Digby’s Story

DR DIGBY CULLEN – GASTROENTEROLOGIST

I volunteered as a Gastroenterologist for ADFA when it was an embryonic organisation in 2005 mainly because I wanted to make a contribution to improving health in the developing world.

Madagascar seems an obscure choice of location to many but was chosen because my good friends Guy and Jules Le Clezio had fascinated me with their tales of the magic of the country and they were offering to provide logistical support to ADFA. Our initial trip to Toliara with ADFA Founder, Dr Graham Forward, Emily Forward (then RN now dermatologist) and the late Dr Mark Thackray was seminal in that it revealed a huge burden of gastrointestinal disease in Madagascar. Gut diseases are the second most common cause of admissions (after trauma) to hospital in Madagascar and there were minimal effective treatments available anywhere in the country.

Since 2005, ADFA has embarked on a substantive and mostly successful program of equipping and training in endoscopy and gastroenterology. With the critical initial support of Cat Ferrie (then Olympus Equipment WA), WA hospitals and companies, we established an endoscopy equipment supply train of donations that has equipped 6 endoscopy units in 4 cities. Using this $2-3 million of donated equipment we have been able to help train the doctors, nurses and technicians necessary to provide services year-round. Cath Poole RN has been the driver of this equipment supply pathway and nurse training over 14 years. A cast of impressive mostly RPH gastroenterologists (especially Dr Chiang Siah), marvellous endoscopy nurses and technicians have done great work in a tough environment over the last 18 years. Our colleagues in Madagascar live and work in this difficult space and Professors Rado and Helio in particular have been inspiring collaborators.

Our new venture is to build a National Endoscopy Treatment and Training Centre in Antananarivo.

I have been enriched by my participation in this program. Learning how to work with the people, politics, poverty and psychology of Madagascar has been quirky, complex, at times all consuming, unpredictable, chaotic, overwhelmingly interesting and fun. Thanks to Graham Forward and the ADFA Board, ADFA staff (especially Chris Tasker from the “embryo” organisation until last year) for the opportunity and their support.