“Island time” is a child’s worst enemy in the remote Solomon Islands when it comes to Type-1 diabetes, but a Newcastle researcher has developed a program that crosses borders and saves young lives.

“Island time” is a child’s worst enemy in the remote Solomon Islands when it comes to Type-1 diabetes, but a Newcastle researcher has developed a program that crosses borders and saves young lives.

It is easy to assume that time, when living in an isolated tropical oasis like the Solomon Islands, runs at a peacefully relaxed pace. Island time, however, has entirely different implications for children who suffer from diabetes.

With roughly 1000 islands stretching over 1500 kilometres, a trip to the hospital in Honiara can mean a 2-3 day boat ride, and time becomes an uphill battle.

When a child develops Type-1 diabetes in Australia their symptoms are met with specialist care and immediate treatment. In the Solomons, the same symptoms of diabetes are rarely identified in time to make this arduous journey to hospital.

The survival rates are stark – based on population figures, doctors would expect to be seeing around 350 children, but currently only two are being treated.

Bruce King, a Hunter Medical Research Institute researcher and endocrinologist at John Hunter Hospital, was invited by the International Diabetes Federation to travel to the Solomon Islands and assess the reasons why the management of children suffering from Type-1 diabetes has such alarming statistics.

“The initial aim of the program was to help with the on-the-ground management of children with diabetes within the community,” Dr King said. “I noticed quite quickly that there were a number of issues that we would need to address.”

First, Dr King noticed the difficulty that the communities had in actually identifying and diagnosing diabetes. Children generally start feeling fatigued and unwell, have excessive thirst and frequent urination.

“Once a child’s symptoms have been recognised and they have been properly diagnosed as having diabetes, a child can go on to live a happy life with a completely normal lifespan,” Dr King said.

“In the Solomon Islands, by the time a parent begins to make the 2-3 day journey to the hospital  with their child to seek emergency medical care, it is usually too late. Sadly, as a result, a large percentage of these children never actually make it to the hospital to be treated.”

The Solomon Island Government has supplied the hospital in Honiara with the medication and equipment to manage diabetes but it was clear that most children are not surviving long enough to reach this care. This presented a number of hurdles for Dr King and his team.

“What this means is that doctors in the major centres don’t have any experience in treating children who have diabetes, and with this in mind we had to come up with a number of methods to counteract this problem.”

Dr King’s initial response was to educate the schools and health care centres across the islands in early diabetes detection.

“A series of posters were developed with the health care workers and were displayed in community centres and schools. These posters describe the early symptoms of diabetes and inform people of what to do if they develop these symptoms.

“Hopefully this will increase awareness and lead to earlier diagnosis, so children will make the trip to the hospital before it becomes life threatening.”

The second and perhaps more complex step of Dr King’s program was to establish a clinical link between Newcastle and Honiara Hospital. This link was in the form of a telehealth program that allows the diabetes specialists and paediatricians at John Hunter Hospital to provide an instant digital consultation with the doctors and patients in the Solomon Islands.

According to Dr King, it will mean an enormous increase in the specialist care available to the Solomons.

“Honiara Hospital has great doctors but they have not had the experience that treating large numbers of diabetic children brings – by utilising the telehealth service, we can interact and talk with the doctor and the patient and establish a treatment plan together.

“The diabetes management that these children will be getting will be the same for child in Newcastle, and that is an exciting thing.”

The International Diabetes Federation has supported this program and has ensured that every child who is diagnosed with diabetes in the Solomon Islands will be given the same equipment and medication as a child in Australia would receive.

However this partnership between Newcastle and the Solomon Islands that was forged by Dr King has now presented a much greater opportunity for medical care in remote countries.

“The long term goal of this project has now broadened considerably, as we work with the doctors, nurses and medical clinicians in the Solomon Islands to develop their skills so they can eventually manage diabetes independently of Newcastle. We can see the opportunity to create a much larger change in health care.”

The endocrinology team at JohnHunterHospital is now in the process of organising for the medical staff from Honiara to visit Newcastle for first-hand clinical training in diabetes education and management.

The success of Dr King’s program is manifested in Kaleidoscope’s (John Hunter Children’s Hospital) firm support. They are now engaging with Dr King to roll out the telehealth conferences between the specialists in many childhood diseases and Honiara Hospital.

“The children in Honiara have all the same medical issues that the children in Newcastle have but the hospital is lacking the experience and resources to be able to treat these children.

“With the support of Kaleidoscope and the many specialists that have agreed to help with telehealth consultations, we are now going to be able to offer these children the very best medical care.”

By giving his own time, Dr King is allowing Solomon kids to run on island time once again.