how use the ultrasound scan the process would be faster. When I saw the Greg Urwin Award advertisement in a local daily, I applied for a workplace attachment in Fiji.”
Dr Vaea was one of the five recipients of the 2013 Greg Urwin Awards. In August he completed a 16 week attachment at Suva’s Colonial War Memorial Hospital radiology department, “I was humbled and grateful for the opportunity the Award gave me. During my attachment I was fortunate to get practical experience in Forensic Pathology which complemented what I learnt.”
Dr. Vaea returned to Tonga this month with plans to work with his colleagues to establish a permanent breast cancer screening program, “A program that is available to everyone in the community and that will especially prevent women from reaching late stage cancer. And of course we will be able to detect other types of cancers too and treat them.”
Dr. Vaea attributes his success and the success of the cancer screening program to support from his family and his employers. Despite leading the initial screening campaign, Dr. Vaea is very modest about his achievements, “The program is not a one man show. What has been achieved has been through team work and support.”
Mindful that funding for such a program could be hard to come by Dr. Vaea has a plan, “I will present the results of future screening sessions to counterparts in Australia and New Zealand who have established program which I hope they can extend to Tonga. We have to start somewhere and not wait for others to do it for us.”
Armed with his newly acquired skills and support from a dedicated team, Dr Vaea is raring to go. He has planned a community screening event to commemorate the global breast cancer awareness month in October. And so, Dr. Vaea’s dream to “provide a cancer screening program to the people of Tonga” begins. One community and eventually one island at a time.