MCRI Student Life - Josh Szanyi, helping newborns survive respiratory distress syndrome in Fiji

"Studying paediatrics lets you be creative and find a career that suits you. You just have to follow a different trajectory.

I'm a junior doctor currently working at Western Health. Last year my path took me to Fiji where I joined MCRI's Pneumococcal Research Group and the Centre for International Child Health, Department of Paediatrics to complete my MD research project.

My project investigated respiratory distress syndrome (RDS) in Fijian newborns.

A well-established treatment for RDS, surfactant, was recently introduced into neonatal care at Colonial War Memorial Hospital in Suva. But in a resource-poor setting this is an expensive treatment, so we needed to understand the epidemiology of the syndrome to work out what sort of impact surfactant had on outcomes for newborns with RDS.

We reviewed all RDS-related admissions at Colonial War Memorial Hospital over a two-year period and collected data related to their demographics, clinical features, treatment and mortality. We found that the rate of RDS at Colonial War Memorial Hospital was 6.7 per 1000 live births, which is quite similar to other low- and middle-income countries.

Our study highlighted that neonatal survival in Fiji can be improved by introducing surfactant replacement therapy, increasing coverage of antenatal steroid administration, and improving the continuum of care between neonatal and obstetric services. It forms the basis of an economic evaluation of surfactant replacement therapy in Fiji.

This was my first time planning and executing a project from start to finish. It was a steep learning curve but I was very well supported and now feel confident completing these processes in the future.

The most valuable lesson I learned was that you need to be flexible and open to setbacks, particularly when completing a project in an unfamiliar environment and cultural context.

As my career progresses I am drawn to community and public health. They're interesting areas because they are where medicine intersects with politics, sociology, and the wider context of health. Working in this field gives you the chance to make a huge difference, not only on an individual level but also to entire communities. I am inspired by the potential for public health research to have such a meaningful impact on so many people's lives.

I am studying medicine because I want my career to help to improve people's lives. Right now, I'm not sure exactly what this will look like, but I'm learning a lot as I figure it out!