Saturday, July 28, 2012
Saturdays in the Solomon’s are a little different from
Saturdays at home. Instead of sleeping
in, we got up early once again to start the day. All the kids were still present, no late
sleepers here! Bishop Chris was heading
to the market at 7:30 after, so Clare and I hopped in his truck with Sister
Matilda. On Saturdays, everything at the
market is very fresh and plentiful. We picked out some potatoes, more
pineapple, and peppers. We caught a bus
back and were ready for the day at 9!
Clare and I played soccer outside a little to get ready for
the Auki Parish soccer game in the afternoon.
We had a few friends join us, Chrisma and Martha. Chrisma is 6 years old and the most adorable
girl. She was born on Christmas, hence
her name! We passed the soccer ball
around for a while and then headed over with Bishop Chris and the soccer team
to check if the game was starting yet (Solomon time). When we found out it wasn’t starting yet,
Bishop Chris kindly drove us to the telekom to get Internet for a bit. After checking in on the cyber world, Clare
and I started the trek home in the heat but Bishop Chris found us! We hopped in the back of his black pickup
truck with all the other kids he carries around and got a ride back to the
house. I think Bishop Chris doubles as a
taxi for all the children in town. It’s
so cute how excited they get to hop in the back of his truck and go for a
ride. He also makes sure to drive them
back safely to their village.
The soccer game finally started a little after noon, so
Clare, Chrisma, and I head to the field.
Our team colors were black and white called Harbour Lights after the
beacon in the Auki wharf. The boys
ranged from 16 years old to 22 and played a team from Lilisiana Village. This village is made up of houses on stilts
actually built into the water near the wharf.
The game was close, but luckily in the last 5 minutes we scored two
goals to get us the win, 3-2.
After the game, Clare and I were in paradise lying in the
two hammocks underneath the sister’s house.
It was so comfortable and cool that we fell asleep reading. We woke up to Bishop Chris suggesting that we
take his car to the river to wash it. I
thought it sounded like another cleaning Saturday duty, but when the entire
soccer team jumped in the back of his car, it looked more like a
celebration. I met the team and felt
pretty cool riding to the river with them!
I hopped in as well with Clare and Chrisma and enjoyed the ride to a
river called Fui. This source of water
is where many people get their supply and also where they come to do their
washing and laundry. I thought the water
would be dirty, but it was actually crystal clear with a strong current. Bishop Chris backed his truck into the water
and all the boys hopped out and started dousing it with buckets of water. There were many people washing their clothes,
swimming, and washing dishes around us.
Not a typical Saturday afternoon!
My job was to keep an eye on Chrisma in the strong current while the
boys washed the car.
Naturally, after it was finished, there was bound to be some
sort of looming dangerous activity. Oh
no, they couldn’t be walking up to that rickety bridge over the river, could
they? OH YES THEY WERE. And you guessed it, Clare followed right
after them. With my history and
struggling background, I remembered a couple of events in my life that should
prevent me from following everyone else.
1. So far, any tiny hesitation/reluctance I’ve
had (e.g. mountains, scuba diving) has been realized and very difficult since
I’ve been on this trip.
2. Anyone who knows
me well will probably recall the story of my dear friend Matt Martin’s boat
cliff jumping experience.
Ah, I have finally said no to something. I felt good about my decision, especially
since there were rocks all in the bottom of the shallow river, the current was
incredibly strong, and I was watching Chrisma.
I was watching everyone jump off the rocks and laughing and recounting
my last jumping experience with Bishop Chris.
It was then that I heard it, “Cayla! Cayla!” Oh no:
the dreaded feeling of letting the entire Solomon soccer team think I
was a wimp. There you have it, of course
I let them pull me up the side of the bridge and put me at the top. And when I jumped in, I didn’t get hurt! Another fear conquered half way around the
world. And when I tried to climb up
higher to keep up with the boys, Bishop Chris wouldn’t let me and you bet I
listened. That was the closest I will
ever get to God physically telling me not to do something.
It was about 4 PM by the time we dropped the boys home and
got back to the house. Clare and I
wanted to test the running conditions so we threw on our sneakers. I wanted to show her the hospital, to we ran
to Kilu’ufi. I was not surprised by how
hard it was to breathe and how tired I became after just a short distance
compared to my usual runs. We made it up
and down the hills and managed to shower and stop sweating before the evening
mass. After the mass, we all had dinner
together in the Bishop’s outdoor hut. The
dinner included all the people partaking in the music workshop from Brother
Roger and Rob and some of the community.
It was another great meal and at the end, almost everyone gave a speech
to thank Brother Roger and Rob for their 2 weeks of lessons. Tomorrow the students will be performing
their pieces at the Cathedral. I’ve
heard that the Solomon’s like speeches, and I found out first hand today. They even asked Clare to make a speech! Some
of the students played songs on the acoustic guitar as well. And no one even showed a sign of sleepiness
or impatience after maybe 2 hours of dinner and talking. These people are so kind and so welcoming; I
wouldn’t have it any other way. To see
the way they are so thankful for any help or time from visitors makes me wish
that kids in America could appreciate their opportunities more. The Solomon Islanders may not have that much,
but they are alive and rich in each moment.
Sunday, July 29, 2012
I’ve never truly considered Sunday a day of rest until
today. I had a whole extra hour and 15
minutes to sleep in, which was seriously a treat. Just being surrounded by the community and
Bishop Chris made me appreciate Sundays more.
It was adorable how the kids actually look forward to walking 25 minutes
down the road in their Sunday best to get to the cathedral. Even though I attend mass most Sundays, this
was the first time I was surrounded by people with an actual excitement. It was like all the hard work and praying
during the week made Sunday a celebration.
And even Chrisma was waiting outside her house for us when we started
walking, dressed in a beautiful red skirt, shirt, and combed hair compared to
her usual unclothed self!
As expected, Bishop Chris spoke beautifully despite the
absolutely sweltering conditions inside.
In the presentation of the gifts, some of the boys (including Richard,
one of the workshop students) dressed in traditional Solomon Island attire including
grass skirts, loincloths, and headbands to dance. It was amazing and made me wish I had seen
the Pacific Arts Festival. Brother Roger
and Rob performed with their workshop students and received speeches after mass
and many thanks from the parish. Bishop
Chris asked Clare and I to help pass out the certificates to the students and
we were called up to the altar. They
received many more gifts from the people and words of thanks were
expressed. Bishop Chris made the point
of saying that many teachers take a break or sleep on their holidays in the
Solomon’s, but Brother Roger and Rob teach more! They set a good example for all the teachers
in the parish.
Thankfully the downpour held out until after we reached the
house, and a little bit later Sister Loretta chopped up some cucumbers and
peppers for lunch. Chrisma and Veronica,
one of the staff member’s daughters, joined us for lunch. Since it was still raining, Clare and I
convinced Sister Loretta to teach us the dances she knows (she’s been talking
herself up!) Chrisma had no problem
breaking it down and I learned some traditional island dances, as well as ones
from Papua New Guinea. Chrisma was
dancing more like a provocative American teenager and Sister Loretta had to sit
down she was laughing so hard. After the
chicken dance, hokey pokey, and a pineapple dance, we took a break and watched
Shrek on the computer! We all sat in the
kitchen and laughed. It was then that it
hit me; Sister Loretta is literally Donkey.
She is hysterical and energetic, just like him. She even agreed.
The rain stopped, but our Sunday rest continued and I
enjoyed some reading time. Clare was
outside on the hammock as Sister Loretta fell asleep next to her! I helped prepare for dinner with the Bishop
while Sister Loretta made some of her famous sweet potato and cassava
chips. I needed to wake up a little
before evening prayer and dinner, so I took out my laptop and opened up the
dreaded Insanity Plyometric Cardio Circuit video. Yes, Dani and Court! Are you proud? Clare and I were laughing at how ridiculous
we looked dragging a mat and chair down the hill into the jungle of a backyard
to work out, but it was necessary. Once
we got started, I remembered how much I sweat just at home, so multiply it by a
million in this heat. When I found the
energy to look up, I noticed we had somewhat of an audience just staring from
the top of the hill by the house. I
don’t think some of the people have ever seen exercise quite like this, but I
continued once I made sure I wasn’t offending anyone (seriously).
After the prayer, we all joined Bishop Chris in his house,
minus the students from the workshop. It
was a smaller group, but we still sat in a circle with our chairs and ate
together. Bishop Chris added his Italian
spice with an eggplant and pasta dish that reminded me of home! Brother Roger and Rob leave tomorrow so it
will be quieter around here, but I’m sure there will always be some
action. Tomorrow Clare is teaching 4
periods of English in a row while I start my hospital work. Clare and Sister Loretta are at the table
working on their lesson plans. I don’t
know how much is getting done because Sister Loretta just asked me to get the kindle
for the bubble game…
Monday, July 30, 2012
The usual morning routine took place starting at 6 AM,
except I was anticipating my first day at Kilu’ufi Hospital. I knew that the sisters and Clare had their
mornings booked, but I had a feeling I would be wrapped up a good part of the
day! I threw on my scrubs and headed off
on the walk to the hospital, judging by the looks I got when I waved, I don’t
think people are too used to me yet! I
kept “Solomon time” in the back of my mind, so I did not expect anyone to set
me up for “orientation” at 9 AM like June said.
But actually, the hospital administration seemed to be running very
smoothly and under control. June was
called from her dental clinic when I arrived and I waited to meet her for only
a few minutes! Dr. Jason, one of the
three doctors in all of Malaita arrived a few minutes later and offered to take
me around. But a head nurse, Julie,
ended up showing me each ward of the hospital.
We looked around the vacant empty spaces of rooms, almost like concrete
warehouses, in the children’s ward, men’s ward, women’s, TB/leprosy,
psychiatric, outpatient and labor. I
have my nurse’s aide certification in the US, but I noticed that many of the
aides were performing duties out of the scope of my responsibility. When walking through the labor ward, I jokingly
teased Julie that I wanted to see a delivery today! She said I most definitely would see one this
week and I was extremely eager. At the
end of the tour, Dr. Solomon (coincidence) had arrived and I was placed with
her as she went around the children’s ward and then the labor.
Dr. Solomon is a very quiet, young woman who is intelligent
and respectable. She was neatly dressed
and warmed up to me as I followed her around the children’s ward. I found out that she went to secondary
school, and only started university to receive a bachelor’s of science. After her first year, she randomly applied to
medical school and got in! She trained
in Papua New Guinea for 4 years and said that she hasn’t even received her
bachelor’s yet. That is why she is so young. I was amazed at her tenacity and the true
honor it is to be one of the three doctors per 150,000 people in Malaita.
We saw about 5 cases in the single-roomed children’s
ward. The first was a baby who had
shortness of breath and coughing at only 2 weeks old. I couldn’t believe how tiny and helpless the
baby seemed with a miniature IV stuck in his hand. After talking with the patient and picking up
on their Pidgin, I learned the woman gave birth to the baby at home without any
medical attention. Her husband cut the
cord but she did not know how. She did
not breastfeed or keep the baby warm immediately after birth, which is probably
the reason for the chest congestion/pneumonia.
The woman did not seem agitated at all by Dr. Solomon’s discreet disgust
and responded that they live too far in the bush to travel to a clinic. They went to a clinic 2 days after the birth
for Hep B and meningitis vaccines. They
were then referred to the hospital because of the baby’s condition. The mothers here are so soft-spoken with no
emotion whatsoever in serious situations.
I could barely hear her as she explained and most of the time she
answered, “yes” by raising her eyebrows (a Solomon cultural sign). Imagine being the suffering baby, just born
into a family in the bush of Solomon Islands?
I felt humbled at that moment and made sure to take a second and be
thankful for the healthcare I received as an infant and the care that children
in the US receive.
We continued to see more babies (the neonatal ward is combined
in the children’s ward) and also a boy who was in a coma for 3 days due to
meningitis or cerebral malaria. He was
awake now, but his temperature was slightly elevated. It did not appear that there was any brain
damage, but the doctor wanted him to go to Honiara to get a spinal tap to make
sure there was no further infection. I
asked why they were not doing a blood test to see if it was malaria, so that
the spinal tap and extra travels could be spared. She said that the boy had received
chloroquine treatment just in case, so the parasite would not be detected in a
blood sample even if it were the cause of the coma. There is a special stain that would show
traces of the parasite, but they did not have any. Who would have thought? A lack of supplies costing another child his
health.
Two more lovely instances of lack of supplies really
irritated me as we finished up in the children’s ward. There were two boys with broken femurs with
casts on just laying on their bed. The
doctor said they have been there 6 weeks and 3 weeks respectively. I asked if there were any complications. The answer was simple: No, their crutches
were not yet manufactured and shipped from Honiara due to missing screws. Oh! Great!
The children were missing school, their family, and friends literally
just staring at the barren concrete walls with battered Mickey Mouse
wallpaper. Not only were they bored out
of their minds; they were at risk of infection near babies with
pneumonia/meningitis and reciprocally risking other children’s lives. Anyone who has ever used crutches, take a
minute to appreciate the ease in which you were handed a perfect adjustable
pair.
After finishing up the children’s ward, Dr. Solomon headed
to the labor ward to do her rounds. I
met some of the nurses and not even 3 minutes after I set foot in the ward, the
doctor was called to check on a high-risk mother who was in labor since last
night. I ran behind Dr. Solomon and
entered the room to find the extremely overweight mother sitting up on a bare metal
table, wincing in pain. She was
receiving intravenous fluid because her hypertension was uncontrolled during
contractions and pushes, affecting the fetal heart rate. Dr. Solomon and the nurse/midwife said she
was a mother to 4 others, and was dilated 8 cm.
This meant that she was in the active phase, meaning contractions should
be every five minutes, and birth could happen anytime. In the latent phase, there is usually more
waiting. Dr. Solomon gave me a pair of
sterile gloves and I actually felt the baby’s head! I could not believe this opportunity, but it
was about to get a lot more interesting when Dr. Solomon told me to stay and
observe/help while she finished some patients and charts. I was extremely excited but also thinking
that “baby soon” was in Solomon time. I
was sure I would be standing there the rest of the day but I didn’t mind at
all.
DISCLAIMER- IF YOUR NAME IS MEG SUTTON OR YOU ARE SENSITIVE
TO GRUESOME DETAIL PLEASE TERMINATE THIS SESSION.
Mothers in the Solomon’s do not scream in pain or groan like
the stereotypical woman in labor. It is
part of their custom to just remain silent and give birth (naturally of
course…that means no epidural…NO drugs) many times alone because the hospital
is too far for family or the husband. So
the whole time I could not judge how far along the mother was
because of her utter silence. She did
not answer many questions, she just squirmed around, occasionally almost
falling off the slippery table and wincing.
All of a sudden, I saw a lot of blood, I mean A LOT. I was thankful I had only eaten toast around
5 hours ago so no way was I about to lose it.
The nurse danced around happily cleaning it up with a mop and throwing
bandages in a bucket under the table.
The nurse was delivering the baby herself. I asked the doctor if I could wear a gown,
but she said they ran out so everyone just tries their best to keep blood off
themselves. Okay. So maybe after a half an hour, the nurse
needed to empty the bucket and get some more supplies. I tried to keep my breathing steady as she
left the room (it was beginning to get uncomfortably hot in the room and smelt
horrible). I tried to comfort Daniela as
she twisted and sat upright.
 |
| Baby Cayla |
All of a sudden, she made an odd expression that I will never
forget.
It was almost like the second
before a projectile vomit where you stop breathing.
I remember my life turned to slow motion as I
literally saw the head of the baby coming and I was the only one in the
room.
Would you expect anything less to
happen to me?
I had never seen a
delivery, but I know that there is time before the rest of the body is
delivered after the head.
But have you
have not met Daniela, the silent rocket ship mom.
My adrenaline shot through my veins and I stuck one hand out for the
baby and one for the door screaming, “NURSE, IT’S COMING!”
She said, “Woops!” and entered the room
running to the table before the baby touched my hand and in one smooth motion
the entire body followed.
She literally
almost dropped the baby because of the fluid and kept propping her up on
Daniela’s stomach.
The baby girl kept
sliding down as the nurse tried to clean up the blood.
I was shaking with excitement but I remembered
one important event that had not occurred yet:
the cry.
This could not be
happening.
I became so nervous because
the umbilical cord was wrapped around the body that maybe there was
damage.
We tried everything to get the
baby to cry, when finally the nurse took a tube into the nose and mouth and
blew.
It sounded like some fluid cleared
and I heard a moan.
Thank goodness.
I didn’t think I could handle a still born at
this moment.
I had just witnessed a
miracle.
I still wanted the baby to cry
louder, but it never happened.
The
umbilical cord was severed, the placenta delivered, and the nurse sewed up a
torn perineum.
All supplies and bodily
organs were disposed of in the bucket.
I
was staring at the tiny baby the entire time, who apparently had good color and
looked like she was breathing steadily.
I quietly asked Daniela what her name was, (no one even told her it was
a girl yet) and she said, “What is your name?”
That really happened.
After the
baby’s weight, 3 kilos, and details were recorded, she had me write my name
down on a piece of paper for her.
I was
so touched.
I was included as part of
the delivery team on the paperwork.
When
I saw Dr. Solomon after the events, she just laughed and said the nurse told
her that I should have just caught the baby.
After some paperwork and discussing cases, Dr. Solomon told me to take a
lunch break.
I actually thought she was
kidding.
Eating was not on my agenda
right now, and I would be happy to move onto the next ward.
I decided to say goodbye to Daniela before I
left, and entered the room.
She was with
some family, and they were crowded around the baby.
I heard them say, “Good job, Baby Cayla!” and
I knew they were not talking about me.
 |
| The Delivery Room |
After my exciting adventure, I met Dr. Jason in the
outpatient ward seeing patients who were just outside waiting to be seen or
admitted. I did not mind this time,
maybe because Dr. Jason looks exactly like Corbin Bleu from High School
Musical? Just kidding. (maybe).
But we saw a variety of cases and he was extremely genuine and helpful
in his explanations and his gestures to the patients. We would go over the X-Rays before a patient
came in so I was prepared. I saw one
X-Ray of a deteriorating left hipbone.
The bone was actually eating away at itself, so essentially the hip was
rotting and needed a replacement. This
could be from an infection, TB, or an untreated injury. When the patient came in, I was fully
expecting an older man or woman. But no,
Patrick, was only 14 and was having trouble with his gait. He walked with a
limp in his right leg that had been getting worse but started years ago. Patrick was very quiet the entire time the
X-Rays were explained to his father. Dr.
Jason spoke with hope in his voice, but in reality there was none. They could go to Honiara to see a specialist,
but this was expensive. And even if he
saw a specialist, they could not operate because of the lack of material and
skill for a hip replacement. Essentially,
an easily prevented problem in the US or elsewhere was costing his boy his
livelihood and almost his life. Almost
all males in Malaita make their money from gardening. This boy would never be able to do that if he
was not able to walk by age 20. Dr.
Jason said his only hope was an overseas orthopedic team performing an
operation if they happened to come to Honiara.
I did not see this as realistic given the time, supplies, and
communication and felt absolutely devastated for Patrick.
Next I saw a woman for an exam with Dr. Jason.
He had to perform a check on her backside for pain. It was then that I noticed the some cultural
differences of this country. It is only
recently that men such as doctors, beside the husband, are “allowed” to see a
woman. In some areas of the Solomon’s,
it is still taboo for a woman to be pregnant/give birth in public and may have
to go into the bush in a hut during menstruation. Just think of how many women give birth alone
in the woods and never come back. This
exam was not so extreme, but it was the most awkward experience ever. Those of you who know me know I’m pretty
awkward. But when the woman refused to
take off her skirt and Dr. Jason turned around to talk to me I could slice the
tension with a knife. Finally, after
about 5 minutes of nervous laughter from her, he performed the exam and found
some hemorrhoids that he would conservatively treat. I could see he was sweating after that one
and I was happy to run out of the room.
I wrapped up my day with a talk to Julie, Dr. Solomon, and
Jason, and Clare came to walk me back (perfect timing, even without
texting!)! I was so excited to share my
experiences with her as she told me about her classes all day. I couldn’t believe we were both getting such
hands-on experience. Teaching is not the
easiest in the Solomon’s and I give her so much credit for getting up in front
of kids her age teaching the obscure details of English while they make
comments to her such as, “Are you married?!”
We took a long walk around and ended the day weeding in the garden and
jump roping with Chrisma and Veronica.
After evening prayer and dinner, we watched Sister Act and were laughing
so hard that the sisters had it on their computer. We decided we’re going to film a “Sister Work
Out Video” with sets and reps of genuflecting. Bishop Chris joked that tomorrow
I will be performing open-heart surgery, but he could actually be right because
tomorrow is “Operating Theater” day.
Operations do not occur daily, there are 2 days of the week for all the
cases. I’m mentally prepared for just
about anything now.
Tuesday, July 31, 2012
Operating theater day was a bit more routine than I
expected, but still was full of surprises.
I left the house early to walk over to Kilu’ufi because I was excited to
get started. I arrived at about 8:30 and
waited in the office for the doctors to arrive.
I ended up walking to the operating theater to wait and helped some of
the nurses make the gauze bandages.
There were two nurses in scrub gowns and hair scarves. The theater is a set of two wooden doors and
composed of 4 very small rooms. The
first room you enter is not a “sterile” center; it is the actual minor
operating theater. So many people end up
walking through the room wearing any outside shoes and clothes to get changed
in the second room. There is a basket at
the end of the room for “outside shoes.”
The doctors and nurses then walk barefoot for the surgeries with the
exception of some wearing flip flops.
Closed toed shoes are worn. I
luckily stuck my feet into Dr. Solomon’s clogs that she let me borrow. The next room you walk into is a patient
waiting center and also a room for paperwork and phone calls. The next two rooms are attached and one is
the major operating theater that is actually air-conditioned and has a
sink. The other is the sterilization
room/prep. I saw a sterilization machine
and was very happy to see the tools packaged in plastic. I already felt better about the day and it
seemed like these doctors were doing the best they could with what they
had. At some points they even seemed a
little embarrassed or ashamed saying that they had run out of this tool or that
tool.
The first surgery I observed was an aspiration, or drainage
of pulmonary edema. The X-Ray of this
man with TB was up on the wall and showed his right lung and rib cage fine, but
his left side was all white, indicating that the whole organ was filled with
fluid. I actually saw the heart and
trachea pushed over to the right side due to the pressure. I couldn’t believe this man was even
breathing, but here he was sitting on a chair waiting. Dr. Solomon performed the first injection of
lidocaine to numb his back. She made
sure to inject above the rib because there are fewer blood vessels there. I thought they would be moving him, but he
actually just stayed straddling the chair the entire operation with his head on
the backrest. Sterile drapes were placed around his back with a small hole from
which the fluid would be drained.
Apparently he couldn’t feel anything as Dr. Solomon injected a syringe
and expunged fluid that was red/yellow in color. She had found the lung, so I helped insert
the IV to drain the rest of the fluid into a bag. It must have taken a half an hour to drain or
even longer. Dr. Jason said that he
would have trouble breathing for a while after while his lung expanded and he
cleared his airways. I couldn’t believe
that someone was living under that condition.
Before I could even blink, Dr. Solomon moved into the major operating
theater on to the next surgery.
The goal for Operating Theater day is to finish as many
cases that were booked. They are not the
same type of case so it is not as simple as performing 3 appendectomies. Speaking of appendectomies, right before the
second surgery, a boy came to the hospital with a ruptured appendix. He had been in pain for 5 days and because
Kilu’ufi’s supplies were not adequate enough for the operation, he would have
to travel 3+ hours by boat to Honiara for the emergency surgery. There was a woman on the operating table in the other room for a major surgery. Over her noisy moaning and heart rate
monitor, I finally asked which type of anesthesia they were using. The reply was “ketamine.” Yes, you heard it, Special K. Not only was this patient “out of it” she was
actually hallucinating from the extremely dangerous and addictive drug. When I didn’t respond, the doctors said
ketamine was all they had to inject. This
surgery should have taken maybe 20 minutes in the US with the use of cameras
and big screens in the operating room, but it took much longer.
The next operation I saw was a terrible case of
conjunctivitis that spread to the cornea.
This strain of conjunctivitis is endemic in the Solomon’s and many
people can lose their vision if not treated.
There was an ophthalmologist performing the surgery. I was incredibly impressed by the procedure
and formality. The lady was awake the
entire time and didn’t make a peep as he scraped. The final two surgeries were a fractured
forearm set and cast placement and a dressing of a diabetic foot. I didn’t think I would necessarily enjoy
orthopedics, but the setting and cast placement was actually very interesting
and everyone was actively involved. I
was amazed that the same nurses basically did as much as the doctors and knew
what to do on every surgery. Two men
pulled on each side of the arm to set it, while the doctor wrapped the
plaster. When the last patient came in,
it was about 1 PM and everyone was getting a little tired after being on their
feet surgery after surgery. This
operation was considered minor but it was actually one of the longest. The patient had uncontrolled blood sugar which
caused damage in his blood vessels. Most
commonly this presents in the feet where sores appear. This is actually a known condition from
diabetes, but so rare in the US because of proper care. I had never seen a diabetic sore until here
where they are common. Worst-case
scenario a limb has to be amputated, and this man’s left leg was already
gone. Dr. Jason numbed his right foot
where there was a small sore, but said he needed to open it up to properly
dress it and make sure there was no infection.
I don’t think local anesthetics were enough as the man was clearly in
pain when the razor was taken to his foot.
Dr. Solomon began to place the ketamine mask on him, but he could still
feel the pain. After maybe a half an
hour of waiting and cutting, I had to sit down for a second because of the
amount of blood. Once again, I will
spare the details, but this sore was unreal.
It was deep enough to fit one half of Dr. Jason’s pointer finger inside,
so they decided to pack it and operate on it again when he was properly
sedated.
Surprisingly after all the action, it was around 2 PM and I
think I was actually starving. Dr. Jason
and I were talking about the surgeries for a while, and I asked about the cost
of the surgeries. I couldn’t believe his
answer: they are all free. He said he
wished he got paid according to the amount of surgeries he does or patients he
sees, but that is not the case. He makes
money, but not that much. Doctor Solomon
is a Level 13 medical professional which is a doctor level with years of work
under her belt but is still paid as a Level 10, which is similar to a
nurse. I will never cease to be amazed
by the system here. The only reason that
patients don’t line up begging for surgeries like they would in the US is
because adults are not educated enough to be conscious of their health and also
because of the lack of transportation.
After talking with Dr. Jason about his history a bit more,
(to Collin and Marcella-he actually performed a fatty cyst extraction on
someone’s back last week that was built up for 10 years, reminds me of the youtube
videos!) I went to the maternity ward to check up on baby Cayla! Daniela and Cayla were doing great and Sister
Matilda has met with them earlier to pray.
I snapped a photo with them and walked around the ward for a
little. When there was not much else to
be done, I headed home for the day.
Clare was home after already going to the market and back so we chatted
and played with Chrisma the rest of the afternoon. Of course we did some Insanity before the
evening prayer! After, Bishop Chris took
all of us out including Father Moses, to the one restaurant in Auki. It was a great dinner and nice to go out on
the town! The restaurant has the same 5
dishes on the menu all year, so everyone knew what they wanted. Clare and I split a fish and a chicken
vegetable dish and enjoyed every bite.
On the way home, Bishop Chris said that Clare and I should teach the
kids exercise tomorrow, so I think that will be our activity for the day! Sister Matilda wants me to put Insanity on
the computer for her. Another eventful
day in Auki!
Wednesday, August 1, 2012
I thought today would be a somewhat slow day at Kilu’ufi,
but I was most definitely proved wrong.
The morning was a bit slow, and I waited for Dr. Solomon in the
children’s ward. Before she arrived, I
walked around and chatted with the mothers and played with their babies. I don’t think I’ve ever seen a worried mother
here, at least how we visibly portray worry in the US. If worry is laughing and just saying “Okay”
to everything the doctor says, even if bad news, maybe I have seen it! The two children, Alick and Rebecca, who were
bed ridden with their broken legs were still in the ward. I couldn’t take one more second, so I found a
tape measure and took their measurements from the armpit to the end of their
foot. When I first saw them two days
ago, the seeds of a grandiose plan were planted, and I decided enough was
enough. I was going to make the crutches
myself. Before getting their hopes up, I
knew that my goal would be somewhat realistic because Bishop Chris’s builder,
Laborio, could probably assist me. He is
a skilled craftsman and artist who built the chapel at Fanualama. Believe me, if the children took the crutches
that I made by myself, they would probably break another limb. I sketched a model out while I was waiting
for doctor Solomon, and so far my materials are: timber, rubber stopper or tennis ball, nails
or screws, tape, and a towel. We’ll see
how this one turns out.
While Dr. Solomon and I were filling out charts, we were
chatting with the nurses. The big news
was that last night, apparently the hospital secretary, whom I met, was
intoxicated and decided to drive the ambulance down to a village past Fui River
where the people had a grudge against him.
Dr. Solomon said these villagers previously beat him up because he was
in the “wrong place doing the wrong thing at the wrong time.” Well, he didn’t quite get his revenge because
the villagers stoned the vehicle before he could harm anyone, and as a result
he crashed the ambulance. Not only was
this a dangerous accident, I was almost sick to realize how many people will
suffer because of this broken vehicle.
That was Kilu’ufi’s only ambulance, and now no transportation will be
available until it is fixed. The doctors
were very frustrated because he brought a bad name to the hospital. This man had also been suspected of stealing
money for ambulance repairs in the past.
Wait until the director May-June gets her hands on him. After finishing seeing the children with Dr.
Solomon, including one baby whose entire lung was filled with fluid most likely
from TB, we headed to the maternity ward.
There were no deliveries today, but I was very upset to hear
that “Cayla” had a fever. Dr. Solomon
said it was related to her delayed breastfeeding and probably an
infection. The prognosis is good so I
hope all is well. We discussed the
patients for exams and overheard the nurses saying that a mother wanted to sign
“leave at own risk” papers. Her baby was
1 kilo, and about the length and width of my forearm. I could hardly believe how tiny she was. It sounded like Dr. Solomon had given up
trying to convince them to stay. She
said that the husband was very harsh with her, and wondered why the baby wasn’t
improving if she was a doctor. He said
that he makes the decisions and he is free to do what he wants. Dr. Solomon is a very strong woman, so I
think she had it with him. I didn’t want
to get involved, but for some reason I felt like I should. When I went to check on the baby, just the
mother was inside the room looking upset.
She asked me my opinion, (most people think I am an expert in
everything) I told her I thought she should stay longer with her baby. If she was to leave, the poor thing would be
prone to so many different infections.
The immune system would not be strong enough, and the outcome would not
be good. She then told me that she
agreed with me and whispered quietly that her husband is very angry with
her. She said whenever she sticks up for
herself and the baby, he yells and says he wants to go home. This was abuse at its finest, but the poor
woman could not even recognize it. Just
at a curiosity, I asked her where home was.
She replied that she was staying in Auki with family, while her husband
lives and “works” in Honiara. Most
times, this means that he has another spouse.
I asked her why he couldn’t leave alone and come back when the baby was
healthy to bring them home, but she said that he yelled and told her she was
wasting her time; he could take care of the baby himself. At this point, I didn’t want to show my rage
or utter disgust for her husband, so I tried stay rational. I calmly asked where her husband was, and she
answered that he was waiting outside. I
thanked her and stepped out of the room.
Did he really think that this baby could leave the hospital, travel by a
crowded boat for 3 or 4 hours to Honiara, and survive? I honestly didn’t want to make a scene, so I
began seeing patients with Dr. Solomon.
She knew I didn’t get anywhere, and she told me that Solomon Islands has
just began a women’s rights movement due to the amount of abuse. Because the submissive woman was part of
their culture, men were accepted to be the ringleaders. She said in a recent study, researchers found
that 2/3 of Solomon Islands women are abused, verbally or physically. The government is just starting to pass laws,
but the police do not enforce them. The
mother suddenly interrupted our conversation by knocking on the window of her
room to get my attention. I ran to the
door, and she whispered to me that her husband was inside now. I got a rush of adrenaline, and had a master
plan. I went up to him and shook hands
and introduced myself as a “US medical worker.”
Hey, I’m a certified nurse’s aide.
He told me that all he wants to know is the condition of his baby. I told him that Dr. Solomon and I think the
baby should stay because it is not safe to leave. He constantly kept saying that treatment
wasn’t working and he’s already been waiting for 2 weeks. He said if he just left by himself, he knew
his wife would call him and he would have to come all the way back to Malaita
to get her. Are you kidding me? After back and forth “arguing” with him, I
could hardly stand his red beetlenut mouth and yellow eyes, obviously on some
type of drug. Finally he agreed that he
is making the decisions and he will discuss it with his wife, but thinks that
staying a week would be a good idea.
There it was, he was lying to my face to make it look like he had
control of his family. The mother
thanked me and Dr. Solomon was happy to hear the baby would be staying. The only safe place right now was in the
hospital, despite not having any cribs, but that is another story.
By this time it was 1:30 and Dr. Solomon and I decided to
take quick break before the emergency appendectomy we were called in for. We stepped outside of the hospital and each
got a coconut which was delicious. We
headed to the operating theater and scrubbed up. All the nurses were preparing and Dr. Jason
came after escaping his busy schedule in the outpatient ward. I couldn’t believe how long the appendectomy
was delayed. The woman’s appendix was
already ruptured when she came to the hospital.
She had been in pain for 5 days now, and then waited 3 or so more hours
to be approved. I knew this couldn’t be
the best, but everyone took their time and began the operation around
2:30. After a spinal tap which looked
absolutely excruciating, the young woman barely made a peep. She was laid back down on the table and given
local anesthesia where the cut would be.
Because of the broken machine they did not have general anesthesia so
ketamine was injected instead. I think
Dr. Jason starting slicing a little before the drug had a full effect due to
her moans. The slice was honestly the
most inhuman thing I had ever seen, and I think I liked it. When I knew the patient was fully out, I got
really interested. I was
ecstatic to see the safety precautions involved and how safe they kept it
despite having few supplies. Once again,
I will spare the details, but Dr. Jason successfully flushed out the
infection around where the appendix burst.
He guided me through every step, explaining what he was doing and what
organ we were touching now. He drained
the area as well as an abcess, and then he told me the principle was to always
properly irrigate infection. He rinsed
the wound with saline and suctioned it back out. After doing this for a while, he was
satisfied, so I helped stitch the fibrous muscle tissue up after inserting a
drain. He said the wound must be left
open because it was dirty, and any remaining toxins can keep draining for a
couple days. After two layers of suture,
he secured the skin with 3 nylon sutures while I cut. The wound was closed, and the operation
finished. I absolutely loved it. The Dr. Jason and Solomon were laughing at
how happy I was. I
am officially the luckiest person and having the best experience of my life.
When I walked home, it was already 5 PM and Clare was
involved in soccer with the kids. I
totally missed our exercise promise, but everyone understood when I explained
why I was late! Sister Loretta was
laughing hysterically when I recounted my day and she couldn’t believe how
happy I was. Sister Matilda greeted me
and told me she did Insanity by herself today!
I was so excited for her. After
prayer and a delicious dinner, all of us are sitting around chatting. McDreamy, I mean Dr. Jason, said I would never
forget this day, and he is 100% correct.
Thursday, August 2, 2012
Just writing a quick post about today’s operations because I
have internet!
The day started off with
a set and cast placement for a re-fractured arm.
The man had gotten into a fight and broke his
forearm before, and decided to fight again with his cast.
Needless to say it took 3 men to set it, and
the job was done.
Everyone was laughing about
how excited I was for the next case of an incision and drainage of the underarm abscess.
The young girl’s mother was in the room and
she works at the hospital, so I was a little nervous.
Dr. Solomon
sprayed the abscess while I cleaned it. I thought there would be more
action, but I was satisfied after dressing it.
The next case was a patient who broke two fingers after getting into a
fight with her sister-in-law.
I was in charge
of the
IV and ketamine injections, and I
got nervous when she was hallucinating after the splint was in place.
They said that it happens all the time, but
it took this woman a very long time to wake up.
Finally, the man with the diabetic foot came back and I braced myself
for blood. Dr. Jason wanted me to help him so of course I gloved up and got in
there.
It was pretty disturbing how I
could see the plantar fasciitis and the bone, but I handled it.
The nurse, David, was laughing and brought
over a chair because he foresaw me passing out.
I proved him wrong!
Clare and I
are heading into town to run a few errands for a special birthday party this
weekend.
I look forward to the next post!
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| Operating Theater Crew |
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| Maternity Ward |
Clare and I helped the sisters pack the picnic and also got
Richard’s birthday presents together. We
decided to make him an American CD too!
When it was 10:30, Bishop and Father Moses drove everyone in 2 pickup
trucks. The ride was stunning and I got
to know many of the girls from Allegegio School on the way. Sister Loretta was once again cracking
everyone up and I couldn’t wait to arrive at the beach. When we arrived, Bishop and the sisters said
that since we were partially the guests of honor, along with birthday boy
Richard, we were allowed to go run around instead of cook. Clare and I were happy to play soccer with
the girls and enjoy the sun. Finally, it
was too hot so I had some of the girls guide me to the edge of the coral reef
so I could go swimming. Believe me, I wasn’t
trying to go alone. And I still tripped
and slipped plenty of times while walking through the sharp coral because of
low tide. I was wearing flip-flops but
some of the kids weren’t wearing any shoes!
When I got to the edge, I jumped in to join Clare who of course had been
paddling around already. Bishop Chris
was also swimming. I jumped in with
Christina and Veronica, and one of the girls threw me a snorkel! When I looked down, the sight was better than
the Great Barrier Reef. I saw huge
mounds of coral, bright fish, and so many colors. Everything was crystal clear, and I could
actually see and breath at the same time.
After I occupied myself for 45 minutes, I swam back in and made it to
lunch. After our sandwiches and
pineapple, Bishop Chris organized a boys vs. girls soccer game. This was a little unfair, considering
Richard’s brother Gabriel actually has been recruited to the national team in
Fiji and New Zealand! Running on the
sand was so tiring, but the girls held their own. After the game, some people went to swim
again but I stuck around on the beach to spend some time with Sister Loretta
and the girls. We ran around for a bit
and they decided to teach me some dancing.
They couldn’t keep a straight face when I showed them my moves, but I
told them I was just warming up. I sat
with Richard and Patrick as they tried to find a special North Malaita cultural
song for dance. But, remember how I
attract disaster? Well, I saw a cute
hermit crab on the ground and decided it would be hilarious to put it on
Richard. I walked back over to where
they were playing the music and put it on his arm, all of a sudden I saw a
flash of brown and, “BOOM!” I seriously
stopped breathing for a second and then screamed. A massive coconut fell just inches from my
head in between Richard and I. Are you
joking me? I would have been a
goner. There are countless people in the
Solomon Islands who get injured from these trees and their dangerous
fruit. It sounds silly but seriously,
not funny. Sister Loretta has realized
my affinity to accidents so she decided to hang on to me the rest of the
day. Everyone was laughing as I walked
everywhere with my hands over my head and invented ”The Coconut Dance.” 
