Contrasts in Medical Care

By some strange coincidence, my last blog post (way back in May) was about the difficulty that some people go through to obtain medical care, any medical care, in PNG.  It was the story about a man who journeyed for days to get his young niece to a clinic in order to get treatment for an injury she had sustained.  The story turned out well in that the man was able to get to Australia, the girl was treated, and by now I am sure she is back home again.

Our family was plunged into a medical care story of a different sort when our new granddaughter Rebekah was born in May with serious Meconium Aspiration Syndrome.   There were some complications at birth and at some point she had aspirated a large quantity of meconium and her lungs were essentially unusable.

She was immediately taken by ambulence to the University of Iowa hospital and admitted to the neonatal intensive care unit (NICU) there.  This is one of the best medical facilities in the US for treating infants so Rebekah has access to the latest technology and is being cared for by a wonderful team of dedicated doctors and nurses.  She has been in the NICU for six weeks now.  The first five weeks were touch and go and we almost lost her several times.  But over the past week she has started to make progress.  Her lungs are slowly being reinflated and we hope that within another week she will be breathing on her own, at least partially.   Our best guess is that she will be in NICU for at least another two months.

Rebekah's NICU room

Rebekah's NICU room

We are thankful that Rebekah lives in one of the few places in the world where she could have received treatment.  In PNG she would not have made it and probably her mom would not have either.  For all its problems our health care system is still the best in the world.  Our prayer is that the leaders of PNG will make providing quality health care for the people there a priority.   While their system will probably never equal ours, for any number of reasons, basic quality health care could be and should be available to every PNG citizen.

A Health Care Nightmare that Turns Out Well

Following is an excerpt from Monday’s edition of The National describing the ordeal one man went through to get health care for his injured niece.  It is hard to imagine having to go through all that but this is often the norm in the more remote areas of PNG.   And in reality the little girl was fortunate.  Had they not lived on the south side of the country, adjacent to Australia, things very possibly would have turned out quite differently.

“A PAPUA New Guinea man made a four-day trip to Cairns, Australia, carrying his badly injured six-year-old niece who had her intestines exposed after an accident. Forty-year-old farmer Lambai Pisau was called to his niece Dulcie Nakai’s village school on the PNG-Indonesian border last April 23 after she fell out of a classroom window and landed on a sharp hibiscus tree. The fall pierced young Dulcie’s abdomen, exposing her intestines. Mr Pisau took his niece to their remote village’s first aid post by canoe only to find the medical officer was away for the night distributing donated mosquito nets. He treated his niece as best as he could using a bandage and tylenol before the pair endured a five-hour ambulance ride to Morehead station on April 24. From Morehead, the two travelled eight hours in a motorised dinghy, which constantly broke down, before spending the night in a bush hut at the mouth of a crocodile-infested river. On Sunday, it was another four hours journey in the dinghy to Boigu island in the Torres Strait. A medical team on the island had a helicopter transfer to Thursday island where the pair was met by the Royal Flying Doctor Service and flown to Cairns (Australia), arriving early the next day (Monday). Surgeons at Cairns Base Hospital successfully conducted life-saving surgery on Dulcie and she is now resting comfortably.”

The full text of the article can be found at: http://www.thenational.com.pg/050409/nation8.php.

A Day in the Life

It is Monday morning, 10 AM.  Monday’s are always a bit crazy as it seems like there is always a backlog of things to do that have accumulated during the weekend.  For some reason this Monday seems a bit crazier than normal.  Sometimes people ask me what I do in this job and I often have a hard time quantifying it.  There just seems to be a long string of “stuff,” some of which seems pretty insignificant, but all of which is important to someone.  And it is all a part of working here and keeping the organization running.  Just for grins I listed everything that has come across my desk in the two hours that the office has been open today.  The list includes:

  • Lead morning prayer time at the office.
  • Provide food for the Nend translator who is in town.
  • Write a letter to the Provincial Government requesting funding for airstrip maintenance.
  • Work up a summary of the duties of a Board of Management to send out to the Mum Board in Katiati.
  • Write an eviction letter to a tenant who is two months behind on their rent.
  • Purchase anti-malarials for a visitor who will be coming over this summer.
  • Work on the logistics of getting a hospital patient back to the village after she finishes her treatment this week.
  • Arrange for purchase of translation supplies (pens, paper, etc) for the Nend translation team.

This afternoon if all goes well I can get into some translation work.  That is the part I like best so I try to work in some translation each day.

Things seemed to have settled down a bit over the past 20 minutes.  But before lunch I get to hand deliver the eviction notice.  That should be entertaining.  Actually it is not a full blown eviction letter.  Rather it is more of a blustery “pay your rent or leave the premises” letter.   So I don’t start the day by being totally wretchedly heartless.  That comes later in the week I suppose.

This should dispel any notions that people have about missionary work being glamorous or exciting.  Occasionally it can be that but often the reality is that it is a job, like any other job.   The retirement plan is much better than most jobs though.

Hauling Stap Isi – Back in the Water Again

Stap Isi resting on its mooring again.

Stap Isi resting on its mooring again.

On Monday I re-installed the prop shaft and reconnected all the bits and pieces.   Everything went back together about as easily as it had come out.  Then I sanded the areas that had been patched and gave those areas a coat of bottom paint.  The next day I and two of the PBT workmen gave the bottom a final coat of paint and lastly we let the rudder down so that we could give the rudder shaft a nice coat of grease.  At last, one week after we hauled out, Stap Isi was ready for the water.

Unfortunately the water was not ready for Stap Isi.  By the time everything was done on Tuesday the tide had gone out and rather than take the chance of not having enough water to launch, we decided to wait until Wednesday morning when tide was scheduled to be much higher.

Wednesday I got to the boat and clambered aboard.  The manager said that going down was much easier and faster than going up – that they just lowered the boat into the water and eventually all the blocks holding it up would just float free.  And that is exactly how it went.  The slip operator reversed the drum holding the spool of 1 inch wire and the cart on which the boat sat slid freely into the water.  Eventually I heard the sound of large blocks of timber bumping along the side and we were once again floating.  A couple of guys swam out and herded the blocks to shore, I fired up the engine, and motored gently back over to our mooring.

I can’t tell you how good it feels to finally have been able to make these repairs.  For awhile it looked like we were going to just end up with a derelict boat, one that we could live on but not much else.  But now, as an answer to many prayers, we have a functional sail boat, ready to take us back out to the Ramu or anywhere else we might need to go.

Hauling Stap Isi – Changing the Cutlass Bearing

Yesterday was the big day, the day I had been dreading; the day I was going to at least attempt to remove the prop shaft and cutlass bearing from Stap Isi.  And as it turned out it was just about the easiest repair I had ever made on the boat.

What caused  my dread was the vision I had of couplings, bearings, and fittings, all sitting in and around salt water, corroding and fusing and generally becoming one with each other.  And then after five years, ten years, who knows how many years of such bonding, here I come with a mallet to take it all apart again.  All I could envision was me wailing away at various fittings while they cracked, shattered, deformed, and otherwise became completely unusable.

So with fear and trembling I arrived at Stap Isi at 7 AM on Friday, utterly prepared for the worst.  First order of business was to remove the front coupling from the drive shaft that connects the shaft to the transmission.  I remembered how difficult it was to pound the coupling on in the first place back in 2004.   Reversing the process was not going to be a picnic.  But nothing ventured …  I picked up the mallet and gave the coupling a solid rap.  What was that?  Did it actually move?  I rapped it again – it definitely moved that time.  About four more raps and the coupling popped off and fell into the swill in the bilge.  Ok, I can deal with bilge swill.

Next I removed a bearing from the middle of the shaft.  Came right off, and of course dropped into the bilge swill.  By now I was getting quite good at de-swilling the parts.  I went out to where the shaft emerges from the boat, took hold of it and gently pulled.  Out it slid.  Part one completed in about 30 minutes.

Now for the hard part.  I had to somehow get the cutlass bearing out of the tube in which it was fit.  I had read on the internet how various people got their bearings out.  Many of them involved constructing a home-made bearing puller out of esoteric parts available at any local hardware store in the states but completely unheard of here.  Some DIY boaters described having to carefully cut the bearing out with a hack saw.  Oh this was going to be fun.

Returning to the cabin of the boat I ran a long pipe down the tube until I encountered the inner end of the bearing.  Then taking up my trusty mallet I gave the pipe a sound rap.  Hmmm, that felt like something moved.  It could not possibly be this easy.  I rapped the pipe several more times and it definitely felt like the bearing was moving.  There was a small crowd of Papua New Guineans sitting around under a tree outside, no doubt hoping I would do something very entertaining.  I asked them if the bearing was coming out and they responded that it was.  Yee Haw.  Now I was inspired.  About six more solid raps with the mallet and I heard the lovely angelic music of a bearing hitting concrete.  The job was done.  And the whole thing beginning to end took only about an hour and a half.

This morning I returned to the boat with the new bearing.  Being the eternal pessimist I was concerned about how hard it would be to fit the new bearing back in the tube.  To tilt the odds a bit I had left the bearing in the freezer all night to shrink it a bit.  This morning I filled a cooler with ice and put the bearing in it, went to the boat, cleaned out the tube and put a thin layer of grease in the tube.  Then I took the icy cold bearing, said a prayer, and tried to insert it into the tube.  It went easily with almost not pressure required, then as the bearing warmed up it expanded and within a few minutes was fitted beautifully in the tube waiting for the return of the prop shaft.

Not all boat repairs go this easily. OK, in reality, no boat repairs go this easily.    From now on I think that we are on the downhill slide as far as getting Stap Isi repaired.  There is still some epoxy-ing and fairing to do as well as finishing the bottom paint.  But I think that we should be able to refloat the boat some time middle of next week.