Saturday, 28 February 2009

Part 2 of the Medivac - Arriving at The Palace [yes, very belated]

I was prompted to action partly by Steve, and partly by seeing Rob and Lara's final entry on the blog: I never finished my hospital saga, and it is a story that needs to be recorded for posterity. (note: datestamp altered to be closer to part 1 - Steve)

When last I left you, Steve and I were preparing to leave the "comforts" of National Referral Hospital in Honiara so I could receive some First World medical care as recommended by the insurance company. We advised them the next flight departing Honiara would be that evening, a Sunday. With about six hours before the flight, a company consultant rang to inform me that yes, I had been approved to fly to Brisbane and was booked on the flight. But how would I fly by myself, I asked in horror? I needed assistance to get to the toilet twenty metres away, had blood pressure of 80/50 (normal is about 120/80), had collapsed a couple of days ago, couldn't sit up for more than a few minutes at a time - how would I carry a bag, check myself in, walk through the airport, get a taxi to the hospital? "Oh," the consultant replied helpfully. A long pause ensued. I explained to her, with minimal hysteria, that I was better qualified than most to assess my own safety to travel - AND I WAS DEFINITELY NOT SAFE! With that, she promised to try to get Steve on the flight as well.

The hours oozed by, the stress levels rose (Steve called our parents, so they were anxious along with us), and I probably vomited at some stage during all of that too. With about 2 1/2 hours before the flight was due to depart, the insurance company called back: yes, Steve could accompany me. Phew.

A nurse came with us to the airport, so that I could have fluids running through my IV until the last possible moment. Steve held me and our scant luggage, and looked for a place for me to sit, or preferably lie, but most seats were full. As we have learned, getting by in Solomons is all about who you know: as we looked, we made eye contact and exchanged eyebrow raises (see previous blogs) with an air hostess we had met on two previous flights! She immediately cleared a couch for me to lie on, and hurried off to sort out a wheelchair and helped Steve get us checked in with minimal hassle. We were waved through, rushed through even, despite carrying about six litres of water, and me and the wheelchair setting off the scanner alarm.

We don't normally have a lot of kind words for Solomon Airlines (none for their domestic services), but the staff were lovely and helpful, and I think we even departed on time. They found me blankets and pillows, and a wheelchair as quickly as they could at the other end. It was an uncomfortable flight, however, as my belly begun to expand very uncomfortably due to my enormous liver and spleen. I now have so much more sympathy for the babies I used to see with liver problems - it is impossible to sit up straight, or lie on your left side with an enlarged liver, it really feels like your organs are being pulled out of you with tongs. But we made it, and must have got through immigration and customs very quickly, as I barely remember it.

A friendly taxi driver drove us (very carefully over the speed bumps, as I didn't want to lose my liver) to the Royal Brisbane and Women's Hospital, hereafter referred to as The Palace. Just being in an Australian city was reassurring, even though we don't know Brisbane well. One way or another, it had to be better than where we had come from. A brief wheechair ride up into the clean, new emergency department, and we entered another world....

Friday, 27 February 2009

The Medi-vac

Some, if not most of you by now, will have heard that Kel is no longer here with me in Auki (she’s been home in Melbourne since the start of Feb). I’ll try describe the circumstances surrounding Kel’s medi-vac, and then we’ll wait to see how long it takes her to correct me, and fully depict just how awful it was to have a bad dose of malaria…

Well, it was during the second week of the St. Matt’s visit that Kel started having migraines that progressively worsened. She was also really tired, but soldiered on as much as she could so we could achieve as much as possible while our friends were in town.

After an agonising week spent in bed, trying to minimize noise and daylight intrusions (if you’ve been here you’d understand just how hard a task that is with paper-thin walls, louvre windows, and mesh curtains… and the dogs, kids, wood-chopping etc) we managed to find a thermometer which confirmed her temp was pretty high. So 10 days into a migraine, and only a small hint of a fever – and no other obvious signs of malaria – we called the health insurance mob.

The health insurance guys make their own jobs a whole lot harder by not listening to the local advice you give them – they really had no idea how things happen in our third-world country – but they managed to get Kel on the afternoon flight to Honiara, nursing a sore sacrum after she collapsed in the shower that morning. They failed to book me a flight, saying it was all booked up (we knew it wouldn’t be – and it wasn’t). So Kel, only barely safe to walk by herself (she was lucid enough to self-assess) escaped Auki by herself, the plane taking the long-way-round to Honiara. The National Referral Hospital (called No.9, a name earned during WWII) sent a vehicle, and Kel made it to the emergency department between about 5 and 6pm.

Our good friend, and (we think) the best doctor from our hospital, Dr Jack, had been transferred to No.9 only a week earlier. Luckily for Kel, he spotted her waiting in E.D. as he was heading home, so he returned to take care of her that night. Dr Jack was able to get her processed really fast, and also organised a single room on his ward (which was fantastic, because whilst we’re used to being stared at, you don’t want to be stared at by 30 other sick women when you’re also not well…). Grace (Dr Jack’s wife), and our volunteer buddy Mike came to visit and bring food – which was lucky as the nurses didn’t offer her any, expecting that she wouldn’t like Solomon food… Despite her illness, Kel was able to launch into a tirade (in Pijin, of course) about how long she had lived in the Solomons and even though she has white skin, she is black on the inside and certainly not afraid of Solomons food!

After assessing Kel, the doctors weren't certain that she was suffering from malaria, but the test was ordered as a precaution. Since it was the weekend, Mike came in to take her to a private clinic for the test, where it was confirmed that she had “PF 4+” – which translates to be the potentially fatal kind of malaria you really don’t want (later in Brisbane we discovered she also had PV malaria: the jury is out on whether she actually had both or the initial diagnosis was incorrect), and a severe case at that.

Here I (Kel) will take over to garner some sympathy as I tell you a little about what hospital is like in Solomons. I spent two days and two nights in No.9, and I had one sheet that followed me from a bed in the resus room, to a bed in another waiting room before finally sharing my ward bed with me: there was no other clean linen. In some wards, there are mosquito nets, but there was not on mine, and so in the evenings, I watched fat black mozzies looping their way around my room. Maybe they were males, as I don't remember being bitten. Steve did plenty of hunting and killing for me, though.

I was put on intravenous fluids when I got to No.9 after they measured my blood pressure at about 80 over 55. None of those fancy pumps, though, just gravity, and waiting for my wrist to swell up to know that the line wasn't in the vein anymore, or me anxiously prompting the nurses about the last bag taking 24 hours to run through rather than the two that the first had taken. Monitoring is occasional and low-tech - a mercury thermometer under the arm, a manual blood pressure cuff, taking the pulse the old-fashioned way. Not that there is anything wrong with that, but somehow it is more comforting to know that multiple machines are checking on your wellbeing.

Even though the nursing staff insisted I use their staff facilities, I am unconvinced of the benefits - the shower walls were as green and slimy as any other cubicle, the toilet comparable in cleanliness. Not that it was such a bother, all I wanted to do was get back to bed, with Steve holding me up, and my IV fluid bag in tow.

The thing I found the hardest, and I didn't even realise this until afterwards, was keeping on talking in my second language whilst I felt so bad that death seemed an attractive option. It takes effort, even though Pijin is not a difficult language and I am very comfortable with it, this was the sickest I have ever been, and even talking was a draining exercise.

But....there was another chapter still to come in my hospital adventures, and that will come next...

Friday, 20 February 2009

St. Matt's visit

January was jam-packed for all of us, with lots of travel and work to do. Kel & I spent a fabulous week home in Melbourne for my little bro’s wedding, and R&L managed a couple of weeks back in NZ, also for a family wedding – we were particularly ticked-off that they got to see the David Crowder Band at Parachute (watch out for a pic – I’m sure Rob won’t last too long before getting one on the site!)

Anyway, Kel & I were accompanied back to Auki by 8 mates from our St. Matt’s community in Endeavour Hills, Melb. The team deserve to be named because of the incredible work done over 2weeks – Roy & Jennifer B, Gay B, Peter B, Clair B, David & Libby E, and Andy E. Even though they were unable to join the team because of personal circumstances, Mark & Rose B made the trip possible with their vision, coordination, and particularly their enthusiasm to maintain St. Matt’s long term relationship with the Sols. All along, the people of St. Matt’s have been our greatest supporters – they provided the initial inspiraion for Kelly & I deciding to volunteer here, after we toured with them in 2005 (even though we were still in NZ at the time) – but that’s another story…

Back to the team’s visit:
We had two main goals – literacy and a little health training at Dukwasi village, and; continuing construction of the workshop at Kilu’ufi Hospital.

The training at Dukwasi village was for their women – many of whom are/were totally illiterate. This village is close to our heart as they’ve welcomed us like one of their own. We can’t begin to describe how excited they were in the lead up to the trip! The anticipation was not without a big spoonful of apprehension, as they told us of a white lady from AusAID who had come once to speak to them, but her intended audience was so fearful they fled, and she never did the talk. (See previous blogs on what a big deal it is to be white over here!)

Our ladies ran workshops at the village each morning for a week (if the village ladies don’t go to the garden each day, the family does not eat). The first day and a bit were focused on basic health issues (e.g. sanitation, nutrition, wound and back-care). The remaining time was devoted to language training. If villagers have some education they can often read English, but they struggle to read Pijin. Additionally, they don’t completely comprehend English, but they “get” everything when it’s in Pijin – it’s all a little backwards really…

The Dukwasi women were very keen to learn to read Pijin because of the publishing of the Pijin Bible mid-2008. Understandably, without really being able to understand Pijin, our ladies were up against it – luckily their skills and experience with teaching, other languages, and creativity allowed them a lot of flexibility to adapt to the challenges.

At the end of the week we all gathered together for a feast hosted by the whole village. There were speeches, little skits practiced by the women’s groups, songs, and gift presentations. St. Matt’s bought 20 Pijin Bibles for the village, which were given to family groups to encourage them to read and practice together. My sources at the village happily report to me that the Bibles are looking a little worn when they take them to church each week – that’s gotta be a good sign!!

Now, the men got down and dirty amongst the workshop at Kilu’ufi Hospital – laying the first 6 layers of bricks around the building, and making the window frames. We started early every day, trying to make as much progress as possible before the mandatory afternoon rains. The conditions got the better of the boys from time to time, but I was really proud of their workmanship and how they gave their all in really demanding conditions.

St. Matt’s, being as generous as ever, donated so much money that we were able to purchase some decent tools and other bits and pieces that we were able to spread throughout the team (thanks to the logistics master, Mark!).

We achieved about a month’s work of work with the team here, and even more significant to us was the phenomenal encouragement of having our friends selflessly come and contribute to our work over here.

The team also managed a few cultural experiences while in Auki – traditional pan-pipe band, man-made islands and shell-money demonstrations in LangaLanga Lagoon – as well as snorkeling, church, and our Solo-style cooking!

I’m also very excited that Karl (Kel’s dad), David and Libby E, and Jennifer B are returning at the end of March to continue helping us in our last month over here (can’t wait to come home!!!)



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