By Dan
Thank you to the community of Fairbanks for the tremendous support for this trip.
We especially appreciate the all people that contributed to our Hospital Lobby Bake Sale.
Donated equipment and medical supplies came from all directions.
Alaska Airlines and Delta Airlines transported our over-weight luggage gratis, and Silk Air gave us a deep discount.
Family and friends of the team were especially supportive.
By Liz
Blog 10
You’ll remember we struggled with luggage on our way to Indonesia. With nearly 500kg of medical supplies this was no surprise, but on our way home we only had 66kg of medical supplies. We expected to breeze through the baggage check for our flight. But alas, once again we found ourselves haggling with airline personnel trying to explain why it was important that our medical supplies were loaded on the plane we were on. Primary reason of course was if not on our flight (Monday) the next flight off the island was Friday and we would be back in the USA by the time they were on their first leg of a 5 leg journey. So, as we boarded our flight, our luggage boarded a taxi for the trip back to the medical clinic. We had to make arrangements for someone to drive it to another airport or the 24 hour ferry and travel with it so that it could catch up to us. It was a relief, once again to see our luggage meet up with us with 48 hours later.
The treat on the flight home was the tail wind that shortened one of the legs by an hour and a half. For me, the best part is I can sleep! Start up that engine and I’m trying to snore louder then the engine. After the first flight, there were enough empty seats that we could stretch out a bit too. Our minds were swimming as we left. So many lives changed, images seared in our memories. A 24 year old that had lived his whole life with a severe bilateral cleft lip, mended, the smile on a mother’s face the first time she saw her 8 year old son with his lip mended, Margaretha the little baby calling out thank you to the doctor, and so many more images.
By the time we got to Singapore, I had an email with a photo of a lady that had just arrived at the clinic. They were expressing sadness that we weren’t there any longer to help her, advanced breast cancer. She had been seen a few times at the hospital and treated for an infection. Her tumor was massive, with a large open draining area. It was worse then any breast cancer I’ve seen in over 30 years of nursing. It was so large she couldn’t even sit up. It is just so hard to explain how things there are so much more than we ever see here. We couldn’t have done much to help her, the cancer is clearly spread through out her body, but perhaps… no, hard as it is to say there is nothing we could have done, there was nothing.
I guess that is the part that is the hardest to explain to folk that haven’t experienced remote medicine. In the USA, it is true that medical problems can bankrupt a person and that a person could end up paying a bill for the rest of their life, but it is rare for someone in need of basic medical care to be turned away. In Indonesia, you don’t even get admitted to the hospital unless you can pay first. If you need surgery, you have to put the money up first, you have to bring your own suture, and prep and dressing etc with you to the hospital. In America you are not turned away from an emergency room because you can’t pay first. Matter of fact, there are laws that prevent a health care facility from turning away a person that can’t pay.
How did we do regarding the goal of our mission? We thought if we worked full hard days, we might be able to operate on 25 patients. We were able to operate on 29 patients and did over 33 surgeries. We weren’t able to see the smiles on the patient’s faces (they were still to sore from surgery) but the smiles on their family’s faces was reward enough.
By Mishelle
April 7th weekend
What I’ve learned up to date…
Internet access is a privilege, not a right…and sometimes it is a flat out competition.
The reason you might not know the dose of abendazole is probably because Alaska does not have that high of an elephantiasis rate.
If you run out of beds at the hospital, a mat of the floor will do just fine…as some patients prefer it.
Rice truly can be served at breakfast, lunch, and dinner
When the village water stops working…the squatty potty still works
When the electricity goes out in the OR for the umpteenth time, the value of a $20 headlamp will shine through
It is still possible for some to continue their job of sterilizing the team’s surgical instruments…even with an IV in their left arm
Although I have learned the most new disease diagnoses from the village population–our surgical team has come in a close second.
Different than back home, sometimes moving a patient from the recovery room to their hospital bed does require an umbrella
It is possible to fit a family of five on a motorcycle…as long as one is a baby.
And….
Sometimes learning comes through a heavy-hearted situation that you might have preferred not to learn. It is in these times that you might struggle for understanding…and work to find the meaning of what just happened. What if’s…should have’s…why didn’t we…. A child’s unexpected death changes the ground you walk on no matter what country you are in…things are less sturdy…life’s reasons are more questioned. You are forcibly retaught that you are far from in control on many levels. It reinforces how grateful we should be for what we have and how grievous it is for those who do not. Taking a step to help make a different outcome possible next time…a small purpose on a small level that if it makes a difference to even one…then there can be worth.
Sometimes it takes a village for one to re-embrace what is truly important.
By Mishelle
Learned in indo April 9
- Even Dr Jensen takes his turn at zapping the stray fly from the OR prior to the case starting.
- In Indonesia, making a bet with Dr Jensen came with a high probability of not winning.
- If you need to transport 30 people (1/2 of which are children)to the local beach…then stand them up in the back of a work truck with their Alaskan friends and drive that winding road..it’s only about 20 miles.
- The Indonesian car horn is multilingual–understood by Indonesians, Americans, cows , dogs, and occasional ferrel chickens.
- Hospital scrubs not only meet OR dress requirements…they also make fine reveal-less ocean swimwear
- If you task a gaggle of Indonesian children to find the most beautiful beach shell…soon you might have to bring an extra piece of luggage to carry them home.
- A thankful village who report they can never repay you for all you’ve done…will try anyway with baskets.
- As a result of these thank you’s ….your group may acquire approximately 4 more pieces of luggage
- There is also a good chance your team will probably be over packed by 66kg and the local airline will request you leave 4 bags behind…to be shipped when next plane goes out next…in 2 days.
- The ocean temperature in Indonesia feels like they took a jacuzzi and a swimming pool and stirred them up before adding salt.
By Liz
Blog 9
It wasn’t by design but we all got a lift when we realized we healed a leper on Easter. Hendrik has been a long time resident of the leper colony on Hohidiai. Matter of fact they call him the mayor. He came there after living 9 years in the jungle alone, shunned by his friends and family. His mother came once a day to bring him food. He lost most of his hands and feet to the effects of untreated leprosy. On top of that he had cataracts robbing his vision. The eye surgeons from Jakarta wouldn’t touch his cataracts until he was able to close his eyes, that’s where we came in. Easter Sunday Dr. Jensen fixed his lids so they could close. A side benefit was everyone telling him him he looked 10 years younger. Michaela said it was the first time she gave anesthesia to a patient and partied with them at night. Hendrik came to our send off party with the rest of the clinic staff.
After 2 Easter Sunday surgeries we made quick order of packing everything and headed to the beach.
Beach!!
Word spread quickly through the camp and I’m pretty sure every free person, young and old, piled into the huge farm truck and off to the beach we headed. Not sure how it happened, but after frolicking and shell collecting and frisbee, we loaded back up and no one was missing.
Rinse off the salt brine and head up the hill for our departure celebration. Dancing, singing, speeches, gifts, tears! It was hard to say goodby but awesome to have gotten to know these people. The clinic workers, the patients, the kids, orphans and the Scarborough’s. A family devoted to make the world a better place, one person at a time.
Hendrik had surgery on his eye lids to allow them to close more completely
By Dan:
Contrary to previous reports of me faking my own demise I have managed to convince everyone of my genuine illness by constantly expectorating. Even doubtors have come to realize the full seriousness of my condition offering to put me out of my misery with copius quantities of quack medicines which I have steadfastly refused. Hence my tenuous survival to this day.
Even on Easter we managed to get in two surgeries…the last of our project. We will have a big celebration tonight and tomorrow morning – early we depart for the long journey home.
My only regret is not being able to fully participate in the Local Easter Festivities which the Indonesians celibrate with great enthusiasm.
Blog 8
A sobering start again today, with a pediatric nurse, Robin Miller and physician, Mishelle Nace sitting just across the hall, a 5 year old died. He was brought in with a diagnosis of malaria and was acutely ill. He started to have seizures and died. If only someone had involved us before it was too late. We have ambu bags, seizure medications, airways, endotrachael tubes, many things that might have gotten him through this crisis. Life here is very fragile, life expectancy is shorter but that doesn’t make this any easier for them or for us.
In this remote area, the lay people don’t realize the level of advanced care available in other countries. They pray for miracles but don’t know when to engage medical care. If someone is sick enough to possibly dies, they expect it to be unpreventable. They stay at home well past the time for medical intervention. Possibly because they are afraid they can’t afford the care or transportation or because they just don’t understand the possibility of survival.
This was the first day we had two “no show patients” after a full week. In the US, we have “no show” patients on a regular basis. Today, it wasn’t the patient’s fault; someone had forgotten to tell them to come. A motor cycle staffer was set out to the villages and within an hour and a half, he had rounded them up and they were ready to go.
It will be an early day, the flow of cases is going well and the procedures are going smoothly. We will be done early, maybe by 7pm! It will feel like a day off. We are trying to take care of each other but some are falling. Dan has missed several days with a major respiratory problem. He might be just faking it to hang out at the Villa instead of working, but those that know Dan, know he wouldn’t miss a minute of this if he could help it. Christina is still putting in full days but between cases is sitting with her leg elevated because of a bug bite reaction that is causing her ankle to swell. She was started on IV antibiotics today which has the situation under control. Thank heavens we have a pediatrician with us, she is barely over the age pediatricians treat anyway. Robin noticed in a picture she had a spot on her neck, “what the heck is that?”, she shouted out loud. We all just thought she had a birth mark on her neck so no one had mentioned it to her. So she is on an anti- fungal cream now. Maybe head lice aren’t the worse thing that could happen here!
By Liz
Blog 7
Lice! I think the hardest part of today was realizing every patient probably had lice. Seeing them actively moving about set most of us into scratching frenzies, all but Doctor Nace. She had reached her happy place. She said this makes her life as a pediatrician complete. I count my lucky stars that I never considered being a pediatrician!
Sleep deprivation is also still rampant. Maybe, just maybe there is some value in required down time between shifts enforced in the USA. We were getting 6-8 hours between shifts but some days those hours included the 40 minute drive to and from the base camp. Yesterday, we decided to roll a case over to Sunday to allow everyone a full 9 hour rest. Tomorrow we will sleep in and start a little later. Even me, a firm believer that sleep is for sissies and there will be time enough for sleep when I’m dead, is hitting the sack the minute I see it.
Our patients and their families are still overwhelmed with gratitude. Today we were able to fix 9 year old, Kristen’s cleft lip. She was a beautiful little girl with a smile so big you’d think she felt beautiful too but her whole life she has heard the story of how her mother birthed her and then was so shocked at the sight of her that she just died. I’m happy to say she was brought to us by obviously loving grandparents.
Dr. Jensen’s pile of loot is mounting! If he tires of the doctor role, he will be able to open a basket shop. This is most amazing to me knowing the poverty the bulk of these people live in.
April 7
More Haiku’s from across the globe
Mishelle
Wind blows clouds to here
Sun takes a break—rain on cue
Welcomed transition
Mom so grateful…tears
On knees, head bent, beholden
Kisses surgeon’s hand
Cleft lips repaired: check
Contracted burns grafted: check
Many lives changed: check
No lines are drawn as
Covered heads help cross wearers
Vice versa thank you’s
Mosquito’s battle
Flies for my fresh skin surface
Swat!! I win…this time.
Lesson learned…again
Never venture out unarmed..
…with toilet paper
Desperate flies try
To eat my food before me
Too many to swish
Hmmm…where is this place
Visa saysIndonesia
Should say Avatar
Wail, cry, sing, moan, yell…
Death one room away…”Papa”
Sorrow self translates
medicalteamblog.wordpress.com 