Ruth Chen’s Blog

22/03/2009 2300 GMT +10 The past week at Kikori

The past week has gone by pretty slowly, mainly because there haven’t been many patients in the hospital, and we don’t have much to do after daily ward rounds.

We took about half an hour to get to church on Sunday, by foot! As we made our way to church, I found that there were quite a number of churches around in Kikori, the nearest being just a minute away from the hospital, a Baptist church. Not many of the hospital staff attends that church though. Thankfully the weather was cool, and as we arrived at church, it started to drizzle, so it wasn’t unbearably hot. Church was quite interesting. Some of the local praise and worship songs that they sing at Kapuna were sung, so I could follow a bit. Sister Sarah, the head matron of the hospital, spoke about equipping oneself with God’s word to do God’s work and quoted quite several meaningful verses during her teaching. It was a good sermon, serving as a reminder for myself!

The rest of the Sunday was spent in the company of Dr Manar, one of the 2 doctors here at Kikori. She comes from England, Newcastle. So in the past week, during ward rounds, things have been somewhat familiar – the English accent, BNF, the way ward rounds are being conducted (standing ones, compared to the sitting ones at Kapuna), the drug charts etc. Its almost feels like we’re slowly integrating back into the familiar UK way we’re so used to! After lunch and sitting around to chat, it was time for bilum making – this time with Sister Alofa, who happens to be the bilum expert at Kikori. We were taught a couple of new stitches here and there, but the trick is remembering how to start and end stitches. Anyway, we hope to get more lessons from Sister Alofa when she makes her way to UK later this year!

**

It’s been unusually quiet at the hospital, not many patients on the wards and not many mothers in labour either. However, for a quiet week, we’ve seen a handful of interesting cases.
There’s a patient on the surgical ward with interesting neurological signs – clonus ++, with brisk reflexes and increased tone (spasticity), with loss of sensation T10-L3/4. He’s on the surgical ward because he developed a pressure sore secondary to immobility/loss of sensation. Poor guy, we don’t really have the means to find out what actually is the problem. We need an MRI machine! Ohwell.
And there was a 32-year old female patient who had really severe chest signs (decreased air entry, creps, bronchial breathing etc). We had treated from pneumonia, but she wasn’t getting better. Then we treated for TB. Due to her pale conjunctiva, indicative of anaemia, one of the staff kindly donated some blood, and the patient had a blood transfusion too. Her condition picked up after the transfusion for a couple of days, but she soon developed jaundice, which was attributed to the TB meds. So, TB meds were stopped, oxygen was continually given, but before anything else was done, she died, at the young age of only 32 years. Sad.
On the O&G ward, there was a 39-year old mother who came in with a 5 day history of losing water. Her tummy looked small for a term pregnancy, and at one point of time, I actually wondered if she was really pregnant (you never know, could be an ovarian mass/fibroid?). Dr Ovoi wanted to make sure and the pregnancy test was positive. After getting more history from her (history taking here is challenging, the story changes all the time), we finally established that she most probably have a spontaneous rupture of membranes, 5 days ago. It explains the small tummy (no more amniotic fluid surrounding baby. Fetal heart sounds were still going strong though, strong baby!).To add on, the woman wasn’t sure of her last menstrual period, so we couldn’t establish if the baby was gonna be a premie (no ultrasounds here, unfortunately). And, I think we all agreed after much prodding (very rigid womb due to lack of amniotic fluid), that the lie was transverse. So, with multiple obstetric challenges in one case, and no option of caesarean, the next best option was to put the mother on the next plane out to Port Moresby. She was out the next morning, and latest I heard was that both mother and baby are doing fine.

On Tuesdays, the doctors do an operating list and the Tuesday that had passed was a very urological day, what with a circumcision and vasectomy on the list! Grace assisted Dr Ovoi for the circumcision, while I assumed the role of theatre nurse, getting equipment/gauze/scissors etc. The patient was under ketamine, so he was confused and I had to hold his hands down several times as the doctors worked their way around. Under ketamine, he told me to get lost, told Dr Ovoi that he was going to beat us up, insisted that having 3 girls in the theatre with him was a big no-no etc! Haha, comical moments were plenty as he sprouted nonsense throughout the surgery.. the effects of ketamine!
It was my turn to assist for the vasectomy case, and just as we were quite pleased with ourselves for finding the vas so quickly on one side, the other took a good 30 minutes or so. Dr Ovoi and I kept feeling, and re-feeling for it, but kept losing it. Anyhow, we managed. Grace and Dr Manar provided us with entertainment while we prodded along – Grace with her jumpy self (it was very very cold in the OT, we’re so not used to the cold already), Dr Manar commenting on how we’re faring much better than the first vas that they attempted! Haha, these 2 doctors are fun to work with. I’d wished we had more time with them. Anyway, I have seen the vasectomy patient more than once since, and he looks happy, so that’s good. The doctors are quite keen for him to encourage the other males around here to go for a vasectomy (read below). Now, who would have thought that the first time I observe/assist in a vasectomy would be in PNG?

I got the opportunity to do a couple of deliveries here as well. On Monday, a primiparous woman was in labour. It was quite funny actually because the CHW was just preparing to use the amnihook to break her waters, and I was just asking for permission to be supervised for the rupture of membranes. I then proceeded to do a PV on her. And just as I felt the bulging membranes, the membranes ruptured, there and then! I’m pretty sure it was spontaneous rupture though – my fingernails are nice and short! Anyway, she progressed pretty quickly from there, going from about 6cm to second stage in just 3-4 hours. I was called back after dinner to do the delivery, and it turned out that she wasn’t that great of a pusher (she was pushing for a good hour or so). We were hoping that she would deliver before the power went off. Thankfully, power went off later than expected, at about quarter to 11 (power usually goes off at 10). So yes, she delivered before power went off, but she had an episiotomy. The power went off soon after and I was left to sew the episiotomy up in the dark! Ok, not really in the dark. Luke, one of the experienced nurses (who happens to be really comical), used a metal tray thingy to reflect the light that was running on the generator power so I had a ray of light shining through as I did my sutures. Very interesting indeed.

On our ward rounds, it’s interesting to observe how the doctors try their best to convince mothers about family completion (after they’ve given birth to 4 or 5 or 6 children!). In Dr Manar’s words, ‘too many pikeninis!’, which means ‘too many children’, she tries in vain to advise mothers to go for ligation of tubes. Mothers here don’t get it though. They frequently reply with ‘custom’, meaning that they will use custom ways to stop themselves from getting pregnant. I’m just as clueless as you are as you read this, because what exactly is the custom way? Then, trying to convince the father to go for a vasectomy would be the next option. But the guys are worried that they can’t go climbing mountains after the op! Sigh. Well, I’ll definitely remember Dr Manar’s phrase - ‘too many pikeninis’!

**

The weekend that has just gone was a relaxing one. I decided to go running with Dr Manar on Friday evening, only to realise my appalling level of fitness. I guess that’s a wake up call for me to get my act together when I get back home. It was a rocky run, with up- and down-slopes, but nonetheless, a good workout. Kinda a good make up for Saturday, which turned out to be a lazy day in. It rained the whole day, and I was glad for the cool weather as I caught up on the sleep that I had lost the night before. My first day not sweating in PNG! The rest of the Saturday was spent watching random movies on the laptop and more bilum making!

Today was spent at church followed by a lovely brunch at the Chinese family’s place. We also spent some time talking about Chinese traditions/family culture/recipes (yum). It was cool getting insight from a Chinese who lived her growing days in China – true first hand information! We’ve been so spoilt by this family because each time we visit, they shower us with different food stuffs. This time, it was dumplings and buns! And as usual, they insisted that we’d stay for dinner. We had dinner plans with the doctors and Sister Alofa, so we kindly turned them down.

As I write now, I’m feeling so full! We cooked too much again! After that dinner of crabs, steamed egg, stirfried beef and veggies, tuna sandwiches, banana cake and pineapples, I think we really had a good meal. And it’s already 1130, but the power’s still on, which I gather it’s because of a op that’s going on. Sigh! Things are picking up at the hospital, only when we’re leaving!

Anyway, we’re going to fly out of Kikori tmr. We were meant to fly out on Tuesday, but just to play safe, we decided to go early. They are capable of canceling flights at the last minute, and because we’ve got a connecting flight to catch to Brisbane on Wednesday, its better that we gave ourselves one extra day. So yes, if all goes well, this shall be my last post from Kikori. I can’t quite believe my time in PNG is coming to an end. Has it really been 6 weeks? It’s really just gone by too quickly. Ohwell, all good things must come to an end. I guess, for now, I’ll just have to make do with the memories and the photos I have with me. Till next time when I’m in Port Moresby!

14/03/2009 0915 GMT +10) Post Patrol and Orientating myself to Kikori

Hello world! I’m still very much alive and am
finally at Kikori now, after meandering through
the many rivers and creeks of Gulf Province!

Its been an interesting week so far. What meant
to be a 5-day patrol was cut short to 3 days, and
we arrived at Kikori earlier than expected.

It was sad to leave Kapuna on Monday – Grace and
I were walking around Kapuna, saying our goodbyes
to the patients as well as friends we’ve made
during our time there, taking some photos along
the way. We were blessed to have received so much
from the people at Kapuna during our stay there –
Valerie and Grandma, for feeding us so well, with
both food and stories; Uncle John, for being a
fatherly figure to us, sending food and
necessities our way; Debbie and Robbie, for
giving us pointers before we even stepped foot
into Kapuna; the kids, for the amount of laughter
they bring; the girls, for the amount of stories
and music they have to share; Paul, for being
instrumental in my connection to the outside
world (he does the radio-thing that allows us to
receive and send out emails); the Kapuna staff,
for teaching us practical stuff like how to
deliver a baby (!); the English speaking
patients, who are lifesavers in terms of helping
a struggling med student like myself to translate!

Anyway, we were meant to leave at about 8ish. But
as with all things, we finally only left at half
9. The tide came up quite high, and we began our
journey of becoming PNG-ified as we waddled
barefooted through the water to get to our dingy!
Our first stop was Baitoti, where we stopped to
get some drinks and random food stuff at the
store. There, we met a Chinese guy (first Chinese
guy I’ve seen since I left for PNG), and very
quickly we started chatting (in Mandarin)! Yes,
my Mandarin is a bit rusty, but good on me, I
still managed pretty well. Apparently his whole
family is here, and his parents run a store at
Kikori (see later). He gave us 2 cans of coke
(haven’t had that in ages), and we were trying to
save it for later in the trip, but some kid from
the village nicked it! Ohwell, nevermind.

**

So after that, we began our patrol proper. Our
first stop was Bavi. We got started really
quickly, with some patrol members doing screening
(where they weigh the children, and check what
immunizations they need), and others doing things
like drawing up the immunizations, giving
immunizations, and seeing patients. It became
rather chaotic with the villagers all flowing in
(like an army), kids crying and brawling their
eyes out, parents telling kids to shut up,
onlookers laughing and trying to pin the child
down etc. You can picture it. I got started on
drawing up immunizations at Bavi, but later that
got quite monotonous so we rotated around, and at
the other villages (Buri, Ubu’o, Goilavi), I gave
the imms (and made lots of kids cry), saw
patients and screened them too. One thing about
giving imms though, you’ve got to be really
strong, and not care too much about hurting the
kid. Some of them are really strong, and if you
don’t pin them down proper, you run the risk of a
needle stick injury/having to give them another
jab bcos the needle comes out. The worst one to
give is BCG – to draw it up is already quite
difficult due to the tiny amount that is required
(0.05ml/0.1ml). To give it intradermal is
tortuous. The kid struggles so much and you
actually need to get the bulge in the skin before
you can withdraw the needle. Anyway, I hate giving BCGs.

Apparently these villages have not been visited
in quite awhile, and because villagers tend to
deliver in the village, very few parents actually
bring their children to the health centre for
imms. So we had a lot of kids who had been
overdued for their imms coming in, much more than
anticipated. Some were quite old (like 3-4 years
old, the worst age for immunizations really), and
what meant to be a small-ish village had about 80
kids coming in for imms (small village = about 30
kids). We intended to go to 6 villages, but
because we ran out of vaccines, we had to cut
short the patrol. A pity though, for the other 2 villages to have missed out.

Grace saw a severely malnourished child during
patrol as well, and it was really heartbreaking
to see the kid. One wonders – how can any parent
allow her kid to go on like that without seeking
any form of help at all? The pains of poverty and
ignorance I suppose? We didn’t have the resources
for that child and the best advice we could give
was for his mother to send him to the hospital
asap. We also saw a emaciated man who had an
array of symptoms with episodes of fainting +
jerking movements (?tics) + chronic backache +
cough + weight lost + lethargy, but no fever or
night sweats (on the contrary, feeling cold all
the time). We wondered if he was Parkinson due to
the ?tremor he had, or some sort of neurological
thing going on (had abit of passing pointing +
intention tremor). We’re not sure if the team
managed to pick these 2 cases up on the way back,
but in any case, we shall find out soon. Other
cases I saw were conditions like malaria, ?TB, GI
reflux, musculoskeletal pains etc. The rest of
the patrol experience from the other villages is
kinda hazy to me, perhaps due to the combination
of the intensity of the work we were doing +
stresses of moving around everyday.

After each visit to the village, if it were too
late, we would stay in that village. The local
villagers would look for a house for us to stay
for the night, and the first night was spent at
Bavi, the second at Ubu’o (the chief’s house). To
actually live out in these villages was quite an
experience, I must say. For one, there was no
electricity at Bavi. So when it got dark, it
really got dark. The villagers use kerosene lamps
and even then, everything was quite dim. My handy
headlight definitely came in very useful those 2
nights. To live out there was to soak oneself in
the PNG culture/lifestyle. After a few failed
attempts to walk with our sandals, I soon gave up
and walked around barefoot (To lose my sandals
while I waddle through the mud would be worse
than getting my feet all dirty!). I tried my best
to control my water intake too so that I didn’t
have to visit the loo (of long-drop variety) too
often as well. Fortunately, we didn’t need to get
up in the middle of the night to find our way to
the loo (located by the river!). I never really
realised the advantage of a full moon until this
time on patrol, where a full moon actually helped
a lot in terms of getting around in the dark!

Each morning, we would have to then pack up our
sleeping stuff, and move onto the next village.
It was fantastic that many people would actually
come forward to help us move stuff to the dingy!
The villagers would then give us parting gifts
like coconuts (yummy), pineapples and guavas (big
yums). On the whole, going on patrol felt really
satisfying. I actually felt like I was able to
help the villagers, especially those who could
not get to help, those in proper need. To wrap
things up, by the time we finished at Goilavi,
most of our supplies ran out, and so we decided to head to Kikori.

According to Olina, the villages we visited were
infested with these annoying flies. But during
patrol, as she said, it was a miracle that the
mudflies were nowhere near us. Praise God – He
really watched over us! Thanks to Uncle John’s
rather soothing insecting repellent lotion too!
Another miracle was journey mercy that was
granted to us. So many times, we saw rain pouring
in a distance. But we didn’t get any rain when we
were traveling in between the villages at all. Our God is really great!

**

So now at Kikori, we’re trying to pass time.
We’ve got no kids to teach music to, we’ve got no
fruits to pick. And, we woke up early too (thanks
to the chickens). So, after having breakfast,
watching a movie, and blogging this post, its only 10.30am! Ohwell.

Kikori has a different feel to Kapuna. I miss
Kapuna already – the community, the activities we
do, the walkabouts we had, the pawpaws and
coconuts (mmm). The compound here feels bigger
and less personal, with more staff housing around
and we’re living in a house that’s next to one of
the doctors. It didn’t take long for us to fit
right back in with the modern tools of living
i.e. gas stove and fridge, + fan though! More electricity time as well.

Kikori is much bigger, with more people as well.
In Kapuna, the staff at the hospital forms the
community. But here, you’ve got people from the
hospital, the local people, and workers from the
big logging companies around this area. It’s more
crowded, and they’ve got more stores here too. We
went down for a walk yesterday, and bought stuff
like tinned curry chicken, ice popsicles, and
chicken! We also met the family of the guy whom
we met at Baitoti. They are a family of five from
the province of Guangdong, of Toechew descent,
and they have been running the Jackson store down
in the ‘town centre’ for about 5-6 years now. I
think they’ve kinda ‘adopted’ us (in Dr Manar’s
words), giving us stuff (my favourite pork mince
with bean paste, plus some pork and beef!). They
even invited us over for dinner! So yeah, we went
over last night (don’t worry Mum and Dad, we
found out from the doctors here that it was safe
to do so), and the mum cooked up a storm, with
traditional Teochew cuisine – taukwa mixed with
pork + pork ribs and red dates + sharks’ fin
even! Who would have thought that we would get
proper Teochew food in Kikori?! Oh, and I’ve put
my mandarin and abit of Teochew into good use.
Afterall, I was speaking Mandarin for a whole
night (yes, hard to imagine). I wonder where our
ancestors come from – maybe somewhere around
their area? (No Kor, not the ‘London version’ of ancestors).

So anyway, that’s Kikori for now. Very
interesting experiences and people I’ve met so
far. We shall see what the rest of my time here
brings! Just 10 more days left here!

(07/03/2009 2130 GMT +10) My last post from Kapuna

I drafted this before my previous post, but
didn’t have time to upload it to send it off, so here it is!

So, I’m at the end of my stay at Kapuna. It’s
been an experience here, practicing medicine in
the bush, learning to survive in the bush. I’m
not sure what Kikori is going to be like, but I
hear it’s more modern, with concrete buildings
and floorings. Anyway, I will miss the way of
life here – my morning alarm clock (thanks to the
chicken), starting the fire for a hot meal,
sleeping under my mosquito net watching the
fireflies create some sort of spectacle under the
roof, listening to the flapping of flying foxes, and lizards chuckling.

This is probably gonna be my last post from
Kapuna. This past week has somewhat gone by in a
haze to me. I can’t really recall what has been
happening, apart from some handicraft work and a
few very sick patients in the hospital. I have
been doing the children ward round with Valerie
this week, and what started out as a quiet week
quickly morphed into a harrowing ward round this
morning. A couple of children have become unwell,
with ?TB Meningitis and typhoid on the list.
Children are really adorable, and its fun getting
the PNG kids here to laugh (PNG people laugh a
lot, at almost everything. Read previous posts).
Grace and I have almost assumed the role of being
the hospital clowns for the kids here, and
everyday as we make our way to and fro the
hospital, its such a joy to see kids (especially
those who have been very unwell previously)
playing in the fields. Some will be carrying
grass that had been cut, or playing with love
grass, or just kicking a ball around.

To deal with very sick children is another matter
altogether. I mean, just take today for example –
to get an IV into a patient, a 12-year old girl
was pricked just about 5 times, by various
people. 5 times! For a 12-year old girl! At my
age, I wouldn’t like that very much. Imagine a
12-year old girl! A fitting 7 month old child
with starry eyes and a desperate mother with sore
breasts from expressing breast milk crying
because of her child’s ill health are painfully
heartbreaking as well. Imagine performing an LP
(lumbar puncture) for such a baby! Seeing
children so ill is emotionally challenging – I
wonder how paediatricians handle such cases.

Today Valerie had to pick the new med student and
the Pettersons, from Baimuru, so she left the
hospital in our hands. Apart from those sick
children, the adult ward was quiet (enough)
(fortunately). I hope we did a satisfactory job.
It was tiring, nonetheless satisfying. I guess
with all things, when you have to bear
responsibility, its slightly different. You start
making active moves, and form decisions based on
common sense and whatever knowledge one
has.  Well, so much for being in-charge for the day!

I’m starting to feel sad about the end of our
stay at Kapuna, kinda abit reluctant to leave!
Some of the girls have started to tear at the
mention of us leaving, and the 2 girls who have
been helping us with the bilum bags are doing the
bilum bag quite religiously. We’re also trying to
do as many friendship bands as possible, teach
the kids as much music as possible, and tie up
loose ends like signing of paperwork for uni and
getting the necessities to bring along with us on
patrol. Well, as with everything, all good things must come to an end.

I don’t really know what to expect from patrol.
Many have said that you will never know how its
like until you’re on one. Nothing can prepare you
for it. Although it leaves us with just a week at
Kikori (where a lot of hospital action takes
place apparently), it will be an experience, to
go out into the community to see how PNG people
actually live, to follow up on patients, to make
more kids cry cos we’re giving them their
immunizations! We’ll probably arrive at Kikori on
Friday.

Time to say bye! (9/09/2009 0800 GMT +10)

And so, my time in Kapuna has come to an end. We take the boat out
today and start our patrol in various villages before reaching our
final destination, Kikori Hospital on Friday/Saturday. A whole new
experience again, and I am looking forward to it!

I haven’t had the time to sit down, collate my thoughts and write
them out yet - been busy with packing and saying my goodbyes around
here. Perhaps I’ll do it during the boat ride - I hope its not too long!

Anyway, its been good here at Kapuna. I shall miss it muchly. Will
write again when I have the chance. Sorry this is short, but it will
be longer next time, I promise!

Of handicraft and food (02/03/2009 2130 GMT +10)

It’s pouring, finally. The feeling of having the
rain can almost be likened to having my first
bowl of bak chor mee after I touch down from
London. It’s been a really hot day here in Kapuna
today, and I was just wondering when it was going
to rain (it hasn’t rained in a couple of days).

So, since my last entry, I’ve been quite slack
with hospital stuff – nothing much has been
happening (I’m quite sure now that I’ve said
this, things will pick up tomorrow, as with all
things!). Patients are all getting better, which
is always good news. The weekend was a quiet one,
with no mothers wanting to pop. Since my last
entry though, I managed to do a couple more of
deliveries – multiparous mothers(had previous
pregnancies), hence quicker labours. I still
haven’t quite gotten the hang of it. After all,
babies all come out in their own unique way! I’m
guessing that it’ll probably take me 10 or 20
deliveries to get the hang of it? Ohwell. The
patients all come in waves – one minute all the
moms decide to pop, and all the kids in the same
village come down with pneumonia or bronchitis,
and the adults all come in with some sort of
nasty illness (read: malignancy. See previous
post). And then, they all get better at the same time.

Anyway, I’m not complaining. It’s nice to have
some time to do other things. Things like buying
wool from the local store to make friendship
bands for the girls as parting gifts (yes, I am
reminded of primary school days where we would do
countless of friendship bands after exams!). Or
learning how to make a bilum bag using the wool.
Bilum is the Pidgin word (Pidgin is one of the
main spoken languages in PNG, after English) for
string. So bilum bag = string bag. It’s a
traditional PNG custom for daughters to learn how
to make bilum from their mums, and the girls here
(by girls I mean the CHWs/nurses who work at
Kapuna Hospital) have all learnt it well.
Basically you take two strings of wool, roll it
together, and using the metal bit of an old
umbrella as your needle, you thread the wool in,
and start your bilum (quite a lot of complicated
stitches). I’m learning from the girls at the
moment. Every evening at half 5, we meet them
under the Old Dorm, and they have been teaching
us, bit by bit. It’s not as easy as it looks, so
we’re progressing quite slowly. The girls are
determined for us to finish a bilum bag before we
leave Kapuna, so they show us the stitching, and
after we do a bit, they take the bag to continue
the stitching! Yes, not the ideal way to learn.
But at least we’ll get a bag each! Heh. One of
the girls teaching us will be heading to Kikori
with us, so hopefully when we start on our new
bilum bag, she can correct the mistakes we make!
(Mum, you should probably youtube it! If by the
time I get home I can still remember how to do
it, I will definitely need to show you how to do
it! The wool here is about S$1.40/ 0.70 for
25grams. Not sure if that’s cheap/expensive, but
the girls say that wool here is much cheaper than
at Kikori, so I might just get more so that I
have something to occupy myself with.)

**

How time flies, its March already! Another 3
weeks here – its going to be hard to leave
Kapuna! At church on Sunday, we had communion
with sago bread and lime juice. And compared to
back home and in London, it’s interesting to see
how different ingredients can be used to signify
the very same thing, of Jesus Christ dying on the
cross for us to save us from our sinful ways.

The girls here really love singing so much – if
they really buy my laptop from me, I’ll leave all
my Christian songs in the laptop for them! I
think they’ll bring Kapuna down with all that singing and dancing!

**

The rest of the Sunday was spent hovering over
the fire stove again. We got the fire going
again, and we’ve established a system around here
– Grace does the fire, and I cook. This time, we
cooked the chicken that Dr Ovoi kindly sent over
from Kikori with 5-spice seasoning, maggi
seasoning + oyster sauce, and using the chicken
skin and a bit of ginger, I fried the rice. We
were smarter this time, and decided to cook the
rice using the microwave. When the power came on,
we put in the rice to cook straightaway. And for
the first time in PNG, our rice turned out just
right. (The last time we cooked pineapple rice,
the rice became really gunky – we tried to cook
rice over the stove, you see. And given the fact
that we normally use the rice cooker to cook
rice, we obviously failed miserably with cooking
rice using the stove, whatmore a fire stove.) At
one point, I had to use my headlight to see what
I was cooking because it got quite dark before
the power came on! So anyway, we’ve got warm
water to shower with today (which is good
considering how it’s pouring!) and that’s the
nice thing about starting the fire.

[Warning: I’m a foodie junkie, so more Food Talk below]
I think I can perish the thought of losing any
weight here in PNG. I’ve gotten accustomed to the
food here – bread with peanut butter for
breakfast, followed by weird lunching habits like
eating papaya, pineapple, guava or
coconut/sago/crackers/more bread, and then sweet
potato/pumpkin/tapioca/pitt pitt + beans and
greens + crabs/fish for dinner! I love the sweet
potatoes here.. they are actually quite sweet,
and make very yummy sweet potato porridge! Crabs
here are good too, and I don’t think I’ve ever
eaten so many crabs in a month before. The
coconuts are great too – the locals keep telling
me which ones are the good ones, but each time I
go back and break it, the meat is too hard. Then
I realized that their idea of a good coconut is
for scraping to make coconut cream. Not mine
though – I want young ones because I love the
soft succulent coconut meat! So I’ve learnt my
lesson to ask them, which one is young, instead
of which one is imau miki (= very good). Today, I
intended to return to the market to buy a coconut
after ward rounds at 9. When I came back at 1,
they were all gone! And they were all young
coconuts! Tsk. So that’s my coconut story.

Other than coconuts, papayas, guavas (the guavas
have decided that they don’t wanna bear any
fruits, so we’re running low on them), bananas
and pineapples, we finally had our soursop
(yummy!). They take awfully long to ripen, and at
the moment there are 2 soursops sitting in the
kitchen, and everyday I look at them and press
them. But too bad, not ripe yet. Sigh. Oh, and
eating papaya with lime is very yummy. Looks like
I’m over the gastroenteritis that I had with the papaya milk already!

**

I think it has been decided that we’ll be able to
go for patrol after all. Patrol is when
healthcare workers go out to a village, and carry
out clinics for child immunization, antenatal
clinics, TB checks, etc. Patrol will be leaving
Kapuna next Monday. And this one that’s going to
happen (we hope it does! In typical PNG fashion,
things can always change!) will be over 3-4 days.
Since the patrol is going towards Kikori, we’ll
get dropped off at Kikori after the patrol. So
I’m guessing by Friday next week, we should be in
Kikori. And we’ll spend 2 weekends there, before
heading back to Port Moresby on the 24th.

So yup. Hopefully the next time I blog, I can
tell you my first bilum bag is done. I shall go
back to doing the friendship bands now.

Funny PNG Patients! (26/02/2009 2200 GMT +10)

The past few days have been eventful. Hospital
wise. The adult ward has got interesting patients
at the moment, with 2 patients with ?malignancy.
One can’t be 100% sure because we don’t have the
investigations to prove it but we are almost
certain that the lady with haemorrhagic ascites
has got some sort of abdominopelvic malignancy,
and the man with lost of weight, clubbing,
inability to first swallow food followed by
liquid probably has oesophageal cancer. Cancers
aren’t common here, but in a span of a week, I
see 2 admissions of terminal stage Ca.

Its really sad that nothing much can be done for
them here. Perhaps they presented too late? But
even if they came in earlier, what more could we
have offered them? Probably advice for them to
seek further treatment at Port Moresby. Afterall,
we are treating patients in the bush. The Xray
machine should be arriving from New Zealand soon,
and that’s about the best offer we’ve had so far.
As I saw the ascitic tap draining bloody fluid,
and the patient vomiting the little water that he
had drunk, I felt a sense of helplessness for
these patients – chemotherapy, radiotherapy,
surgery.. so totally unheard of. Its really sad
that nothing more can be done for these patients.

Yesterday, during children’s ward round, I saw a
kid with dextrocardia (heart on the right side of
the body). With cyanotic heart disease, it is a
miracle that at the age of 3, this girl is still
alive (mind you, she hasn’t had any surgery yet).
She was admitted once again for pneumonia. Option
of surgery was discussed with parents, but as
what Valerie says.. it’s a tough decision for the
parents to make. Finances is one thing.. the risk
they have to take - that surgery may not make the
child any better, if not worse.

Talking about xrays earlier, thanks to the
graduation, there was a canoe going over to
Kikori to drop the guests back there. Making full
use of the opportunity, patients who needed xrays
got onto that canoe, went to Kikori, and got
their chest films done there. Just yesterday they
all arrived back to Kapuna, and I found it
amusing how everyone (including patients)
gathered around the veranda this morning looking
at the xrays with us. They must be so curious to
actually stand there for a good hour or so
looking at all these films! I actually took a
photo of it – will try to see if I can post photos up!

I’m really enjoying hospital work now. Finally
getting into the swing of things. Plus, funny
things happen all the time. Funny as in haha
funny! Things like teaching a patient how to use
a peak flow – Valerie shows the patient how to
use it. The patient attempts it, albeit wrongly.
Then the CHW does it, and the patient tries
again, unsuccessfully. Then another patient
explains it, and the patient tries again. By this
time, everyone is laughing away, both healthcare
workers and all the other patients!
With my morning sniffles, Valerie chides me for
being the worst patient ever, for not using my
nasal spray. I’m sent away to take my med, and my patients all laugh at me!
I was taken aback to hear a patient’s dad use the
F word today (I haven’t heard it since I came
here), and apparently in Pidgin, its primary
meaning is screwed up. Not so for the English
language, Valerie explains and everyone laughs!
These PNGs, they laugh at everything! Such a happy bunch of people hehe.

I’m enjoying teaching the kids music more and
more each day too. I guess its all part of
building relationships. 2 weeks here, and with my
routine set up, I’ve settled in. We don’t know
when we’re going over to Kikori as yet, but I
don’t think either of us minds staying at Kapuna
longer! Better still if we can go on patrol
(Patrol is when we go out to the village to treat
patients out there, each trip lasting about 4-5
days). I definitely look forward to more story
telling with Grandma and Valerie and the girls in
my reminding time here. I think the time has come
for me to realise and accept the fact that I will
definitely miss Kapuna when the day comes for me to finally leave.

The wonders of God and Medicine (25/02/2009 1630 GMT +10)

I just returned from the labour ward after having
done my first delivery. This woman who was in
labour had been having regular contractions since
last night 9pm, only to deliver at 9.20pm
tonight. Her contractions reported from last
night were probably Braxton-Hicks, but still, she
was dilated at 2cm at 2am. For a multip, this one
was taking a long time to pop. Apparently her
membranes were ruptured earlier in the day today,
but when we did a PV again, it seemed that the
SROM was probably incomplete. Anyway, Valerie
gave me the opportunity to deliver, and although
I’ve been putting off performing deliveries for
the longest time, the time had finally arrived
for me to do one (under supervision of course). I
shan’t go into why I havent done any deliveries –
partly my own fault, but the education system
doesn’t help either. Anyway, being grossly
incompetent, I was relieved that Susie, the main
nurse who does deliveries, was there to guide me
along. As with all babies, this one came really
quick after the SROM, and with hands-on things
seem to happen much faster than it would seem
with observing. So a baby boy was brought into
this world. This woman had a history of retained
placenta with manual ERCP, so we had to be
cautious with removal of placenta. Unfortunately,
the cord actually broke, and Valerie went in to
pull on the cord. I wonder how she did it really,
everything becomes so slippery. Slowly but surely
though, she got the placenta out.

When I first read feedbacks from previous
students who did their elective at Kapuna, they
spoke about how Kapuna is a place where one could
observe how God and medicine came together.
Tonight, I witnessed that for myself. This woman
was really having a difficult labour, and Susie
led the group and decided that we took a moment
to pray to God, with the patient and her
relatives. I don’t know if they understood our
prayer, but in any case, I definitely felt God’s
hand at work in that delivery - even when the
cord broke and we couldn’t quite find the other end of it for a while.

It is customary for the labour team to say a
prayer and sing a worship song after each
delivery and given my time here, I have observed
how open surgeries have been done with grossly
limited supplies, but never short of God’s grace
and providence. Patients have been able to walk
away with healing lesions and regained hand
functions. Their scars heal beautifully (they have their PNG skin to thank).

Other hospital stuff , there’s a patient in the
ward who’s been having repeated knee effusions
and we’ve aspirated it 3 times already. Mr Knee’s
(that’s our nickname for hime) right knee’s been
flaring up with tenderness and stiffness, and now
his left knee seems to be following the
progression of the right. His left ankle’s also
starting to hurt. We treated him as TB knee, but
symptoms aren’t improving on TB meds, so that’s
been stopped now, and we’re treating as septic
arthritis now. Have to see how that goes. There’s
another woman, Mr Knee’s neighbour, Ms Ascites,
who’s having severe oedema all the way to her
sacrum, and without jaundice, one wonders if
she’s got a malignancy going on somewhere.
Valerie says its too tense to be TB abdo, so
we’ll be doing an ascitic tap tmr. Trouble is,
there’s no microscope here so the tap wouldn’t be
that useful apart from seeing the colour and appearance of it. Ahwell.

**

The graduation ceremony took place on Saturday
and that morning, Valerie and I were doing our
normal morning ward rounds. It was a lovely
morning, the breeze was cool, almost chilly and
the clouds were beginning to look really angry.
It was going to rain, which wasn’t great news
because the grad was going to be taking place in
the open grass field. Anyway, the rain came, and
what it left was a perfect nice afternoon for the
ceremony. Ah, bliss. The ceremony was a very
heartfelt one, nothing like the ones I know of
where lists of names are called out. When each
student walked out to collect his or her
certificate, family and friends would carry their
gifts and walked up to the stage with her. A
particular grandma of 2 students was so ecstatic
and she started dancing in front of her
grandchildren as they walked towards the stage!
The gifts that they brought to give away, either
to the graduate or the tutors, were things like
brooms, grass skirts, straw mats, and even
chicken! Simple gifts they were, yet so
meaningful and genuine were their intentions.

**

Shortly after the graduation, we were told that
one of our patients had died. This patient had
been admitted since the beginning of the year,
and we hadn’t been able to diagnose him properly.
It’s a great pity because I think in a developed
country, this would probably not have happened..
at least more tests could be done. Ohwell, that’s
the one thing I really struggle with over here –
having to make do with limited resources, and
learning to practise proper old school medicine
using clinical judgement (this of course is
really difficult due to the way we now learn
medicine in med school – so much emphasis on
investigations and results! Even the most basic
patient in hospital in UK would have a FBC at
least.. But not here unfortunately). Back to my
dead patient – he had these lumps all over his
body, and they almost felt like hardened skin. He
was having proteinuria, and developed extensor
paralysis of both his wrists. Apart from that, he
had peripheral neuropathy with bilateral foot
drop, ulcerating lesions all over his scrotum,
amongst many other signs. I should actually get
his notes and properly document it so that I can
search for an answer when I get home. He reacted
to almost every drug we gave him, and the morning
before he died, he was complaining of SOB, which
we decided to treat as pneumonia. I think its
something autoimmune, Valerie’s take is pyoderma
gangrenosum, and Grace thinks its lymphoma. Hrms.
Anyway, the whole Saturday afternoon was spent
dealing with logistical issues of getting his
body back to him village, and suffice to say,
everything around here is the doctor’s problem –
from curing the sick, to replacing medical
stocks, fixing the broken light bulb, and
arranging transport for a dead man. Oh, and
hungry patients look for Valerie too. Jack-of-all-trades, you can say.

That night, a gravida 4 woman came in and her
abdomen didn’t feel quite right. It looked as if
it was a transverse lie, but I could hear fetal
heart rate at the left lower quadrant (which
meant baby should be in vertex position). However
others thought it was in the right upper
quadrant. The worry was that baby was breeched,
which turned out to be a false alarm. So no, I
didn’t get to see a breech delivery in the end.
Which is a good thing for mum.. But it would have been cool to see one!

**

Church on Sunday seemed to go on forever. In the
same time we had one service here, second service
would be over and done with back home. I guess
its because sharing is really encouraged over
here. Rita, the girl I met on the plane to
Baimuru, had just returned to Kapuna after
spending 3 months in Australia. She had new
experiences to share, and it was really good
hearing her share as she inspired the people at
Kapuna to rise up and pray for the Gulf Province.
I can really see and feel the hope she has for
her province – so passionate, such a deep sense
of burning desire. It’ll be an awesome revival
for the land of PNG for the people to rise up and
stand in the gap. I am really looking forward to see how things in PNG change..

The kids came together during the service, and we
finally put together an item of Ode to Joy
together (they were on the recorder, while I
accompanied them on the piano. Grace played the
recorder with them too!) It’s all Valerie’s hard
work though, and I think we should have given her
the credit! The kids were all so pleased with
themselves, and I’m so proud of them J

**

I’ve established some sort of routine around
here. Day starts at around 5am, where the chicken
intermittently awakes me. I finally get out of
bed about half 6 and get to hospital sometime
between 645 and 7 where ward rounds start. After
ward round, its time for breakfast and we go
round to Valerie’s for some homemade bread. If
Grandma’s around, we’d get toasted bread. Or
else, we’ll make do with normal bread. After
that, I go round to the computer to see if I’ve
got any new mail before heading to devotions
(that is, it devotions is still on. Timing
depends on what time ward rounds end). We’ll sit
around until 11, where we go back to the hospital
for either outpatients/postnatal/antenatal
clinics. The walk to hospital at 11 is the worst
– the sun’s shining in its full glory and the
short 2-minute walk is enough to make me feel
uncomfortable for a good hour or so. At 1, we
leave clinic to teach the kids piano – Grace
takes the young ones, and I take the older kids.
Depending on how fast the kids learn for the day,
we’ll spend the time after class ends to 4pm just
sitting around, catching whatever wind that blows
our way. Oh, we try to find something to eat too,
for lunch. Or start the fire if we’ve got too
much time to kill/get too hungry/want to eat
something hot. 4 to 6 would be a walkabout around
the hospital to see if any patients require
attention. If there’s no problems, we would
either be sorting out meds in the drug store or
clearing stuff in the OT or checking the labour
ward out or walking around kapuna looking for
food (we sound like animals don’t we – the food
bit). Then its time for dinner after the
electricity comes on, and checking mail again,
and time for bed – I love going to my bed and
hiding under my mosquito net. I feel safe and
clean under my mosquito net hehe. Aveline says I
should just get used to not being clean (which is
a big deal for me. I’m quite the clean freak)
well, I’m getting there.. slowly. If we’re in a
very keen mood, we may be tripping down to the
ward to see if any mum-to-be is gonna pop anytime soon.

This week, we taught the CHWs some anatomy and I
had to teach them terms. Terms, of all things!
Terms like medial, lateral, proximal, distal..
And I’ve forgotten how it’s like to teach until I
taught on Monday. Its.. tiring. Once again,
respect to all my teachers who once taught me.
Another challenge I faced this time round was
teaching these students when their command of
English isn’t that great. It’s not quite a piece
of cake getting them to understand what proximal
and distal mean. Anyway, I’ve done my best. I
hope they understood at least 60% of what I said.
Oh, and apparently we’ve been given another
learning outcome each to teach because we were
such efficient workers that we completed our
learning outcomes early! Cardiovascular and
Lymphatic system. Hm, its going to be challenging!

I’m quite happy that my older kids are finally
able to read notes and understand that notes
ascend step by step. They are no longer confused
about the treble and bass clef. So that’s
satisfaction I’m getting out of teaching. Yay for me.

Ok, the electricity just came on. I’m going to
make full use of it and stop here now. Till next time!

The rain came! (20/2/2009 1130 GMT +10)

I had a slow start to the week as I nursed my
problematic nose and sore throat. Thankfully, I
got better after some self medication and
intranasal steroid spray from Valerie. Hospital
wise, things have been going fine and I have
started seeing my own patients during the ward
rounds. Some interesting cases this week – a
woman with a 5 year history of growing mass in
her pelvic cavity spiking temperature, a GORD
patient with ?haemoptysis/epistaxis,
oligoarthritis in a 21 year-old female with no
genitourinary symptoms and an ulcerating
offensive smelling lesion in the vulva, spreading
inferiorly to her medial thigh. Many of these
patients presented quite late, which is very
unfortunate and saddening because more often than
not, nothing curative can be done at that stage.
If only they sought treatment earlier – and this
seems to be the main problem here. Villagers tend
to put things off, until it interferes with
activities of daily living when it is often too
late. Apart from ward rounds, we have been
attending the outpatient clinics, where we deal
with minor injuries, mostly cuts and wounds. I’ve
also got the chance once again to feel pregnant
tummies and go through the whole antenatal checks.

We started teaching the school kids intensive
keyboard lessons this week as well, everyday at
1pm. I think we’re overloading them with the
lessons, but because we’re only here for 2 more
weeks, we thought we would just make the most out
of it. Now, I think I might have been abit too
optimistic about the scope I had in mind to
cover. I actually had to go back to lesson 1 to
revise/teach again. Perhaps I’m talking too
quickly. Or maybe the kids do not understand me
very well. Hrms. It’s slightly discouraging, but we’ll see.

The graduation for the CHWs is this weekend, so
all around Kapuna, people are preparing for the
big event. Workers have been collecting tree
trunks and bamboo poles, and coconut leaves to
build shelter, and the first year students have
been putting Hillsongs ‘At The Cross’ on repeat
as they practise for their dance item. That kind
of got me started on listening to all my favourite Hillsongs songs on my iPod.

It was so good to hear Mummy’s voice when it was
by coincidence that I was sitting at the computer
sending out my emails when the phone rang. And to
all those who have been sending emails my way,
thank you so very much. It’s always comforting to
hear from you. I wonder how people did it in the
old days, without telephones and internet!
Imagine having to do snail mailing all over again!

It rained really heavily beginning of this week.
I think I would actually call it a rainstorm. The
whole house actually shook at one point, but it
was perfect weather to sleep in. Perhaps because
of so much rain, I’m noticing more insects and
flies around. Yesterday was probably my most
miserable day in PNG so far. I was victim to
mudflies/sandflies so they bit both my legs and
arms like there was no tomorrow. For those out
there who has ever been bitten before, I now
truly understand what it feels like. They’re
painfully itchy, and the itch lasts for at least
one whole day. They’re small bites, but way more
potent than mosquito bites. I probably have
gotten at least 10 bites in each limb. Pity I
don’t have any mopiko with me. Preventing bites
is one matter, relieving the bites is another
matter altogether.. My advice? Bring mopiko
(anti-itch cream) and chermos (?spelling) towel
(for afternoon wipedowns). We were told to try
aloe vera, so I picked some out of the bush, and
applied them on. So far, so good. It’s providing
some relief (colgate somehow didn’t work this
time), or maybe it’s the zyrtec that I took
that’s working. Either way, if anyone out there
has got any homemade remedy for mudfly/sandfly
bites, I would love to hear from you Email me
at <mailto:kapunarh@online.net.pg>kapunarh@online.net.pg Heh. Thanks.

The weekend is near once again, and its going to
be all joy and merry this weekend as the CHWs
graduate! We’re going to be teaching the first
year students some basic anatomy next week –
hopefully I won’t bore them with all the new
terms! I definitely know how it feels like to be
on the other end, having fallen asleep in most of
my anatomy classes anyway (oops)!

Not much fruit picking lately – probably cos
we’ve picked almost all that can be picked. We’ll
just have to wait. Not much fire starting as well
cos its takes up too much effort and time. We
just eat over at Valerie’s and bath with cold
water, which is fine for the hot days here.

Alrighty, that’s all for now. Till next time.

15.2.2009, Finally stepping on Kapuna soil

Today, being Sunday, is a day of rest for
everyone, and I munch on my starfruit and
pineapple as I type this. Its been a week since I
left the comforts of my own home for PNG, and one
week on, I’m sitting in the balcony of Colin and
Barbara Calvert’s house, trying to recollect my
thoughts on the past week, to put them down into words.

The journey into Kapuna wasn’t too bad. We made
it for the airport at Port Moresby pretty early
(Bob so kindly sent us all the way to the gates),
and customs stopped us when our bags were being
scanned. Apparently, some metal item was showing
up on their scanner, and after unpacking 2-3
times, I suddenly remembered that I kept all my
lovely aussie coins together in a Ziploc bag and
shoved them into a pocket. That was quite a funny
incident that got both Grace and the officers
laughing (at me) and the night before, I was just
telling Grace that the coins won’t be seeing the
world till we get back to Brisbane. I even
proudly told her that they will hold out in that
nice orderly fashion I OCDedly arranged them in.

The plane we sat from Port Moresby to Baimuru is
probably the smallest plane I’ve ever sat in. It
was quite difficult to get any sleep on the
plane, so I kept looking out of the window to
take in the spectacular views of PNG – endless
streams of rivers and deltas, trees after trees.
Along the way, some passengers were dropped off
at Kerema, and there, we got round to getting to
know the other passengers on board. Got to know
Rita, who works at Kapuna Hospital, and John, who
was Kapuna-bound as well to do some engineering volunteering at Kapuna.

We finally got to Baimuru where we were greeted
by Dr Archer, one of the two doctors at Kapuna,
and Everlyn, a CHW (community health worker). Our
bags, before we knew it, were carried for us by
the local villagers and Everline! I was so spoilt by their hospitality.

On route to Kapuna Hospital, we stopped by the
Baimuru store and got whatever necessities we
could get our hands on. It’s abit like shopping
the Argos way, where you tell the shopkeeper what
you need, and he gets it for you. None of the
typical pick and choose sort of grocery shopping.
We were pleasantly surprised to find oyster sauce
too – Singapore’s Kee’s brand even! We were then
given a tour of the local medical ‘health centre’
there and I saw the work of Dr Valerie where she
took on the roles of doctor, stocktaker,
storekeeper, and friend. I guess that’s how it is
in rural regions, where the doctor is just about
the port of call for everything and anything.

After an hour on the dingy, we finally arrived
Kapuna. Kapuna, which means place, is not
actually a village. Before I came, I tried
looking it up on Google maps, and what I got was
a jungle. And literally, it’s in the midst of the
jungle. Its not part of another settlement, it
functions wholly as a hospital. I guess you can
call it a hospital village. The buildings here
are all made it wood, and they house the staff,
patients, and patient’s family members. Here, the
whole family travel from neighbouring villages
for the sick to seek treatment, and when the
patient needs to stay in hospital, the family
stays in these houses, where they can cook and
provide for themselves. It’s a very different
concept from modern hospitals, where meals are provided by the hospital.

We were showed our home for the next three weeks,
and as soon as we got our stuff into the house,
we went around walking as Dr Valerie showed us
the locations of different fruit trees where
we’re free to pick our own fruits – coconuts
(favourite); pawpaws (which is papayas);
bananas(none for me, no thanks to my allergy);
guavas(ok); mini jambu; starfruit(second
favourite); lime etc, the hospital, and her own
home. She also gave us a breakdown of life in Kapuna along the way.

I guess I’ll give myself credit for doing rather
well so far – we’ve made ourselves somewhat
comfortable with the living conditions here; only
thing I can’t really handle yet is ultimately the
heat and humidity. I actually don’t internet
withdrawal symptoms (I’m pretty sure that’s the
heat taking over my whole mind – how to make
myself feel cooler!), and I am happy to put
myself to bed by 11pm (cos that’s when lights go
off, literally.) I look forward to simple
pleasures of life, like thinking of what fruit to
pick next, getting emails from family and
friends, and experiencing any amount of breeze I
can get. So, its my 5th day here. What have I learnt?

Well, I’ve learned that to cook anything, we have
to start a fire (Yenling jie, I wished I took
proper lessons from you over Christmas at Wales),
and its not all that fun given the climate that
I’m currently experiencing! Electricity runs from
7pm to 11pm (hence my bedtime of 11pm), so
boiling water from the electric kettle is unheard
of! I’ve definitely learnt to treasure whatever
electricity we’ve got. The heat and humidity are
also issues I battle with (on a daily basis), and
I’m so thankful I brought my prickly heat powder
– it does wonders! The early morning is cool, but
come 11am to about 4pm, the heat is unbearable,
and I can’t wait for it to rain. It’s also during
this time of the day when Grace and I are free,
and all I would do, is to sit out at the balcony
as I’m doing now, to catch as much breeze as
possible. It gets too hot to do anything though,
and I hope I’ll get used to the heat soon cos I
would probably need to do some reading, and
that’s about the only free time I can get each
day! 6pm is my favourite time of the day because
the weather is just right, I don’t mind getting
really smelly cos its time to bathe anyway, and
its time for picking fruits and gathering eggs
(at the expense of getting a loud chuckle from
the mother hen) and walking around Kapuna! I’m
also trying to face my phobias of lizards, slowly
but surely! There’s so many here, its literally a
way of life to be friends with them.

Hospital wise, we have been shadowing Valerie
around on her daily ward rounds. The day starts
early at 7am (yes! I can actually wake up at
6.30am nowadays, thanks to the chuckles of 20-30
chickens – I suspect they all think they’re part
of a choir or something), with Mondays,
Wednesdays and Fridays being kiddies’ ward round,
and Tuesdays, Thursday and Saturdays being
adults’ ward round. Wednesdays are also TB clinic
days, and everyday, Dr Lin (Dr Valerie’s
84-year-old mother) takes the mummies-to-be/new
mums clinic. We have seen quite a number of
interesting cases so far – a couple of
deliveries, a procedure to join the extensor
digitorium longus tendon of a woman who
accidentally cut herself with a knife back
together, TB affecting different kinds of organs
(breast, knee, lungs), a lady presenting with
pelvic pain + a huge lump in the hypogastric
region, and a male patient with symptoms that
can’t quite fit a diagnosis. Come tomorrow,
hopefully we’ll be able to run our own clinics
and see our own patients. Hope language won’t
pose too much of a problem (many patients come
from different villagers, where they speak their own local language)!

Dinners are times when we get together with Drs
Lin and Valerie, and the 2 Johns and the
Pattersons. Stories of snakes and crocodiles
experiences of working in the mission field and
sharing of NZ, Aussie and Malaysian/Singaporean
cultures have been exchanged over the meals, and
we’ve been blessed with good food. Mum and Pap,
don’t worry – I won’t starve. Just having had 4
dinners here, we’ve already eaten 2 meals of
crabs, pork, local vegetables, sago (different
kind from back home. The ones here come in
blocks), pasta, Chinese stirfry, fried rice with
smoked prawns (similar to dried shrimps,
hairbee), and lots of pawpaws (papayas).

I’ve met some pretty amazing people out here too.
Dr Valerie and Dr Lin are probably two of the
very few women I know who have boundless amount
of energy. They are on their feet the whole day,
from 6 in the morning, to 11 at night. Dr Lin,
affectionally known as Grandma to all, is a very
fit woman for her age, and she’s always out,
either doing her gardening, or seeing her
patients. Dr Valerie is on her feet 24/7 as well.
After seeing patients, she would teach the local
kids the recorder or piano (she got me to teach
them as well, and I’m probably gonna be teaching
them quite a lot these 2-3 weeks here!), or
she’ll chop the banana trees, or sort things out
in the medicine store, or jump into the river for
a swim. Really, the two Calverts put me to shame!

We attended our first church service today, and
as we sang different Christian songs in different
languages, I reflected and felt amazed at how I
could be miles away from home, from Singapore,
and yet be in a house of God, in a building made
of wood. The differences in surroundings between
PNG and Singapore/London are so apparent, yet all
God’s people can come together on a Sunday
morning, to worship the same true living God.
It’s just amazing. God really loves all His
people, and I was reminded of this song, which is
a personal favourite during my Sunday school days:

Jesus loves the little children
All the children of this world
Red and yellow, black and white; they are precious in His sight
Jesus loves the little children of the world.

And so, that’s how it’s been in PNG so far. It’s
been a week of many firsts. Tomorrow, we shall be
starting on hospital work proper. I shall bring you more next time!

My Journey So Far

And so, I’m finally here in Port Moresby, the capital of Papua New Guinea.

The flight from Singapore to Brisbane was uneventful, and fortunately, I was able to catch quite alot of sleep on the plane. At Brisbane international, I managed to clear customs (thankfully - I had to gobble my Bengawan Solo munchie just before landing) and by about 9, I was out. It took me awhile to find the tourist information centre. Given that it was a Sunday night, I was very relieved that the info counter was actually operating. I got transport to my accommodation, and ventured out to look for food at Chinatown after settling in. Grace met up with me at the apartment just before midnight, and it was nice to see a familiar face again. A familiar face in foreign land is very comforting.

I couldnt really sleep that night, perhaps due to the fact that I had a flight to catch early next morning. The manager at our accom got us a taxi, and we arrived the airport early, which was a good thing cos we had to do the whole packing-unpacking business to make sure we weren’t overlimit with our baggage.

As we flew into PNG, I saw the vast amount of jungle and the blue sea, all so beautifully untouched, isolated and kept away from the world. It was truly a sight to behold. The flight was rather empty as well, it was nice to stretch out my feet and to catch a good 40 winks.

We arrived into Jackson Airport and as we exited the airport, we were greeted by Mr Browne, who in his hands had a poster bearing both our names. He is originally from London, and has been in PNG since the 1970s. I’ve been truly blessed by his kindness as he waited so patiently while we sorted out our flights for our onward journeys, took us for a drive around Port Moresby, and shared stories of himself and his family with the both of us. Coincidentally, his wife used to work with OM, and they are friends with Uncle Kenny, my sunday school teacher’s husband and a family friend of ours!

Bob brought us to our accommodation at Mapang, and it has been good so far. We have been staying in mainly, only venturing out briefly earlier this morning to get some food from Boroko Food Worlds. Things here are quite costly(!), mainly cos most things are imported I guess. Apart from that, I’ve been kept entertained by the piano, a couple of episodes of Gossip Girl, and conversations with different people here at Mapang. Last night, we had dinner with the other guests, and met this lady, Debbie Petterson. She’s from NZ, and is working here as a translator. She was so kind as to offer us stories and tips of Kapuna, and even showed us a couple of pictures! We’ll be seeing her again this Thursday when we finally get there (by air, then by boat).

Tomorrow, we’ll be getting the plane to Baimuru, and I really hope the flight goes according to schedule. After that, it will be an hour or so of river meandering before finally reaching Kapuna. They say PNG is the land of unexpected. Well, we see. In such a short span of time, I’ve seen the hand of God work in so many ways. So amazing, so blessed!

Alritey, for now, I think I shall retreat to my room and enjoy the air-con while I still have it here at Mapang.