Robs Blog #5 - Come one, come all

Every man and his Dog - Rob’s log #5

Monday comes and it is game on for one and all as Akas and Athes (proun: Ah-Tays) come for their weekly blister packs of medication, and mothers and aunties bring sick and recovering pikininis for review.  The recent bout of “belly run” has produced a disproportionately large number of presentations this morning.  The interesting observation about children presenting to the health centre, is that they are nearly always accompanied by a mother, sister or aunty.  It is a rare thing for a father or uncle to bring a child in for a health concern.  Steeped in culture is the notion that children, and especially sick children are strictly women’s bussines.

One man did come in with a sick 3 year old, and was an uncomfortable sight in the waiting room.  I ushered him in and we got chatting about the child, I took some vital signs and a few assessments, and sat to talk to the uncomfortable man.  He shared that he is the father of 6 and that his wife has had to go to Thursday Island (TI) for a course.  Being a traditional man, a crayfisherman, he admitted that he felt out of his depth when the child started to have diarrhoea and needed to be cleaned up.  I shared some advice on hydration, and just offered the bloke some support and encouragement that what he was doing was a good job.  He seemed relieved to have me as the nurse to assess his boy, and we soon turned the conversation away from the uncomfortable topic of sick kids and onto fishing, and cray fish, and other more manly pursuits.  I might come across as a confident nurse when caring for sick children but if the truth is known; I really don’t like sick kids.  I have always maintained that … “sick kids are like farts, you can stand your own, but no one else’s”.  This bloke was having a hard time “standing” his own.   Kids that is!

Another “smol gal”, came in with an episode of chest pain.  Normally you would put it down to something epigastric, or abdominal, but when I took this 5 year old girl’s pulse it was irregular and only 55!  Normal for an adult is 60-100.  For a small child I would expect 80- 120 as a normal range, so you can imagine my concern that her pulse (heart rate) was only half of what I was expecting to be normal.   It is a surreal thing doing a 12 lead ECG on a 5 year old, and whilst it did not show anything terribly sinister, I was concerned.  I listened to her heart sounds, and she had a murmur.  A normal human heart has 2 sounds.  We call them S1 & S2, or “lub dub”.  But this kid had three sounds, indicating that perhaps one of her heart sounds was sluggish.  This can happen with Rheumatic Heart Disease, upon which I have already blogged in www.robsoverthetop.blogspot.com . All in all this was one where I was glad that the doctor was on the end of the phone, and to be able to send a faxed copy of the girls ECG was a comfort.  As it turns out we are just going to watch her over the next few days, and all being well, plug her into the next doctor’s clinic on the island next week.

After lunch we had a visit from the Mental health outreach team, who fed back to me on our Heat stroke bloke.  They are a team of two.  An Islander health worker, and a nurse.  They are based on TI and travel to the islands for consults and check visits of community members who are affected by mental illness.   The stigma here is so high about mental illness that when the MH team are here, people wont come near the clinic for anything, because some one might see them come in and assume that they are here to see the MH team!!!  It is sad really.  Mental illness has always had a stigma attached, but out here, it is so profound.

Another Team of community workers that came in to ‘chat’ today was a domestic violence team, who are from an organization that counsels victims and child witnesses of domestic violence.  It (DV) is loud, and obvious, and common in these communities, and the process for dealing with DV cases is well planned.  But there is nothing for men!  If a woman is beaten by a partner, then one organization can ‘rescue’, another can offer safe housing in TI, and a third can offer counseling to the victims.  But if a man is in the same situation (and it happens) there are no services for him.  This is just an observation, and I am not making any political statement.  I would like to see a men’s support group on the islands, but then the stigma is huge.  What man is going to be admitting that he is being violated by his partner, when that man comes from a proud warrior people??

Still, that rant aside, I am really happy that these ladies came and explained the system to us, and I must admit, I feel a lot more confident in dealing with the referrals.

Child Health department also came by today.  Some follow up on children in the community that are under protection by the department.  We learned about that issue, and by the end of all these visits by various departments, I was left with a sence that the Nurses, and health workers are the ‘front line’.  Out there and exposed, and the importance of screening and channeling our patients into the appropriate services has been highlighted today.

That aside, the sense that we, the health work force, are supported is strong.  To have a name and a phone number to ring for these issues offers a relief.

After knocking off tonight, Ben, Amy, Jo and some island kids from Amy’s class went fishing and swimming back at the jetty where I caught my shark yesterday.  It was a nice relaxing end to the evening.  Jo made Wendy Moore’s amazing Sausage Curry and rice, and we are listening to the ocean breeze and Ben’s gentle Guitar melodies as we type out our blogs.   Life on this beautiful coral cay is good…complicated, and rich, and messy under the surface, but good!