I Wear Computer-Geek Glasses

I see someone wearing glasses, I automatically think: they are smart. This is ridiculous, I know, but that’s how my brain is wired. Glasses=nerd=intelligent/genius.

I don’t consider myself dumb. If anything I think I’m quite smart. Not to be prideful or anything, but I’m quick to grasp on things and action them on to results.

However, if there was a thing I didn’t use to understand… (without just refusing to learn, like any manly jobs… such as car stuff, or electricity or plumbing…) it’s IT!

I’ve had quite a steep learning curve since joining YWAM, I’ve had to use more Microsoft programs than ever before, develop this blog, send newsletters (proper ones, not just a long black and white text in an email) then I’ve learnt about apple stuff (like appleTV), and google stuff (like Google Earth, google spreadsheets…) then it was YNAB a budgeting app, then Salesforce and OH! ArcGIS, I learnt how to make maps a few years back! Then we got Trello and Basecamp to track all of our work. And it’s a lot of work just to keep track of those tracking tools! But in the last year, my mind was completely shattered and expanded.

I have been introduced to something that makes me love IT. It’s also something that makes me feel incredibly intelligent and incredibly dumb at times! Some days every thing works brilliantly, we are developing things, growing and improving, and seeing so much change it’s incredible. Some days it seems like there’s more problems than solutions, it seems like there will always be things to improve and need for my brain to be so much more! Days where I want to play frisbee with my computer and call it quits! For those days, I wear my geeky-computer glasses. They bring me perspective and remind me of how far we’ve come. How far I’ve come with my skills and how far we’ve come as a mission with our data management!

None of this would be possible without Marty at Gearbox Solutions and his team! Big shout out to them and all the hours they put in. Oh! You should totally watch this video if you haven’t seen it!

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And it you know anyone that is IT savvy, please send them my way, I will put them to good use :)

Jurassic Siassi

I love pioneering, and going to new places. I love being in the middle of no where! When I’m in Townsville, I often ride my bicycle as far as my legs will take me, then look around and go: “Wow! No one would ever find me here!” I have a problem, I know! I love the sight of the untouched, pristine even wild looking land.

When I heard we were taking the ship to Siassi Island I got excited. One of our land based team had gone to Umboi Island just a few months beforehand. Siassi is the local name for what the Western world knows as Umboi Island. The team had gone on a scouting trip to find out what health services were available, where the ship could anchor and came back with heaps of stories… I heard that Umboi Island had one of the most recent sighting of …

dinosaurs…! Haha, oh the world we live in… I thought I’d check it out. If one looks on Google to get some information on the island… this is what they’d find:
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During orientation, I was talking about where we would go with the ship throughout the outreach and for the first week, I told them we would go to Jurassic Park! I asked our local friends to tell us more about the rumours we had been hearing about dinosaurs… All I got out of them was a nervous laugh, and a stare, not denying nor confirming..! I might not have seen any dinosaurs during our time in Siassi, but I reckon if they exist anywhere, surely they could be hiding in PNG!

But don’t worry, Google isn’t where I get all my information… I love the Health Facility Map for PNG.
screen-shot-2017-03-05-at-3-56-15-pmOn this map of Siassi, every red dot is a house. This is a very good database for us to know if we’re going to be busy and where the health centres are. Zooming in, we saw that one island had over 100 houses on it’s tiny amount of land! Something we found in the area is that people are very attached to their piece of land and won’t relocate to the main land even if they’d have more space there… they’d rather have their neighbour within arm’s reach (really!). Personally I wouldn’t want to live on the mainland either if I thought it had dinosaurs! Haha!

In all seriousness, Siassi was gorgeous, and the people so welcoming! They did an official welcome for us and danced for ages, have a look at the video our media team put together and travel to Jurassic Siassi with me :)

Reaching Kira

I first heard of Kira in 2014.

It was mentioned in passing in a meeting with provincial health. I remember that we were discussing where to target our medical efforts for the remaining two weeks of our primary health care school. The District Health Manager for Sohe suggested we go to Kira, but with only two weeks remaining we agreed that it’s be better to try to make it work another time, with a bigger heads and a potential funding.

At the time I liked the idea of going because it was far, it was inland, and they needed help. I was keen to get there by boat and by foot. My good friend and local health worker Philip had done it before.

“Angie, to reach Kira, you take a boat past the border into Morobe, you go into the mouth of the river and travel as far as the dinghy will take you. You might have to get out at times and pull-push the boat. But when you can’t go by river anymore, you’ll have to walk up the mountain. That’ll take you two days, then you’ll reach Kira.”

My brain was thinking… how will I convince the leadership team that it’s a good idea to venture into the unknown with medical gear and food and ride up in rickety dinghies, and then hike up mountains for days!? Not going to happen! Not that way…

In 2016, it got mentioned again, seriously considering this time. Funding was available, we were going to go by helicopter to two different locations in the mountains. One of them was Kira. Eyes wide open and heart full of hope, I did my homework and built up a risk analysis for helicopter patrols. We had an eight weeks outreach on land in the province, surely that would have been enough time to get the logistics organised and the funding released. We work in partnership and want to involve the local health workers and authorities in place to empower them to take ownership, and share in the victories/stories of bringing services to their people. Long story short, it didn’t happen in 2016.

But in 2017… it did! And it happened quick! It was a lot of people rowing together to make it happen. It was part of our collaborative outreach to Oro Province. We had two helicopter patrols that outreach. One to Ioma and one to Kira. I got to go to Kira. So did my friend Philip.

We planned to go for two days and bring immunisations, reading glasses and health teachings. Kira is a health station, but the facilities aren’t open yet and they do not have cold chain. In fact, Philip believed that the last immunisations were given roughly five years ago. According to the Health Centre Facility Map, there should be approximately 500 houses in the area, so we’d be quite busy if people came for services.

Unfortunately, Kira is so remote far inland and without telephone network that they have not heard we were coming. Those that heard the chopper land came to see who we were and what we were doing in their village. Amongst them were village leaders and constables (police officers). Those guys agreed with the officer in charge of the (closed) health centre, to run up the mountains and spread the word in the adjacent wards that a health care team was there and to make their way down to Kira.

The first day we didn’t see too many people. We saw those living at the station. Focused on family planning (Papua New Guinea term for contraception) and education. We also did outpatients consults to see the sick ones. Some ear infections, some musculoskeletal injuries, a man that probably had AIDS, and lots of simple coughs.

It was the end of the first day and I was sitting down with the health workers talking about everything and nothing from health worker training, to life in the village to health care politics, everyone seems to have dreams of a better system! Some village people and kids were still around, it’s not everyday foreigners come, so we become a bit of entertainment in a way…

Mid conversation I heard a sound I knew to be bad. I stopped listening to the ongoing conversation inside and turned my ears outside. There was a little boy roughly 10 years old, coughing his lungs out and then I heard it again! “Whooooop!” Eyes wide opened I stood outside on the porch and watched him cough again, a set of cough followed by a whoop. WHOOPING COUGH!? I had never heard that in real life…! Sure we learn about it in school, I teach my students each year, but had never heard it live.

I brought the boy into the exam room and had a look at him. He had come to the clinic earlier that day for his cough. But he wasn’t coughing like that then. I was actually proud of the local health worker that had diagnosed the boy with simple cough and prescribed “Rest, increase fluids and citrus” as a remedy for his condition. Too often I see antibiotics prescribed where it isn’t needed.

This boy however didn’t have simple cough; he had whooping cough or pertussis! In talking with the local health extension officer, apparently there were many cases of pertussis in the area. Understandably so if the last immunisations were administered in 2012! We decided something needed to be done about it. The local health workers didn’t have much supply of antibiotics and didn’t have the right ones for pertussis.

The next day was market day. Pertussis awareness was done at the market. All were informed to bring children to the clinic. Those showing signs of pertussis were prescribed a course of antibiotic and those not affected yet given a vaccine to protect them. 9 were treated for pertussis and 76 immunised against it over the course of our patrol.

I often think of the timing of things and why we didn’t get to Kira earlier, then I’m reminded that we got there at the right time. I think of what would have happened if I had gone to the house right after clinic rather than sitting there and discussing all these things. And I thank God that I can trust Him to have me at the right place at the right time as He intends for me.

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Not by ship, nor by foot…!

I fell in love with ships because they can bring you to remote places.

I’ve always loved hiking because you can reach remote places! I used to think that there’s nothing worse than a road that goes up a mountain because the view from the top of a mountain should only be available to those who conquer the heights…

Well working in Papua New Guinea (PNG), I now think that roads should be everywhere! Roads bring access to people, they allow health workers to travel, medicine to reach people. But unfortunately, roads don’t extend much beyond the main cities in PNG.

Now one of my new favourite way to get to places is helicopters. I’d still trek to the middle of the jungle, but not everyone wants to follow me. And that’s why helicopters are brilliant! I can bring medical professionals who haven’t got the time or the desire to train right into the middle of the jungle.

We have recently been working in partnership with Manolos Aviation and reaching far inland with little prep time! It’s been amazing to drop in a village for a day and provide specialised medical services! One day we took a dental team with portable dental chairs and extracted teeth (decayed ones and retained roots) until we ran out of lignocaine or anaesthesia!

Or the time our team ended up teaching the local health workers how to do incision and drainage of abscesses! Trust me, you’re glad I’m not posting those pictures ;)

Another time we sent an overnight patrol to provide immunisations to the community.. boy oh boy we were not expecting what we found! Read up about it in my blog “Reaching Kira”!

All that to say… I’m a pretty big fan of the flying bird :)

Oh and a big shout out to Manolos Aviation/Niuguini Heliworks! Their commitment to improving health outcomes for women in labour needing emergency medical services is unreal!

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Pink Canoes in the Ocean…

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Or Mycobacteria… It’s like pink canoes in the blue ocean really.

I have been quite behind in writing up stories from outreach, but even though this is from a while back, I wanted to post it :) So during outreach 8 in Milne Bay last year, I got the chance to spend some time training in the lab! I have this passion for TB and want to see what can be done to make a difference in this space. So spending some time with the lab was so refreshing and inspiring!

We’d go out to the village in the day, collect sputum sample… I must admit I can’t take sputum. I gag every time I hear someone cough it up. The consistency grosses me out, and the smell! Ugh! It reminds me of tracheotomy care during my time as a nurse on the surgical floor. But once the thick sputum is spread thin on the microscope slide all is well! We let it dry, burn it, then stain it with a bunch of dyes and it doesn’t look like sputum anymore. Everything is blue.

Until you look under the microscope. Then this is where my attention to detail comes in handy! To diagnose or read a slide, you have to look through 100 fields of vision and scan them thoroughly to ensure there’s no trace of TB.

That image is from one of the many that tested positive on that outreach. Roughly 70% of those tested had tuberculosis. Once tested positive, they can be started on treatment, start getting better and stop spreading the disease.

Testing is relatively hard in Papua New Guinea due to the remoteness. It is hard for patients to get to the health centre. And if the health centre don’t test for TB, they might take a sample, but without proper transport, the sample won’t be viable when it arrives to the next destination. Having the lab on board, not only allows us to diagnose, but also help identify locations that could have a lab and train their staff.
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That Village – a Story of Forgiveness

It’s not often I share stories like this… and I purposefully won’t share everything. But I thought that the end result was such a powerful story that I couldn’t not share it.

This story takes place in, well you guessed it… a remote village! In fact, we took the road as far as it would take us, hopped off the 4WD onto the surveyor track and hiked to the end of it, then followed the narrow bush trail into the village. We later heard from a minister in Port Moresby that “Nobody goes there; it’s just too hard & far to reach!” and I absolutely love the fact that we took local health workers with us and that they are the proof that it is possible, they can do it! We arrived in our village just before sunset. The villagers gathered as they saw us trek in, congregated around our rest hut and listened to our introduction. They were super welcoming, and excited to have us in the village and so grateful for the opportunity to receive medical care in their village the next day!

 

During the night, an incident happened. It wasn’t a major incident, nobody was injured, but some of our property was damaged.

In fact, I only became aware of the incident as I was having a chat with Philip. He had noticed something slightly off… his story linked with what I noticed waking up, and sure enough, he linked the dots…

As soon as he realized what happened, he was devastated. I could tell by the look on his face that our plans would have to change. I had also been in PNG long enough to know that the village would be upset. And as I was going through possible scenarios in my mind, Philip spoke out what I was afraid of: “We’ll have to leave; the village won’t let us see patients today.” PNG is an extremely generous nation and its people are way hospitable! In the even that they don’t look after you well, they’ll feel ashamed. In this case, we were well looked after by 99%, but 1% messed up.

When our other brothers (our police officers and health workers) found out what happened, they became angry. PNG is known for it’s passionate people. They were extremely passionate… wanted to protect their extended family (us).

Philip decided to inform our host of the incident before they heard from someone else. Immediately, he called the village chief and elders and convened a meeting. We were on stand by. We couldn’t get ready for clinic before the issue was resolved.

A quick walk to the loo showed me that the coconut wireless was working. Everybody seemed to know already. They’d point at us and whisper. They’d avoid eye contact. The air was so thick you could have cut through it.

I came back in the hut and had a chat with Philip. Our suspicion was confirmed. The village elders wanted us to leave, and were refusing treatment, believing that they had disgraced us and couldn’t accept our gift of health care after doing us wrong. We all agreed that the 99% goodness was more important to focus on than the 1% wickedness. Philip preached to the convince and told us that Jesus would stay and care for those in need. We agreed with him and commissioned him to go convince the village. While he was speaking with the leaders, we gathered and prayed. We decided to share with them about forgiveness and the importance to teach/disciple or mentor rascals into good people rather than to punish and possibly kill them.

 

When Philip returned he shared that the Chief wanted to hold a reconciliation ceremony. But that the chance that we could do clinics afterwards were very slim. Our local health workers weren’t keen (with the exception of our exceptional Philip!) one even said “don’t ask me to see anyone today, I refuse! I won’t see any!”

We saw a large crowd make it’s way towards our rest hut, then Philip indicated that the Chief was ready to start. That was our chance to change their minds, extend forgiveness and share from our hearts.

The Chief introduced himself and explained the situation and how disappointed he was. He said that he roamed the village to find people that shared his burden and wanted to apologize. He apologized and presented us with traditional necklaces to officialize the ceremony. As the team leader, I received the chief’s necklace, made of wild boar tusk; a highly esteem gift in PNG culture. My co-leader also received an intricate necklace, as did the rest of the team, and as the male leader of the team, he accepted the apology and extended forgiveness. We then had a chance to speak and had decided that one of our students she share her story and how she came from a hard past. How countless time should would have deserved jail or by Papua New Guinean standards, a good beating, possibly even loss of limbs. She explained that if she had received what she deserved, she wouldn’t be able to stand in their village that day to bring health care. She asked if the village would consider grace and mercy on the perpetrator of the incident. Not to turn a blind eye, but to opt for the loving option, the harder option of discipling and mentoring the young men rather than beating him up.

The villager cheered loudly as she made her petition, and agreed to consider our request. Some people came forward with gifts to present our team, some ran home to bring Tapa (a traditional mulberry bark cloth with intricate design), necklaces, and even a bird of paradise (taxidermy); an extremely rare and expensive gift! We then asked if we could stay and do clinic… their faces lit up! They couldn’t believe that we wanted to stay but agreed to have us!

When we returned to our hut to get ready, our health workers who previously wanted nothing to do with the village were excited to get to work and bring services to the community! I had never seen such radical transformation in the attitudes of people before! The village who wouldn’t look at us, and was ashamed was now smiling, singing and happy to see us, and our health workers let their anger go and decided to joyfully serve along!

What a story of forgiveness and transformation!

 

 

Philip’s Village

I made it! After all these years, I finally made it to Philip’s village!

I first met Philip in 2013 during my first visit to Oro Province. A trained Community Health Worker (CHW), Philip is also a Village Health Volunteer (VHV) Trainer for the Kokoda Development Program. Although he doesn’t have extensive formal education, he has extensive field experience and has been rubbing shoulders with various professionals and specialist that contributed to shaping him into one of the health workers I trust the most in the province.

Philip is not strictly a good health worker, he’s also an amazing man who will always fight for what is right and has an incredibly heart of compassion for his patients, coworkers and a strong faith that is contagious.

Much of  the beginning of my passion for TB streamed out of conversations with Philip. Dreaming out loud of what could be and how we could tangibly make a difference, influence others to advocate and change the trend! No idea or dream is too big or too hard for Philip he inspires me and many to do better and serve selflessly.

Philip often spoke of his village with pride. How welcoming, how peaceful and how beautiful it was; a true corner of heaven he would say. I was expecting a nice village, but I wasn’t expecting it to be that nice! We arrived in Barevoturu in the morning, and the whole village (we counted ~400+) was waiting for us, ready to welcome us with the traditional dances and singing typical of Oro Province! Philip in his typical cleverness had planned for the whole village to welcome us to ensure they’d all receive the health eduction sessions we usually conduct prior to clinic! We had amazing feasts prepared by the mothers and also a pretty cool dance party before leaving the village.

Some of the things that were dramatically different in this village was the Clinic & the Aid Worker’s house! They were massive, new, solid and very high tech by PNG standards! Solar electricity and water tank (running with a pump inside the house) for drinking water & flushing toilet! That in itself is a feat, but the health of the community is an even greater testimony for the work of Philip and his wife Sandy (also a CHW)!

Our two days in Barevoturu were the calmest we’ve had all outreach! The health of the community was off the charts!!! Pretty much every one was immunised; most kids that came for immunisations weren’t due yet, and were only weighed to be found in the right weight bracket! Well done mamas! All mothers were registered for antenatal care, and the sick people we saw were already on treatment! We had patients trickle in from surrounding communities… some a bit sicker but overall, they had a great understanding of the concept of active care and seeking treatment rather than the common fatalistic approach of “well it’s normal to get sick, that won’t ever change…”

Patrols are a very common thing..! Philip goes out monthly to the surrounding communities to bring essential medical advise and treatment! He hikes over mountains to cover his “catchment area”! And Sandy is a saint! She keep the fort along with their 5 children!

We need more Philips & Sandys in the world!

History of Barevoturu

This is the story I was told in Philip’s village regarding some of their past… specifically in regard to the 1951 eruption of Mount Lamington.

Barevoturu is pretty much sitting at the base of Mt. Lamington; located in the northern f0othills just a mere 8 kilometres away from the crater, smack middle in the 14km radius called the “avalanche valley” of the volcano. During the eruption, ~3,500 people lost their lives due to lava, rocks, ash, smoke, or the shear heat that caused fires to start throughout the area bringing extreme devastation on its path. One of the most devastating eruptions of the 20th century!

The people of Barevoturu took us on a tour of the village and stopped in the middle of what is now a village open air gathering place. The chief pointed at the line carved in the ground and explained how this area is the most significant of the their history.

Barevoturu had been a mission station for many years before the war, but despite the efforts of the priest, the village hadn’t adopted the christian faith as their own. When the Japanese reached the coast of Oro Province, the Barevotureans, afraid of losing their lives protecting their priest (whom they believed the Japanese would want to kill), exiled their missionary to its death in the jungle. The war finished and peace returned, the people in the village although not necessarily christian didn’t forget the teachings of their priest.

In 1951 when Lamington erupted and the lava was raging down the mountain, one of the elder in the community, out of the energy of despair decided to literally “test the Word of God” and put his Bile in the middle of the path. He asked all the villagers to grab their bibles and they lined them up in the middle of the path (what is now a carved out line in the ground) and prayed that God would push the lava back.

The elder of the village claims that their village was saved by God that day! As they watched the lava recede, they knew beyond shadow of a doubt that their priest had been telling them the truth. To this day, the community still has a strong faith testifying of their saving God that rescued them from disaster. Barevoturu became a place of refuge for many of their surrounding communities and a relocation centre for the people of Isivita!

Wow! The stories we hear from the “Land of the Unexpected”… Hard to fathom! But like Uncle Hub says in Secondhand Lions:
“Sometimes the things that may or may not be true are the things a man needs to believe in the most. That people are basically good; that honor, courage, and virtue mean everything; that power and money, money and power mean nothing; that good always triumphs over evil; and I want you to remember this, that love… true love never dies. You remember that, boy. You remember that. Doesn’t matter if it’s true or not. You see, a man should believe in those things, because those are the things worth believing in”

At the Right Place, At the Right Time!

Don’t get me wrong there are plenty of times where I wonder what in the world we are doing… but, every now and again there’s golden moments when we’re at the right place, at the right time, and the day we went to Harange was one of those!

Before I tell the story, I first have to clarify the way we pronounce the name of this village, just so you don’t think that we went to an “H-arrange” village…! So it’s pronounced “hah-ran-gay”.

Harange is in the Kokoda district so if you’ve been following along, you understand that this is in the mountains, fairly remote and that the village doesn’t have much access to health services. But beyond that, Harange is also situated inland beyond the Kumusi river. “The Mighty Kumusi”! This river is known for washing down vehicles that attempt crossing and wiping villages when it floods. Now the only way into Harange is across the Kumusi.

When I heard the possibility of reaching the people of Kumusi, my heart jumped at the thought of bringing health services to this remote place, but I got even more excited when I heard the provincial health team’s plan to get there…tubbing   Yeah.. “floating across” with all our gear and drugs :)img_6875

I then understood why the village hadn’t seen health workers before! The last health care team that came to see their community dates five years back and went as far as the end of the path but didn’t attempt the great crossing. Instead those who were sick or in need of immunisations (older people and babies were floated across!) Unbelievable.

We saw many patients that day, many that I wondered how they were still alive! Including a man that fell off a coconut tree and broke his back! But the one that struck me more as the reason why we were there was a baby Junior. One of my students asked me some advice for the mother, she was sick and too weak to feed her child. I asked to see the child, it was a “brand new” baby. we found out she had given birth two days ago and he hadn’t been breastfeeding since he was born. We proceeded to do a “healthy baby check” to find a grossly underweight infant. After a few questions and answers with the mother, we found out that the baby was 2 months premature!  That explained why the baby weighed less than 2kg… but not why the baby wasn’t feeding. So we asked the mother to breastfeed. Then it was obvious, the poor baby’s mouth wouldn’t open big enough to suck on his mother’s nipple.

We taught mum how to express breastmilk and feed it to baby with a syringe. Junior was HUNGRY! He must have gulped in 5cc instantly and sucked dry every syringe we’ve given him afterwards during the couple hours we were with him!img_6861By this point it was obvious that both bub and mum would need to go to the hospital for further care and follow up. We arranged for them to get across the river and for our transport to bring them to the hospital.

Imagine if mum didn’t have money to get to the health centre to give birth, how much longer she would have waited to cross the river and attempt to get to town… I love that we reached Harange that day, not a week earlier or later!

Ambene’s Passionate Mother..!

We have finally left Popondetta, Oro Province’s capital, and we’re on “actual outreach” in other words we’re finally getting far remote!

We set for our first village, Ambene! Ambene is in a difficult piece of land… They are in the middle of the mountains and there’s a road 3hrs out of their village, but they can’t build or pave a road to connect their village as the land surrounding their village doesn’t belong to them and they don’t have permission to build on it. So instead of having a smooth ride, we take a 4WD and go bush for about 90min, crossing mud patches, river beds and beetle nut gardens.

Ambene is like a little lost paradise! Everything is green and luscious, the village is pretty; it’s in the shadow of a mountain and there’s even flowers bordering the paths!

It’s our very first village we visited so we started with health promotion, followed by clinic. A day wasn’t enough to see the sea of people that had gathered for services! We returned the second day and opted for the same format; health education to draw a crowd before clinic.  We covered different topics on the second day to address the issues we had seen in clinic the previous day.

At the end of our helt toks (health education talks), we asked if there were any questions. One mother stood up and started speaking in the local dialect. It wasn’t long before her speaking turned into some loud, and animated expression. It pretty much looked like she was angry and shouting at us or at the community, I wasn’t sure.

Then I looked over at Philip (he’s a good friend and local health worker, fluent in over 12 dialects), I always turn to Philip in case of doubt. He seemed calm, purposefully looking at the mother and nodding his head in agreement. No need to worry, explanation will come… eventually!? Maybe :) The mother continued for what seemed like 5minutes. Then Philip thanked her and turned to us to explain!

The mother was beyond herself happy that we had come to visit and provide health care! She realized through our teachings that her village is a paradise where they pretty much have everything they need for life in abundance as long as they do a few things differently! She went from someone who had a fatalistic worldview about life and believed that sickness it a normal part of life to someone who is an activist for life and solution. She was encouraging her fellow villagers to build “tippy taps” or “leaky bottles” to help improve their hand washing & sanitation practices! She asked for our education charts to be able to spread her newly acquired knowledge with the ones that were in the field in the morning! She decided to act for change and no longer be ok with death and sickness in her community!

Needless to say, this doesn’t happen in every village at such a dramatic level, but it was such an encouragement to our team in our first few days to see the impact health education can have, the power of good, true and practical information in the hands of the villagers. Happy hearts!

 

Follow Ups = Happy Days!

I love that I get to work in very remote places! Unfortunately that often means that I have very few follow up visits with my patients. But in this post I want to share about 2 follow ups I’ve had this year!  The first one is oh so good and really happy! The second one is awesomely good, but sensitive stomachs, please abstain from reading ;)

This year I took the Primary Health Care School to Oro Province! (If I had favourites.. Oro Province would be one of them!) It was my fifth time to the province and we targeted the mountain areas around Kokoda, my third time there. One Sunday we went to church in Papaki. Although I hadn’t done clinic in Papaki before, I remembered walking through the village and across the river to reach Eiwo on the other side. I remember Eiwo for two things: 1- a cool cliff to jump off in wet season! 2- a girl called Ethel* with Pott’s Disease or Tuberculosis of the Spine. You might remember her…!
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I showed a friend in the village a picture of Ethel and asked if he knew of her. He recognized the mother and said that she was currently visiting in Papaki! He sent word for her and within 5 minutes, Ethel, who was also visiting was in front of me!

When I saw her in 2013, I was unsure of what would happen to her. She had already gone 5 years without treatment and she didn’t have too much longer before getting paralyzed if left untreated. Leaving her with nothing more than health education and a referral letter to the hospital for treatment, I prayed that her mother would take her to the city for treatment. Most of the time I don’t get to follow up… so I tell myself as I leave a village, that everybody was granted their miraculous healings and fairy tale endings! Naive, yes, quite possibly, but the only way I can see what I see on a daily basis and keep going.

Seeing Ethel all grown up, taller and bigger than before and NOT in a wheelchair, made my day! Our time in Eiwo 3 years ago wasn’t in vain! Ethel’s mother believed that she could be healed and made the hard sacrifices to get to the city and complete the whole 9 months of TB treatment her daughter needed! And Ethel got her good ending :)
3 years later

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First seeing Ethel launched me on a journey with Tuberculosis and understanding my role in “Ending TB in MY Lifetime”. I remember walking back to our village after clinic that day and having a long discussion with Philip about health promotion and the need to increase health awareness surrounding Tuberculosis as well as the need for mobile diagnosis! I’ve always held the picture of Ethel as a reminder that something needs to happen for TB. And now I can also associate it with the fact that health promotion does work and that sometimes the most seemingly helpless situations can be turned around with a little faith!

Alright! Sensitive stomachs, this is your warning ;)

The next story is about a patient I had in Ajeka! Before I write about the patient, I must tip my hat to his wife! The most loving and dedicated person I’ve ever seen… who accepted to put up with way more than anyone should ever!

So this amazing lady comes to see me and says “Angie, you’re back!” (Who is this lady!?) “I have to bring my husband to see you.” (Oh no!) Her husband, Jack* was seen in 2013 for a “boil” on his buttock. Instant flashback!

I, unlike some of my students, highly dislike when I need to ask my patients to remove their pants… I unfortunately tend to have a very good memory for things I’d rather forget… When Jack came to see me, he had had this boil for over 20 years! taken many antibiotics and never really improved. The right thing to do, was to give him a fair assessment and look at the thing… unfortunately. I had to remove the dressing his wife had put on the boil in order to see… as I removed the dressing, a scab pulled off and let pus along with tiny maggots ooze out of his wound. What a sight! I haven’t forgotten yet! At the time, I put him on Flucloxacillin, a great antibiotic he hadn’t had yet, and referred him to the hospital for surgical draining.

When his wife said that I had to see him, I was so sad! How & why should someone have to suffer through 25 years of but ulcer!? And poor wife!!! I immediately thought the worse… He hadn’t gone to the hospital and sat on his infected ulcer all this time… His health card surprised me with multiple trips to the hospital since my first consult, which is a good sign! He did get surgery, yay! But then, it got infected… according to the book, at the time of the last visit, things were in a good state.

So why did he need help? Did it get infected again? Dr. Thomas!!! A case for you :) He was surprised I had seen this guy before, and I was pleasantly surprised to find out that his sore was completely clean!!! I remembered what it looked like in 2013 and expected worse… but to my surprise, there was no inflammation, no redness, no puss, no worms, nothing but a small hole! Mind you that wound was tunnelling to the anal canal making a small fistula, but it was a minor surgery to fix the whole problem. And this reference in the wife’s hands was a guaranteed good outcome :)