Tropical Island Medicine in the Coral Triangle

Hoga Island is an uninhabited island situated in the golden coral triangle in the Western Pacific Region. The triangle includes the waters of several idyllic destinations including Indonesia, The Philippines, Papua New Guinea and Timor Leste. With over 200 species of fish living amongst nearly 600 species of coral, this place is a hub for marine research including the Operation Wallacea Marine Research Station.

Ariel view of Hoga island, the beautiful turquoise coral reef is visible around the tropical island

Hoga attracts marine biologists from around the world, year round, due to the state of the art facilities. Students conduct vital research on the reefs, the impact of climate change on the coastal communities and the billion dollar fish-harvesting industry which sustains the lives of many living in the area but is putting huge strain on the marine habitats.

The marine site researchers produce data to develop sustainable plans for reef conservation; monitoring, protecting and restoring the coral in addition to developing more sustainable fishing initiatives for the local communities.

The beautiful turquoise water extends from the tropical island where you can see a long pier, ideal for snorkelling

Life on Hoga

Whilst on expedition both the staff and students are housed in traditional wooden houses situated above the islands coral holes, each with a mandi (squat toilet) and bucket shower. There is a large communal dining area, an open-air lecture theatre and wet and dry laboratory facilities.

With no roads on the island, small paths join the huts with the main buildings and nothing is more than a 15 minute walk. You are guaranteed to chance upon tropical species each day including the poisonous banded sea-kraits, who frequent the paths at night. Carrying a torch is essential.

A black and white banded sea-krait surrounded by beautiful red and pink coral in indonesia

The dive centre on Hoga offers gear rental and diving qualifications ranging from PADI open water certification to divemaster. Under the water you will find an impressive array of sea life including several species of nuddibranch, blue spotted rays and dwarf cuttlefish.

tropical fish underwater on hoga island where I was practising tropical island medicine.

The dive centre has five small shore boats available to take you to a variety of diving locations including Pak Kasim, inner and outer pinnacle and Bouy 1, my personal favourite dive spot, a drift dive with a shoal of barracuda.

Tropical Island Medicine

Access to the island is by boat and there are no roads or motorised vehicles, this makes emergency evacuation complicated. Early treatment of medical problems essential to avoid the need for evacuation. The medical clinic is fully stocked with all the necessary medications to treat anything from minor everyday ailments to stabilising patients with suspected emergencies before arranging evacuation from the island. There are carefully planned evacuation procedures for potential emergencies and lower priority evacuations. It may be possible to evacuate patients via public transport, normally this method takes around 24 hours.

The closest medical facility is located in BauBau, here they have facilities suitable for treating medium priority illness such as cellulitis, pneumonia and other general medical problems.

If an emergency situation arises and someone life is in danger, they will need an emergency evacuation from the island immediately. In this specific scenario it would involve the special charter of boats or planes.  Any form of decompression illness requires emergency evacuation to Bali where there is a fully functional decompression chamber. The onsite medic makes decisions regarding evacuations alongside the site’s management team.

Summary of Presentations

Tropical island medicine poses several challenges to traditionally trained doctors. Primarily adapting to practice in a resource-poor environment. The most common presentation was otitis externa with several students suffering from both bacterial and fungal infections. Often, due to the humidity and damp conditions, infections take longer to improve. Barotrauma and otitis media were common presentations also. Any ear problems often mean students are unable to dive for the rest of their expedition.

There were no major emergencies during the expedition and no one required medical evacuation from the island. One student complained of lip tingling during a dive requiring dive abandonment and urgent oxygen treatment. However, symptoms were secondary to hyperventilation and subsided with calming measures and oxygen therapy.

Infected mosquito bites and skin rashes compromised the majority of other presentations alongside minor cuts and wounds from coral.

If you are interested in expedition medicine, check out our opportunities page for information on the latest expeditions.

A beautiful sunset on Hoga island where the sky is various shades of pink orange and purple with a small fishing boat in the foreground

 

 

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Hoga Island is an uninhabited island situated in the golden coral triangle in the Western Pacific Region. The triangle includes the waters of several...
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