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Since 2010 gynecological oncologists from Australia and New Zealand have traveled regularly to countries in the Western Pacific to provide support and training to local gynecologists. In 2021, gynecological oncologists from the Australian Society of Gynaecologic Oncologists (ASGO) formalized their collaboration with colleagues in the Western Pacific, forming the ASGO Western Pacific Liaison Group. The goals of the group have been defined as: to promote gynecological oncology services in the Western pacific; to work with local clinicians with training and development of a gynecologic oncology service; to undertake advocacy with other stakeholders in the area (eg, International Gynecological Cancer Society (IGCS), WHO, Australian and New Zealand Foreign Affairs, Pacific Society for Reproductive Health Trust); and to work to make sustainable holistic oncology services available to women in the Western Pacific.
Accepting many visits were undertaken previously, since formalization members of the ASGO Western Pacific Liaison Group have traveled to Fiji, Vanuatu and Tonga. The structure of these trips involves collaboration with in-country gynecologists, undertaking clinics, surgical cases and teaching, formal lecture-based teaching, and collaboration of the care of patients on the wards. Furthermore, creation of formalized multidisciplinary meetings or ‘tumor boards’ has been critical, with additional involvement of local and international nurses and pathologists.
Fiji (Figure 1) was one of the first islands in the Western Pacific where a regular visiting team was established. There was strong national collaboration to support visits to two of the three major centers usually three times a year. This allowed establishment of strong local connections and, with consistent teaching, both local skill acquisition and the role and function of multidisciplinary meetings have developed over the visits. This then allowed the training and subsequent graduation in 2021 of Dr Nanise Sikiti, who became the first fellow from the region to graduate from the IGCS Gynecological Oncology Global Fellowship Program.
Regular visits to Vanuatu (Figure 2) have occurred since 2017 and in 2023 we undertook our first trip to Tonga (Figure 3). Clinical review of known or suspected cancer cases and operative management of confirmed cancer cases is the main component of work. Clinical education, surgical teaching and up-skilling of gynecologists and senior gynecological trainees remains the primary goal to continue to build sustainability.
Close collaboration between the ASGO Western Pacific Liaison Group members and in-country healthcare providers has been key to the successes of this group of clinicians thus far. The provision of gynecological oncology services in the region requires approaches which are sustainable in settings which are geographically widespread (eg, Vanuatu is made up of more than 80 islands) and where the population may not support a full time gynecological oncology service (eg, Tonga has a population of just over 100 000). It is likely therefore that ongoing gynecological oncology service provision will be a combination of trained IGCS global oncology fellows, upskilling of in-country general gynecologists, visiting gynecological oncology services via the ASGO Western Pacific Liaison Group, and some movement of women out of country to undertake treatment elsewhere (eg, Australia or New Zealand). The ASGO Western Pacific Liaison Group is committed to optimizing these approaches and to supporting the women and our colleagues in the Western Pacific region to continue to provide excellent oncological care.
Patient consent for publication
Ken Jaaback for assistance in the writing of this paper. All members of the ASGO Western Pacific Liaison Group and our colleagues from Fiji, Tonga and Vanuatu including Margaret Tarere, Boniface Damutalau, Maake Tupou, Siake Ela, Peneetiketo Falesiva, Vanessa Misinale, Christie Otunuku, Sia Toumoua, Nanise Sikiti, Jimi Taria, Kelera Sakumeni and James Fong. Joe Ng and Susan Ralph at the International Gynecologic Cancer Society.
Twitter @Jim Nicklin
Contributors EA wrote the draft of this manuscript. All authors contributed to the reviews and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.