Its Thursday already!!!!

Its been a slow blog week, sorry. Its not because things have been too slow here, I think its just that time has gone so fast and our days are so consumed with learning new things and getting to know people and how things are done here. I haven't had my camera out this week but have a few interesting photos to punctuate this blog with....
The days here are at island pace. Its a relaxed, calm pace but when each encounter with a patient involves a new task, new form to complete or new process, that time is a welcome friend. We are slowly getting to know people and each time we are out and about now we get more waves. Ben and Amy are also getting to know more people and Amy has had a playmate for the past three days.

Tonight is my first night on call. I came home at 5, got dinner in the oven ( baked red emperor ) and was just about to relax when the phone rang. A young Mum with her new baby and a couple of her frightened looking friends were outside, asking for help following an assault. I was surprised by how calm I felt as soon I had them inside, icepacks to injuries and Robert off in the car to collect the health worker. We are so lucky to have a great team of health workers here. When Lucy arrived she took stock of the situation, organised the police for a report and we got the wheels in motion for domestic violence team to escort the young woman and her baby off the island tomorrow to shelter. Now back at home, I reflect on how different this world is to the comfortable one I have left at home, where I know domestic violence exists, but its not in my face, and I can be ignorant of its impact.....this young woman tonight is only 2 years older than Ben, she is already a Mother, and dealing with difficult issues, no one ever wants their children to have to face. My steep learning curve continues...

Tomorrow there is a tomb stone opening here on the island. My understanding is that when someone dies here, the normal burial process takes place but it can be some years later before a tombstone is placed on the grave. At this time, the tombstone is unveiled and a huge feast and party is held. Everyone is invited and the family provide the feast. I think the delay in the unveiling is often the cost of the party! So tomorrow, we are closing the clinic at midday in time for the celebrations to start at about 2. There will be island dancing after the feasting so we are really looking forward to being a part of that and seeing some traditional island celebrations. Rob and I are on call tomorrow night, so hopefully celebrations will be peaceful.....

Week two on Darnley almost complete. Yorke Island seems like a distant memory now, Meringandan even further away...Life has changed forever through our eyes, not in a bad way....just different. Yawo

The weekend

Its Monday night. We had a great weekend on Darnley Island. The unit where we are living is over the road from the sea. At high tide, sitting in the lounge, all you can see is the ocean. Its really relaxing, and certainly not a sight we are used to seeing at home.At  low tide, the fish trap becomes exposed. This was built hundreds of years ago, before colonisation. At high tide, it is well submerged and as the tide drains out, the rocks trap fish and the families go out and collect dinner. It reminds me of the stone walls built across Scotland to mark out fields and separate land and cattle. Ben was out walking o Friday and watched one of the locals collecting fish from the trap with his dog. The dog would collect the fish from the water with its teeth and drop them on the sand, waiting for his owner to collect them. Ben said the dog knew which was harmful and left those alone....amazing hunting. Speaking of amazing hunting, this is what Rob caught on Friday morning before work! Delicious breakfast.

 Saturday morning we went out reef walking. When the tide goes out, it leaves behind the fish trap, then a sandy, grassy area, followed by increasingly beautiful corals and fish life. Its so interesting to explore and look in rock pools. Once the sea settles down, and the winds die off, the sea is like glass apparently and then it will be like looking in a huge fish tank. The water is so warm, you can walk in it for hours. We came across a Heap of starfish....?not sure what the collective noun is??? Anyway, we collected up a heap of them and looked at all the different colours and shapes. They really are beautiful.

You can see behind the kids, where the sea turns deep blue. This is where the big gutters are and apparently where the big fish hang out. Rob and Ben are competing to see who will catch the first mackerel. The locals fish off here too as well as heading out in boats. The seas have been quite rough since our arrival but a few people have offered to take us fishing once the seas settle down.

Sunday, and Ben turned 16. Bit of a milestone and what a place to celebrate It was quite surreal and while I know Ben felt separated from his peers, he had some lovely emails and phone calls and heaps of messages on facebook. Continuing with the tradition of making a special cake posed quite problem this year as we were very limited by what we could buy. The local shop here was almost cleaned out by the weekend, the shelves looked like they did in Toowoomba after the floods!! Probably a combination of the other local shop closing recently and all the hungry teenagers home for the 2 weeks school holidays. Anyway, Amy came up with the great idea of making a sea urchin cake. We managed to find a chocolate cake mix and some chocolate sticks and created this....

Ben was suitably impressed and said it tasted a lot better than the last sea urchin he tried! We had a relaxing morning and decided on a drive around to have a look at some of the beaches we had not yet seen. There is talk of a crocodile somewhere on the island but it hasn't been seen for some time. Not wanting to be the first to see it for a while (!) we avoided the mangrove areas and found another interesting spot to walk and collect shells. We also drove to the highest point on the island and looked out at the sea. Its really beautiful having a 360 degree view of the island and surrounding water. I am not sure what the elevation is but you feel like you are on top of the world

One week in, Darnley is feeling like our new home. We had a snorkle out the front of our place on Sunday afternoon and the colours and variety was just amazing. It really is so untouched here and unspoilt. We found Nemo ( clown fish ) a huge moray eel and many many different  corals and fish. A lovely way to end the weekend. I have to finish up with Ben enjoying his birthday lunch. Happy 16th Ben. It may not have been the liveliest birthday, but One you will never forget!!

First Friday on Darnley

Wow, what a week! This time last week we were eating prawns with Robyn on Yorke Island, that feels like such a long time away. It has been an amazing week of learning new things and meeting new people. I feel exhausted, my brain feels full, but I feel happy and content going into the weekend. Today I started the day with woundcare and followed it with taking blood, giving a nasty injection of antibiotics into a very brave young bay, and chatting with a young woman about some pathology results. I feel like its starting to make sense..... Last night we had a dinner with the health workers and the outgoing RN's and Doctor. It was a mixed emotions night as we were welcomed and the old team was farewelled. Everyone took a plate to share and we had a delicious meal together. To Juerg and Susie, Annie ad Chris, best wishes for your adventures ahead, and thank you for a great hand over to the clinic that has been such a big part of your worlds! We feel very honoured to be able to step into your shoes.

After work today, we headed to the jetty. It was a very windy afternoon but we were looking forward to getting outside as a family. Ben had been given some gar fish by one of the locals and Rob had his new hooks,  massive things that cover the palm of Amy's hands. We could see barracuda leaping out of the water, chasing the fish in the bait ball that swirled around the jetty pylons. Rob cast in his line and has he pulled in the bait, we saw them surface, two huge blind sharks ( a species of cat shark ) were following in the bait. They would have been about 3meters in length! We watched them follow the bait around for about 5 minutes, just fascinated, until one of them took the bait, and snapped Robs line as if it was cotton! The locals have advised no swimming on this jetty, and now we know why!!

There are a number of dogs on the island. Some can be quite aggressive and we have been advised to be on guard and just be careful when out and about. Amy has befriended this puppy who is very gentle, but we all have had to become mindful that not all dogs are good to approach

Each afternoon, outside of the clinic,an energetic football takes place. Its made up of anyone who wishes to join in, any age, male or female. The sea on one side, and the clinic on the other. It looks like a heap of fun. Today, Ben was invited to join and did so with gusto. I love how Ben and Amy are making the most of opportunity. They have both had episodes of home sickness, and been sad, I am sure there will be more of these days to come in the months ahead. But they are both making us so proud, and as a family, this time together is really special. Thank you Darnley Island....our first week down, bring on the next!!

Flying solo with training wheels

Flying solo with Training wheels

Well, day one working in the clinic today with my bride.  A unique experience.  Annie the former permanent nurse had today and yesterday to pack, and get around the community and say her good byes.  Jo and I turned up this morning after a restless night, and the clinic had a patient.  An elder had had an altercation with a family member , alcohol was involved, a sad messy situation which I wont bore anyone with details suffice to say that he was offered a safe house last night, and needed respite and placement to be organised today.  How amazing is it that on Joanne’s first solo day her first job was one that she can do in her sleep.  She was right into it, ringing this nursing home, and calling that HACC team; a real pig in mud!  Here I was stressing about how she will embrace island life as a Remote Area Nurse, and the realisation hits that is all the same nut, just a different palm tree.

The rest of our day was pretty much core business.  Jo and Susie played secret women’s business, with a woman that was newly diagnosed as pregnant.  Not my thing.  One of the confronting things here and something of a culture shock for Jo and I is the notion that terminating a pregnancy is considered a viable and normal contraception option.  Many young women (20’s) have had 5 or 6 children and probably more pregnancies.  When a woman is “late” and we test them as pregnancy positive, then the next question has to be “do you want to keep it?”  This really rubs us up the wrong way, not because we are placard waving pro-life activists, but because our value and upbringing has always placed abortion in the “taboo subject” category with alcoholism, suicide, depression, and Labor party supporting.  To have a woman not bat an eyelid when you ask them if they have considered an abortion is a bit confronting for us.

I hear you ...”so why do you even ask such a thing”?  you are saying!!  Well, if we get them before 9 weeks, it can be done with less fuss, a few tablets, and no- one needs to know.  If they want a termination later in the pregnancy, then it is an expensive trip to Cairns for a surgical procedure.

I had some pharmacy stuff to sort out today.  Our clinic has no working air conditioners.  One of the problems with this, other than the fact that it is starting to get hot up here, is that pharmacy items on the shelf need to maintain temps below 25 degrees.  With literally thousands of dollars of stock on the shelf, the product is likely to be unusable if we don’t get an air conditioner soon.

I also had a few psych patients to sort out.   We have visiting specialist teams come for a day to see patients, Diabetes educators, hearing teams, dental teams, and psych to name a few.  Well the psych team came yesterday, and that means that there was a bit of follow up and sorting to do today.  I was able to put on my psych nurse hat again and try my hand at some counselling.  It was a refreshing change from the norm.

Ben has been meeting with a dremel artist that carves shells, and coral.  He is the bloke that did the coconut husk beer steins a few nights back.  Ben has polished and cut some beautiful pearl shells, and is learning to carve.  He was gifted a piece of precious black coral, to add to his collection of geology specimens.  We went online to Ebay and bought Ben a dremel of his own, so I am looking forward to see what he does with his shells and some creativity.  Amy is meeting some of the local girls, playing chasing games, and swinging on an old rope swing in the common beach.  They (kids) seem to be occupying themselves while Jo and I work, and we are really proud of their resourcefulness.  Amy went to check out the play group this morning, and then after morning tea, decided to make pikelets for the staff at the centre.  She took them down to the conference room/tea room and wrote a sign on the white board.  “PICKLETS  HELP  YORSELF!”  it was too cute.   Lucy our health centre manager took a photo. 

Tonight Lucy has asked us to bring a plate to the conference room to celebrate Annie and Chris’s farewell.  Annie has been the nurse here for 2 years, and has really become a part of this small community.  She will be missed. Annie has been a big part of my orientation into RAN nursing in the Torres, and is one of my mentors, so I am honoured to have worked with her and proud to call her my friend.  Hers will be hard shoes to fill, and whilst Jo and I have the luxury of a well organised and well stocked clinic to take over, it is with some amazement that I reflect that for the most part of the last 2 years, Annie has been the only nurse here; a feat worthy of a mention.  I thought that is was fitting that I make my Coconut, and sweet potato chicken curry with fenugreek and black mustard.  Those that know my curries will recognise this as one of my favourite dishes, but one reserved for special occasions. 

Friday tomorrow, and the end of a random but exhilarating week.  Jo and I are going to try a bit of reef walking, and a bit of snorkelling.  Ben and I will try to catch some mackerel, and Jo and Amy will no doubt find an array of shells to add to their collection.  Happy times ahead on Erub.

Yawo!!

Darnley Days

The last three days have been full on. I have been orientated to Darnley Health Clinic. Its been a great 3 days, a mixture of fear of the unknown and doing things I know and love. So far this week I have learnt, Venepuncture ( taking blood ), Medication management ( which can be quite complex out here!) STD testing and management ( sexually transmitted diseases), discussing a new diagnosis of pregnancy and the options available, including termination, how to order medication, how to test bits of equipment I have never heard of, all the emergency equipment including the emergency delivery bundle ( which I vote we NOT use in the next 4 months, Cardiac management, woundcare ( hey! I love this stuff), cultural stuff, and how to stitch up wounds! Big few days. I feel well supported by a great team of health workers. They must be sick of my questions but hopefully those questions will get less and less as I know the place better. In the true education philosophy of watch one, do one, teach one, I did a bit of a work shop with some of the health workers yesterday on suturing. It was good to rethink what I had learnt and know what a capable group of people I am working with too! My brain feels full but I also feel optomistic about the days ahead and look forward to rekindling all that stuff I havent used for a while.

Last night we went down to one of the beaches or a while. The water was not too clear but the sun was setting and it was lovey to watch it all unfold in front of us. I had a bit of a walk along the rocks with Ben and then sat with Rob as the sun headed down towards the water. Everyone seems friendly here, a few of the kids Amy had not met, called out to her to play on a swing they had made so she headed off to join them. It was great to just be.....after a big day of learning.

The kids are doing really well this week, considering they are on school holidays, new to the island, and we are at work from 8 - 5 ( although we are just down stairs). They have had to work out  themselves how best to look after each other ( not easy for any one who knows them...) We have also divided up some jobs for them both at home to ensure we dont come home to a brothel. Today I introduced Ben to the washing machine. This will be one of his daily chores. He was very reluctant, but suitable financial reward has convinced them both of the benefits of being part of a family team, and helping Mum and Dad out while we are at work. So fingers crossed it will all come together. For all the changes we have had in the last 4 1/2 weeks, they have been awesome and we are both very proud. So, life on Darnley continues. My training is now complete and tomorrow I hit the floor running. .........Yawo Darnley, good luck!!!

Darnley Days..Comblo

Darnley First Shift.

This blog is a comblo (combination blog). One in which Jo & I both write our experience.  For a few reasons, it is a good idea.  You see Jo and I had the same day.  Today was day one in our job as nurses at the Darnley clinic.  Darnley is located about 40 km south of Papua New Guinea. It is one of a collection of small volcanic islands that emerge from the ocean in the eastern Torres Strait.  The Torres is divided into many islands, some just a whisp of coral or sand , and like Darnley, or Murray Islands, a vast rocky island measuring up to 5-6 km in diameter.  Traditionally the Islanders of the Eastern cluster of islands (Murray, Darnley and Stephen Is.) are different than those in the central Coral Cays (Yorke , Coconut and Sue Islands); or the western clusters.  The Eastern cluster people speak a different creole, and their traditional language is Miriam.  Darnley is the first island that Christian missionaries came to in 1871.  McFarlane and his wife were from the London Missionary Society and anchored in a sheltered bay where they befriended one of the warriors.  Some days later they sailed around to the village on the Southern coast (where the we are living and working) and attempted to come ashore.  Every missionary and other visitor to the islands prior to this time had been killed and eaten by the cannibalistic locals, but McFarlaine and his wife Elizabeth, were spared, because the warrior that they had befriended went before  them and told his people that McFarlane brings a good magic.  The Light.  The bible, and the good news of the Gospel.

Christianity was introduced to these head hunter warriors, and the rest as the say is history.

The first two days of our stay here, Jo and  I and the kids drove down to the monument at the beach where this first landing occurred.  The beach is littered with black basalt volcanic rocks, totally different to the coral and sandy beaches of Yorke island.  The under water terrain is amazingly different too.  Boulders and rocky gutters and bommies adorn the sea floor, and Amy and I had a great time duck diving in around massive schools of bait fish and trevally.  Ben and I caught another painted coral crayfish, which was a nice bit of kaikai (food) tonight.

But work today; work was a surreal experience today.  In a clinic that I am familiar with, I worked along side Jo.  Most of the day was our formal orientation.  Acronyms and jargon filled our head space as we learned about key performance indicators, quality management systems, pharmacy ordering, stores and purchase requisitions, maintenance reports and failed airconditioning.  Sadly the air conditioners in the clinic died, and whilst the Torres has been in the low 30s because of winter; the absence of Airconditioning has not been a real issue.  In the next few weeks the wind on the eastern pacific drops off, and the seas turn flat, and the mercury sours.  The air con will become a necessity to keep pharmacy items cool, and delicate computer and biomedical systems cool, and us, the health care staff.  Heat is one thing, but that humidity is going to start to bite, so I hope they get it fixed soon!!!

I will hand over to Joanne, to give her spin on day One…but there is a real sense of optimism, as we can see ourselves in this place, making the clinic our own.  I want to thank Annie and Susie our out going nurse for making our transition so much easier that it would have been without your hard work, and diligence.  We also want to thank Lucy, Annie and Lizzie for making so welcome in your place.  We are getting to know and love your island…Erub....Bye from Rob...

Erub is different to Yorke, it has rocky shore lines and steep hills. The beaches are littered with tiny shells and thousands of pieces of coral. It is beautiful in its own right. I love the change in landscape as you follow the coastline along the island, and while windy on one side, the other can be calm and glass like. The water is so clear, its like looking through glass at the sea floor.

Last night we were invited to a dinner party at Jeurg and Susie's house. They are the current Dr/ nurse team. It was hard to know what to take to contribute as we had just done a fleeting shop on arrival at the local Ibis store which is waiting for the latest shipment from Cairns, so was a bit light on. We headed to the beach to give it some thought, and saw coconuts ( as you do here ) Ahhh great idea. Green coconuts are filled with coconut water, which is  light and sweet  slightly fizzy. Its very refreshing. SO Ben scaled the palms, and only got hit by one falling coconut (!!!!!) We got them home and planned to open them after visiting one of the local artists on the island who was going to show us his work. After chatting for a while, Rob told him about our coconut idea and he offered to carve the nuts into beer steins as Jeurg is Swiss / German heritage. Well, what a wonderful idea. He spent three hours on the coconuts. Another example of the generosity of the Islander locals. They looked fantastic when he was finished. We just added and oxygen tubing straw ( as you do ) and they were very well received.

Today it was all hands on deck for our orientation at the clinic. It was a great day. I am looking forward to working with the team here. They were all welcoming and the clinic runs well. Annie is the departing full time RN and she orientated Rob and I today to the paper work and systems side of things. My head was full after a day of it, but I feel optomistic and excited about the challenges ahead. It will be great to be a hands on nurse again and I am really looking forward to working alongside Rob and the team here.

Darnley Island

We were up at the crack of 745 for the start of our big day. Bags packed, things squashed into extra bags!! Already??? And 2 boxes of prawns rescued from the freezer. Its strange not leaving for the airport until you hear the plane, but that's the way it is when the airport is less than a km away. We joked about going early to the airport and having a nice coffee in the departure lounge. The reality is that no one mans the tin shed that is the waiting area for the plane! Anyway, we pulled up in the car to see Scott the pilot waiting for us, and the plane, the little plane, the plane that Ben's guitar could not fit across the seat in because the plane is not that wide!!!!

We loaded up the plane and climbed in with Scott. The kids commented on the size of the plane and Scott replied with "yeah, its pretty small, and in this wind its a bit like a roller coaster but with no track, ha ha " At this point I was happy to swim across. But we taxied to the end of the runway, which looks over the sea, and roared the engines and took off. Take off was smooth and it was amazing to now see Yorke Island from the air as we had pretty much walked over most of it. Despite the clouds, we could see reasonably well and the colours of the ocean were just beautiful. Deep blue, and light blue and reef visible most of the way. I settled back and was enjoying the flight and then I looked up and saw that Ben was flying the plane now!!

He had a ball, Nanna Timmings and Poppy you would have been very proud. 15 mins later and Darnley Island appeared out of the haze. Unlike Yorke, which is flat and almost at sea level, Darnley is very hilly and  about 5km in length. The runway end is a drop off into the ocean! It was an amazing landing, and I think we all had our feet bracing on the floor pressing an invisible brake and praying we would stop in time!! Having said all that, I think it was my favourite flight so far.
We spent to afternoon settling in to our home for the next few months. The flat is very comfortable and the kids are settled into sharing a room now. Once we had unpacked we took off in the car for a look around and find a spot to swim. This is a rocky island, rather than sand. The beach is covered with coral bits and shells. It is really beautiful, not so nice on the feet but amazing to look through. We had a snorkle off the beach and found Nemo and a few star fish. It was a lovely was to relax after a day of lots of new things. Its good to be here but I think we all feel a bit frazzled again. The kids have slept in four different beds in 4 weeks. They have done well. We just need time to settle and get used to the new culture, new people and new surroundings. Yawo for now

Last Day on Yorke Island

It was with mixed feelings that we had our last day on Yorke Island. We have known all along that this was just a stop off before going to Darnley for most of our time away. Its interesting to reflect on the last few weeks. You tend to forget the negatives and remember the good bits, filtering the days through rose coloured glasses. There certainly have been heaps of positives. But like all places there are the positives and negatives, the people who are just fantastic and those that require a bit of extra hard work.
The last day for the school kids was a break up party on the beach. We walked around the back of the school, along a little sandy path shaded by trees and came out onto a great spot on the beach. The principle of the school has a beach hut there that he utilises for personal occasions as well as school events. It was just perfect. All the kids roared into the water and had a ball in the turquoise sea.

It was a lovely relaxing picnic. The kids played in the sand and built sand castles. The teachers looked relaxed. All the kids were confident swimmers, from prep up. I guess thats a big advantage of living with the sea as your back yard. Ben came down too and enjoyed playing with some of the lads in the sand.

Our last night was spent with Robyn, the resident RAN. She cooked up a delicious meal of brandied prawns ( yes Dad, MORE seafood!!) They were mazing. Even Amy tucked in and enjoyed the feast. It was lovely to sit and chat with her about her years on the island and the experiences she has had. Ben had also caught some sea urchins during the day as Robyn suggested they made good eating and something she really enjoyed. A bit dubious, but keen to try something different, we smashed one open as she showed us.......

Not the most inviting looking thing to eat, and well, it pretty much tasted as good as it looks! But, we have tried it! So tomorrow, we hop on a Cape Air flight to Darnley Island. It is just the four of us on the plane. Chapter two of the adventure starts. Big Esso to Yorke Island

Island dress

One of the Aunties on the island, made Amy a traditional island dress and gave it to her yesterday. It cost $60 (!) but the work that has gone into it is appreciable, and its a one off, and something very special. Amy was nervous about wearing it to school today but Wednesdays at school here is flowery day. All the kids wear something floral so it was fitting she wore it today. I think she looked beautiful but know I am a bit biased.

I spent a bit of time this morning walking around the island and taking a heap of photos. Our travel was confirmed today and we will be leaving Saturday morning for Darnley Island. So I want to capture as much as possible of this place. Yorke Island ( Masig) is not somewhere you can just go to unless you have a purpose. So I am mindful that we may not come back and really want to record as much as possible. It really is somewhere very special. Its not perfect, nowhere is but this little piece of earth in the middle of the ocean has been a wonderful experience. One of the things I have loved is walking around and seeing the different gardens. Some people are very house proud and have made a real effort with their gardens. Often shells are used as features in the gardens and this is certainly a unique features you don't see in Toowoomba gardens

After my walk around I headed into the clinic to shadow Rob for a while and help out as there was only him and one of the health workers today. I did a couple of dressings and met a couple more islanders. They seem very grateful for the care they recieve. Once it quietened down I had a look around the pharmacy and Rob asked if I would do the monthly check for expired stock. It was good to go through each item, remember drug names and what things were used for, and learn about a lot of new things. Diabetes, high cholesterol and renal disease are common problems here so the stock of those medication is always plentiful. As I went through the shelves it was nice to see some familiar things....and then I came accross this, not something I had seen before, and hope not to have to use!!!

Half way through the afternoon a fax came through to the clinic to say a plane was on its way to deliver some pharmacy items that had been ordered yesterday. So we hopped in the car and headed to the airport to wait for the plane. We parked at one end of the runway to see the ocean while we waited. The runway stretches from one end of the island to another, literally from beach to beach. I noticed this sign on the gate across the road that crosses the end of the runway, and then I realised the reason for the sign as I snapped this one:

I made a heap of pikelets this afternoon in preparation for the after school hordes. Today was the last day of proper school as tomorrow there is a clean up followed by a picnic on the beach. So there was much excitement among the kids today. The older kids will also be coming home to the island from boarding schools down south so they are also looking forward to having older siblings home for a few weeks. Once the clinic shut at 5, everyone piled into the ute and we headed off for our nightly trip to the jetty. It is such a nice thing to do at the end of the day. The colours of the sea, never ease to amaze me. The water is warm and so clear. It really is very relaxing. I snapped Amy and Jocelyn together in the back of the ute. I hope Amy will find another good friend at Darnley....Yawo

Robs #11 - Doctor on Masig

Doctor comes to Yorke.

A busy couple of days in the clinic as one of the TI doctors flew out for a chronic disease clinic for locals.  Dr Alex, is a great bloke who we got to know a little over the last 2 days.  Doctors come often for 1-2 day clinics.  Part of the Torres Health care model facilitates frequent check ups.   The folk here all “ALL” have annual health checks looking for chronic disease markers, diabetes (about 50% of the population >50 and about 30 % of the community overall.)  High cholesterol , high blood pressure, and renal disease.  Everyone in the community has appointments to come see the doctor who visits for 2 days every three weeks.  On Wednesday mornings, we run a Blood taking clinic, where all the chronic disease patients due for their annual check up in the next 3 weeks, come for fasting blood tests.  You can test how “well behaved’ a diabetic has been by a blood test called a HbA1C which put simply tests the stickiness of blood.  We can measure blood fat levels for a population that lives on high cholesterol  Dugong, Turtle and shell fish.

If you were born on the other side of 1976 (that is you are over 35)and you are a TS Islander, I can almost guarantee that you would be on a cholesterol  lowering medication…..Now are you ready for the big observation??  These people rarely have infarcts (Heart attacks).!!  Is it the medication, or is it that there is more about high cholesterol that we don’t understand?

In the last two days this place has been busy.  I have had a 10 month old child who was handed to me fitting.  Some fever had triggered the scariest (for parents) presentation called “febrile convulsion” , I have seen a Prawn Trawler operator with hideous oral hygiene, and infected gums that grew a culture that Yoplait would be amazed at.  His breath would have stripped paint and the garden of toxic flora, resembled some level IV biocontainment lab held in a secret US military installation working on bio-warfare agents.  I selected a cocktail of antibiotics from the pharmacy, based on the pretty variety of colours of the pills, and a mouthwash that was 1 part, chlorhexidine hospital strength antiseptic, and 1 part floor polish.  He was so happy with the treatment that he gave me a box of prawns and Moreton Bay Bugs, freshly cooked.  After shelling those for lunch today, Jo accidentally left the shells in a plastic bag in the humid Torres sun, on the back deck.  Smelling the foetid stench of the prawn shells this afternoon, was no comparison to a Prawn Trawler’s mouth when gingivitis and tooth abscess, meet in a battle for bacterial turf in one mans mouth.

A bloke’s  aunty phoned me today asking that I come to the house to see her nephew.  “Em b cold sick, and bone sore”   she said,  “Can yu go come house, for look em?” she asked.

I was in the middle of seeing a sick Aka with a flu like illness, but when someone rings the clinic and wants a house call, then a red flag goes up.  I drove around to the house, and this man was not looking well.  He told me that he was tired, and hot n cold, and bone pain, joints aching, headache.  The differential diagnosis was huge…I took his pulse and temperature, and he was on fire.  With a temp of 40, my differential diagnoses narrowed.

At this point I was thinking swine flu, Dengue Fever, malaria, or meningococcal septicaemia (bacterial blood poisoning).  No mosquitos or trips to PNG lately…narrowed down diagnosis to bacteria, or flu.  No access to any one with known flu, no trips down south or to TI/Cairns.  I was looking at something bacterial.   But where.  Chest was clear…not pneumonia, no photophobia or neck stiffness, no rash, so not meningococcal disease.  Urine test was clear, so not a kidney infection.  No abdominal pain, so not peritonitis, or pancreatitis.

I asked him, “eh Bala, yu have any infected sores?”  “Waa” he said, and bulled up his tracky daks…and there it was!!  Jumping off his leg like an eager primary school kid with his hand up wanting to be picked by the teacher!  “Pick me, pick me!!” it was saying.  An insect bite that he had scratched on his shin, just 3 days before, was now a volcanic purulent sore, about to erupt.   All around the sore, was red shiny swollen, inflamed skin.  This man had a condition that we call Cellulitis.  And it is dangerous.  I took him up to the clinic and cannulated (put in a drip), took some blood tests, and spoke to the doctor .  He prescribed 2 days worth of strong antibiotics into the drip, to be given straight away (stat), some pain killers and arranged transfer to Thursday Island Hospital.  This boy was not going home today.  He was flying south.  It was an exciting intervention filled two days in the clinic, and whilst I have not had a lot of sleep in the last 48 hours, I have been loving the clinical variety.  What is so cool is that with Jo in the house attached (physically) to the clinic, it is really easy to get her to come for a spare set of hands, and to help me with women’s business, and to show her some of the interesting stuff that I thrive on.

Infected Scabies, and staph infections (boils) are rampant here right now, and the clinic has been hopping with kids and adults coming in.  We are running out of antibiotics, and I can lance an abscess with my eyes closed now.

Yesterday, I had a boy with an infected foot.  There must have been some foreign body in the foot, because there was a huge blister oozing fluid.  Just as I prepared to cut open his foot and explore the wound, the febrile fitting kid came in and trumped my attention.  To be able to call Jo to come and do my kids foot, was a real bonus.  That wound stuff, is what makes her tick, and to see her in there hacking away at the foot, was very satisfying for me and her.   That boy came in today for me to review his foot, and it is all clean, healing super fast, and the Mum and the boy are wrapped.   I don’t know what kind of wound magic Jo does behind those closed doors, but it must be good pouri pouri.

The Barge came into day.  Tonight as has been custom for us at knock off time, we went down to the wharf, to watch them loading stuff on and off.  The breeze, and smell of salt spray, and the sound os water washing gently onto the coral sand, is hypnotic, and despite the chaos that was Yorke clinic over the last two days, the anxiety relieving phenomenon of seeing the sea, breathing the air, and having sand between your toes, is good medicine for my soul, and like a battery recharge for another big day tomorrow. 

Living the dream could not be better than it is right now, with my girl beside me,  my kids content, and a wave and a smile from locals that openly tell us that they don’t want us to leave on the weekend.  Part of me really wants to stop here for a bit longer, but a new adventure awaits us on Erub, and our trust is in God for this rollercoaster ride.  So we will see what comes.

Yawo!!!