Dr Oswald was travelling with St John of God Hospital Ballarat’s international health project officer John Macdonald last month to review a twinning program they had set up all those years earlier.

Collapsing on Nuku’alofa streets due to a mismatch of medication and hot weather, Dr Oswald was rushed to emergency and was amazed at how like an Australian hospital it could be.

The twinning project had started when a young Tongan anaesthetic registrar had interned with Ballarat Health Services in the early 1990s and explained in a visit to Rotary Club of Ballarat West about the lack of equipment and impoverished health care in his country.

Dr Oswald, a Rotary member, and Macdonald, a nurse, worked together to help provide equipment. 

When they first visited Vaiola Hospital they found picks roaming hospital grounds, rubbish dumped out hospital windows and diseases like diabetes were rife. There were no ambulance.

Dr Oswald said while many other government agencies had been involved in rebuilding and refurbishing the hospital, the twinning program remained central to hospital training and development.

“An enormous education program, driven by John (Macdonald)...quietly raised not only the clinical profile of the hospital, but also the maintenance infrastructure,” Dr Oswald said.

Each year the twinning program, working with other health organisations helps to bring in major medical advances, like dental, ophthalmologist and in prosthesis.

A radiological twinning program has also been set up by Lake Imaging in Ballarat.

Macdonald announced his retirement in the visit to Vaiola Hospital.

In his time leading the program, 132 Ballarat delegates had visited the hospital and 134 Tongans had sent at least a month-long exchange in Ballarat in the past 25 years.

St John of God Ballarat surgical nurse Carolyn Murnane will take leadership of the twinning program.