We were much better prepared this trip with all the appropriate paperwork being completed for customs well ahead of time. There was a complete team with an anaesthetist, a scrub nurse and junior registrar. We chose not to stay at the hospital accommodation because of the lack of reliable hot water and the number of dogs and cockroaches in and around the location.

We sent equipment ahead by courier but this was not at the hospital when we arrived. It took a phone call to Australia and 7 or 8 phone calls to customs, stores and so on to get the equipment released for our second day. Most of this equipment was for the staff to use after we left so it didn't delay our lists.

Rather than flying into Nadi and driving across country on poorly maintained roads we flew to Nausuri where we were met by one of Rosie's staff with a rental car. The week would have been much less enjoyable without the freedom the car gave us.

There are currently no dedicated Orthopaedic trainees with Siti Traill having completed his training and working as a consultant along with Emosi and Eddie.

Outpatients clinic followed Grand Rounds on the first morning. There were inpatients with Neurofibromatosis, primary and secondary tumours, open fractures, osteomyelitis, SCFE and so on.

Two registrars were assigned to me and because they knew me from last year they were keen to attend and learn. This was quite different from last year when a great deal of the time I was doing the work without any local support. I was able to teach basic joint examination and corticosteroid injection techniques and created an operating list for the following few days. Again we were better organised having had one theatre allocated to us for most of the week. The patients selected for surgery were taken next door and assessed by Dr Lambros and only one was not deemed to be fit for treatment.