Reflections And Stories
May 16th, 2008 by INMED
Posted in Uncategorized|
I just wanted to give you guys one last way-overdue update on the last two weeks I spent in Papua New Guinea. We didn’t have internet in Kikori my last two weeks, but I have so many great stories that I want to tell y’all about…so read this at your own risk; it’s long enough to be a short novel. I’m still excited about the trip, even writing about it two weeks after-the-fact.
Kikori is another hospital operated by Gulf Christian Services in the Gulf Province of PNG, about four hours down the river from Kapuna. It’s really a busy hospital–seventy beds and they are usually filled. It’s hard to imagine one doctor being able to take care of all the patients. There had been no doctor at Kikori for a year before Dr. Ovoi started (and she started on the same day we did). Apparently one of the big struggles that the hospital has is keeping physicians there—many plan to come and never show up; others leave after a couple of weeks. Prior to our arrival, a nursing officer by the name of Sister Sara had been running the hospital. She was an absolute saint. Sara somehow managed to be a mother, a wife, head of the hospital, and survive being called three or four times every night. She confessed to us that she and her husband want to move to an area with better schools for their daughters, but know that they are needed at the hospital. She is an amazing woman.
The community was pretty small, but was a little more spread out than Kapuna. There was a little store and a daily market, where we would walk to get food for dinner every night. The church was a 45-minute walk each way. There was an oil company about an hour up a ridiculously bumpy road. The people were also exceptionally friendly and we became close friends with the nurses really fast. We hung out with them in the afternoons, had video nights, and cooked dinner with them a few times. The friendships I made while I was in PNG really will stick with me forever.
From a medical standpoint, I really learned a lot in my weeks at Kikori. We saw patients with all the infectious diseases, complications and poor outcomes that we are able to prevent here in the United States. We saw tuberculosis manifest not only with pulmonary symptoms (the worst was a woman who brought in a /bucket/ of frank blood she coughed up), but also in the hips, spine, and pelvis. There was a boy on the ward whom the nurses called their “miracle boy” and had recently woken up from a three-week coma because of TB meningitis. Many patients had complications of leprosy, leading to horribly infected ulcers and wounds. One two-year-old boy had an infected tropical ulcer that had destroyed the bottom half of his leg. Another five-year-old came in with malaria and a hemoglobin level of what we estimated to be 3 or 4 (dangerously anemic) but we didn’t have the equipment to do a blood transfusion.
We set many fractures and sewed up a woman’s finger that had been bitten off down to the nail bed in a fight. There were many women who came in with injuries that had been inflicted by their husbands. One in particular had been hit in the chest with a club and was in a complete panic when we got to the ward to see her. When we were examining her she suddenly stopped breathing. I was just a little concerned (!) but Dr. Ovoi gave her a deep sternal rub and she woke up. Apparently this was the result of hysteria and it’s really common in PNG.
I witnessed a tremendous amount of healing take place in an amazingly short time. On my second day, a 13-year boy came in with what was supposedly a two-week-old stingray injury—the tail had entered one side of his calf and come out the other. His leg was infected so badly you could smell it walking into the ward and we knew something had to be done immediately or the boy would lose his leg. Drs. Ovoi and Manar and myself took him to the operating room, where we proceeded to play the part of surgeon, anesthesiologist, and nurse simultaneously. Ovoid opened up a little bit of the leg attempting to drain what we thought would be a collection of pus. The only thing that came out was calf muscle, red and swollen. Ovoi then handed the knife to me and told me to see what I could do. I’m obviously not a trained surgeon but knew that we had to be fairly aggressive in cleaning up the leg or the boy would either die or have to have an amputation. It was an almost surreal experience—I had the scalpel and the charge to do whatever I thought needed to be done (which was ?)—but in that setting I felt pretty powerless. So what did I do? Prayed—that God would give me the wisdom and the skill in my hands to do what needed to be done, and that He would help to heal this young boy with such a long life ahead of him.
I ended up removing a lot of dead tissue and opening up the leg a little bit to take pressure off of the muscle and blood vessels in the leg. At one point I had fingers from each hand touching each other inside the boy’s leg (sorry guys… you know I like this stuff). We washed out the wound as best we could, packed it and bandaged the boy up. The next day he looked worse and was writhing around in pain with a high fever, so we took him back to the operating room and cleaned some more dead tissue from the leg. We couldn’t keep an IV line in the boy, so he couldn’t get the antibiotics and fluids he needed. It was an awful situation, and I spent most of that next night awake trying to figure out what else we could do for him. I was at a loss.
The next day I decided that I literally couldn’t and shouldn’t do anything else for him. Apparently the father had become “aggressive” the previous night when the nurses were trying to put yet another IV line in him, and was walking around the ward with a 3-foot machete, threatening to kill whoever came near his son. I would have been slightly amused at this, except for the fact that word around the hospital was that this man had killed his first two wives and was likely responsible for the boy’s injury (it was thought to be a spear and not a stingray). Where was hospital security when we needed them? I really felt helpless at that point.
The nurses continued to do dressing changes but we weren’t any more aggressive with treatment. All I could do was pray for the boy. He seemed to be slowly getting better and stopped having fevers, but I didn’t want to get my hopes up. One day, about a week later, I was walking through the ward and saw him on the veranda in a wheelchair. I said hey to him and he smiled the biggest smile I had ever seen. It just melted my heart. He looked great on the day I left and I hope that he continues to get better. That boy was living proof of the power of prayer…it took over when we reached our limits as humans and physicians.
At Kikori, I was blessed to see a lot of life begin on the obstetrics ward. I also sadly was witness to the last breath taken by one little baby. A woman brought her four-month old adopted nephew—little Mick–to the hospital. He had been suffering from some stomach illness for a week and was very dehydrated. On top of that, he had severe protein malnutrition from not being breastfed. We had an IV line in him for a few days and were attempting to rehydrate him. The IV stopped working a few days later but Mick wasn’t looking any better. We were called one afternoon because he was having trouble breathing. When we got to the ward, it was apparent that he was again very dehydrated and a really sick little baby. We tried for 45 minutes to get an IV line in him and his difficulty breathing just kept getting worse. Suddenly his little chest was still and his life of pain ended. I cried with his aunt that day, even though I knew we had done all that we could for little Mick.
I think that’s all I have in me to write right now. My time in PNG was unquestionably life-changing. It was also incredibly humbling. Human life is such a gift…and I was able to witness the miracles of life, death, healing, human love and courage at their purest, without being confounded by the technology and frills of the society in which we live. I would love to be able to go back one day (if I survive residency training). I couldn’t have done it without all of the support and love you all have shown me and I thank you so much for that. God Bless!