Sunday, 1 March 2009

Part 3 of the Medivac - The Palace

After a couple of months of being back in Australia and working in our embattled public health system, I have plenty to complain about. My experience as a patient in that system, however, was one we are eternally grateful for, and every aspect of care I received was exceptional.

We arrived in the emergency department and were greeted by my panicked parents, who flew up the same evening on hearing of my plight. The wait in the ED was not long, but still uncomfortable thanks to my distended tummy and painful sacrum (traumatised by its sudden and abrupt meeting with the bathroom tiles when I passed out in the shower two and a half days prior). I was considerably relieved to be wheeled into a cubicle and then seen quite promptly by one of the doctors for another recount of the history, plus an explanation that no, I was not contagious! My poor parents and Steve sat out a couple of hours in the waiting room before being brought in to see me, now newly punctured and hydrated with another IV and bag of fluids. At some time after 1am, however, it was not a long visit, although we were all pleased that I would be admitted overnight, and that they could check in to their respective hotels to sleep.

It was a long five hours on my little trolley, punctuated by several trips to the toilet (the fluids were getting in fine now, but clearly they had to get out, too) and a few outbursts from aggravated psychiatric patients. Early that morning, though, there was a bed for me on a ward, all pillowy soft, well-blanketed and with the crispest, almost glowing white sheets I had seen in.....I don't know how long.

I stayed in the hospital for five days, over which time I was looked after by the head of the infectious diseases department (the kind and the wonderful Prof Patterson) and his juniors, wonderful nurses - everyone from the clinical staff to the cleaners and tea ladies were just delightful. And the food was excellent! Steve could probably tell you more about it than me, though, as he cleaned up most of my meals due to my very poor appetite.

Interestingly, the malaria parasites they found in my blood in Brisbane were different to the strain I had been disagnosed with in Solomons. The debate then arose about whether I had both, or whether the initial diagnosis was wrong. I guess we will never know. Either way, I was sick enough that the prof recommended I stay in Australia, and not return to Solomon Islands. By the end of my stay, only my spleen was still enlarged, and so I was a good guinea pig for the registrar to teach a few medical students about examination. They did quite well with some feedback, and were a little excited to palpate a big spleen for the first time. With a few not-so-subtle dropped hints, they deduced that I had malaria.

At the end of the week, I was discharged, having lost my tropical tan, and looking rather scrawny in my now very loose clothing. I stayed with Steve in his hotel, but a couple of days later, we had to part ways: him back to Malaita, and me to Melbourne with Mum. I managed to walk the whole way through the airports, which was the furthest I had moved on foot in about two weeks!

It was another two months before I actually felt healthy again, as the fatigue and malaise persisted for all that time. I caught a couple of gastro bugs while I recovered too, which was pretty demoralising. At last, at last, I feel good, but still just thinking about Solomon Island food is enough to turn my stomach, as I felt so terrible when I left. Yeeeuch.

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.

Steve 
------
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...
Kel

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!!!)

Steve

Saturday, 10 January 2009

Samerai's Demise


Previously rumoured to be Auki’s favourite car, with 5 potential buyers (prior to giving any indications of selling!) the samurai has lost it’s podium in one foul swoop. This intrepid adventurer surviving river crossings, overloading with wantoks and negotiating our perilous drive with the ease of a pikinni climbing a coconut tree, would not have believed it’s demise would occur as a result of a stuck 4x4 transfer gear lever. There it was, last night . . . alone outside the government buildings. Some have tried to argue in a thrill seeking attempt the samurai independently rolled across the level carpark, raced down the slope colliding with the tree. We believe it was pushed.

What could be more riskier for a car with 5 good tyres than being isolated outside its secure compound facing a Friday night alone in Auki township. The samurai knew Rob was going to restore it in the morning ready for further adventures.

Alas, wrangling about the cause does not change the outcome. Although vital parts are intact, the samurai has been bent beyond rectification. The end of the samurai has come. And with it the end of freedom of exploration and the ushering in of hardship with the completion of the Kilu’ufi workshop.

Asta la vista Samurai!

Friday, 9 January 2009

Paradise

Happy Christmas and New Year!!




Rob and I have discovered a wonderful tropical hide-away. Tavanapupu Resort. We had the privilege of staying there 4 nights. This is where we insert a huge rave about everything – the service (second to none – the staff are truly legendary, no glass is allowed to empty, ladies are served first, nothing is a hassle, filleting and cooking fish in their kitchen is greeted with smiles and offers of freshly baked bread to accompany your catch), the accommodation is amazing, tasteful, the beds allowing even us a sound night sleep, location is superb - beautiful grounds, gardens, snorkelling and fishing available. Good swimming beach including shade from the sun. Enjoy a pleasant walk around the island. And that’s while it’s still under renovation!

Saturday, 20 December 2008

You know you are in Auki when:

  • Your hand gets tired from waving at anyone & everyone on the 10 min drive to work.
  • Filling up your water bottle becomes the main attraction for the National Psychiatric Unit.
  • You spend NZ$42 for 2 kg of basic cheese for a taste of home.
  • One of the mars bars you got for Christmas 2007 is still in the fridge in Dec 2008 (too valuable to eat!)
  • You see in a shop a tin of bake bean's used by date was 2006.
  • You stork strange 'whitemen' for conversation and entrap them into coming for dinner.
  • You pass a 3 ton truck crabbing while competing for the world record of passengers.
  • Four vehicles in a row is heavy traffic.
  • Power is off more than on!
  • The daily sunsets far surpass those on Hollywood movies!

Friday, 21 November 2008

Froggy challenge

FroggyA


Here's how the froggy challenge works. You get to write a caption each for the two photos in the comments section. The competition will be judged on Christmas Day with the best captions being displayed on our website.



Froggy B

This will achieve two things - 1) allows us to see if anyone reads these blogs! And 2) Gives us something to look forward to on Christmas Day rather than sitting around missing friends and family!

Have fun, think crazy and enjoy yourselves!

Wednesday, 29 October 2008

On being white - part 1

I have been reflecting, rather seriously sometimes, on my experience of being in a racial minority group. We are white fish in a brown bowl, a walking freak show, objects of curiosity, a temporary distraction for crying babies, things to be gazed on, pointed at and whispered about from a safe distance. Even after a year in this little town of Auki, I can’t walk down our own road without attracting many stares. A stroll through the main street practically halts business and stops trucks. It is rare for people to be unpleasant in any way, rather most offer a smile, a raise of the eyebrows or a “morning”. Rarer still, though, is the prospect of anyone actually speaking more than a few words to me.

I walk through the hospital in the mornings, passing the outpatients department on my way to my own, and keep my head down as I hurry past, to avoid the stares, smirks and even outright gaping. Of late, it has meant I have not seen some friends who have been waiting there, but I am encouraged that they have been brave enough to attract my attention, even though by communicating with me, my peculiarity and “whiteness” envelops them too. For me, it means someone shares in my experience of being ogled, at least for a little while.

On any of the wards, I snatch the attention of at least ninety percent of the occupants. Silence often falls across the dingy concrete room as I slink behind the nurses’ desk to read a patient’s case notes. I sit down to treat a patient, and one or two onlookers will move to a neighbouring empty bed to observe my movements a little more closely, whispering knowingly to each other, “oh, exercise”. On the paediatrics ward, my presence alone will make some small children burst into tears, never having seen a European before.

I swing from being amused by my effect on people to being mildly annoyed. Sometimes, when a child calls out “bye bye white man” (the “bye bye” was picked up from the American Peace Corps, in Pijin it designates future tense, so doesn’t make sense on its own, and we are called “man” regardless of sex), I will mimic their tone and call out “hello black man” in Kwara’ae, the local language. Some of the older kids and the adults pick up on the irony, and we have a good laugh. Many don’t realise, and go on pointing and staring, “oooh, white man”.
One friend suggests that the reason locals distance themselves from we whites is that they don’t expect to be able to communicate. I think this is true for many people; recently I was speaking with a local motel owner who looked at me completely blankly even though I spoke to him in Pijin (spoken by most Solomon Islanders). He initially spoke to me in English, but I replied in Pijin, which usually elicits a surprised smile and an “oh, you know Pijin” response, and then the conversation segues into Pijin and flows more freely. This time, the Pijin didn’t work. My local friend repeated what I’d said, then translated it into Kwara’ae, to which the man was able to reply. It frustrated me that I was unable to participate in the conversation even in one of the man’s own languages, but I couldn’t help but smile at the way my white skin somehow created a language barrier where there was not one.

As I write this, I start to remember a few pleasant encounters we have had lately: a neighbour who lives down the road met us and spoke to us for the first time at the market last weekend (she knew who we were, we’d never seen her before!), a new friend called me at home for the first time wanting to give me some bananas, and a lovely girl working in a store shyly spoke with us last week, identifying herself as a relative of our landlord and has since greeted us with smiles and conversation. It won’t change the gasps and wide eyes when I go into town, but it’s comforting to know some Solomon Islanders are brave enough to reach across the colour spectrum to be our friends.

Kelly

Tuesday, 28 October 2008

Unanticipated Suzuki drowning

Another wonderful weekend was had with Ants & KC down at Su’u. Filled of snorkelling, relaxing and regular bathing in the river - no bathroom could ever have such beautiful surroundings or clean flowing water. Thinking to extend this time we decided to leave early Monday morning to make the 2 hour trip back to Auki for work.

Everything was going to plan until we reached the river crossing near Maoa. Here on Friday we discovered two huge sago palms felled across the road. (Landowner’s dispute) A lovely local lady showed us an alternative route, transversing the river further up and then driving along side until connecting with the main road again. Unfortunately we were unfamiliar with this part of the river and forgot where we had crossed. No friendly local was in sight to share their knowledge so the attempt was made.

The water rose at one stage above the bonnet and the Suzuki went on, growling up a stony gradient and then. . . although the volume of growling increased the movement stopped. Stuck Suzuki! There it hung suspended, three wheels grounded as the river washed away the stones from under the fourth. The river continued its flow through the Suzuki. Fortunately rumblings were still audible and my mission was to monitor and foster these while Rob went for help. It was a surreal experience lingering, alone, gazing on a pageantry of tropical delight, cool water rushing around feet, hands grasping the steering wheel, foot hovering over the accelerator, ears intensely tuned on that vital grumble ready for action . . . yet frozen, inactive.

Rob emerged from out of the bush with about eight locals ranging from children to adults. As they approached the Suzuki a sudden silence filled the air. The engine stopped. Devoid of mechanical assistance Suzuki was surrounded and manually extracted from it’s peril deposited safely on the dry stony bank.

Unfortunately the Suzuki didn’t escape unscathed from its near drowning. Water entered the fuel system and the following two hours were spent in Maoa as Rob worked to restore it to life. God assisted having overseen the tools Rob had selected for the journey, so we were again journeying home with an operating fuel gauge, revived Suzuki (including an improved starter motor) and a great story to share.

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