 In the plastic surgeon's story, we learned of the leading role Australia plays with assistance and in advising on strategic planning for the health sector in Kiribati. It has also responded to needs when they arise. For example, the Centre for the Treatment of TB. There's also a brand-new maternity ward in Beso at the far end of the island. Three weeks after the plastic surgeons have left, once again large numbers have gathered at the hospital. The world has gone out. A team of orthopedic surgeons has arrived. The Bone People. It makes us think about what we do at home. We have so many people coming and complaining about petty things back home and the people who come here with the problem, it's a serious issue. It's humbling actually to come out here and to see how people struggle sometimes, not only in their everyday life but with medical problems and they don't have the facilities we've got at home that we take for granted. I mean, we can't get an x-ray immediately, we jump up and down at home. Once again, the first day is dedicated to assessing the patients and whether the team can assist each individual case. We're just looking at some x-rays of the next patient who's coming in with, we assume it's back pain because we're looking at x-rays of the lumbar spine. I'd say the most common cases are trauma that's been neglected and needs to be corrected or club feet on this visit. Six days ago, this little girl came in for a small first operation for her club foot. They're very common, we've seen a lot this trip. Today she's come back for the team to do a small incision and lengthen the Achilles tendon just above the heel. These club foot conditions can now be treated with a high degree of success. But the secret for the success is that they should be carried out in infancy. But the good news is that these procedures can now be carried out at the hospital here by the local surgeon. And with careful management, there's no reason why small children like this can't grow up to be as mobile and carefree as their friends. I think it must lie, it must lie just on where the bundle lies. Although they're known locally as the bone doctors. Their work is also about muscles, joints and ligaments, and a person's ability to move freely and without pain. I'm just trying to think why. I think you might need to take this off or sit up. The ward rounds are good because we get other people involved. We see the ward staff and we as doctors enjoy it because it's what we call old school when we see the patients. The nurses actually come and we tell them what's going on and they report their side of the story about how the patient's going and we give our instructions and there's a bit of interface or interaction occurs at the bedside. Whereas at home that's something that's lost a bit. Can you move the ankle up and down? Yep, that's good. Do a little bit more each day. Well we've got two roles. One is to treat the patients that are here and one is to try and assist the local surgeon and instruct him and show him how you can deal with the cases when he sees them on a day-to-day basis. He's actually very good so we've had the same local surgeon with us for several years now and so we feel that the educational role's been quite good. Oh this was a kid who came over from the islands. I think even a lay person can tell that that should be there. It's completely snapped off and then this is it fixed. The team faced a similar but much more challenging case during their last visit. Prior to their arrival this man could not walk. The gentleman with a badly united or ununited fracture was just joined by fibrous tissue and it was badly displaced and he could hardly move his knee at all. And we did an operation that you'd hardly ever see done in Australia where we took the fracture apart and put it back together and released all the muscles off the bone so they could move his knee again and it was very rewarding to see a good result from that surgery. One of the cases I can remember is a young boy who came in who had TB of his spine and he was going paraplegic and he had an ascending level and his sensory level was up to here on his chest so he couldn't feel anything below that. And he had an abscess in his spine from TB and so we suggested and stressed strongly to the Minister of Health and to the administration of the hospital that this boy needed treatment outside of Curbus so he was in fact sent to New Zealand and he came back to see us about five years later and he was walking albeit with a little bit of a limp and they had cured his TB they had infused his spine over a segment like that and he had only a mild residue of neurological problems in his lower legs and by that stage he was about 19 and he just came in with all smiles on his face and just to say thanks so I thought that was pretty good. Yes, these teams bring so much experience to assist the people of Kiribati but it works both ways when the team leaves the responsibility is now on the local staff to continue the care and management for example the small girl will need her dressing change every one or two weeks in this way there is a partnership she is supported by both local staff and the visiting expertise. I feel I had a scholarship covered education I didn't pay anything for my medical education I feel I owe someone something back this Australia doing a good thing with this program I think they're doing a very good thing yes.