Update on this story: the job of doctor on Tristan da Cunha has just been re-advertised. The advert seeks a medic with wide clinical experience from May 2012.
Dr Gerard Bulger runs the world’s most extreme single-handed medical practice, according to a magazine for general practitioners in the UK.
The internet has transformed medical practice on Tristan da Cunha, says Dr Bulger in a self-penned article for GP magazine. It’s made it possible for the island’s doctor to be a general practitioner, rather than a surgeon – meaning someone who is skilled in keeping people healthy rather than cutting them open.
‘Now that the internet is getting a little better here, and Skype works, doctors could now be supported by specialists back in Cape Town or in the UK when an emergency arises.’
But like St Helena, the island struggles with a bandwidth that would be considered feeble in Britain.
‘It’s 512kbs for the whole island, so if I had a crisis, everyone else would have to shut down their computers.’
Dr Bulger must also be one of the few medics in the world whose job includes checking the island’s water supply, partly to help the fish factory gain a European Union certificate.
‘I used to be irritated when my old practice in Bovingdon, Hertfordshire, was called single-handed. I said there was no such thing; the smallest practice had a practice nurse, an assistant and worked in a team. But Tristan is single-handed practice in the extreme, perhaps the last one in the world. There are no nurses, only care assistants.’
There is no airport, and supply ships are infrequent. ‘Keeping the pharmacy and consumables in stock is a nightmare, and too much goes out-of-date.’
As on St Helena, diabetes is a big problem. Dr Bulger is investigating its cause. ‘Despite all this,’ he writes, ‘the community is fit. There is true community care here.
‘To my delight, consultants in the UK are very willing to advise me by email and reassure me.
‘My favourite questions to ask consultants are medical Desert Island Discs. What eight bits of equipment or drugs would you choose, and what would be your luxury item of medical kit to have?’
For those interested in medical insights, the full article is here.