Dialogue: Where doctors rule a brave new world

By TAPU MISA

You have to hand it to the members of the Cook Islands Government. They're nothing if not adventurous. Not for them the laid-back approach that so many mistake for the Pacific Way. They'll try anything, even if it means boldly going where our own Ministry of Health fears to tread.

As the Cooks' Prime Minister, Dr Robert Woonton, and his predecessors have found, you have to think laterally when you are on a bunch of islands with a population smaller than most Auckland suburbs and next to no natural resources.

And if that means jumping head-first into the brave new world of xenotransplantation and pig-cell transplants, Dr Woonton and co aren't about to quail at the fear of a rogue retrovirus or two.

As Auckland diabetes researcher Dr Bob Elliott has found to his undoubted delight, few regimes anywhere are quite as welcoming or as keen to push the frontiers of medical science as the Cooks.

There he was, unwanted and misunderstood by health authorities at home, and forced to take his revolutionary pig-cell trials all the way to Mexico, when along came a former Cook Islands Prime Minister, Dr Joe Williams, with an offer that would have attracted any red-blooded researcher: a chance to go to the Cooks and have a go at curing the country's growing number of diabetics.

You can't blame the man for being tempted. The Cook Islands have to be one of the best places in the world for researchers, and I'm not talking about balmy temperatures and tropical scenery.

This is a place that has been run by the medical profession for much of the past two decades - four of its past five Prime Ministers are doctors. That's high, even for the Pacific, where doctors run a close second to God and are seldom challenged.

Take the good Dr Williams, for example. He's the New Zealand-based MP for the Cooks, and a doctor at the Mt Wellington Accident and Family Health Centre. In the 1970s, Dr Williams was Minister of Health and one of the chief cheerleaders for the now infamous Milan Brych.

Brych was something of a self-made alternative cancer specialist. He was booted off the medical register in New Zealand in 1972 after it was discovered that he had not only never received medical training but had been in jail in Czechoslovakia on a charge of robbery at the time he claimed to have been in medical school.

That didn't seem to hurt his reputation in the Cooks, where he was warmly embraced and invited to set up a clinic to treat desperate cancer sufferers.

Most of those patients are now interred at the neglected Nikao cemetery on Rarotonga, aptly nicknamed the Brych Yard.

It took another doctor, newly elected Prime Minister Dr Tom Davis, finally to get Brych out of the country in the late 1970s. Brych went the United States, where he was eventually jailed, chiefly for practising medicine without a licence, grand theft and grand theft by false pretences.

Which is not to suggest that Dr Elliott is of the same mould - even if one of the New Zealand diabetics making an impassioned plea for local support in the Cooks last week forgot to mention that he was also a shareholder in Dr Elliott's research waka, Diatranz.

Prime Minister Woonton assures us that Dr Elliott has the island diabetics' best interests at heart, and there's no reason to doubt him. but it must be nice all the same to work in a country singularly unshackled by bothersome regulations and controls.

Dr Woonton was until recently the chairman of the Cook Islands Medical and Dental Council, which was set up in 1976 to help to get some regulations and codes in force for the islands' doctors.

In its 26 years of existence, local journalists say, it has not passed a single code or regulation. Nor has it struck off any doctor for misconduct.

That would speak volumes for the professionalism of the islands' doctors if it were not for all those hospital deaths that go uninvestigated by the part-time coroner, who also doubles as the registrar of the High Court.

He has been in the job since 1997 and cannot remember ever having done an autopsy on anyone who has died in hospital, suspicious circumstances or otherwise.

Some people - the folk from the International Transplantation and Xenotransplantation Association, which despite being pro-animal transplants is deeply worried about the risks of Dr Elliott's research - have suggested that the lack of safeguards is the attraction of countries such as the Cook Islands.

Dr Elliott counters that they are members of a flat earth society, and racist to boot. He insists that the Cooks is not at all a crummy place to do research.

One thing is certain. If things go wrong, it won't be Rarotonga Hospital dealing with the fallout. It will be Auckland.