Yen’s Blog | Month 2 | August 2018

Month 2.

Going to the toilet at night on patrol.

Dr Yen Lim on Patrol in PNG
Mind your step (that’s not a pit toilet by the way)

Boy do I love a cup of tea at night after dinner. Sadly, I refrained from indulging in this particular favourite activity on patrol as I wasn’t keen on being woken up by a full bladder in the middle of the night. What I loathed even more was to then be kept further awake by the debate in my head of whether I should nip to the loo in the middle of the night. Bathroom facilities on patrol consist of a pit toilet with flimsy walls and muddy floors, located in a slightly out of way area from everything else. So a trip to the ladies overnight involves a) finding a torch and putting on a pair of long trousers; c) untucking your carefully tucked in mosquito net under your mattress; d) creeping out of the house without waking up the rest of the female patrol members or tripping over kitchen equipment/food/lights/bags/more bags; e) finding the toilet; f) avoiding stepping on toads en route to the toilet; g) avoiding toads in the toilet; h) doing the deed; i) returning to bed with steps a to g in reverse. The flies and smell don’t even bother me now. But I think I’ll just stay in bed and refrain from drinking any liquids past sunset, thank you very much.


Wet, fishy and bloody

ADI Patrol members chuffed at the catch of the day
Patrol members chuffed at the catch of the day

We had a rather wet and wild patrol on this last one. Patrol members got soaked. The oceans tested our resilience and our boat skippers’ skill. But it was all smiles when we trawled for 10 mins on our way back and caught 5 good sized fish for dinner.

The tourist in the stand out waterproofs
The tourist in the stand out waterproofs

I learnt how to de-gill and gut a fish with my bare hands (look mum no knives or scissors!) from the other patrol members. It felt odd not from the fishy after smell it left on my hands for the rest of the evening, but that the fish felt slightly warm when I did it. Perhaps my hands were cold from the hour’s wet boat journey prior. Or that this experience slightly detracts from the norm of preparing fish chilled to the appropriate temperature from the supermarket/fish mongers.


More fishy tales

I thought I’d include a clinical story as I do actually work (and surely it can’t all be about tropical paradise island living).

Patient Being loaded into ambulance
Patient being loaded in to the Troopy Ambulance

On our last morning of patrol, as I was casually setting up the clinic with our equipment, I heard the recognisable flurry of panic and shouts that accompany an emergency case in a remote setting (and the unusual quickened movement of human beings in a culture where a slow pace of life is the norm, unless you are licking a melting ice-cream). I quickly belted out for help from my colleagues still getting ready at the nearby staff house, and grabbed our 2 emergency medical tool kits.

A man was being carried from a truck into the health centre with a foot that was dangling precariously off his ankle. What happened after that really impressed me. The whole patrol team with local health workers and local public members all worked together to stabilise this man. The non-clinical stuff was what stood out for me. The team got lighting sorted in a room which had no lights. His family were quickly informed. A quick history was taken from the patient and his friends – apparently a fish bite injury.

There were noticeably no cries of pain. The patient had the most stoic expression and demeanour, and complained of no pain throughout. His sister was equally calm and she happened to be our cook. I had to arrange payment for her prior services before they departed on the ambulance, issuing receipts and obtaining a counter signature – a first for me midway through a resus case. Family members got her and his belongings packed before anyone could say boo to a goose.

Patient being loaded in to the helicopter ambulance
Patient being loaded in to the helicopter ambulance

Within 30 mins, he was stabilised and ready for transfer. Within 45 mins, he was in the troopy ambulance and sent off to a nearby provincial hospital 2 hours away via unsealed rough roads where the fate of his foot awaited him. The health centre had no ambulance driver so our driver volunteered to drive to free up the local health worker to tend to the patient on transit. So we all waved goodbye and wished him and his foot all the best as they drove off. We completed the rest of the day’s clinic, packed up and made our way back to the nearest town.

Coincidentally, we were dropping a patrol member off later that day when we heard the rumble of a helicopter. Again, most would be only vaguely interested back in Sydney but here in remote PNG its big news and a crowd gathered to witness the landing. I then saw a couple of troopy ambulances pulling in and behold it was our fishy patient! I quickly said my hellos to the patient and his sister and spoke to the medical team involved. It was satisfying to see the helicopter take off and again I wished him and his foot all the very best.

Sister placing a hand on him and saying a quick prayer before they took off


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