Landing in Kavieng airport, you are greeted with smiles from beyond the wire fences of locals waiting for their loved ones. Your baggage is then loaded on to a trolley and brought at a snail’s pace by a farm tractor to the open aired arrivals lounge which comprises a bench or two (see pic). I have been fortunate enough to have my surfboard bag brought up on last two occasions meaning that I have learnt that carrying mosquito repellent in your hand luggage at all times is a wise thing to do.
Showering on patrol
This involves all the female patrol members gathering together in their lap laps (sarongs) and making our way to the nearest freshwater river to rinse off our daily dirt, endearingly called was was. The water is beautiful (see pic) and is the highlight of the day for both Dr Penny Uther (previous patrol doctor) and myself. Women folk and young children bath and chatter about their day, as well as wash their clothing. Drying your clothing is another matter and I have yet to discover the trick of getting your clothes to smell nice on patrol (tip: pleasant smelling insect repellent bug off works wonders). This leads nicely on to the feeling of gratefulness on return to Kavieng to shower in the privacy of your own bathroom. That is, until the power cuts happen. A standby bucket of water with a scoop and torch has come in handy on more than one occasion, especially with shampoo in your eyes. Most may not appreciate what it takes to have a flushing toilet and running water/shower (pipes that work, clean water supply and electricity to pump water in), but I certainly do.
Buying chicken on patrol for the next day
Again most would not appreciate the logistics (this would soon become your favourite word should you decide to come to PNG) of buying meat for tomorrow’s dinner. But on patrol, most guest houses and health centres run on solar power for lighting. If you’re lucky, you get a generator for lighting and charging laptops/mobile phones, but is only turned on at night. Therefore, buying and storing fresh chicken for next day’s dinner on patrol when both your troopies are out collecting other patrol members returning from faraway islands, is a bit of a challenge. Troopies are your main mode of reliable transport here, but more on that another day. We managed to secure a large enough esky from the guesthouse owners, only to find that supply of ice was short in the shop where the chicken was decent. All in all, after a couple of to-and-fro trips to the respective chicken and ice shop, we managed a nice farewell dinner (which included chicken) for Dr Penny Uther on her last night on patrol (see pic).
Thus far, the clinical work feels the most familiar and welcomed task as an ADI doctor. Practising medicine is by and large the same everywhere; with diabetes an upcoming problem and muscle aches and pains from overwork a common presentation. Perhaps a quick browse through malaria, TB and tropical skin infections section wouldn’t go amiss. The local health officers will keep you right if you ask nicely and smile a lot. The potential for learning from them is huge if you have the right attitude, and this goes both ways. Managing resources available to you, on the other hand, is a different beast. This can be applied to both clinical and non-clinical work of an ADI doctor; the former I will cover another day. The latter was felt when I saw an older diabetic gentleman who had run out of both his diabetic tablets a week ago. He was at risk of being severely unwell and was feeling pretty awful. The health centre had no diabetic tablets (if you’re thinking about insulin, please refer to the electricity issue in the chicken section above) and could only support him with IV fluids. The logistical discussion on transferring him to Kavieng hospital then ensued. Ironically, as I was perusing the outpatient tray of tablets whilst this discussion was taking place, I found a bottle of Dianil 5mg for diabetes. Elation of the staff was soon brought back down to reality as I posed the question of how much of that bottle should we give him – the whole thing, 1 weeks’ worth, 2 weeks’ worth? Funnily, health officers here have not been trained in managing resources for the future and I suspect that with life being so tough in PNG, living for today is the cultural norm.
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