Standing tall in his hospital scrubs, curiously looking through the file of a young toddler before greeting him in a cheery voice which is instantly reciprocated with a generous smile from the patient. This is how Dr Savenaca Seduadua, the Pediatric Registrar at CWMH normally starts his daily shift consulting and checking on his young patients who are suffering from various kinds of cancer.
The Oncology Unit of the Pediatric Department is a special unit dedicated to children who are suffering from cancer.
Speaking about his work Dr Seduadua says, “My work is general paediatrics which includes ICU care of children and newborns as well as pediatric oncology. I enjoy the satisfaction of presenting healthy kids who initially came in very sick back to their family.”
Growing up, Dr Seduadua had no doubt that he would be a doctor one day. “Medicine has always been of interest to me and so growing up I took up Science subjects in high school to ensure that I would be able to pursue that goal,” he said.
Tertiary Life and Career
Originally from Muanaicake, Vutia in Rewa, Dr Seduadua grew up in Suva and completed the Bachelor of Medicine and Bachelor of Surgery (MBBS) at the Fiji School of Medicine (FSM) which is now the Fiji National University’s College of Medicine, Nursing and Health Sciences (CMNHS).
Reminiscing his FSM days, Dr Seduadua says, “Thinking of my undergrad days brings back happy memories, living in the dorms, having tea with my classmates all in one room and conversing away.”
Adding on, he said, “My family was always supportive of my studies at FSM. In my second year, however, we had some difficulties as my father had passed away. My mother had to support my brothers and me by herself. We are fortunate that she prioritised education and ensured that we finished our studies and had good jobs.”
The six-year MBBS journey began in 2006 and ended in 2011. He completed his one-year medical internship at the Lautoka Hospital and had his first posting as a Medical Officer in Ra Subdivision.
After two years, he was posted to the CWMH as a Paediatric Registrar. He used the opportunity to complete the Postgraduate Diploma in Child Health Programme at FNU in 2017.
Pediatric Oncology Unit
Most of the children coming into the Oncology Unit are on chemotherapy, which weakens their immune systems, therefore, making them vulnerable to various illnesses.
“Unlike other sick children when an oncology pediatric patient is sick, they are admitted irrespective of how mild the sickness is,” he shared.
“The other thing that makes them different as well is that because of the chemotherapy that they receive children can be very fastidious with food, so we usually give them a preferential diet facilitated by the hospital dietician,” he added.
The Oncology Unit rooms are painted with cartoon characters and have the comforts the child and the family would appreciate. For example, the room has a television, a fridge as well as air conditioning. The objective is to make the patient and their family as comfortable as possible.
According to Dr Seduadua, the challenges faced in oncology is mostly to do with end life care especially with those patients whose cancers cannot be treated. This can be quite difficult for the medical staff and most of all the patient’s families.
“The rooms in oncology are private rooms so if the patients need to be admitted we try and minimise visitation restrictions as much as possible and accommodate for any last religious rites, etc that the family needs. We also involve the counselling centres if needed. We do this to assist the families to cope with the situation,” he said.
“I like working in pediatric oncology because of like primary care relationship over a long period of time. As patients are diagnosed with treatable cancer (certain leukemia and kidney tumour cases) usually receive treatment over a long period, so I get to know them and their families better. I am able to develop a relationship which I cherish.”
Advice to the General Public
According to Dr Seduaedua, cancer has always been thought of as a “death sentence” but that is not the case anymore. Few childhood cancers can now be treated in Fiji such as certain cancers of the blood, kidney, eye, and so on.
Dr Seduadua says that pediatric cancers present itself very differently.
“These are non-specific meaning their manifestation may mimic other diseases such the common flu. There is a common mnemonic (pictured below) that has been formulated that represents “red flags” and is highly suggestive of malignancy to help parents and guardians,” he said.
Continued, unexplained weight loss
Headaches, often with early morning vomiting
Increased swelling or persistent pain in bones, joints, back, or legs
Lump or mass, especially in the abdomen, neck, chest, pelvis, or armpits
Development of excessive bruising, bleeding, or rash
Constant infections
A whitish color behind the pupil
Nausea which persists or vomiting without nausea
Constant tiredness or noticeable paleness
Eye or vision changes which occur suddenly and persist
Recurrent or persistent fevers of unknown origin
“Presence of one or more of these signs in children is an indication for presenting to the nearest health centre or hospital for evaluation by a medical professional,” he added.
Dr Seduadua is currently pursuing a Masters of Medicine in Pediatrics from FNU. He aims to complete that and eventually obtain a specialist registration in paediatrics.