Postcards from Vanuatu

Well not really island hopping. The others were keen on a trip to Aore with some snorkelling and coffee included. I was pretty keen on a sleep in, which I had. I haven't mentioned the nights here.. We are sleeping at Michael and Amanda's place, which has several guest rooms and bathrooms on each of the two floors. Each room has a fan. The whole house is open with slats, so when locked up there's air circulation. While there are screens, any mosquito with anything beyond a grade 1 education could easily gain access, and they did. I haven't talked about mosquitoes so I will, then I'll get back to the nights. When you think mosquito here you think Malaria, and Dengue. The others are taking malaria prophylaxis, but it's still wise to use repellent as an added level of protection. Michael and I prefer to be outrageous daredevils, so we are flying by the seat of our pants. As long as we look out for mosquitoes flying by the seat of our pants we should be ok. Mic...

Saturday - Millenium Cave. This is a full day's expedition. It's awesome and it's physical. It's like a 5 hour workout with breaks. The bit I was looking forward to was the "relaxing drift down the river" at the end. It was a cool day, so this was more like a "chill out" which I think were actually their words.. Clever! Here's a sample of descriptions from the web. Pure Epic Insanity! This tour is so off the hook. It's likely not even legal in most countries. No other way to put it, this is a TRUE jungle adventure. It's insane.... Here's a review that tackles the touchy subject of risk assessment- "It's only a matter of time until someone is killed at Millenium Caves.... There are many unnecessary risks and incorrect caving equipment." To read more of this review go here... Here's what the company says on their website. Safety & Risk Millennium Cave Tours is a physically demanding adventurous act...

This was a sleep in morning, so I didn't. At 6:30 I was wide awake and up. This is quite unusual, but it was nice to sit with the throng at breakfast. As usual with this group, the communal energy transforms into a plan. The plan was... Check out Turtle Beach Lodge! Full of newfound purpose we were off in the vehicle. I know I have described this before, but it's worthy just noting that travelling at anything above about 20km per hour on a main road with all the hazards, vehicular, pedestrian, animal, and even the odd overhanging branch, is not without its anxieties. At 80km/h it's exhilarating but you know that in an accident you are basically dead. There's just no way you could protect yourself, hold on, or plan to minimise injury. Even sitting in the tray (which you end up doing sometimes) you are quite vulnerable. Such is life. The east coast road is now a familiar one, and soon we were beyond Sapi, on rural roads, waving to virtually every pedestrian, especially ...

A quick breakfast was followed by rapid setup and we were in action again. The demand was much more paced today and we felt slightly more proficient. My cases included a scabies that was a bit tricky to diagnose, a woman with hyperventilation from anger with her husband (I got a chance to do some basic feminist advocacy), and a classic case of a child with nocturnal asthma. I was pleased that this patient understood my demonstration of how to use a spacer. I got a minor injury making the spacer using Trevor's Swiss army pocket knife on a water bottle. Everyone worked hard, and Trevor entertained the children continuously, which was delightful to see, and gave a lighter atmosphere to what could have been overly serious work. By lunchtime the waiting list had dwindled to nearly nothing, and there were several requests for housecalls to the village. One patient was the chief here and another a 76 year old who was in basic good health and starting to develop signs of ageing. Unf...

The plan was a 7am departure. This is well before my normal time of morning brain activation. The following paragraph is typed deliberately to reflect my brain functioning at this time of the morning. (It's an artistic technique I'm experimenting with.. go with it.) Very early. Alarms everywhere. Footsteps. I know Robyn and Amanda are early risers. I think I heard them but they were probably trying not to disturb. I need more sleep ... can't be near time get up.. check watch .... it is.. that's very disappointing. Bed is warm. Bed is horizontal. Packing can't be done horizontal. That's very disappointing. I am pretty much packed. Can lie for longer then. Breakfast is optional. Dozing is imperative. Rest is a basic human need. More footsteps, now voices. That means I have to get up soon, probably now, very disappointing. Judder. Must have fallen asleep. Time check. 5 whole minutes of unconsciousness. That has to be good. Now the whole house if pulsing with ac...

Tuesday was another big day. Jade and Janice had organised a physio home visit in Luganville, so we had to be all sorted by 1.30. There was a fair bit of washing and tidying up to do after the big night last night, and some preparation for the big night tonight. Lawrence, the local hospital doctor, and Ednah the Medical Santo nurse with a strong public health and TB leaning were coming to dinner with their spouses. Was, Ednah's man, was our driver on the trip up the east coast. He also had entered into an agreement with Michael that he would supply a vehicle for the trip to Big Bay, so we needed to pick up a hire car as well to transport the 13 of us. The day started with an amazing event. Amanda had arranged for us to visit the house of Rex, the local paramount chief for the community in which their house was situated. Rex is a thin man with a soft voice, an entertaining sense of humour, a past history of "stuffing up" and a newfound devoutness with rejection of his pa...

Today started with a bang. The bang of people up early. By early, I mean they were up before 7.30 am. While this is admirable for some, I find that my brain doesn't start functioning until about 9am, so I was on autopilot until then. That means that I really took in very little of the tour of the Medical Santo clinic, but it was wonderful to meet the lovely staff and to see Michael and Amanda so much in their element. The whole medical scene in Vanuatu is an amazing and complex interaction of immense potential with modern technology, hampered by variable presence of personnel, large variability in standard of medical care, with huge cross cultural factors (Doctors can be "western" or "eastern", the latter mainly being China trained), high likelihood of supply chain breakdowns (no reagent for serum sodium in the last few weeks), and poor health literacy. The clinic hadn't really opened for the day, and after the "registered" practitioners donned t...