Visale

Sunday, July 22, 2012

How do I even begin to explain today’s travels… First, Clare and I wanted to wake up and cook Sister Catie and Stephanie breakfast before 8 AM Mass.  We didn’t have many materials, ingredients, or power, so we decided on a makeshift banana French toast.  After Clare spilled cocoa all over herself in the dark and I burnt myself lighting the stove with a match, somehow we came away with a feast by 7 AM and called everyone to the table.  The meal was not half bad and they highly enjoyed it!

Clare and I walked to church just across the street and watched as all the students came in.  Luckily, we picked to sit on the right side (girls) and the pew we were sitting in was the last to be filled.  Everyone was afraid despite our waving!  There was barely any speaking in the service except for the readings.  The children sang and played acoustic guitar the entire time and it literally sounded like a choir.  They were all rehearsed and the music and melody of every song was incredible.  The handcrafted alter, grass roof chapel, and painted rainbow colors around the church was one of the most beautiful sights.  At the end of Mass, the deputy principal of the school had Clare and I stand up and introduced us as a “nurse and a sports teacher” and said that no one could go to the clinic unless they were seriously ill and everyone laughed.  It was an honor to be mentioned.

After church, Clare and I headed back to pack up our things.  Sister Catie was already almost crying and saying she didn’t want us to leave.  She is seriously a riot.  After we were done packing, there was a patient waiting for her injection, so I walked to the clinic and took care of that and also cleaned an open sore on her finger.  Clare and I were sitting outside the clinic just chatting and laughing as Sister Catie took our cameras and took photos of every single flower and spoke about every single blade of grass, when we saw Sister Veronica and Sister Leonie drive up in their car.  That meant it was time to go, and we were so sad to leave.  Sister Catie and Sister Stephanie packed the car with food and said that if anything went wrong for the rest of our trip to call and she will come get us.  It was so sad to leave and see her upset, and her 4-foot tall body running after the car.

We stopped at Panatina Ridge to switch cars where we met more and more sisters and visitors.  We had a quick lunch, and then started off on our journey to Visale, about an hour away.  On the way, we saw Guadalcanal war memorials as we drove along the coastline of the island.  I’ve never driven on such a beautiful road and I was in awe as we came out of the city into the more rural villages with no power or electricity.  It is such a sight to see the rich land and ocean juxtaposed with these poor families of 10, 20 people and their children without any clothes.  Sister Veronica comes from Visale and she explained to us that the road we were driving on had mostly Catholic villages.  They all first learn to speak the mother tongue, then pidgin a form of broken English, and then English if they get to a good school.  It really sets the family dynamic, because if one does not go beyond the mother tongue, you can only communicate with those in your surrounding area.  There are 15 mother tongues in Guadalcanal alone.

After driving through rivers, rickety bridges, and receiving many laughs from people looking at white people as we passed, we reached Sister Veronica’s school where she teaches home-ec and health as well as her house.  She is set back from the school in a group of homes all built for the staff of the school.  Her house is owned by the Dominican Sisters, so whoever will come here next in their placement will stay in this house.  Clare and I are sharing one room of the 2-room home, and it is the cutest place ever.  Decorated with beautiful Solomon Island drapes, a purple floor, and a homemade altar, you can barely notice that there is no power ever!  We dropped our things inside and Sister Veronica took pineapple, rice, watermelon, and tea in the car and said we were going out to the beach.  I was so excited!  We drove down a small road and Sister Veronica pointed out each one of her family’s huts and one of their villages.  It seemed that she was related to every single person on the road.  We stopped at her sister’s house and met their entire family.  The kids were hysterically laughing when they saw us because Sister Vero told them we came especially to see them.  Some of them clothed and some unclothed, they laughed and laughed and were embarrassed to introduce themselves.  Clare and I were enjoying this so much!  Although it looked like they barely had a sturdy house, the children and parents came out holding coconuts for each of us.  We thanked them so much and headed off to the beach. 

We parked at Sister Vero’s cousin’s hut that was actually on the beach, and walked down to the water with our coconuts in hand.  I’ve ever seen such a pristine and untouched scene.  I’ve also never had a swim in water where 2 people were spear fishing about 50 feet away from me.  The water was like a bath, and I just floated and enjoyed the sun.  After our swim, Sister Vero told us that her nieces and nephews had something for us.  We walked near their house, and they set up a whole table for Clare and me, with a tablecloth and flowers!  They cut up the fruit and watched us sit down.  I was in shock.  I certainly to not need to be treated like a princess and I felt so horrible about how selfish we can be sometimes in America.  These kids were in joy just by giving someone a gift.  Not to mention, they made me close my eyes and tied a beautiful flower necklace around my neck and one on Clare’s.  They were the cutest kids ever and I wish that they will be safe and healthy in their future.  So far, this was one of the best days and I could not believe by just visiting and doing work I enjoy, I was practically getting showered by gifts.

Our beautiful picnic!

After our swim, we drove to Sister Vero’s family village about 5 minutes down the road.  They literally had about 7 wooden and grass huts and a bamboo archway with flowers as you enter.  It was so beautiful that this extended family lived together so close, without any power, and looked so peaceful and calm.  There are no worries in the Solomon’s.  Sister Vero set up camp and opened yet more Tupperware containers of food and served everyone a dinner of sweet potato, chicken, and more fruit.  She left a ton of food for her family and the parish priest who lives in their village, and I could see the joy on her face as well as theirs.  We headed back to the school and house when Sister Vero’s sister flagged the car down.  They wanted to give us more!  One by one, the uncle and children carried out pineapple and cucumbers “for the American students.”  The pineapple was just picked from their garden!  I felt so terrible taking the food, but they are so happy to give.  Clare and I just couldn’t believe their culture.  So carefree, easy, and simple.  Sister Vero’s laugh is contagious and we spoke pidgin saying “see you later” and “good night” out the window to all the people passing.  Some stopped us saying they wanted to shake our hands. 

When we got back to the house, we toured the school and the clinic where I’ll be going tomorrow.  We each had a freezing cold shower outside, which felt amazing, and said an evening prayer.   Sister Vero, Clare, and I sat by her table and told stories for so long.  We were all hysterically laughing as we recounted stories of crazy Sister Catie.  She was one of the first sisters in the Solomon’s, refuses to tell anyone her age, and even though they say you don’t have to wear a veil anymore, she insists.  She also had a parrot before Pacifica called March, and a dog ate it.  The way Sister Catie told Clare and I we were both almost in tears, but Sister Veronica told us that Catie put so much attention on the bird everyone was neglected.  When the bird died, Catie did not eat or do anything for 3 days.  The Sisters had to buy her Pacifica so she would come out of her slump.  We were laughing so hard.  We reminisced on the time Clare and I taught her yoga and her tiny munchkin self, trying to throw herself on the floor eager to learn.  And also how she thought we were doing “yogurt.”  Finally Sister Veronica told us that she wanted to be a nurse at one point and took her entrance exam with one other boy.  She passed with flying colors, and the boy failed.  But, just as politics are in the US, the boy’s family who were parliament of Western Province, paid off the nursing school so Vero would not get in.  They accused her of cheating.  I could not believe this injustice.  Sister Vero is so happy teaching health, but to think that her dreams were stolen away unfairly is sickening. 

Heading to bed early at 9 PM for another eventful day.  I have no doubts I am going to sleep well on the floor in this beautiful house.

Monday, July 23, 2012

After my first full day in Visale, a village without running water and power, I am truly amazed by the community.  We woke up around 5:45 and got ready for mass.  We walked to the church and listened to the choir sing in perfect harmony the entire time.  The deacon welcomed us once again and I felt honored.  After breakfast, I changed into my scrubs and felt a little nervous for my first day at the clinic.  First, Sister Vero took Clare and I to the staff office of the school and we were introduced to everyone.  The teachers’ staff room looked like a few desks pushed together with stacks of books piled on top.  They looked so eager to teach despite this cramped office and I wished that one day the school building could be improved.  All the teachers plus Clare and I then piled in a room for the “pre-assembly.”  This was the first day of school starting the third term.  However, school was supposed to start last week but because of the Pacific Arts Festival, not enough students came.  This is how things work here.  And also, the principal didn’t even turn up yet.  I felt sorry for Sister Vero who is one of the nicest an genuine people I’ve ever met trying to make a difference, with so few resources.  All the students started laughing and whispering when Clare and I walked in.  This seems to be the typical reaction!  I just smiled and waved and felt so many eyes staring and me and turning away as I looked.  It was hysterical.  The head staff teacher introduced us and we spoke about ourselves.  Most of the children can understand some English, but mostly speak pidgin.  After the students received their lecture about no beetlenut, alcohol, or smoking, everyone was seated and 3 girls walked in holding leis for us!  It was the cutest thing ever as they placed fresh white lilies and a braided palm lei around my neck.  I do not deserve this kind of welcome, but it is all part of their culture!

I headed off to the clinic where I met Nurse Michaela taking her time with the line of patients waiting outside. I first worked in the lab, examining slides of blood to test for malaria.  Keep in mind that this lab is a tiny room with one table and one microscope.  I learned about the types of parasites in the Solomon’s, mainly Pf and Pv.  Pf is more dangerous and more common.  It affects the liver where the parasite can hatch its eggs.  There are three stages, and as they progress the parasite becomes darker and rounder under the microscope.  A positive slide looks like a crescent moon with the opening connected by tiny dots.  A tiny blood sample stained after 10 minutes is enough to f=diagnose.  There are many patients that want to be tested, but surprisingly, not many have it.  February was the month where most had malaria, with 76 diagnosed and about 100+ coming in for checks.  In the month of June there were 90 people coming in for checks and only about 17 positive cases.  This disease is so dangerous, and proper prevention is key.  Most families do not have access to bug repellent or mosquito nets, and their children suffer as a side effect.  It was truly heartbreaking to see this disease take control of these people’s bodies and their minds.

After learning about the lab, I helped the nurse record all the patients down including their name, age, sex, village, new/returning, history, and treatment. In total, we saw about 22 patients for the day.  Mothers and children kept lining up outside because Monday is a “free day” meaning anyone can come and people walk from very far away.  I saw patients with abscesses, infections, diabetic sores, flu-symptoms, forehead gashes, and simple cuts.  I took blood pressures and helped with dressings.  Probably the most heart-breaking thing I saw were young mothers coming in with their babies, no older than 2 months old, with a terrible cough and chest infection.  These babies were still breastfeeding and were already given doses of antibiotics, yet still wheezed and could barely make a sound without coughing.  It is sickening that these children have no control over the family or location they are born into.  The nurse told me that oftentimes the mothers neglect the children and forget to finish the dose of antibiotics.  It was amazing to see how freely the perscriptions are dispensed.  No signatures, only a $5.00 payment.  The only money patients pay for healthcare in the Solomon’s is if they see a private doctor, get an injection ($5.00-less than $1.00 US), get a malaria test, or get a prescription.  Healthcare is just not emphasized.  The kids waiting to be seen were staring at me as well as their mothers.  They couldn’t believe I was there and one grandma even ran away from me scared because she couldn’t speak English. 

Two cases were most memorable for me today.  After I came to the clinic around 8:30 AM, the nurse just left saying she had to take a shower.  Schedules do not exist here.  So apparently I was in charge, and I was talking to a lady maybe 20-30 years old who was waiting for her malaria test.  She kept asking me why I was here and she was so interested in everything about me.  I just feel so bad, not feeling sorry for them, but just that they are so genuine and could have life so much easier.  She asked me my name a couple of times throughout our conversation, and then asked how to spell it.  When she was leaving (no malaria, thank goodness) I saw she wrote on her hand, C-a-y-l-a.  I don’t know what she wrote it for, but I was touched.

St. Martin de Porres Clinic in Visale

The other case was an “admittance,” the broadest sense of the term, to the clinic overnight. For an admission here, basically the patient just lays in one of the 2 rooms with a bed and sits there all night, even when there is no nurse on staff.  This woman must have been over 70.  Another interesting fact is that no one knows his or her actual age here.  It is 20+, 30+, and so on.  This particular woman had a severe case of pneumonia and needed intravenous fluid and antibiotic.  Whenever I asked a question, the nurse agreed with me thinking I was trying to diagnose.  Once I asked her if the patient could have bronchitis and she actually gave that as the final diagnosis.  I just asked!  Recording everything factually and worrying about being correct is just not a priority.  There is no such thing as a lawsuit.  This lady needed an IV, so I helped the nurse insert it into the vein and I injected the fluid and antibiotic.  I am so thankful I brought gloves with me for the blood, because the nurse did not even wear any.  The lady was then just told to sit in the room with her family until her next dose at 10 PM.

Tomorrow brings antenatal care, or prenatal care, at the clinic.  The nurse said only pregnant women come to be examined, but I certainly have learned that things do not go according to a schedule.  I think I am supposed to be there around “8:00 AM” which means more like 9.  I am learning so much each day here, and slowly realizing that their system is no system.  Diagnoses are made by at a glance and emergencies are driven to hospital whenever the next vehicle comes to town, but the people and nurses are happy just the same.  People thank me whenever I walk by, but I feel like I am not doing enough to help.  I am just taking it day by day thankful for this experience. 

Tuesday, July 24, 2012

How do I even begin to explain today?  It started off like usual, heading to church early for 6 and then having a quick breakfast.  I wasn’t feeling too hot the end of yesterday and this morning, so I hoped I would be fine for the time I was in the clinic.  Clare and Sister Vero set off to town to buy supplies for the library, and I set off for the clinic. I started walked down the path and when I passed students would yell out their windows, ”Good morning, Cayla!” I felt like a regular! When I got to the clinic there were many patients lined up already, some for antenatal and some outpatient.  I knew that having an antenatal day only was not possible.  I jumped right taking blood pressures to help the two other nurses today who were taking their time.  Once again, I was surprised how steadily the nurses worked and how they diagnosed at a glance.

Randomly, it was time for antenatal, so we walked around the corner to one of the four rooms that had two rickety beds, one for delivery and one for exam.  With the dust and scattered medical papers everywhere around the room, I could hardly believe that this could be a room for pregnant mothers.  The exams were short and sweet, the mothers would come and be weighed and they would tell the nurse about all their other children and history.  Keep in mind that the only comorbidities they check for are hypertension and diabetes.  I noticed that some of the women had higher gravidity than parity, meaning they carried a child and lost it before birth.  After the talk, their urine was tested for glucose and protein.  High glucose would indicate diabetes and high protein would indicate an infection.  One of the mothers had high protein, but nothing was done besides record it.  Most of the mothers were bringing in battered “baby books” or medical history charts with dirt all over them.  The nurse would constantly tell me that I am privileged and lucky to have technology in the US.  There are no such things as prenatal vitamins, diet, or ultrasounds in the clinic.  An ultrasound is only administered at a hospital if it is an emergency and it is very expensive.  They kept telling me to come back when I had trained in the US.  I was really starting to feel hopeless at this point.

Antenatal Exam Room

During the antenatal exams, instead of a heart rate monitor, the nurse would stick an old-fashioned horn object on the mother’s stomach and listen for the fetal heart rate.  They violently pushed to see if the baby was breech.  I was observing but also worrying.  My main job was to write down baby names for boys and girls for the mother.  They usually don’t think of names until they are born.  Don’t worry Coll, all the mothers liked your name for a boy, so I’m sure there will be plenty of Solomonese alter egos in your future J.  One of the mothers was happily lying on the table and told me that her husband left her for a woman in the Western Province and she didn’t know who the father was of her baby.  I was seriously heartbroken and couldn’t believe how nonchalant she was.  I tried to smile and go along with everything, not letting anyone see how sorry I felt that these poor women were denied basic technology to ensure a safe delivery.  The nurse and mothers told me that in the Solomon’s I probably would have already had 4 or 5 children by now.  Their fertility rate is more than 3%.  They couldn’t believe when I said that women wait to have children until after school and a job in America.  There have been girls in the Solomon’s that give birth at a mere 12 or 13 years old.

When the mothers were finished, we went back to outpatient care and I gave some fluid to a man through an IV who came in from a 2-hour boat ride from the weather coast of Guadalcanal to get to Central Hospital.  He did not look too well, but I moved onto the patient we admitted yesterday for her dose of penicillin, but her IV created a boil in her arm, so we had to remove it and start again.  The poor woman sat in the chair as the two nurses tried and tried again to get a vein, but each time they were too deep in the tissue.  Finally, they looked at me and handed me the IV.  I had my eye on a certain vein the entire time and was happy to give it a go.   I sat down and slowly pushed in the needle just under the skin, not too deep, and gently pushed.  And what do you know, blood started coming out the other end, I got it!  The nurses were laughing at the irony and congratulating me and the lady looked just as pleased. 

After a break, I headed back to the clinic to wait for the nurses to open up again and practiced my Pidgin with the people around.  As I was sitting outside, I noticed that the man who was waiting for his ride to Central Hospital was still lying on the ground looking terrible.  When the nurses came back, his wife who was chewing beetlenut, finally stood up and decided to take a bus to the hospital.  I asked if there was anything we could do and the nurses just shook their heads.  They said because of no mobiles, no service, and no cars, many patients die waiting to go to the hospital.  Even if they had a car, no one knew how to drive.  They said communication is awful and transportation is worse.  The ride was radioed from his original clinic, but there was no way to check where it was.  The man tried to stand up, but when he did, he began vomiting blood.  The nurse went over to check on him, and noticed the edema in his feet was getting worse, and so was the jaundice in his fingernails and eyes.  To me, this screamed liver failure.  He was also known to be a drinker, so cirrhosis was also possible.  The nurse said there is no treatment for cirrhosis and he would probably have to wait it out.  Excuse me?!  I was witnessing a man slowly deteriorating in front of my eyes, in front of his children, and the nurses were laughing about how ridiculous the transportation is and sat back down.  They finally turned on the radio which “didn’t work before” and got a signal.  It sounded like there was some communication but I couldn’t tell.  Finally I had it.  I was so angry I told them to write down a doctor’s number who could speak English at Central Hospital and I would walk down the road until I reached service.  They said it was only a half an hour walk.  ARE YOU KIDDING ME?!  Someone easily could have done this 5 hours ago.  I ran to Sister Vero who drove me to a cell signal and she tried calling the number.  I felt horrible to involve her in this but honestly; I had it with the lackadaisical approach to medicine.  Not so cute anymore.  Oh and guess what?  The number was not in service.  I was holding back tears and felt defeated.  I was frustrated with the clinic and with myself.  I know this is the system and they realize they have few resources, but lighting a spark for them to utilize what they have is nearly impossible. 

Clare said that some of the boys wanted to take us on a hike up the surrounding mountain, and I was in need of exercise, so I happily agreed to go.  I changed out of my scrubs and headed out to the start with Jerry, Godrick, Cecilia, and RisaLynn.  I vaguely remembered the Mt. Sorrow hike in Cape Trib and laughed.  This wouldn’t be that hard; after all, the kids weren’t even wearing shoes.  About 10 minutes into the hike, I was sweating profusely.  I could hardly breathe in the humid air, and the hike turned into a steep climb.  I could barely grip anything and started to panic as these children hopped along.  We reached the top after maybe 20 minutes and I admired the view.  I could see the island of Savo in the distance and I was surrounded by paradise.  Jerry interrupted me and said, “Okay, let’s keep going.”  WHAT!  I seriously couldn’t chicken out and let the Solomon Islanders think I wasn’t tough but when I looked up, I realized it was the huge cliff I had been staring at since I got here.  I love a challenge and everyone knows that about me, but seriously, this had to be impossible.  Cecilia called it quits but I sucked it up and bit my tongue, and started the climb by hanging onto to blades of grass while my feet slipped off the slope because of the mossy rocks and mud.  To make things worse, a rock fell from above which made me look down and I seriously have never felt that scared.  This feeling of panic mixed with struggle and embarrassment continued for another 40 minutes of pain until my mud covered body reached the top.  I guess no one warned me?  I was exhausted.  The view was the most amazing scene I had ever seen. I felt the climb was worth it.  But I realized, now I had to go down.  Clare was trying to perk me up but I started to worry about the sun going down and also the fact that I could hear wild pigs and we were walking through grass taller than me. 

Finally at the summit!

Apparently there was an easier way down (I made sure they knew I could not go down the way we came), I convinced myself to get moving even though I was shaking.  What was wrong with me?  I finally just decided that sliding down would be the best for me and finally I was laughing again.  How could I not laugh when I was enduring the most physical activity probably ever in my life, and RisaLynn still had time to make me a crown out of leaves while she was waiting for me to recover.  I took a moment to picture where I was, what I was doing, and who I was with.  Clare and I were in the middle of a jungle mountain in Guadalcanal, with 4 jungle children as tour guides.  Jerry kept apologizing to me the whole time and I was just laughing.  He made me wait while he kicked down trees to clear a path.  I must have asked him 30 times if we were going the right way.  A little friend Dominic joined us earlier on the hike, and he was jumping up and down like a monkey.  They hysterically laughed as I slid down whenever we reached a slope and I called it my “system.”  Everyone was working as a team, especially when I slipped off the slope and Clare grabbed my wrists to hold me while the rest had the pleasure of hoisting me up.  The sun was setting, and the boys kept saying, “soon, soon.”  Finally, I saw a grass hut and ran toward it.  They belonged to families and we just casually walked through their yards waving while their unclothed children ran around.  Jerry pointed to a blue house and said, “Look, that’s where you live!” and I took off.  I thought I was in Sister Vero’s yard lying down but it was one of the teachers from the school. I asked her where I lived and she pointed right next door while laughing.  Finally, I saw Sister Vero and she saw me basically black with mud donning a leaf crown and starting laughing so hard.  Apparently the whole village and the students could see us at the top of the mountain and were cheering for us the whole time.  Good thing I made it!  The boys looked fine in their bare feet, just another day in Visale.  I seriously couldn’t believe it. 

After my success, the rest of the day brought good news.  The patient at the clinic was transported to the hospital FINALLY and Sister Vero prepared a meal of fish, pineapple, papaya and cabbage.  I survived another day, but America’s reputation might be a little damaged from my hike performance.

Top of Mt. Chiromagati with Savo, an Active Volcano Island in the background

Wednesday, July 25, 2012

10:30 PM

So I was about to start my blog for the day and took out my journal to write something down when all of a sudden everything in the room was shaking.  I looked up at Clare sitting on her bed and she said, “Um, earthquake?”  I threw my book and ran out of my room and everything was vibrating and almost toppling off the counters.  When I reached the outside door (probably not a good idea) Sister Veronica was coming up the stairs after just going out for her shower and was like, “I think we just had an earthquake.”  We all started laughing when it was over and couldn’t even believe it.  They don’t happen quite often here, but when they do, people panic because they think it is a tsunami.  Sister Veronica said that she should always bring an extra pair of pants to the shower in case something bad happens and she has to run.  She is hysterical.

This day has been filled with excitement, beginning to end.  I couldn’t believe it was my last day, just as I was getting so comfortable in the community and at the clinic.  But I was also kind of embarrassed to show my face because I’m sure Jerry and Dominic told all the kids about my mountain climbing experience.  I first went to the library Clare was constructing for the students.  We alphabetized books and she had plans to label all the fiction books in order and to place mats and curtains in the room.  It was a big project, but all the kids were looking in through the windows so excited because the donated books from Australia were just collecting dust before.

I walked to the clinic and waited outside for the nurse to arrive and sat with this one little baby, Frederick, who had a moderate ARI, or respiratory infection.  He has been coming with his mother for a “repeat nila” or repeat needle for 3 days now.  Frederick is the first baby I have met that doesn’t cry or run away from me.  In fact, it is quite the opposite.  Whenever he starts crying his mom brings him over to just stare at me and he opens his eyes so wide.  He is seriously fascinated with my bizarre appearance.  It works just up until he gets his shot and then the tears start flowing. 

In the Solomon Islands, there is no such thing as “first come first serve.”  Who every is getting a repeat nila goes first so the nurse can get it over with.  It doesn’t matter if there is a semi-emergency or someone has already been waiting for an hour.  And all the people are completely fine and patient waiting.  We did the usual patients and blood pressures and I found out that everyone already knew I completed the mountain hike!  Then the action picked up.  Sitting waiting outside for all the repeat nilas to go first was a mother and a little boy, 5 years old, who stepped right on a metal fish hook.  Fishhooks are a little different in the Solomon’s because the fish are large and strong.  The part that was in his foot was probably 4 cm long and he wasn’t even crying.  His mother seemed pretty amused as well.  But as soon as the lidocaine was injected in 3 spots around the hook to numb the area, he was screaming.  I felt so horrible and tried to calm him down, but I ended up having to hold him in place.  The nurse cut right into the bottom of the foot with a razor and I do not think the lidocaine was kicking in yet.  Finally after a couple slices, she got the hook out, cleaned it, and gave it to the mother.  The wound was cleaned and the little boy was sent hopping along on his way.  No worries about tetanus or infection either.

Just after I thought I had seen my action for the day, I saw maybe 10 people walking very fast to the clinic from the road.  They looked like they were on a mission but when they arrived they sat on the bench and waited outside.  When I glanced the little boy a woman was carrying on her back and saw the blood, I figured that they probably should just wait outside.  I took them in and when the nurse saw the little boy’s head she just said, “Oh, wow that’s really deep,” in pidgin.  Not so comforting.  I glanced at the 11-year-old little boy, Ezekiel, and saw his eyes were rolling back in his head.  I got him some water and told everyone to stop crowding around him.  It is custom for a whole family or village to accompany someone to a clinic if they are seriously injured.  The nurse didn’t exactly see the problem with eight of his family members sticking their head into the 2-foot wide doorway, but after sitting the boy down and seeing his head closer, they needed to leave.  Just as I thought it couldn’t get any worse, the grandma showed up in a taxi, opened the door and started screaming at the mother in pidgin for being careless.  The boy was home from school with Rubella, and was climbing a tree when he fell and hit his head and back on a stick.  I convinced the nurse to get the family out beside the mother and shut the door.  Finally we could concentrate and began to clean the deep gash out and numb the scalp.  I was in charge of cutting his hair and he started to scream.  I told him to breathe in through his nose and out through his mouth and he actually concentrated on this and toughed it out the whole time.  After cleaning, the nurse said it looked good but I could still see dirt.  After a thorough cleaning, we began stitches.  The nurse pulled it through while I cut and after 6, we were finished.  They had taken a bus to a clinic and his family smothered the boy for another hour until the next bus came.

Available meds in the clinic

There were two other interesting patients today.  One 24-year-old came in with severe abdomen pain she could barely speak or walk.  The nurse kind of just stared at her and thought maybe she should take amoxicillin. I’m no expert but I don’t think amoxicillin would work.  It has happened to this woman before but she only treated it with “local remedy” which is herbal medicine. The nurse decided to take her in for an exam (first one I’ve seen) and felt her stomach.  She felt something “hard” on one side.  I think after my IV performance yesterday the nurse was looking to me a little too much when she asked me, “What do you think?”  Well, I know she needs to go to a hospital, but that is not possible until Friday on referral day.  I said she needed an ultrasound to see for possible gallstones.  For now she is coming back on Friday, but I secretly told her if possible to go to the hospital earlier and get checked.  The nurse also turned to me for another patient who was having trouble seeing.  Apparently she had clear vision but sometimes her head hurts and her vision goes blurry.  This happened twice before and was happening again now.  The nurse turned to me, and the only thing I could say was that she needed to go to an eye specialist. There is one in Honiara at Central Hospital so they agreed to go.  I was worried because it was not a simple “glasses” case.  I was suspecting a possible optic nerve problem.  I tried explaining she needed a brain scan or MRI without scaring them but no one understood.  I took her medical chart that she brings to the hospital and wrote a note to the doctor about the MRI.  I seriously hope this family goes and takes that advice.

Ceremony

After entertaining some of the patients with my remedies for ear problems, getting water out with baking soda and vinegar, I was told to report back to the school for a little gathering that the students were having for Clare and me.  It was about 1 PM, and I worked in the library until they were ready.  I could not even believe the room when I walked in.  There was Sister Vero, all the teachers, the principal, our mountain tour guides (Jerry!), and all the kids around us we have grown close with.  There was fresh fruit and sandwiches that Sister Vero made for everyone and I felt so overwhelmed.  I could not believe they were treating me this well.  There was a table in the middle for us so we sat down while each person stood up and spoke.  The words of thanks they expressed were so sincere and they hoped for more students from PC to travel to Visale.  One of the teachers cried and I almost did as well.  Finally, they presented us with a shell necklace, as it is part of their culture to give gifts to those who travel far.  I couldn’t believe this moment and how welcoming everyone was.  When I got a chance to speak, I spoke seriously first and then apologized to Jerry for my mountain climbing trauma and everyone erupted in laughter.  While we were eating, everyone joked about how I was panicking on the mountain and how poor Jerry got an earful of my complaints.  I filled Jerry’s plate with apology sandwiches over and over again and everyone was hysterical.

Visale Sunset

After this special ceremony, Clare and I worked long and hard to finish labeling the books in the library.  After a few hours, Sister Vero took us for a walk on the beach for sunset.  We enjoyed our last night together and finished up in the library with the help of Cinderella, one of the teachers.  Clare and I were elated when we were done.  Finally these children have a place to read and study and spend their time constructively if they prefer not to go home right after school.  Clare’s project will live on long in the history of Sacred Heart School, and I think most of the kids will think reading is “cool” now that Clare set up the library!

Sister Vero just turned on the radio and the earthquake was a 6.6.  That is probably not the best news because I have to be up at 5 AM and on a boat to Auki tomorrow morning.  I’m on Solomon time for now.