How We Packed a Cell Saver in Bubble Wrap and Took It to the Solomon Islands

If you’d walked into my living room in Sydney one afternoon late last year, you’d have found me kneeling on the floor next to a decommissioned Autolog cell saver, a giant moving box, and what felt like half a warehouse of bubble wrap. I was trying to work out how to get 25 kilograms of medical equipment to Honiara in one piece.

A few weeks later, that same machine was sitting in an operating theatre in the Solomon Islands, returning blood to a neurosurgical patient in a country that had never seen perioperative cell salvage before. This is how we got it there, and why it mattered.

The ask

The invitation came through ALEAN, a neurosurgical outreach program run out of Nepean Hospital in Sydney. ALEAN takes neurosurgical care to patients in the Pacific who otherwise wouldn’t get it. The program is led by Narko Tutuo, an anaesthetist at Nepean who is originally from the Solomon Islands.

On the trip before ours, the team had run into trouble. Patients presenting for tumour resections were losing enormous volumes of blood. These are the kinds of cases where, in Australia, we’d have caught things earlier on imaging. In the Solomons, patients present much later, and the tumours are bigger, more vascular, and a lot messier to operate on. Without a blood bank to draw from, members of the team had rolled up their sleeves and donated blood directly in the operating room to keep patients alive.

It worked. But it wasn’t sustainable, and it wasn’t safe. Narko reached out and asked whether we could bring perioperative blood salvage to the next mission.

We said yes, on one condition. The goal couldn’t just be running the service ourselves for a week and flying home. It had to be about training the local team so they could keep doing it after we left.

Getting it there

We sourced a decommissioned Autolog, a machine that had finished its working life in Australia but still had plenty to give. I packed it at home. One big moving box, endless bubble wrap, more tape than I care to admit.

Because of the time pressure, we air-freighted the machine ahead of the team. The disposables, collection reservoirs, bowls, tubing sets, suction lines, came with us as checked baggage on the flights. Nicole Sham, my colleague at ABM and the other team member on the trip, helped shoulder the load.

The machine landed, and then it stopped. Customs held it because, even though it was donated, it had an intrinsic value attached to it. We waited. It was released one day before we arrived. Our very first job at the hospital was to unwrap it and power it on. It had survived the trip intact. That was a good moment.

A brand new hospital (and a broken lift)

We were based at the National Referral Hospital in Honiara, and we had access to a brand new facility built and donated by the Chinese government. Modern theatres. A proper training room. On paper, everything you’d want.

The patient lift didn’t work. The other lift was too small to fit a trolley. Which meant that patients, including some who had just had hours of neurosurgery, were being transported through the hospital in chairs. That detail has stuck with me, because it captures the reality of working in resource-limited settings better than any statistic I could give you. Beautiful new building. Broken lift. You work with what you’ve got.

Five cases, fifteen units

We ran the cell saver on five neurosurgical cases over the week. Mostly tumour resections. Across those five cases, we salvaged and returned the equivalent of 15 units of blood to the patients, in a country where the alternative has, until now, been family donations or your colleagues opening a vein in theatre.

Fifteen units is a lot. It’s roughly the entire circulating blood volume of two or three adults. In context, it might be the single biggest impact ABM has ever had in one week.

Teaching it forward

The education was the whole point. We started with a full day in the classroom, principles of autotransfusion, indications, contraindications, how the machine works, how to troubleshoot it. From there it shifted into the theatre, where the local anaesthetic nurses and junior anaesthetists worked alongside us on live cases, taking on more and more of the operation of the machine as the week went on.

By the end of the seven days, most of them were close to being able to run a straightforward case themselves. They were enthusiastic, they were fast learners, and they were already thinking ahead.

What excited them most wasn’t neurosurgery. It was obstetrics. Ruptured ectopic pregnancies are a major cause of maternal morbidity in the Solomons, and without a blood bank those cases are devastating. The local team immediately saw that the same cell salvage technology we’d brought for neuro could save mothers. When your trainees are already telling you where else to use the thing, you know the training has landed.

The machine stayed

When we packed up at the end of the week, the Autolog didn’t come home with us. It’s still in Honiara, with the local team, ready to be used in their own theatres.

The harder question is sustainability. A cell saver is only useful if you can get disposables for it, and getting consumables reliably delivered to the Solomon Islands is a real challenge. We had a lot of meetings about it during the trip, and it’s something we’re still working on.

Going back in May

We’re heading back in Novmeber 2026 to keep the work going, more training, support for the local team as they start using the service in their own hands, and hopefully progress on the supply chain problem. I can’t wait.

A mission like this is never really about one thing. We went there to bring cell salvage, but the reality is you end up helping across the board, problem-solving with the local team, learning as much as you teach. The thing I’ll remember most is how hard the local staff worked to take it all on. They made it easy to want to come back.