TRIP TO DOWN UNDER

In May 2003 JPA (Jabatan Perkhidmatan Awam), offered the first ever scholarship to pursue fellowship in Urogynaecology.  Following few contacts and recommendations, I manage to secure an urogynaecology and pelvic reconstructive surgery fellowship training programme with Professor Ajay Rane a well known professor in urogynaecology from James Cook University (JCU), Townsville, Queensland Australia.

Little is known about JCU and Townsville. My first reaction was to look up in the world atlas and search the wed site, to see where this place is? Townsville is the “capital city” of the northern Queensland, with a population of about 150,000 people along with it twin city Thuringowa, and it make up the largest city in tropical Queensland. Townsville got the name from Sidney businessman Robert Townsville, who sponsored the establishment of a port in 1864.

The excitement turned to horror, especially when I was trying to gain entry into Australia. There are various levels of screening and protocols to follow before getting a visa. It took almost 4 months to obtain entry permission. There are also various levels of bureaucracy in obtaining medical registration with the Queensland medical board.

After the long wait, it was time to travel. The flight took 7 plus hours and further 11/2 hours from Brisbane as Townsville is situated about 1300kms north of Brisbane. Townsville is quite and peaceful town. The weather was extremely hot ranging between 32 to 38 degrees. However the weather became very pleasant between Mac to September (winter months). We (with family) managed to settle down quickly and the training and posting commenced smoothly.

Adapting to the new environment and system did not take very long as the team in the urogynaecology department was very helpful. The real work started after the Christmas and New Year break. The urogynaecology and pelvic reconstructive department in Townsville is the first subspecialist services in the North Queensland and this unit covers a wide area as up to the Northern Territory.  Our referrals are mainly from general practitioners and occasionally from the O & G specialist.

Prof. Rane and this team of one senior lecturer (Dr Christopher Barry), 2 fellows in urogynaecology, and a bladder nurse (Audrey Corstiaans) and other allied staff is well known not only in Australia but also in the world of Urogynaecology as a centre of excellence. The centre carries out various multicentre trials in urogynaecology. It is also the first centre to invent and publish about Perigee, a device invented to correct the anterior wall prolepses using transobturator route. I was lucky to be part of the team when this procedure was introduced and to date numerous abstracts and papers has been published with regards to this product.

The urogynaecology department is a very busy unit, with almost 95% of their work concentrated on incontinence and pelvic reconstruction. We were involved in 3 and half days of Clinics, urodynamics & surgery in both the public (Townsville Hospital) as well as the private hospital (Mater’s Hospital) and Townsville Day surgery Unit. The other days are allocated for research.

There was so much going on at the same time. During my one-year sting, we managed to organize a North Queensland Urogynae and Pelvic reconstructive surgery conference. Prof. Bob Schull a well-known pelvic surgeon attended the conference from Texas, United States. We also carried out nearly 6 trials or studies. Some of the studies are still on going. We also presented few papers in the IUGA/ICS conference in Paris. Apart from that we also published few papers pertaining to urogynaecology. 

Life was hard initially especially with regards to research as being a clinician for so long. As time goes by it has become part of work and it was interesting. There were ample operating opportunities to learn new surgeries in Uogyanecology and pelvic reconstruction.

Training aside, the weekends were completely free and we had great time visited the surrounding areas. Schools are fantastic; children had stress free schooling with minimal exams and homework. Quality of life was certainly fantastic as there was ample time to spend with the family. Townsville has few exciting places to visit; this includes the Billabong Sanctuary, where you can see and play with Australian wide-life.  The Reef Headquarters’, the largest reef aquarium world is in Townsville. The Great Barrier Reef and the Cairns tourist town are only about 350kms north of Townsville.

Work, research and pleasure as an urogynaecology fellow in Townsville/JCU quickly elapse and it was time to set back to the routine and hassle bustle of Malaysian life. The knowledge and experience gained during this short sting is there to stay in my memory for a long time.  I wish l could one day follow the foot steps of my “GURU’ Prof. A Rane, to establish a vibrant and active Urogynae and pelvic reconstructive unit (Pelvic Health Center) in Malaysia.

Back in Malaysia, with the help of Dr Mukudan, head of O & G department. I have the opportunity to start the first Pelvic Health Unit in Ipoh Hospital. The response was tremendous. We can see that there is so much work in urogynaecology and pelvic reconstruction in Perak alone. These poor patients were suffering in silence for so long, no where to turn to or they were provided with substandard advice and treatment. To start with we introduce the Pelvic Health Concept which basically teaches public how to take care the pelvic structures.

Ipoh hospital is the first public hospital to set up the Pelvic Health Unit (urogynaecology and pelvic reconstructive unit) under the department of obstetrics and gynaecology. The first line of management is to educate patients about good bladder habits, such as posture during micturation, avoidance of bladder irritants, pelvic floor exercises and maintenance of good general health. Our unit has started the “Beat The Bladder Blues” campaign to create awareness among care providers and public and how to seek advice with regards to their bladder or prolapse problem.

We in the Pelvic Health Unit, Department of O & G. Ipoh Hospital, welcome your referrals and support. We are contactable at  05-2085089( urogynaecology Clinic, Ipoh Hospital), 05-2408777( Sessional clinic Ipoh specialist hospital) and email: aruku64@yahoo.com.au. aruku1964@gmail.com