Graduation

Today was graduation day -- fourteen nurse practitioners and nine midwives.
They are all experienced nurses who have taken 10 months out of their lives, leaving families behind to sleep in dormitories and having to learn a huge amount from malaria to dental problems to how to run a budget.

Now they are finished and are having a celebration to commemorate the event. They designed their own gowns and had them made up by a tailor. First they gathered to wait for the Minister of Health. He arrived, was given his salu salu and led in by Pentecost custom dancers. He was in Santo for 2 weeks and had a huge entourage of chief advisory assistants to the assistant chief advisor.

Speeches were mercifully short and we soon came to the presentation of certificates. It was an excellent mixture of formality with the formal presentation by the Minister and then the relatives crowded round to put salu after salu on their good boy/girl. Some even got dusted with the customary baby powder. There were many bright dresses and the younger woman were wearing more fashionable dresses.

Then came the individual prizes with Steven Nako getting the academic prize (he finds it difficult to take praise), .... and Lolita getting the prize for most improved. (She had been a nun and had worked in an old peoples home in France  before taking up nursing. A joyous bubbly person who needs just a little of Steven Ns organisation!) Seven then gave a blistering speech about the poor living conditions, the lack of supervision and the desire to have more doctor input and more time. He was completely right nut not a man to make friends!

Later came the team photographs (with all kinds of unimportant people in the front row)

Congratulations!
We wish you luck and happiness in your future work.

Malau again

Hilary, one of the Solomon Island nurses, had asked us many times to revisit them in Big bay.
So freshly back from Banks islands and after a lovely weekend at Aore we set off on a grey blustery Monday morning. Two hours later we left the truck at Matantas and were met by Hilary and his son Hamish. The sea and sky were grey but with kagools it was not cold. The ride across was  bumpy.

We were greeted by Haema his wife and their daughter Haish who was delighted to see us.

Hilary and Haema showed me round the clinic again and we sorted out some probems.

Meantime Annie watched as a laplap was made. First the manioc was grated into a paste and then spread on banana leaves and coconut cream spread on top. A parcel was then made and the lot put on the top of hot stones and covered with more banana leaves to keep the heat in.

They did the same with island cabbage.
About three hours later it was ready to eat and was delicious. 

Late afternoon we went to the beach to go swimming with Hamish and Haish. The surf was strong and we quickly retreated, not before Annie and Haish were knocked over and lost one of the masks into the surf. We abandoned it to the sea but next morning Haema went down at low tide and found it had been washed up onto the shingle!!

Hamish enjoying the  rain

A happy twin

That evening a woman came in with a retained placenta. (The last one I had dealt with was forty years ago! Fortunately Haema is a good midwife.) She had delivered at home four hours before and had walked and taken a boat to come to the clinic. She was cold and tired. H and H put up drips, gave appropriate medication and tried to remove it but it would not budge. Hilary called  the obstetrician in Luganville who advised transfer . But it was now 8pm and the surf was up so we advised 'stay here'. Just as well as out it came 30 minutes later with no bleeding.

Later the relatives said they wanted to call their baby after Annie and asked her name. On being told it was 'Ann' they were not impressed but were much more enthusiastic about 'Isabella'.

Next day we had hoped to go back but we could hear the sound of the surf from the clinic. Closer inspection revealed some impressive breakers and there was no hope of launching the boat.

Even that evening was no better. So we spent an extra night and early next morning the boatman Glenden reckoned it was reasonable to try. So off we went in our lifejackets. Haish was sad to see us go.

The first two breakers came straight into the boat over us but we were then free. However it was five minutes before the engine started. It was a brain bumping ride back and we were expertly landed on the beach through some much larger rollers. So off Glenden went, though they almost capsized when his helper sat on the stern (with out board motor and driver) and the boat lifted to almost 70 degrees taking water in over the stern. They disappeared off into the greyness as we found the car. (The passenger well was inches deep in water as there is a leak but since we were soaked through it didn't seem to matter)

The visit was worthwhile, it was good to meet up with some old friends and to be with Hamish and Haish. It was good to end our touring on a damp note so we are reminded that it is not all plain sailing!


For the sake of remembering good times these photos were taken 6 months ago when Laura was with us
see http://rupnannie3.blogspot.com/2011/09/malau-clinic.html and
see http://rupnannie3.blogspot.com/2011/09/hemma-hamish-and-haiish.html

Island visits

With the coming of the  new year and only a month left I arranged to visit some VSO volunteers; first Eric in Ambae then Lucy in Banks Islands

The plane took about 30minutes to Ambae, a volcanic island with lush green slopes and generally very craggy inhospitable shoreline. There are occasional black sandy beaches.
I spent the week at Lolowai Hospial, an old Anglican hospital built next to Lolowai harbour, a natural volcanic crater  providing good shelter. The hospital is tucked into the right side of the aerial photo.

The arrival of a boat from Santo provided some entertainment as people struggled too get on and off without getting too wet. In the middle picture a pig is being hauled ashore in a crate and gas bottles are returned for refilling. The Efate Queen is a definitely more comfortable option.

Lolowai has a few stores, a bank and post office and a small cafe.
There is a small market once a week and of course a nakamal or two for Kava consumption.

I stayed in the 'doctor's house' which I shared with Dr Tracey, a Canadian doctor and her  geologist husband and four children who were visiting to look at the volcanic crater on top. Dr Tracey is part of ViVa a small charity that has sent doctors from Victoria BC to Tanna island for the last 15 years. There is a lovely garden with many shrubs and a glimpse of the harbour.

Eric was my guide and mentor. He is a Kenyan nurse, ever positive and cheerful, who has been trying to get the message across to the people of Ambae, Pentecost and Maewo. Life is slow in Lolowai!

The hospital had two wards and at the time had one female and two male patients.  This little house is their isolation ward for TB patients,
I spent the mornings with Handsom (an experienced female nurse practitioner) and in the afternoons gave talks to about 8 nurses about this and that. They were eager to learn and showed a very positive attitude.

One day I went out to Lolovange Dispensary, an hours ride away over very poor roads. Again I was welcomed and spent a day with a charming eager young nurse with the unfortunate name of Hitla.

After 5 days I felt my heart rate slow and my general metabolism grind to 'dead slow' so I was glad to get back to the busy streets of Luganville. I may have stopped moving altogether after another week.

After a weekend in Santo with a visit to Port Orly, I was off to Banks islands to visit Lucy at Sola in Vanua Lava. The plane diverted to Torres islands and I was pleased to meet up with Leni the nurse at Loh airport who was seeing her grandchildren off (covering them in Baby powder as is the custom). We then flew back over the Reef islands.

The clinic here has had major extensions and appears large but it still functions as a medium sized clinic and could easily exist on a staff of three rather than the 10 that the sacked previous manager managed to install, five being his relatives.

Lucy is working closely with Colenso and has had a punishing schedule from last year. She has a pleasant house and has planted all kinds of vegetables. A local farmer keeps her in other vegetables in exchange for seeds.

Lucy looked after me extremely well and we chatted about Brighton and her home town Lewes. Jasco a Japanese volunteer popped in and we met up with Amanda a peace corps from Ohio doing preschool education to savour some Kava.
Douglas is the excellent nurse practitioner here. The midwife was away taking a patient to Luganville and the other on holiday. So teaching was limited to Douglas who seemed a bit preoccupied and a nurse aid.

I went off one afternoon visiting Lucy and Colenso in their office and then along the beach. It was a lovely day.

Past a nakamal and the mangroves to end up at Karen and Capt Ian's guest house. Diane the sister in law was looking after it and after  a chat I wandered back. The heavens opened and I sheltered in a house for an hour whilst it passed.

 The beautiful blue sky and sea were now a pale grey!!
After five days it was time to be enlivened so off back to Luganville and a weekend in Aore.