Tip #1 How to cross the road in Manila: be bold, step forth, and try not get hit by a jeepney.

This was the first lesson I learnt from my fellow interns as we walked together on my first Monday morning to the World Health Organisation (WHO) Western Pacific Regional office in Manila, Philippines. It’s a 15 minute walk from the apartment complex where I’m living. On the way we pass stalls with vendors selling snacks, phonecards and other knick knacks, men resting in rickshaws, piles of rubbish on street corners… Mind not to step in the puddles - that was another piece of early advice.

It’s been an exciting, unexpected, challenging, fascinating first week at WHO. After a hectic month of uni exams, then sorting visas, tickets and applications, I finally boarded a plane on Sunday and arrived in Manila Ninoy Aquino International Airport on Sunday night. I’m living in a little studio apartment looking over a sprawling shopping mall just opposite our building, surrounded by high rise complexes and a constant background hum of traffic noises.

I’m interning here for the next 2 months at the Western Pacific Regional Office (or WPRO for short, everything – and I mean everything – has an abbreviation). I’m just learning the ropes about the organisation, its complex structures and procedures. I’m a hepatitis intern, which fits within the HSI unit (HIV, Hepatitis and Sexually Transmitted Infections), under the broader umbrella Division of Communicable Diseases (DCD).

Before coming, I had heard that I’d be the only hepatitis intern, and I had no idea if they’d be other interns around. So I kind of resolved myself to spending a lot of time alone. As it turns out there are not only heaps of other interns floating around in the other divisions, but at least 4 of them are living in the same apartment building together! The intern community has been really great, those who have been here for a few months and approaching the end of their term have showed us around, shared stories about their experiences (both good and bad!) and given lots of pointers about WHO, intern responsibilities, places to eat and travel to on weekends.  There’s also a trend of inheriting random household items from previous interns; spices, rainboots and a yoga mat have found their way into my apartment.

In just one week, I’ve started to learn about (and be incredibly confused by) disease modelling for hepatitis B and C treatment in Mongolia, the Philippines and Kiribati; become acquainted with the maze of floors and rooms at the WPRO office; sat in on a very formal annual Technical Meeting across all the divisions at WPRO; talked to various staff and interns about their involvement and the work of WPRO in the region; attended a day-long WHO communications training session for DCD… Basically being exposed to much much more public health and epidemiology in a few days than my whole education so far, which is both mind-blowing and and overwhelming.

I could rant on for ages about the situation in Mongolia, but I’ll try to keep it short. In a nutshell, Mongolia has very high rates of hepatitis B and C, and one of the most liver cancer deaths in the world. There is very little treatment available, and tends to be very expensive. A team including WPRO and other researchers conducted studies to work out how many deaths could be averted from introducing more treatment, as well as the costs that it would take. By working with the government, they have been able to design a national plan to get treatment in to the country. This will save tens of thousands of lives for people that may have otherwise be sentenced to a life of disability or early death. Pretty cool?

It’s a very very positive outcome, and it would be incredible if these disease burden studies (like the ones done for Mongolia) could help out other countries too. But if there’s one thing I’ve learnt so far, it’s that in many cases the situation is very complex, as well as dependent on relationships with local authorities.

A highlight of the week was Friday night’s annual Christmas party. It’s a huge festivity celebrated together with all the staff, including the local Filipino general staff. It involves each division preparing a 10 minute performance of song, dance and acting, complete with music and costumes. I was initially amused and couldn’t believe how seriously this party was taken by the staff! This year’s theme was “A Knight’s Tale”, loosely medieval but from an onlookers perspective it was more of a cosplay/pop-culture dream-come-true with a mish-mash of pop cultures with some medieval hints thrown in. We’re talking full-blown Disney, Lord of the Rings, Game of Thrones, Alice in Wonderland, Harry Potter costumes. There were at least 2 Ariels and Ursulas, 2 Beauty and the Beasts, and 3 Maleficents walking around. Everyone got really into the spirit of the celebrations, hyped up by the decorations, music and elaborate costumes. 

Ultimately the winner was DNH (Division of Non Communicable Diseases and Health throughout the Life Course – what a mouthful!). They absolutely killed it, not only with very well executed dancing but also incorporating their “healthy diet” message into the skit, using “Sugar” by Maroon 5, and signs saying “Use less than 6 teaspoons of sugar” and “Healthily ever after.” DCD (our division) came away with a respectable 3^rd place :)

As interns, we stayed back late and danced our feet off on the lawn, feeling free and exhilaratingly alive.

Carrie

Tell us a bit about yourself?

Hi, I’m Jocie! I’m a second year medical science student. I really want to become a doctor one day, that’s one of my biggest passions in life. I’m loving uni and all the opportunities it’s given me. I’m involved with a lot of activist-y things around uni as well as in the broader community. I guess I try to live in a way that’s serving other people and fighting social ills around us; that’s where I find fulfilment.

I love the ocean, jazz and old-fashioned music… hanging out with friends, cooking  together, reading... going for bushwalks, doing yoga and getting in touch with nature… being spiritual.

Reclaim the Night’s coming up soon, tell us about that!

Reclaim the Night (Reclaim the Night Facebook event link) is an annual protest to raise awareness about violence against women. It’s an opportunity for everyone in the community to stand up, have their voice heard and object to issues such as domestic and family violence, sexual assault and harassment. As we see regularly in news, with 69 women having been killed already this year as a result of gendered violence, and 1 in 5 Australian women experiencing sexual assault, this is such a systemic problem in our society, rooted in sexism and pervasive attitudes that are denigrating to women. It’s just so tragic that we keep seeing all these deaths as a result of gender violence, and not nearly enough is being done about it.

As an organisation we stand up for women’s equality, and their right to feel safe. This year’s event is on Friday 30^th October. It’ll be super fun, there’ll be a picnic beforehand with food and performances from local feminist comedy groups, and speeches from remarkable women activists. Then we’ll have a protest walking through the CBD, starting from Victoria Park near Sydney Uni.

What are you hoping the event will achieve?

We really want to gain attention of community leaders and the government and pressure them into taking serious action. Recently in NSW the “Going home staying home” reforms were introduced. These are creating a big problem endangering the safety of many women, especially those escaping harmful situations such as domestic abuse being unable to access services. The state government has grossly taken away so much funding from women’s shelters and frontline services which are being forced to close down.

This year in particular, Reclaim the Night is also trying to represent a diverse range of women’s experiences. For example, Indigenous and migrant women are extremely overrepresented in statistics of gendered violence, as well as recent horrendous reports of rape perpetrated against asylum seekers and in detention centres. Issues faced by trans and queer women also often go unheard. We want to shine a light on this and reflect on how some women are adversely affected more severely than others amongst us.

What do you think young people can do about gender equality?

Be informed, first of all. Be an expert on what’s going on; make yourself aware of the issues. But also be wary of political spin and don’t always trust what you hear. Seek opportunities to take action on the issue - there are heaps of awesome campaigns running that you can jump on board with. Start small - changing the culture of gender inequality begins with shifting the attitudes of those around us, including friends, family and classmates.

How do you keep yourself informed?

For me, it’s about joining networks that discuss these issues and offer real women’s perspectives; hearing from activist friends; the news… I’ve also been privileged to go to educational events at uni, such as the Global Health Short Course and Crossing Borders Asylum Seeker Panel, run by Medical Student’s Aid Project, which gave incredible insight regarding international health issues and inequities, especially maternal health.

What else are you involved with on campus?

Well, aside from clubs and societies like Hep B Free and Whitlam Club, I’m pretty active in the Student Representative Council (SRC). I’m part of the Women’s Collective, where we can all come along to meetings to discuss important issues female students face and how we can enact change on them.

I think one of the biggest problems is sexual assault… We’ve heard anecdotally from students that assault and harassment on campus is a big problem, but there’s no data on it... That means universities aren’t being held accountable to taking action, implementing better reporting procedures and policies, and providing services to better support student welfare. That’s something we’ll be fighting for next year through the SRC.

Anything else?

I’m currently launching UNSW Women in STEMM [Science, Technology, Engineering, Mathematics and Medicine] Network! It’s a network connecting undergrad and postgrad students, research, academics and alumni to advocate for equity and opportunities for women in STEMM. We also hope to lobby the university to implement better equity targets and strategies, do more outreach to school students, that’ll be really fun!

These are fields with significant gender biases that the Sciences aren’t something that women should do; there are great structural barriers for women in these professions. At UNSW women make up only 25% of professors and this is even worse for senior academic women in STEMM. For example, abhorrent sexual harassment involving the Royal College of Surgeons has been in the news recently, with women asked to give sexual favours in return for career opportunities...

This is a really important issue, because gender equality is a right – it is our right as women to have equal access to educational and career opportunities, and seeking justice on this is really important… We have such talented professional women achieving so much for our communities and they deserve the access to equal opportunities.

UNSW STEMM Facebook page

Who are some of your female role models?

I’m always really inspired by the women around me - friends and family - I feel so lucky to have amazing female role models!

I was really inspired by Julia Gillard becoming the first female Prime Minister, especially seeing all that she had to deal with. The criticism, the unnecessary comments on her appearance, not having children, being unmarried– all these really sexist attitudes disrespected her position and achievements, but she showed remarkable strength … other  political leaders like Tanya Pliberseck and Penny Wong are also really inspiring.

In international health, there’s Dr Catherine Hamlin, a surgeon who’s done amazing work in Ethiopia assisting women with fistulas and other obstetric issues… In developing countries there is such poor access to the most basic healthcare and maternal health is a huge problem... In these settings it is so great seeing women taking initiative to provide quality healthcare and make it sustainable, by empowering women who have had surgery to develop vocational skills, and by training local midwives… Making real sustainable change is the key to ending poverty.

If you could give a piece of advice to young people thinking of volunteering, what would it be?

Believe in yourself! Never underestimate the capacity and strength of young people working together. If you team up with friends and people who share the same passion, dreams and sense of injustice as you do, there’s nothing you can’t achieve. Believe in yourself, believe in your capabilities, and work hard. All the resources you need are within you…

We’re so young, just open your eyes and your mind to all the opportunities there for you, and all the human struggles we face globally, as a society, in your community, with family and friends. Always be an activist, always be asking yourself, what is unjust here? and how can I change that?

Broaden your perspective as much as you can. Work on yourself and your ability to understand different people’s perspectives and what they’re going through. I truly think the greatest thing we can develop in ourselves as humans is compassion and empathy.

It was early morning when we arrived at Siroga clinic. For some, we were greeted by familiar sights, vividly evoking experiences of last September’s visit. For the newer team members, the sky blue wood panels of the clinic’s exterior, the front veranda – now empty, but soon to be crowded with patients, and surrounding forest-green stilt houses were seen for the first time.

As the major health post under Liz’s care, Siroga was one of the better-equipped clinics, consisting of various consulting rooms, in-patient areas, a lab, and well-stocked pharmacy. There was even air-conditioning in some of the rooms! We split up throughout the clinic, and the building was quickly filled with the constant flow of people moving in and out of rooms, passing messages and arranging various aspects of care for each patient. Patients waited on benches and corners all around the building, fighting heat and flies outside on the veranda, or in crowded corridors indoors.

As resident young-pleb-person, I floated back and forth, lending a hand where needed and becoming well-acquainted with the general activities of the clinic. Hours passed by drawing vaccine vials, listening to doctor consultations, seeing the drug dispensary, taking photos, helping out with visual acuity measurements.

Darlene (left) and Fiona (right) in the drug dispensary

The way that sickness touches not only individuals, but families is incredibly striking. And it is often in these settings that the doctor’s greatest asset is not their technical expertise, but their empathy and ability to reach out with words of reassurance. I watched my mum consult with a man whose wife had died from complications of hepatitis B, who continues to look after a family of many children and worries about their future, whether they too have hepatitis B. Immediately he was given a kind listening ear, reassurance that his wife’s passing was of no fault of his own, and arrangement for him and his family to be tested that day for hepatitis B.

Another of the patients I met at Siroga who made a vivid impression on me was a softly-spoken lady in a yellow dress. She had nodules/bumps on her face, and the fingers on her left hand were locked into a bent, rigid position. She has a disease virtually forgotten to the developed world, one that has become something of “fiction” or past history, and remains classified as a “neglected tropical disease”. This is leprosy. It has not disappeared. It is not eradicated, indeed there are over 200 000 people living with highly stigmatising disease.

Meanwhile, lucky Moe Moe (paediatrician) was being swamped by screaming children… she put on a brave smile and soldiered on for hours, seeing pikinini after pikinini (pikinini – child) come with fevers, watery diarrhoea, chronic cough (TB), and the characteristic swirly-skin pattern of grille infection.

Marcel, a community health worker at Siroga (left), a family, and Dr Moe Moe (right)

Rex, the lab technician, gave me a tour of his laboratory, explaining the tests he ran for TB (A real life Acid Fast/Ziehl Neelson Stain, my nerdy dreams come true!). A poster illustrating how to do the AFB stain hung over a violet-dye-splattered sink, and on a bench to the left lay rows of sputum smears waiting to be examined under microscope. Rex also spoke about what his work involved, trips out to the other health posts to collect samples, his accountability and reporting to national health officials, and his anticipation of a CD4+ count machine (for HIV detection).

Rex, his microscope and rows of sputum smears on the desk (right)

In the office next to Rex’s lab, there works another highly motivated officer named Morris, Siroga’s young TB officer. Fiona (pharmacist) and I spent some time talking to Morris about his work, Fiona and Morris barely containing their excitement as they shared stories about how TB is treated in PNG and Australia. They compared their “Bibles” – a highlighted and annotated copy of the PNG Standard TB Protocols for Morris, and a pink pocket-sized Thearapeutic Guidelines for Antibiotics for Fiona.

Morris was enthusiastic in talking about the various medications he gives to patients (Directly Observed Treatment Standard Course – DOTS program). The TB meds stood out brightly in red pockets, each pill containing a combination of the 4 first-line drugs Rifampicin, Pyrazinamide, Ethambutol and Isoniazid. Standing on the shelves, the boxes of drugs weren’t labelled with patient names, but rather numbers. Morris explained that he did this to protect his patients from the stigma that still pervades about TB. There are still many people that believe in sorcery, he said, and I educate children in schools about health and diseases. Things will change, but it will take time.

They say that education is priceless, but I disagree. For some, it might just be the cost of sacrificing 1 lunch per month. 

In my interview with Esther Yap (pictured second from right below), President of Compassion UNSW (2014-2015), read about how for just $10, your lunch money could transform the lives of children in need through sponsorship programs.

Links:

Compassion UNSW Facebook: https://www.facebook.com/compassionunsw?fref=ts

Compassion Australia Website: https://www.compassion.com.au/

Tell us a bit about yourself?

I’m in my fourth year of my commerce degree at UNSW. [It’s] normally 3 years, but I’m in my fourth year as I’m doing a cadetship at EY (Ernst &Young)…which means for the first 2 years of my degree I’m working full time and studying part time.

How did you get involved with Compassion?

In my first year of uni, a guy at church who is also the regional manager of Compassion told us about Compassion, child sponsorship and the issue of poverty. The video and the way he described it really broke my heart for the kids - the injustice and hopelessness of it all… It made me want to do something, and I sponsored the kid.

As I mentioned, I was a cadet so I had some disposable income (we both laugh). I was living at home, I was 18, I didn’t have anything that occupied my time…I thought, why don’t I sponsor 50 kids? But then I thought - from a strategic point of view, if my aim was to see lots of kids sponsored, the best way wasn’t to do it all by myself. The best way to make a difference… [was] organically, to tell other people about it so more kids can be sponsored... I thought I would find a group of people genuinely interested in what Compassion stands for and putting them together to sponsor kids.

For someone who hasn’t heard about Compassion before, how would you describe its overarching goals/visions?

“Christ centred, Child-focused, Church based”. The main focus of Compassion is to spread Jesus’ love in a really practical way that impacts communities and generations for the better. Giving them the hope not only in a tangible way like education, getting them out of the cycle of poverty, giving them a future; but looking at eternity, as Compassion is a Christian organisation.

Programs such as sponsorship look at children between the age of 3 to 22, putting them through school and giving them an alternative that they wouldn’t otherwise see in their communities. They see their parents living the cycle of poverty, people around them not having a future. Through the program they can get an education, the food and clothes they need.

Another program is a leadership program [which] identifies kids who show potential in school, puts them through university and [provides] other leadership opportunities so they can change their communities. One of the sponsor kids (Margaret Makhoha, a Leadership Development Program graduate) was elected as a member of the Ugandan Parliament in May 2011. She has the opportunity not only to represent her geographical district, but also a people living in economic and spiritual poverty. Compassion also does relief [including] look after water and sanitation, so lots of things, it’s pretty amazing!

Why do you think child sponsorship an effective way to give aid?

Child sponsorship is important as it’s there at every stage of the child’s development. It’s not only about giving them the physical things, the education, the food… it’s giving them hope, showing them love, that someone cares about them and believe they have a future beyond poverty…The children who get chosen for this program are the lowest of the low…their parents have died, people can’t afford to support them… Compassion nourishes the child not only in the physical sense, but in the emotional, spiritual, mental sense – they tell them that they’re loved, because they are. It goes off the Bible that says that God has put value in every person: it’s not adding value to them, its showing them the value that they do have. Compassion can do that because of individualised care, they have workers coming to their house and they get letters from their sponsors.

Do you have a story to share as an example of the long term impact of child sponsorship?

We had someone named Jane Alam from the program come to speak [at UNSW]. He’s from India and grew up in the Mollahati slums. God completely transformed his life and he has overcome poverty. One of the most amazing thing about seeing him in person was how human he is, how much he is like us. If we had been born in any other circumstance that could have been us...

[The program] makes people independent…not only for themselves but also to give back to their communities. Jane graduated with a Masters in International Business at Manchester University, and he came back to change the community that he grew up in. The impact of child sponsorship from beyond the child to their family, to the community…that’s the way you see long-term change. Like that saying, give a man a fish and he’ll eat for a day, teach him how to fish and he’ll eat forever (laughs).

A lot of young people want to make a difference or do something good, and they might have doubts about whether they can indeed have an impact. What comment or advice would you give?

While our knowledge may limit us in the technical impact we can make, I do think that young people have a lot to contribute. The Bible says not to let people despise you because you are young - even young people can set an example in their actions for others (1 Timothy 4:12). We’re given value, ability, capacity to do things at any and every stage of our life - it looks different, say for when you’re a young person and a student, [to] when you’re older and working. Your capacity to make a difference doesn’t change.

It’s easy to view people in terms of their ability in just one area, but it doesn’t account for capacity. It’s important to make that distinction between ability and capacity... Capacity is about how much they are able to do, their potential, what they can give. Ability refers more to the technical side, and that might be what we’re deficient in [as young people]. But we’re mobile with social media…we can spread information. That’s something our generation does very effectively, and we shouldn’t discount the value of that.

Our generation is really accused of slacktivism, we’ve got information at our fingertips. You like something on Facebook and feel like you’ve done your part but you really haven’t made a difference. That’s why I love Compassion sponsorship – it really marries information and action, it gives a practical impact on the world. You know about the issues of poverty and you’re doing something about it – you’re putting your money where your mouth is. It shows how strongly you believe in something when you put a dollar value to it. Yeah, there you see where your convictions are…

I think everyone has something to give at every stage of their life. For us right now, the advantage of being young is that we have energy! We don’t have money, we don’t have knowledge, but we have time and energy... at the point later in our careers when we have money and knowledge but not time, that’s when we can help with the technical ability or funding younger people to accomplish the vision that you set out…When you’re retired, you don’t have the energy but you’ll have wisdom of your years, and that’s something you can share... Everyone has capacity, young people and old people.

Could you describe what Compassion UNSW does and how people can get involved?

Compassion UNSW is a society on campus that supports Compassion. Compassion offers a sponsorship program where one person sponsors one kid, at a cost of around $50 per month, which most uni students can’t afford. But there are still those who want to sponsor… even if they can’t afford giving such a big chunk of their income. At Compassion UNSW, we’ve had a look at people’s desire to sponsor and we’ve tried to mobilise that [by] facilitating a group sponsorship program… usually a group of 5 friends who give $50 collectively ($10 each) per month. It’s effective, $10 per month is basically giving up buying lunch at uni for one day to provide a child with education for one month.

Other things we do is fundraising directly for Compassion and advocating, such as on social media, sessions where people speak to inspire action and the drive for justice, and to educate people on how to do that in a practical way.

You can get involved by joining a group sponsorship program, or helping with our volunteering and fundraising. Bake for a bake sale, run in the City 2 Surf with us! (These events have since passed). Even if you can’t afford it yourself but you know someone who can or would be keen, tell them about it. It’s not just about how much money you have, it’s about what you do with the information you know!

Day 1 5/7/15

Sydney to Port Moresby 

Our adventure starts at 6am. It’s a chilly 6 degrees in Sydney, and we rendezvous at the airport just after the sun has risen. We’re a team of 9 this time – 2 doctors (Alice/mum, Moe Moe), 2 nurses (Mel, Jodee), Sue, 1 pharmacist (Fiona), 1 optomestrist (John), 1 bioinformatician (Magda) and me – the resident pleb, aka documentarian/student. We’re a mix-and-match multi-disciplinary team, a lot of newcomers. But some things never change – the massive trolleys piled with suitcases, travel backpacks, bulgingly obese duffel bags; crammed full of medical supplies.

We touched down in Port Morseby just after 2 o’clock in the afternoon. Today heralds the opening day of the 2015 Pacific Games, this year hosted by PNG’s very own Port Moresby capital. It’s a momentous occasion, with athletes here to compete from 24 countries including New Caledonia, Fiji, Vanuatu, Fiji, Tahiti, Australia and New Zealand. Signs of the event are everywhere – from the freshly renovated airport interiors, to the Australian girls rugby team dressed in green and gold who we spotted on our flight, to the orange traffic cones marking the inner lanes of the main roads for speedy passage of athletes. Driving through Port Moresby we were pointed out to the games village, build on the grounds of the university of PNG.

Everytime we come back there are signs of new development. The streets are cleaner, the roads busier, and high rise buildings more abundant. Joe – a manager at the Lutheran guest house where we stayed overnight – told me that the crime rates have dropped too, and the population has grown to about 600 000. He comes from an industrial city on the north coast called Lae, where he used to be a schoolteacher – he gave us (John and I) a geography lesson on some major landmarks in PNG. He was sincere and enthusiastic in sharing his knowledge, answering our questions about PNG, and it made me wonder about the circumstances that would have shaped his journey from pedagogy to hospitality, and on the other side of the country.

Despite the physical, aesthetic improvements in infrastructure, other features are familiar and stir a sense of nostalgia and curiosity. It was the afternoon when we arrived, and in PNG afternoon means burning, much like in other countries around the world. Mist-like billows of smoke emerged from ditches along the highway and plots of land beside smaller roads; glowing piles of burning rubbish. We passed gravel fields where children were playing soccer; markets where women were selling drinks, packaged food, BBQ meat; and scores of buses and trucks where people ride open-air. In the back of one of these trucks there was a group of women dressed in vibrant traditional costume: feather headdresses in black, red and yellow plume, with matching coloured skirts. They were a “sing-sing”, Joe told us, on their way to perform at the Pacific Games opening ceremony, which we watched on an ancient television later that evening. Performers from all across the country had come to showcase their province’s unique cultural songs and dances on national television, a celebration of diversity with a sense of unity – national pride in one’s incredible rich culture and traditions. As part of the Oro Province’s performance there was a man dressed in bright green butterfly costume, depicting their native Queen Alexandra butterfly (the largest in the world at a whopping 30cm!). Tomorrow we head to the Oro Province.

***

Day 3, 7/7/15

Popondetta Clinics

The team set out on our maiden clinic voyage this morning, full of hope and excitement. It was the beginning of our third day in PNG, and although the first two days had been great for relationship building and planning meetings, we were itching to get our hands dirty and start the work that we came here for.

The clinic we worked at today is called Saiho, it is one of the major community service providers in the Popondetta area. Saiho clinic is run by a highly dedicated (if not overworked) staff team of 13 Community Health Workers (CHWs) and one nursing officer. The clinic itself is a cluster of buildings painted green and blue, each block dedicated to a specific purpose, be it treatment/medication distribution, inpatient beds (a small room with 6 beds lined by worn mattresses, family members hovering around bedside and children seated on the floor), a TB clinic building from which the DOTS (Direct Observed Treatment, Short Course) program is coordinated. In between the buildings is a grassy plain bordered by trees, the shade of which gave refuge to patients waiting for the eye clinic.

We practically leaped out of the 4WDs at 8:30am and were received by community elders who warmly greeted each one of use with a smile and friendly handshake. A small crowd gathered outside the TB clinic building and both the Hep B Free team and each of the Saiho staff introduced themselves and their roles. A Provincial Health official named Dr Toro also addressed the community and explained our purpose and the set-up of the clinic. The people gave 3 hearty cheers of “Oro, Oro, Oro!”, meaning “Welcome!” And we scurried off to our respective positions.

As Sue put it, each clinic we run is a little different – to an extent we don’t really know what to expect before it happens. There are features common to our set-up: registrations (Mel), triage, immunisation, outpatient/treatment clinic (Mum + Moe Moe), drug dispensary (Fiona), wound dressings (Sue/Jodee), eye clinic (John). We adapt to the space, the available supplies, the time and the people. Being my third trip, there was a sense of familiarity in our rhythm and drill, mixed with a sense of excitement about what was different.

I’ll try write up a few snapshots of some things we saw in today’s clinic. There was a woman with asthma who had been taking salbutamol tablets. When offered by the doctors on our team, she declined a salbutamol puffer. This stemmed from a cultural fear that people who start using the asthma puffers will die. Considering how commonly asthma puffers are used in Australia, and with virtually no ill-effects, we postulated why she might feel this way. Was it because only people with really severe asthma were given puffers, who might be more likely to have a fatal asthma attack? Despite some gentle encouragement and reassurance, this lady’s opinion was firmly established and she left without accepting the treatment. It’s difficult to swallow…but ultimately it’s her health and her right to choose, and whilst we can try to educate and provide reassurance, sometimes cultural assumptions and beliefs can be complex and deeply entrenched.

There was an elderly man with deafness in both his ears, he came accompanied by his wife, who throughout the consultation, interpreted to her deaf husband using a combination of mouthing, speech and hand gestures. The man previously had otitis media (middle ear infection) with perforation, and this had presumably contributed to if not caused his deafness. He had come with an expectation that he would be able to have his deafness cured. The sheer disappointment on his face when he was told that we didn’t have the equipment or expertise to help him was heartbreaking. It made me wonder whether we were close to his last hopes of some kind of recovery. There’s very little that is comparable to the hopelessness of telling someone, “sorry, there is nothing we can do.”

In most of our clinics, we get about one acute/emergency case. On this particular day we met a young man who had walked 3 km to the clinic using a self-made wooden crutch, where he presented with severe abdominal pain. The multi-disciplinary team of doctors, pharmacist and CHWs hustled to their action stations – after brief examination it was determined that this man’s appendix had developed an abscess and ruptured, leading to very dangerous and painful peritonitis. He needed surgery – urgently. After the exertion of his journey to clinic, he was laid to rest on a simple cot in the corner of the treatment room while waiting for transfer to hospital, and administered IV fluids containing gentamycin, the first of a triple antibiotic series to cover a broad spectrum of bacteria (gram pos, neg and anaerobic). This was to act against a barrage of nasty critters that could have escaped into the peritoneal space as the appendix ruptured.

These are just a few stories out of what happened today. Overall it was an encouragingly positive start to our work here, and there was a good sense of team morale as we faced challenges together, shared laughs bumping over crooked roads, worked together in the clinics and collapsed with satisfied exhaustion at the end of the day. We felt so warmly welcomed by the local people who had travelled from the surrounds to attend this clinic, and by the CHWs who were so friendly and engaging. But at the same time, it's utterly frustrating and disillusioning at times to encounter people suffering for no fault of their own. Each person who arrives at the clinics comes with some degree of hope - no matter how big or small - that they'll be helped or cured. And sometimes that's just not the case, because we don't have the equipment that we can access so easily back home, or the knowledge to correctly diagnose and treat the problem. Sometimes it's just too severe. Often people expect a simple solution - a tablet, a drug mostly - that can cure them. But there are many patients waiting, so the best we can do is to hear them out, apologise that there's nothing to be done, and send in the next person, hoping this time there'll be something we can help them with.

So Jess, can you tell us a bit about yourself?

I’m a third year student at USyd studying arts and law. I’m currently President of Hepatitis B Free USyd which I started to help support the charity Hepatitis B Free. I’m also involved with thee Aboriginal legal services in Redfern. As part of that I help right bail applications, help solicitors in court and generally do odd jobs.

How did you get involved with the Aboriginal Legal Services?

I was looking for some legal experience to complement my studies of law, as wanted to see what the practice of law looked like in reality and how the principles I was learning in the classroom applied outside. I also wanted to contribute to the community and apply my skills to help other people.

Aboriginal Legal Services website: http://www.alsnswact.org.au

What kind of things have you learnt there?

I’ve learnt a lot about how the criminal justice system works. I’ve been able to look at the bail process, particularly the recent changes to bail laws…I’ve learnt more about the Aboriginal community and the incarceration of Indigenous youth, which is a serious problem at the moment. It’s been very moving to meet some of the clients; they’re not just criminals…but real people, often from very difficult and disadvantaged backgrounds. [It’s] been a really valuable experience.

You’re very involved with social justice and applying what you learn in a humanitarian way. What interests you about human rights and humanitarian law?

The potential to help people in a very real and tangible way, to uphold their fundamental rights as human beings – I think these are very important goals for any society. The law in particular can be a very effective tool for protecting rights…and I’d like to be a part of that, it’s very worthwhile.

Can you tell us about your experiences with Amnesty International?

I was involved with Amnesty at my university during first and second years. In first year I was the campus coordinator, in second year I was the president. As a university society we ran weekly talks about human rights, we talked about North Korea, Ukraine, LGTBI human rights in Russia… we were educating people and getting them interested as much as we could about human rights issues around the world. We held an art exhibition at the Verge gallery at USYD … raising awareness about asylum seekers in Australia. We also organised an art installation to get people to campaign for children in detention, and we worked with numerous channels and NGOs…

This year I’ve also been involved with Amnesty International (AI) at the NSW centre (outside the university) - the state headquarters for AI. I help to write articles about different campaigns [such as] LGBTI human rights… recently we had the Mayor of Sydney and other LGTBI campaigners to speak to the general public about the issues, in particular the laws and how they need to be harmonised to promote gender equality. We also had a campaign about Indigenous Australians, the need for constitutional recognition and issues of incarceration.

It sounds like a lot of what you do is raising awareness about areas of disadvantage and inequality in our society - it’s really important we need to hear about things. What are some challenges you’ve experienced being involved with Amnesty International and the Aboriginal legal services?

With volunteering in the university society I was in leadership roles and needed a lot of teamwork. It’s very important to make sure that everyone has the opportunity to contribute to allow the event to run smoothly as possible. Sometimes it’s hard to run events, especially when people are very busy with other aspects of their lives…that’s the main challenge I faced, inspiring people to contribute and encourage them to participate even when other things come at.

At the Aboriginal legal services the main challenge has been dealing with the emotional toll of helping clients who have been through a lot of trauma…things that you’d never imagine should happen to anyone, and representing those people. It’s quite emotional.

How do you cope with these confronting things?

Always trying to see the optimistic, positive side of things…and [knowing that] as part of the legal representation we’ll be doing our best to help them represent them.

In what ways have you seen the lives of the people you’ve met impacted by the Aboriginal legal services?

I definitely think that the Aboriginal Legal Services provides vital services to the Aboriginal community and to the legal system. Legal representation makes so much of a difference when  people are fighting for their case in the criminal justice system…there are issues of literacy and understanding the legal system is very complex, it is hard for a non-lawyer to understand what is going on with all the procedures. It’s really helpful when a solicitor is able to take up a case and present it in a convincing to the lawyer, argue for that person’s rights in terms of that person’s background and other factors.

In medical terms we talk about treatment versus prevention. I guess I consider such legal services as something that happens after crime or adversity has taken place in people’s lives. Are there interventions you’ve come across that try to prevent them from happening in the first place?

I definitely see what you mean about the legal system coming in after the event, which is unfortunately. I think the legal system, although very flawed in some aspects, tries to prevent re-offending. For example, in some conditions of bail there is participation in drug and alcohol rehabilitation programs, participating in other programs that aim to educate and consult the offender to avoid re-offending and build a better life for themselves. Unfortunately I haven’t been involved much in the stage of preventing these things, but I think we need to research the root causes of why these things happen and have targeted interventions, together with consultation, to prevent them becoming such huge problems.

Why do you think that young people should be involved in volunteering and what skills or attributes do you think put us in a good position to help others?

A lot of people my age are interested in volunteering because we want to give back to the community; we want to be involved in things outside uni. I think that’s what volunteering offers – to move outside the bubble of study and work to actually look at how you can help other people. That can take place in so many ways – conservation, social justice, cultural events…these things expand your view of life and allow you to become more conscious of other people and what they’re experiencing. That’s what happened to me from Amnesty and Aboriginal legal services, I’ve been exposed to so many different issues and met people I wouldn’t normally meet, and that’s really widened my understanding of life. I think that’s really important, particularly when you’re young, to keep an open mind and explore different things.

What motivates you to be involved with Hepatitis B Free?

I guess a general interest in the wellbeing of people. I’m know that I’m not studying anything related to medicine, but when I met you and your mum I was so inspired by how passionate you were about it, and I really wanted to help what you were doing. I think it’s so important, hepatitis B is such an overlooked issue considering its scale and the fact that there is an effective vaccine available means that as a university we can raise awareness and funds to help prevent and limit the scale of hepatitis B.

How can people get involved with Hep B Free USyd?

We have a Facebook group (www.facebook.com/groups/usydhepbfree) and an email mailout with details about upcoming events. Search for HBF Usyd on Facebook, get in touch at one of our events, look us up on the USyd societies page, we can add you to the contact lists so you can get involved.

Facebook Page: www.facebook.com/hepatitisbfreeusyd

Club Description: www.usu.edu.au/Clubs-Societies/Our-clubs-societies/Humanitarian-Community-Aid/Hepatitis-B-Free-Society.aspx

You’re very busy with juggling many different experiences, how do you balance the demands of Law and Arts school with various other activities?

I always try to figure out what’s essential and I need to prioritise, as I can’t do everything at the same time, I can’t focus a lot on my assignment the same time I have other events. Knowing how your own schedule works, how much time you need for yourself, knowing when to say no to certain events, knowing how much commitment to take on and how involved you want to become, having those boundaries rally helps. Having a set time to filter your messages and social media demands can be useful, I find that I can get bogged down asking people to do various things and that can take time. Always having time for yourself and setting boundaries around everything else, is what I find helps.

And what do you like to do to relax and distress?

I like reading, I like talking to my family and spending time with friends, I really like running and exercise and sport. I also play the viola in a string quartet (www.stringularity.com), that’s a lot of fun. All these things help me to keep perspective and stay balanced.

Thanks heaps Jess! We look forward to hearing your string quartet play at the Charity Ball!

Yes! I can’t wait to play as well!