PNG Journal / Day Four - Last clinics at Itokama

14:02

Clouds rising from the mountains, seen behind the colourful school building.

From under the mosquito net:

It is nighttime at Itokama. I haven’t journalled since Day Two as we have been busy all day and night, and yesterday was too exhausted to do extra writing.

(Note: Day 3 journal was written at the end of Day 4)

As everyone has been saying, it feels more like it has been one month out in the wilderness, away from the comforts of home, and not a mere four days. We are slowly getting used to the simple meals of instant foods and the less-than-lovely latrine (a hole in the ground covered up with a cardboard contraption Liz humourously named “the thunderbox”. Better to laugh than cry.) We are slowly getting used to the communal living with and joking with a group of 11 others; the constant feeling of sweat, dirt and grossness; the delicious (not) flavour of Bushmans insect spray…

If I had all night I wouldn’t be able to write down everything that has happened.

***

Day four: Itokama

The path down to the clinic

Woke up feeling incredible. For the first time in the last few days, I felt refreshed from sleep and happy to open my eyes to the sight of a mosquito net above my head. Roosters made a racket outside as per usual, this morning I joined in the chorus with my own calls standing outside the outhouse before we went for breakfast (“ahk ahk ahhhhhkkkk….ahk ahk ahhhhhkkk…”)

Sarah was not impressed.

Men being manly…with sticks. I think they were taken down to the clinic to hold up more tarpaulin.

Another morning clinic at Itokama, one that I thoroughly enjoyed. Everyone kept busy swapping around different roles – I drew vaccines into syringes, snapped photos, helped out with a couple pairs of glasses, and learnt how to do the “Grille talks” from Sue. It involved speaking to a small group of patients identified with the skin condition called Grille (pronounced "Grill-ee") which manifested as itchy swirly patches on their bodies.

The swirly patches are indicative of Grille

The patients could do three things that would help: maintain a clean body, clean clothes, and apply a special cream. We handed out blocks of soap for body washing and for powder for laundry, as well as clean clothes to change into while they washed their clothes. (Another one of those moments where you quietly reflect that only having one pair of clothes really does cause problems.)

Harry collected blood, and became confident with more practice and helpful advice from Gary, the paramedic from the Redeemer church team . From my vantage point on the clinic verandah, I could see Alexandra (also from Redeemer) ran a great duck-duck-goose session at “discharge” (a bit of shade under a tree). As usual, Sarah was swarmed by the crowds as she was busy doing heights and weights.

Jodee flushes out a young girl's infected eye

A man named Cecil receives a new pair of glasses

A billon bag hanging inconspicuously from a tree.

People patiently queuing

Meanwhile, an EPIC TRIAGE TABLE was running at the back of the clinic. A row of tables was set up along the wall, with a whole squadron (okay slight exaggeration) of doctors and local translators (health workers or community members) seated together: Australians and Papua New Guineans working side by side.

Mum (right) consults with local health worker Ezekiel (left)

Elayne examines the left cheek of man, noting an unusual lump. It turns out to be something he was chewing.

Paul writes a "P" on the hand of a child for the Pentavalent vaccine

Now at home, reflecting back on that sight, I remember something my mum said a few months ago when this whole PNG/HepBFree shebang was still just kicking off. About how the Fuzzy Wuzzy angels in WWII sacrificed so much to help the Australians, and how it was time for us to give back.

But it has never been about the heroic western doctor that struts in telling the local health workers what to do, or just treating some patients for a few days and getting out, gaining some smug personal satisfaction but essentially leaving the system exactly how it was when they began – in need.

This project has always been about working together from the local workers, learning and teaching each other, cooperating to provide more services to their own community, and to help create stronger links with their local government.

But I digress.

Patients waiting patiently. (UNINTENTIONAL PUN!) Everyone goes barefoot; rain, hail or shine.

LIZ gives vaccinations

Happy faces at the glasses clinic

A few more interesting things of note at the first clinic. We had dragged three crutches from Australia to PNG, and after a few days of waiting, the doctors identified the young boy they met in July 2013 with the limp in his leg. Mum spent some time showing him how to walk using a crutch support, and adjusting it to the right height. These were exciting times.

Support for the individual is support for their family and community

Elvis (a young girl who developed a life-threatening hand infection in July 2013 which Dr Liz performed emergency surgical removal of pus…long story…using the powers of satellite phone they arranged for her to be flown out to Port Moresby hospital, then to Australia for better hand surgery. She, and her hand, were both saved and she spent 6 months living with the Cannon family. Like I said, long story) found a grasshopper and came to show us – it was huge! I was amazed by the camouflage, and how beautifully it resembled a lush green leaf. Not a sight you see everyday!

Walking back to the main village. Mud mud mud. (Pictured: Liz)

We held a second afternoon clinic. There were less people, and I found myself wandering around a little clueless and lost, trying to keep busy. Took photos, clumsily stuffed up another vaccination (by this time I was seriously losing confidence), tried to help a few more glasses patients but had to send them away as we had none left of the appropriate degree.

A young boy with an injured foot. Sarah and Mel cleaned and dressed the wound.

There was a severely aneamic young boy, his pale yellow palms a tragic contrast to the healthy brown shade his skin should have had. Elayne, Liz and mum together used to ultrasound to examine his body. Mum wore her distress on her face – knowing the child was very sick, watching the skin pulsate beneath his neck as his heart struggled to pump blood around his body. They knew he needed the kind of support that wouldn’t be available out here, but only in a hospital such as Popendetta or Port Moresby.

So ended our last clinic in Itokama. We packed up and left for the last time, walking back across the airstrip to the main village. A group of us took a shower in the spring (for some, it was the first wash in four days…)

The view from the verandah of the clinic, at the end of the day.

Clouds rising from the mountains, seen from across the airstrip.

Sunset, viewed from the verandah of our huts.

Soon afterwards, we received a call from a messenger saying there was a very sick lady in the village who had been too unwell to come to the clinic. She was in her early twenties and suffering from extreme pain to the point where she had been bed-bound for 5 months. Her relatives worried it was a form of paralysis that had suddenly come upon her.

As a group made our way towards the house where she lived, we absorbed the atmosphere of our surroundings. Sunset was falling over the village, raw and melancholy, yet incredibly beautiful. We could see the smoke rising from the huts, and as it became darker, the warm embers of the cooking fires flickering inside.

Mum and Elayne discussing the patient's situation.

It was incredibly sad. The hut was small, too small for someone to be confined in for many months. The patient lay on a mat about 10cm thick, suffering from the pain. Solar lights and headlamps lit up the cramped room, with doctors kneeling by the patient’s bed and other family members nearby. Standing my head nearly touched the ceiling, and the walls were strung with bags holding various bags.

The feeling was claustrophobic, the cries of pain heart wrenching.

Later that night after the sun went down and everywhere was pitch black, we all sat down for a communal meal – members from the Australian Redeember and medical teams, together with people from different villages. We (the medical team) were each presented with a handmade billon bag as a token of gratitude and a symbol of the culture of PNG. Billon bags are difficult to make, and if one makes a mistake, the whole thing needs to be re-weaved.

The Barai people are pure-hearted and genuine. They wear no façade on their face, only honest joy and sadness. They are a strong and resilient people who face hardship everyday, who have very little and yet are so willing to share everything they have. The leader Simon laughs in the middle of his speeches, as if the sheer joy and excitement in his heart is spilling out into his words.

***

From under the mosquito net: The rain falling on the tin roof makes a gentle pitter-patter sound contrasting with the rush of the shower outside onto the grass. We are here, in Papua New Guinea. The people of the Barai and the experiences we have shared together as a team have become more special as the days have gone by.

But we are all still looking forward to different conditions and new adventures in Popendetta. We fly out tomorrow at “10.26am”.

Carrie