Pharmacy gradute contributes to public health in Fiji

May 2009

Volunteering in Fiji is more than tropical beaches and ukulele serenades.

For pharmacy graduate Kara Milne, volunteering in Fiji is more than tropical beaches and ukulele serenades. As part of a 12-month assignment for the Australian Youth Ambassadors for Development Program (AYAD), Kara is helping establish Fiji’s National Medicines Information Centre from the ground up.

At the Essential Medicines Authority, part of Fiji’s Pharmaceutical and Biomedical Services, Kara’s (BPharm 2004, GradCertPharmPrac 2006) pharmacy skills have been extended as she is working as a medicines information pharmacist, publishing a local Pharmanews bulletin, reviewing the country’s rational use of medicines policy and physically helping to set up the new information centre.

“I’ve been involved in everything from organising the installation of power points, air conditioning and shelving into the room, to cataloguing current resources and stacking books on the shelves,” Kara said.

Based in Suva, Kara lives and travels with other AYAD volunteers. She also works alongside another pharmacy graduate, Viki Lui (BPharm 2007), collaborating to improve medicines inventory management. While there are private pharmacies in Fiji, the community largely relies on the public health system. Pharmacists are employed at the hospital level, but not at health centres and nursing stations.

“Most of the pharmacy work that supports the system, such as medicine procurement, stock management, distribution and dispensing, is undertaken by pharmacy technicians or nursing staff,” said Kara.

“Record keeping and inventory management are critical to maintaining a reliable supply of medicines,” she explains. “When medicines are out of stock, they can’t just be ordered in overnight. This issue is incredibly complex due to many factors, such as extended lead times, stock forecasting, the drug budget and geographical limitations such as over-sea deliveries and lack of road access to all health facilities.”

To get a better sense of this, Kara and Viki plan to travel to Vanua Levu, the second largest Fijian island, to experience remote Fiji and gain an understanding of the work situation and challenges facing staff working in these facilities.

Access to current references that pharmacists may take for granted in Australia is something that Kara is working to create for health workers in Fiji.

“Therapeutic Guidelines very kindly donated hardcopy editions and an eTG as part of their Developing Countries Fund, which has been invaluable,” she said. “I’m working towards developing a standard reference list to be held by all healthcare facilities so that they are able to readily answer drug queries.”

Since graduating in 2004, geographic variation has been a theme in Kara’s work experiences. Initially training at the Royal Melbourne Hospital, she spent time working in a community pharmacy in her home town of Mildura, Victoria, only to move further north to The Townsville Hospital in Queensland.

"I've been involved in everything from organising the installation of power points, air conditioning and shelving into the room, to cataloguing current resources and stacking books on the shelves."

Kara attributes her time at Monash as having influenced her decision to take on her current assignment in Fiji.

“Our public health lectures really struck a chord with me,” she said. “I decided that volunteering was something I wanted to do once I had some professional experience.”

Kara said that, to perform her work in Fiji, she has drawn on the knowledge and skills gained from her pharmacy degree and placements as well as her subsequent working experience.

“It’s still a very steep learning curve and I’m particularly grateful to Beverley Snell, the Burnet Institute and to the AYAD Pre-Departure Training program for preparing us to live in a different environment and culture,” Kara said. “As well as providing me with formal support, AYAD has also been a fantastic way to meet so many interesting people from different backgrounds.”

At the local level, Kara said she has been lucky to have had the opportunity to learn Fijian, attend school musical and dance festivals, learn how to cook both Indian and Fijian dishes, wear traditional dress to work on Bula Fridays, and celebrate Diwali, the Hindu ‘Festival of Lights’.

“I’ve also met people through a weekend bushwalking club here,” she said. “Viki and I recently did a three-day cross-island walk with them. We stayed at villages and saw the most amazing scenery and parts of Fiji that tourists don’t normally get to see.”

As for her future plans, Kara said she is still undecided. “I’m just beginning to realise the scope that exists for us as pharmacists within public health.”

For now, she’s looking forward to her trip to Vanua Levu, followed by a short break during which she will, of course, visit one of those tropical, ukulele-serenading resorts.
For more information about this project or to learn more about volunteering contact Kara,
email karamilne@gmail.com or visit www.ausaid.gov.au.