Northland’s new mobile ENT clinic, inspired by the Māori Battalion

A surgeon from the legendary Māori Battalion has created a mobile clinic designed to bring healthcare to the most remote corners of Northland.

The new ENT clinic on wheels has been paid for by Richard Douglas, an ENT surgeon and professor at the University of Auckland.

Douglas said the concept for the mobile clinic was not new.

“The man who took the initiative was Sir Patrick Eisdell Moore, the medical officer of the 28th Māori Battalion in World War II.

“When he came back, he was working in Auckland as an ENT surgeon, but he was aware that his soldiers’ children had poor ear health, so he put together the original ear caravan with his own hands. It was literally a caravan that he put on the back of his Land Rover. He often drove to the Eastern Cape and saw children there, diagnosing them as having glue ear or other ear problems.

Those children would then receive their treatment at the Greenlane Clinical Center in Auckland.

Douglas said the new version of Sir Patrick’s ear caravan was equipped with state-of-the-art equipment and digital technology, meaning doctors working in it could access the same data and information as if they were working in a major hospital.

“And so what it really means is that you can run a clinic outside the confines of the hospital with the same efficiency as if that clinic were within the walls of the hospital,” he said.

The idea to follow in Sir Patrick’s footsteps emerged at a conference four years ago, during a discussion about the difficulty of ensuring equal access to health facilities for people living in rural New Zealand.

Douglas designed it with Whangārei ENT surgeon Dr David Waterhouse, who used the van one day a week to see patients while it was parked outside Whangārei Hospital to ensure everything worked as intended.

Douglas had not met Sir Patrick personally, but the generation of ENT surgeons who trained him had been trained by Sir Patrick.

“And they spoke of him with great reverence.”

He had chosen to focus on Northland because the “tricky geography” meant some patients were like that far from a big hospital like almost everyone else in New Zealandbut also because his colleague Waterhouse immediately saw the benefits for the region.

Waterhouse said mobile ENT clinics had existed for many years but were limited in their ability to assess patients until the advent of digital technology.

“So this van has really been set up to provide the same level of care that we do at our Whangārei and Kaitāia hospitals. It has been a very, very generous donation from Richard and his family, and we are very grateful for that.”

Waterhouse said they had worked together on the project for three years, had the van blessed in October and held the second pilot clinic last week.

“Our plan is to rotate the van into areas where the need is really high. At the moment we don’t really serve the Mid North and Dargaville well. Those patients have to travel quite a distance to see us in Whangārei, so our The aim is to take the van to Kawakawa and Kaikohe and Dargaville, on an eight-week cycle, providing a service closer to home.”

It was scheduled to make its maiden voyage to Kawakawa on January 10.

Unlike previous ear caravans, which focused on children’s ear health, this one was suitable for everyone.

“We have a huge waiting list of patients across our specialty, so we are focusing on our tall waiters and our urgent patients. But we have also had some walk-in patients,” Waterhouse said.

Waterhouse said Northland’s ENT service was good at seeing urgent patients within a few weeks, especially those with cancer. However, patients with routine or semi-urgent conditions often had to wait six to 12 months before they could be seen.

“Some of our patients with tonsillitis or sinus disease or diseases of the external auditory canal, conditions that really affect people’s lives but may not be life-threatening, are definitely waiting longer than we would like. There are a lot of factors for that – it’s certainly gotten worse since the health care issues due to Covid, and the significant changes the public health system is undergoing – but this is something that we hope will make it a little bit better.”

Waterhouse said Douglas had not only paid for the van – named Tarāpunga, after the native red-billed gull – but had also set up the Tarāpunga Trust to cover ongoing running costs. If successful, the service could be expanded to other parts of the country, such as the Eastern Cape.

Douglas said his dream for Tarāpunga was simple.

‘What I would like is for the communities in the more remote parts of Northland to feel that if they have a problem with their ears, nose or throat, the mobile clinic will come along in a few weeks and it will be very easy for them to to go there. And all the things you could have done at Whangārei Hospital will be done very close to their home, and they will be confident that the van will show up again in eight weeks. .”

Built in Hamilton, the mobile clinic was based on a third-generation Mercedes Sprinter van, with ample headroom and space for not only the patient and doctors, but also the patient’s family.

The Tarāpunga Trust will loan the van to Health NZ Te Tai Tokerau free of charge.

All procedures performed at Whangārei Hospital’s ENT clinic can be performed in the van, including eardrum transplants, head and neck skin biopsies, endoscopy, vertigo maneuvers, treatment of chronic nosebleeds and investigations for hearing loss and thyroid abnormalities. Insertion of grommets can only be performed on adults because children require anesthesia in an operating room.

According to Health NZ, almost 40 per cent of all Northland children waiting for a first appointment with an ENT specialist are waiting – more than double the figure for adults.

Nearly 60 percent of patients waiting more than four months for an ENT appointment in Northland were children.

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