It had been raining last night. Nothing seemed out of the ordinary until morning, and we woke to the news that the bridge connecting the roads around Kokoda had been washed away by the river. It’s the only road we can take out of Kokoda back to Popondetta, and we had to be back for a morning session at Siroga clinic. Would we have to wait until tomorrow for the road to be fixed?

A few phone calls later (Liz ringing her husband to help us damsels in distress) and we had transport arranged to help us get to Popondetta relatively on schedule. When we reached the bridge, a huge concrete slab was missing, exposing the wild, muddy, swirling waters about 3 metres down below.

To be quite honest, it was a little bit frightening. The truck stopped at the edge of the bridge and we walked up to the point where the concrete fell away – hopped across a ledge and landed on the grass on the other side. Luggage followed closely behind.

The bridge is located around a central area drawing many people together. There were women selling food just on the street – peanuts, green sprouts and palm-stick brooms, lamb heart (2nd/3rd picture below) and betel nuts – a cross-section of market vendor culture.

There were more people than usual today – because the bridge had washed away, and also because it was PNG Independence Day. Everyone carried around a token of national pride – wearing tee-shirts and dresses bearing the national red, black and yellow colours. On the top of a truck were perched a few kids, seated in between two large flags flapping in the wind. Behind them I could see the splendour of the cloud-covered mountain-tops – it was nothing less than picture-perfect.

We bundled back into four wheel drives and sped down a bumpy road littered with pot-holes and mud-puddles at top speed. We were lucky to have Nick, an Australian expat, to drive us back to Popondetta. Sitting in the very back with mum and Mel, every time  we hit a bump in the road, we’d be thrown up, suspended in the air for a moment before crashing back into the seat – ie. it was pretty fun (although to admit, I was holding on pretty tight). Needless to say the trip back to Popondetta was considerably shorter than the trip on the way up.

We passed through rivers and little streams, bump-bump-bumping over rocks. Through the window I saw women washing clothes by hand in the shallows, with children splashing, playing and helping wash clothes nearby. As we crossed one of the deeper streams, we passed a row of lorries decorated festively with flowers and PNG flags in celebration of Independence Day. People were crammed into the back like crowded, open-air buses. Thinking about how comfortable that would be in the stifling heat put all our complaining about Sydney transport into perspective – by comparison, it’s hard to find fault with our home bus/train system.

Road travels have been interesting in PNG. We rolled over a speed bump, unusually placed in the middle of a long stretch of road (it was the first I’d seen the whole trip). The sign nearby read “SLOW DOWN HUMP”, written roughly in black ink. Robert said that it had been informally erected by the community after a young boy was killed when he was hit by a car on this road. I wondered about how much road safety the children would receive, growing up in surroundings where vehicles are few but when they occur, accidents/serious injuries are plenty. We nearly hit a puppy-sized black dog but Nick braked to a halt. Don’t run over these dogs – apparently the compensation for a dog can cost 500 Kina (a pig can be around 600-800 Kina).

Patients patiently waiting

Eye clinics: tested around 40 patients, most of whom we managed to fit with glasses. Most common need was for refractive error, and it became difficult as we ran out of the glasses most needed – roughly +2.00 reading glasses. We also identified cataracts and a few pterigiums requiring surgery. We (being Sue, mum and I) were seeing so many of what we thought were cataracts that we started to become paranoid that we were seeing things.

Sun damage is also a huge issue out here, with many people saying that the sun gave them teary eyes or pain. For these patients we explained the importance of using sunglasses to protect their eyes from sun-induced damage.

The most interesting case was an elderly man who had an accident as a child where a bird had pecked his left eye. Since then, he had lost all vision in that injured eye, and I could see that it was pale, cloudy-coloured and unresponsive to the surroundings. Surprisingly, his other eye maintained function and he just needed some reading glasses to assist him.

I say this again and again, but these eye clinics are so incredibly rewarding. It means so much for the people to have a chance at receiving much-needed eyecare, mainly to help them read. For some people, they have been struggling with strained eyes for anywhere between a few months to a decade.

Even more so, it is such an incredible feeling and experience to be able to be a part of helping this to happen – to meet the men and women of the community, their sense of hope and gratitude. They shake my hand firmly, with affection and with sincerity. The women are so sweet, and some of the elderly women are like grandmothers.

Meanwhile, outside in the fly-infested heat, Mel was booking in patients and triaging them for any combination of vaccinations, eye clinic and medical consult. Jodee and Karen (immunisation nurse) gave Tetanus, Measles and Hepatitis B together. In a room down the corridor, Aunty Rahda (I’m going to abbreviate this to A.Rahda) and nurse Olive ran medical consultations together, dealing with a variety of cases.  Mum floated back and forth wherever she was needed – medical cases, helping out in the eye clinic etc.

A.Rahda showed me an X-ray of the shoulder of a man. There were some areas of white spotting in the right shoulder, and I was super surprised to find out it was remnants of gunpowder from when he was shot! The problem had been going on for some time, but only in the last few months it had started to cause pain. It was likely that there was some kind of inflammatory response to the chemicals in the gunpowder, although exactly what it was reacting to was unknown.

It was suggested by A.Rahda that the best treatment would be to have it fixed by a plastic surgeon. But according to Olive, there is a grand total of 1 plastic surgeon in the whole country. Let that sink in – think about all the plastic surgeons in the US, in Britain, in Australia, then consider 1 plastic surgeon to service the needs of an entire country. And as I suspected, they charge prohibitive fees that only the wealthy can access. 

There are just so many challenges with the health care system here. They’re not issues that can be fixed overnight, but with greater empowerment of motivated health care workers like Olive, Karen and Dorothy, real changes can be made from the ground up. The benefits have immediate impact on the communities they serve.

There are a lot of other little things that happen throughout the day that I can’t go into full detail without becoming a super long essay. Domestic violence – a huge issue, absolutely heartbreaking. On the radio it was said “Men, don’t beat the women, even if it is your wife.” Any further comment needed? There was a case of domestic violence presented in clinic today – I’m not going to go into the details and I wasn’t personally involved, but to put it simply, it was very distressing to hear.

With the end of our last clinic session here in Popondetta, we returned for a little bit of R and R. We’ve been so fortunate to be looked after very well, thanks to Liz’s arrangements. Things are very comfortable here, I feel spoilt or perhaps very fortunate, to put it in another way. I guess I need to mentally prepare myself for whatever is to come on the next stage of our trip, as we travel to Madang and Karkar Island. 

Tomorrow, after a morning session of presentations to the health workers at Siroga clinic tomorrow, we’ll be heading to the airport to depart Popondetta.

Carrie