The Remote Village- Jere - we can't even find it on the local maps here

'After what appeared to be hours of discussion, and tooing and fro-ing, and Esther, Hanna ( the Bule teacher) Litje, the mission all rounder, and the others, it was decided that 

A. We would go the the teacher's house for tea.

Where we had amongst other wonderful food, golden syrup dumplings, and custard, and wonderful conviviality, for which the 'girls' dressed up.  Nathalie thought she could borrow Lisa's ( 5 foot and a little bit) dress.

NOT

And B.  We would somehow go to a place called Jere.  This is a Muslim village, several hours away, we think to the north.  Now the large scale maps on the walls here don't even show this place.  The hospital visits this village once a month to take TB and other medication, and it is 2 hours by 'fast boat' and five hours by road.  The seas are still a bit high for the boat so it seems the road is the way.

No bookings have been made, but are told that traditional hospitality will provide for us, as long as we are appropriately respectful, which we have no doubt we can achieve.

Jere

Starting on time from Hohidai( as per the Indonesian horologigical society standards) we set off wit Litje. Hannah, and Ato, as our driver.

Well..... Due to start at 1000hrs, we got to the 'base' at 0900 hrs to do some internet stuff.

1045- still waiting for Litje to come back from Tobello, where she had Togo to do the shopping

1100- still waiting

1115- leave the base 

1130-return to the base because the medications had been forgotten

1200-arrive at Tobello and seek to get some lunch.  Nothing ready to eat, ordered nasi goering, 

1230-assured that there is a car waiting for us at Tobello, port.

1245- galaxy supermarket get ice creams and drinks waiting for lunch to be ready.

1250- lost Litje - in the market getting food to give as gifts, and a huge sack of watermelon.

1310-at port the car isn't there, so we have lunch

A useless phrase to learn in Indonesia.

Waspadalah terhadap gunung es di Teluk

(beware of  icebergs in the bay)

While waiting for the car to take us to Jere, we were loitering in front of a 'homewards/bed" shop, and the proprietor found several chairs, placed them out and insisted we sit, even sourcing some spoons for us to eat our previously purchased lunch.   There was a catch, he wanted his photo taken with the Bule, especially the blonde white woman (perawat).....

Picture with the white woman.... The other one he was hugging her!!! 

The car we contracted was a form of Toyota, about the size of a Prado, but 2 WD for the seven of us.    It was difficult to see through the windscreen due to the coating of strings of little fluffy toys, solid window tint six inches wide along the top.  There was a 20 litre water container (not Jerry can) of petrol in the area behind the back Dickie seat, and the roof was piled high with food and medicines as gifts for the village ( food about $10 worth, of fruit)

Just putting the fuel IN the boot.

The journey out of Tobello was still in Indonesian time...."whenever".  Stop one, at the tyre shop to replace the unroadworthy spare tyre, with the unroadworthy spare tyre, which was pretty handy, as you will see later.

After about 20 minutes and a major river crossing we had the blow out on the rear right tyre, it led to a closer inspection of the other four tyres.  Rear left...good tread, apparently balanced, no scrubbing or unusual wear patterns.

           Rear right..the replacement tyre...not roadworthy, but had some tread on the outer edge.

            Front left...good for skid pan work, no tread on it.

             Front right.. No good for skid pan work, as the metal threads poking through would have caused a bit of friction as it grabbed the road.

The dead tyre was just thrown on the roof( not rack) and tied up.

After a quick roadside conference, and consideration of alternate forms of transport

Alternate firm of transport that passed us whilst fixing the tyre.

The dead tyre

It was decided that we would continue with this vehicle, as long as the driver travelled no faster than 50 kph, and that he get at least two replacement tyres before going much further.

Litje did some good work and the driver agreed that his village was "only half an hour away and he would get a change of tyres there". I think his nose was growing about that one, because when we got to "his village " two hours later, the car from which the replacement tyres were to be obtained! was 'not there" .   

Eight of us (including the driver) in this vehicle was a bit of a squeeze, with Sandie, Hannah and Litje squashed in the back, Nathalie Andrew and Lisa luxuriating in the middle seat and Kevyn navigating in the front.  Every time we stopped, and there were lots of them, we had to get out and uncompress, get some blood flowing, and it was at times,  like hearing kittens, getting everybody back in with Sandie first etc....the journey cost us about $8.00 each.

Bule. As we travelled through most of the villages, after it was dark, the driver turned the interior lights on, we imagine, to show that he was carrying Bule or foreigners.  

Regardless of his disregard of every road rule, we are used to relating to vehicle road-worthiness,  his almost incessant smoking, spitting regularly out the window, and him telling us porky pies about the replacement tyres, he was an excellent and safe driver.  He was intimately familiar with the road, and not once did we hit a pot hole hard, ( there were hundreds ) , a large puddle in a hurry ( tens thereof) , stuck in a rapidly flowing river crossing ( there were at least 20 small ones and 3 major ones)  or stuck halfway up, or down major grades, of which there were many.  

Towards the end of the journey, most of the road was along basic jungle tracks! which would get very hairy if the weather turned wet.  ( which it should have well and truly done at this time of the year.)

That bloody flashing seat belt light....very annoying, and no doubt if we could have found both ends we would have worn them.  Seat belts don't happen here.

As you can see above, it was not without its adventures.

We made it to Jere, which is about as far north as  one can go on Halmahera.  From the village you can see the island of  Motatae .   It is a Muslim fishing village, still using hand carved outrigger canoes.  The Main Street is a single landed concrete lane which  runs along the beach front with a row of houses between the ocean and the road.  

The Main Street of Jere 

Arriving after dark, we were taken to the  Kepella's (sp.?) or village leader's house where the welcome could not have been warmer.

                           

                              Not the way we were greeted( far side gallery 5)

We were almost immediately fed a lovely rice and noodle meal, sweet black tea, and smokey water.  The water is smokey because for some reason all water is still boiled.  The chief.s house literally has it's back door three metres from the ocean. There is a 1.5 m sea wall there, but I think given a good storm, his substantial concrete and brick house would cop a bit from the sea. 

Back of the Kepella's home

I was really tricking about the head hunter bit, I have no idea, what the  traditional native customs are here. All we experienced was abject and respectful  hospitality.

Nathalie and I, because we are married ( and have been for a million  years) were given a room in the house of the Kalabah's son, and daughter in law  Probably his bed. The four 'girls' in one room in the chief's house, probably displacing part of the family there, and Kevyn sharing a room with the men in the bosses house. It would be very hard for us to offer the same relative value of hospitality at our homes.

The married persons quarters

Due to the esteem with which we as visitors are held, we were only permitted to use the (newly built) toilet in the Kepella's house, which was three doors away, and on the other side of the road.

Our bedroom, probably the best room in the house, was very comfortable, albeit very open, and bright room, with a bed and mattress.  

Come 0500 hrs, one of our party (either Nathalie or Andrew) had need to go to the little house.  This person would not go by herself. So the both of us were wandering through this village, pre-dawn to go to the dunny.  The door to the Chief's house was locked, so plan B was enacted, and finished with one minute to spare before the call-to-prayer was announced.

The breakfast did create some problems, because we were expected to eat at another home, but went back to the bosses home. 

First call was a wander down the Main Street, up a path to a lovely waterfall, past Nutmeg , coconut (Palm) trees, then back to town for the impromptu Klinik, where mostly fungal skin conditions, and a lovely old lady, who had previously entertained us with a drum solo from her front door, with what was clearly an arthritis condition.   

We also made the time, to follow the hoards of children to the primary school, which was about 50 m above the village, with an amazing view of the Morotai sea. It seems that because there was Bule in the village, they were more fun than school.

We left the village with the boss telling us we would be welcomed back, and if we come back we will stay at his home.

Having dismissed the driver and especially his car, we contracted a local man to take us in his fast boat, further north to the island of Morotai, a two hour journey. This was to cost us r1.5m~ $150.00 between the six of us.

Surprisingly Indonesians are not renowned swimmers( go on name the last Indonesian Olympic swimmer!). The pale looking one is Litje our guide colleague, and not a good seafarer

We stopped on a coral island  Dodola, for a swim and look around.  It was  tremendously blue and clear but the coral reef was on the other side of the island. Then a short hop to a nearby island of Kolorae, for fuel, then to Morotai with minutes to spare to catch the Tobello  ferry.   Worried by the arrival of two military policemen, were pleasantly surprised to see that just wanted to help us scramble over to the jetty.

The KMS Gorongo is a car ferry, and the car floor had several trucks, many motorcycles, and hundreds of locals set up with their sleeping mats, the next two floors were enclosed, smokey and LOUD.....they love their loud music. 

The car deck

For our outrageously expensive. $1.70 ea for out 3 hr journey,  we were invited not only to the bridge deck( where one has to take one's shoes off as it is the 'master's' home) but to the shady side.  Maybe because we were the only white people on board?  Even if it was only sitting on the floor, it was lovely.  The girls, did, however, stretch the welcome, and clear the deck, by changing into dry clothes under sarongs.

 And having a Nanna nap on the deck....  Ohhhh!

Tobello, and shopping with Esther.

A million things at one time, tens of people who, at any given time, want /need/ require, demand Esther's time.   Miraculously, it seems that she is able to deal with all the crisis, medical, personnel, shopping, and still have time for everything else she has to do.   She seems to have hundreds of people who need her time at any given time, and amazingly well too, with what appears to be her tens of children    Peter, her husband is the constant 'voice of reason', trying(not all that successfully) to keep Esther on line.

Tobello doesn't deserve the Lonely Planet accolade of "grotty little backwater."

We went shopping there on Wednesday afternoon with Esther, and at various stages two to four of her children, her house keeper assistant Lisa (not Lisa V our co traveller) the driver Lody, and the other school bus driver Ronnie.   

It is about 45 minutes north of the Hohidia mission, along pretty good roadway, and quite reasonable driving.  Many of the houses are almost adjacent to the roadway, and there are definite Christian  and Muslim sections of the journey. The speed limit through some of these towns in 40 kph, ( being the first speed sign seen here) and the speed humps are lumps of old shipping hawsers across the road. 

Our shopping included spending $500 in donated money that Sandie had brought.  The mission decided that the money could be spent on supplying the set up of an independent kitchen for Tamariska.   Tamariska is the separated section of the mission which houses long term leprosy , HIV, and TB patients and their families who choose to stay with them.   The Indonesian govt supplies the TB medication but not the services to house or supply the administration of the drugs( ie the people to visit and give the drugs or the accom.) 

Tamariska

What was purchased were, a refrigerator, two rice cookers, at the fridge shop, some screws at the 'hardware shop', through the labyrinthine Tobello market, to the plastics shop, for some (surprisingly) plastic ware, to the cookware shop for the bottled gas stove, a Hock oven, which is an oven that is put on top of the gas jets, and four local range top steamers ( $4.50 ish) for us all to take home, big dishes, plates, and other stuff, then to Galaxy...which is the Woolies of Tobello.  Where small change is given in lollies. 

There is a story that the proprietor of a local shop found some compromising photos of her husband's very special friend on his phone.  Allegedly these photos were printed rather largely, with identifying naughty  features very apparent and posted over the front door of this supermarket.  Who says they haven't good sense of whatever here.  We must confess that we did indulge and had a ice cream here.

The market was pretty typical of many of the Asian markets we have seen,  mazes of shops, that only a local could negotiate, every colour  of vegetable imaginable, especially peppers and chillies, smells; mostly of fresh fish girts' and chicken innards, splashing into the open gutters , and very politely correcting the locals who have the audacity to accuse us of being American Oi. Oi Oi.

Something fishy here.

On the way back, just on the outskirts of Tobello we stopped at the house of an elderly gentleman who makes traditional wooden shields and swords.  Esther is asking this man to mentor some of the older youth at Hohidai, to continue his skills, which have been handed down for at least three generations at we could work out.

As usual, the kids loved having their photos taken, the pigs were rooting around the houses, and the locals were just sitting around enjoying the dusk.

Just enjoying the passing parade.

Screws/ ambulance.

There is parked in the carport here a Toyota trouper, 4wd Ambulance, that has had its electrical insides removed, dash, back to the firewall gone, and more bits missing than there, short of a completely new dash assembly and wiring loom, the vehicle is nor going to move. There was, however, quite some consternation when Kevyn, appropriated some screws and a bolt from the vehicle to make other things around the mission work like the  motor mower, hinges, table tops, waiting 'room' seats, door catches, etc.  So......there is a need for $50k for a new one, or at least a good high clearance two wheel drive vehicle.

Medical stuff.....provided by Nathalie.

The Klinik days are where the local, and at times not so local people come to what is a clinic.  Notwithstanding people seem to appear at the hospital door at any given time with various minor ailments, Thursday and Tuesdays ( or for the purist pedants Tuesdays and Thursdays) are the days that minor ailments are seen.   Major injuries and illnesses do not have to wait to clinic days.

The treatment is free, medications are free, and there is no rebate from the government.(with the exception of TB andHIV medicines)

A typical Klinik day for the visiting medical staff is as below, with explanatory notes....

Thursday

Slow beginning bought nappies for Lexie from shop.(Lexie is the two year old boy 'abandoned' and in the care of the hospital, his uncle and father is the same person. He sits, but does not independently walk or crawl, and is non verbal.  Toilet training is not widely practiced here as in the west, ( howdy parderner.), and it seems that eventually it just happens, so the visiting staff have taught the hospital staff to put a nappy, of triangular bandages , rather than just a plastic bag, on 

First patient 23yo male wasting syndrome treated outside just in case he had TB  then brought in

Vitals T 37.1   BP    HR 107 sats 94%. RR 48

IVC inserted bloods taken tested positive for HIV we had already diagnosed this

IV Cephtriaxone 2 gms given then challenge to start fluids with the parts we had in stock this is all about putting thing together to make do. Fluids in progress 15 d/m.

(Yeah, what she said)

Next pt in with ethanol use 2 months ago causing blindness came today hoping that they could fix it but too late. (Home made grog, pretty potent, and not much quality control, is a regular problem presented here)

3 rd pt  Victor who is fully adopted by Ester and Peter , came off his bike whilst going down the hill very sore and sorry for himself as Peter wasn't impressed with the antics multiple grazes and the front tooth chipped to the pulp? Off to see the dentist now.( what was not recorded on the patient's record was the fact that the Bule, especially Sandie, were encouraging Victor in his valiant efforts to ride up the hill on the only concrete road in the mission, which we later discovered was a practice banned by parental management)

The road in question, showing the scene of the crime.

Now all the pt have left the ED within the 4 hr limit.....how good is that!!!  Put Dandenong ED to shame.

Good news tooth root not exposed so it can wait till the dentist returns.(Victor's tooth that is).

Next edition dinner with the teachers, and visit to remote village Jere (Jeray).

So if we don't make it back, you know where to start looking

Duffer, Fair Dinkum, Chook and Bonza.

Andrew's mastery of the Australian language has been imparted upon the grade three class of the Hohidai primary school.  That, with his lack of  coherence of the maths cirriculum, will leave lasting scars on the development of all the trusting souls.  

The usual teacher, an Australian, (Hannah) has now returned, and management, if not the children as well, are happier, and learning heaps.

The children here have a unique opportunity to experience many real and not-so-real teachers from many countries, mostly Australia and the US.  The first half of the day is in English, and second half to about 2.20 pm is in Indonesian.   

Advanced life support

Every time Sandie comes here she undertakes to provide the medical staff with refresher Advanced Life Support classes. This includes CPR and tying people up and making them wear somewhat suspect neck adornments, then moving them on an ancient slide board/ stretcher.

The dummy whilst it still had a head

When Andrew walked into the room, and he was challenged to save the poor resuscitation dummy, not only die he rip the head off it, when he dropped the head, the jaw broke off, so there was. Quite a bit of mirth.

In the patient moving exercise, Lisa was volunteered as the 'dummy'. Sandie, as the risk management specialist took into all the aspects of risk, against probability and established a plan to protect the health of Lisa.  It went something like this....'if you drop her, you're sacked' .  Way to go Sandie,

Lisa, looking very relaxed...NOT.

The weather

The weather here, we are told is unseasonably dry.  It is still hot, and still very humid. Probably 70-90% all the time.   It is not very monsoonal for the monsoon season.  So we drink heaps, wee no much, and sweat lots and lots.    

Sandie feeding Lexie at the hospital, but he wanted the biggest piece of watermelon.

What is next.....how much more exciting can it get?

The Bakso man!

Rather than eating at the base again, we decided to travel  the few kms to Kusiri township, where there is a mobile restaurant, otherwise known as 'the Bakso' man, trading in the side street.  In the pouring monsoonal rain we got our bowls of what was basically a broth with tofu, boiled egg, beef balls, and noodles.  About $8.00 for four of us.

Bule

This is a term that we have become quite familiar with.  It means 'foreigner'.  And the Bule, were certainly a sight for the locals on this occasion.   

  Then back to the house for cola and Farkle(go on look it up).

The local taxi. Ox cart.

Sunday the day of rest began with a fruit salad breakfast, and it was surprisingly almost a tropical fruit salad, who'd have guessed!

Lisa, Rheese(NZ) Kevyn, and Sandie.

A Sunday visit to the hospital saw us eat at the base, rice chicken and noodles.

The 'ladies' were invited to the Scarborough's on Sunday afternoon for a local cooking class, led by Esther, and they made puffy steamed pastry, with coconut stuff inside it, and steamed banana stuff in banana leaf.  As you can deduce, cooking, too, is not the author's strong point.

The steamed pastry thingies.

Electricity.

The electrical infrastructure on the Island of Halmahera is such that, with apparent randomness, sections of the island are just cut off the grid for , one, two, three, or more hours at a time.  I am sure that there is a plan, but it always pays to have a torch handy, especially for the medical staff, even in the middle of the day.  The mission has a big diesel generator that is turned on if the power goes out at night, it kicks in.  During the day, it is just get along without it.  This is fine, unless you want water from more than one tap at the hospital, as the pumps supply all but one, gravity fed tap in the toilet.   There is a mission to sort out how we can get more taps that work, when the electricity goes out.

The tap thatworks

The medical reality

.....next

Dinner with the Scarborough's

Anke, the maintenance manager, and Kevyn, spent the morning surveying, designing, and doing the bearers and some floorboards on an accommodation bungalow, whilst Andrew was doing sport and maths for the grade threes.  

Nathalie and Lisa took the pre school and grade one class.  Because the room is near the wifi, Lisa was face booking and the comment was along the lines  that it was terrifying and they ( the children) were in full control.  That pretty much sums it up. It just so happens that Peter(the director) was checking his FB at the same time, and ran to the rescue.

You can feel the fear.

 Fortunately the letter of the day was "e', so the residual videos and photographs of the Sri Lankan elephants tied up 10 minutes of the lesson. 

After lunch, of chicken and rice, and a sort of sweet potato, Andrew returned with Kevyn and Anke and was swinging a hammer, belting,  nails in.

The building renovations. Anke (right)' Andrew doorway, Kevyn, Lisa and a glimpse of Esther. Two little souls in the middle were also helping.

Nathalie was in touring mode with Lisa, leaving their post at the  hospital and wandered down to check out the workers, visited the directors home and  Esther invited Andrew and Nathalie for dinner...pizza. 

Anyone who has been at  Caulfield Christmas dinner can begin to appreciate dinner with Peter, Esther, John, Christy, Molens, Theresa, Anna, Lillian, Lee, Daniel, Jasmine,  Victor, and several others  who make up grandchildren, adopted and non adopted children.    

The dinner table at the home of  Peter and Esther Scarborough.  The blond chick is the odd one out. We think there were 11 children.

 For example, John, the child this side of Nathalie was malnourished when brought to the hospital, (other siblings had died from malnourishment) and left there, his mother giving him up as dead. He was so sick Esther believed for quite a while that he was still going to die.  Each of the children at this table have what we would consider to be horriffic stories.  Parents deceased, mothers who were prostitutes, lepers(cured) , sexually abusive and physically abusive, step fathers who have killed mothers, and it goes on.  What is certain,  is the unconditional love, and feeling of family that is here for all these little souls.  Maybe they need to barcode the children, to keep track.

We were all then invited for brownies and chocolate pudding.  Esther doing a million things, was making the pudding based on Nathalies memory, and questioned if the baking powder was 'off', it felt looked and smelt not quite right.

The baking powder looks very similar to the garlic powder

It wasa lovely evening, seeing the love in action, and the length to which Peter's and Esther's words and actions meet a  practical and full on commitment would be hard to imagine.

The 'Dementors'

For those of you who are familiar with the Harry Potter series of films, would be aware of the dementors.

Practice for when they go back to Eastern Health, for entering the NUM's office, with a request.  Or yoga practice.

The beach

Our first day off was designated to be a visit to a beach about 20 ks south of Kusuri. 

The Scarborough family were our hosts. 

Nathalie and Lisa.with transport to the beach.... there were three others in the cabin and one in our car.

Three degrees north of the equator has to be quite warm, and it was.  White coral sand, a reef 100 or so metres off shore with many colourful fish and coral.  It was lovely, and we think there were 10 children there. 

 

And we had telephone reception for the first time in a week.The phone signal elsewhere has only been strong enough for SMS at best.

And John, dressed for the occasion.

 

The week so far

An apology/correction

It has been brought to my attention that in the last post, I used the word "enginuity" where the intended word was "ingenuity".  Hopefully not too many of youse were confused.

Dooff Dooff cars in Melbourne are amateurs when compared to the moving speakers that are the taksis in this area.   It is not just a bass sound thing.......it is a you can hear the whole song (many in Ingrish) for at least 500 metres before and after the vehicle passes.  And, and, and, whilst I am in a picky mood, they could do with some mufflers on motorcycles.  Bloody noisy.

Driving!

So far, we have borrowed a  minivan/ people mover, and finally the community ute, to travel to and from the house. It is about one to two kms.   Andrew is the designated driver (because the others are far too drunk after the post work drinks) and thus far has done o.k.  Hopefully the IDP ( international driving permit) that he hasn't  got has not expired.

Tonight, the two mini vans were missing, so it was either the standard Nissan ute, or the 3-5 tonne truck.  So we unloaded the ute, and it was Andrew and our two NZ colleagues inntHe front, and the other four in the tray........ Where is a camera when you need it.   Maybe in the morning.

As has been previously described, the roads and traffic are positively benign, when compared to other Asian localities.    

Klinik

Today was clinic day, but as these go, it was pretty quiet. So much of the time was spent in the hospital.  At this point we would like to thank our GP Dr Kevin Quek, for strongly recommending the outrageously expensive Japanese Encephalitis immunisation.  There is a strong suspicion that one of the patients in the hospital, has JE. Not that one can catch it from the patient, but it means that it is in the environment, and a very ugly disease to pick up.(Mosquito vector).

The main hope of having the expertise of the visiting medical staff, is to educate, advise, mentor, motivate, and oversee, best medical practice as is permissible by the relative lack of training, experience, funds, and clear lack of initiative of many of the staff.  One of the tasks undertaken is to survey the several large bins of medical supplies, most of which have been donated, to establish the usage, and if necessary dispose of items too far past effective use parameters. 

It is very difficult to work in a hospital when the water and electricity is a variable commodity.

Lisa, having an ECG, performed,after a hard night, just in case.  No she is not in AF. The steam driven machine with suction cups. BTW Lisa was heard to say "you see I still know how to nurse."

Many of the medical items not used, include specialised dressings, splints, various catheters, etc.  many of these are not used because the staff have not been (or don't remember that they have been ) trained, which is quite frustrating.

Some of the wonderful patients

I couldn't guess how many patients there are in Melbourne with JE, TB, leprosy  or malaria, but there would be many injured and long term I'll patients who are getting top notch care in our health system.  What makes the patients here so special is the rarity of health care options available.  A very severely disable person would be cared for, within a village, usually to the extent that they would have a hut, and food.   

There are several patients here who have an opportunity of a lifetime, to access care that was not possible to them before Hohidai, set up here.  There is a young man Tison, who many years ago was badly burnt, and was destined to a miserable deformed, and non productive life, in the village.   Coming to the mission offered initial treatment, then the opportunity for him to travel to North Americal to have his chin un fused from his chin, skin grafts on his face, legs, chest, and arms.

T is an inspiration years after the injury he still requires daily dressings to his legs, which stillsuppurate and smell.  He is very active which still causes problems with the wounds not healing, but if he is not active the muscles will contract.... He is always happy, loves a hug from nurse Sandie, and is as cheeky as they come.  His English is magnificent, is currently in the grade three that Andrew tries to teach, and he has the detimimination to achieve if he can continue to be given the chance.  It's all about $$$, that often is not immediately available.

Nurse Nat, and nurse Andrew dressing Tison's burns...Andrew is the one in the background with the gloves on.

But he is learning to do Tison's dressing, under close, very close supervision.

Octavia is a young lady who has spent much of the last few years at the hospital

Thirteen year old Grace, who with the determination of volunteer Peter, and ingenuity of Kevin,  You should see the smile on her face.

That is all.

What do we do?..

Having signed on to do whatever was required of us, resulted in the Indonesian education system (especially grade three maths) being set back 10 years.

After morning prayers, it is expected that the medical staff will report to the hospital/clinic by 0800, Kevyn, tracks down the maintenance 'manager' to see what is on the agenda, and Andrew has ended up in the school.  As there is s severe shortage of teachers here at the moment, Esther, the director, who is not a trained teacher, is trying to keep the school open. 

Some of the Grade three class

With a three second briefing, Andrew was landed in a grade three class with 17 little souls. Mostly all by himself.      His mission has ranged from maths concepts such as scale, measuring a tv (diaganolly) then order of the values.  Then there was the bahasa  Ingrish session.  The children have amazing grasp of English.  Why teach the children English? It was explained to us that if these children have another language they have an enormously greater opportunity to expand their studies and opportunities after school.  Many of the students are orphans, some are children of the workers, and some are paying ( they'd want their money back for today) customers from the local village.

The food

As previously described, the food is local fare, but we suspect that the visitors are given the lion's share of the better quality stuff. 

Breakfast is taken at the house and usually consists of sweet bread toast, with jam and fruit.  Hot water is one of the taps from the water 'cooler' bottle.    Tap water is a big no no.  The water is imported in the big bottles from the bore at the mission.   

Lunch at midday,  is taken at the  communal hall, and can consist of boiled rice, fish bits in hot water (soup Nathalie tells me)' fried chicken bits, beans with lots of spices, fresh cucumber, and fruit.  

Fish bit soup

Dinner at 1800 hrs, in same place is pretty much same as lunch.   

I'd be thinking that weight putting-on will not be a residual issue from this expedition. 

The medical side

O. K the secret will be shortly out.  Nathalie does not write all of this blog... So the medical side is somewhat brief.

And then

After teaching, Andrew and Kevyn, watched Anke, the maintenance manager and his team, pull up an immersion pump from one of the 35 m bores on the property.   It was no easy task, but as easy as it could have been with a crane, winches, and a clear area, this was done with much enginuity and many  hands, the full length of the galvanised pipe and pump was pulled up, pump replaced rewired, and the whole lot put back down the hole.

Then we finished fixing the linen  cupboards in the hospital.  If Jerry had a failed apprentice, he would have been the one to have built this cupboard.  No two screws were the same, all the hinges were skewed, and the locks were all broken.   Fixed as they are, I doubt that they will last 12 months.

The 'fixed' cupboard.

We then briefed the boss about having the cupboards cleaned out properly. The wasp nests on the top  of the cupboard was indicative of the scheduled maintenance in place. 

There is little initiative in the system here, as one would expect in Melbourne, everyone has a very narrow job description, and does not see that things that need doing needs doing by them so it doesn't get done.  Like whose job is it to clean the thick layer of dust from the bottom of the stores cupboard: like the need for contemporaneous complete and consistent patient notes.  Sandie and Lisa, have tried for years to create a sense of initiative, but this seems to have fallen victim to lack of consistent close management and accountability of the staff.

Incongruous photo of Halmahera from the airplane

Another incongruous and non sequitur photo of Lexie.

Hospital Tours initially 19/1/14 - reposted with minor amendment.

Epen, who is the, new volunteer, liaison person, met us after breakfast, where he gave is advice as to the local customs and mores.  Many of these are quite generic across Asia, so weren't all that foreign to us.  It is always well worth brushing up lest we risk offending our hosts.

Right hand for eating, don't point, eat all that's on your plate, don't expect your host to eat with you, it's ok for males to hold hands, but not ok for males and females to do so in public.  It's all about respecting where one is, and the people.

Then we caught a 'blue bus' which seem to be bus like taxis which travel along a given route, but for a bit extra will go out of the given route.  The traffic here in Manado, is busy, crowded and frenetic, but is not a spot on Colombo, phnom pehn, or Saigon, were little horn honking, absolutely no aggression, but not very fast.  Sandie was commenting on how the relative costs have risen since last year, but compared to Melbourne, is quite cheap.

Visiting the 'Base' in Manado, was a very welcoming experience.  The NGO/Aid organisation was initially set up after the 'horizontal/religious' conflict in the region. There were many thousands of people(on both sides of the conflict) killed and hundreds of thousands of people displaced.  So the early 2000's was not a good time.  May who is the treasurer of the group, told us of her story.  Because she and her family were from the minority group they had to flee first to the police, and when they could not assure their safety, they went to the army base and then it was strongly suggested they flee to the island of Sulawesi as refugees.

(Eo&e)It was there she met Peter and Esther ( ex pat Australians) who provided the base which was a refugee medical/ social / welfare centre, dealing with hundreds of people a day.   

When the. 'Troubles' settled down and land was cheaper inHalmahera, the hohidia centre was brought and the clinic/orphanage/school, was begun.  (This is a very potted version of the story that May, told us)

Accompanied by Epen and his fiancé (getting married in two weeks time)we were given the opportunity  to have a look at the Manado public hospital, particularly the ED.  It was an eye opener, quite a new building, yet, ancient furniture and equipment.  It is the expectation here that the family will do all the care other than direct medical intervention, which includes providing and feeding food, washingpatientsand clothes, bedding etc.  There seemed to be many many people in white coats, not doing particularly much.  Kevyn and Andrew, being the non medical 'ring-ins', nodded and smiled at the right time.  By our (eastern health) standards the level of infection control, primary patient care, medical intervention, was a touch under expectations.  Lisa, did, however, recognise many of the ECG machines as the ones used in the days past.   What was clear was the pride with which the local medical staff displayed their facilities, and were mostly happy to explain the processes.  I think we worked out that the ED at Manade hospital would see 150+ patients a day! 

Photos have been removed due to very narrow bandwidth and unreliable service

Then Maya, who is a nurse at a non government hospital, took us for a tour of her workplace, which was very interesting, from the comparative view point of our group.  What is clear is the important role of the family in whole patient care, whereas in Melbourne the relatives etc tend to get in the way, especially in an ED setting.

Maya's workplace use your imagination......

Then the 'shopping' started, not satisfied with the supermarket, there is yet, in Manado, a (an) Hypermart, and yet again, a Megamart.  Whilst I am unsure if a hyper is bigger than a mega, they were pretty much of a muchness.   Couldn't wait to find the super-doper wonder mart.   We did manage to source all we needed.

Monday 21st- Monado to Kao (cow) by biplane.

Bit of a shame to spend all that money and have to leave the hotel at 5 a.m.  But that's what happened.  We had 30 or so kgs excess baggage, even after we put all the heavy stuff in the boat pile.  The inter island flying company had reduced baggage to 10 kgs each.

See imaginary photo of our baggage for the boat

Having been advised the time of the flight has been put back to 0700, from 0640, we thought the ground staff were quite effusive in waving us through the gate.  We had not been told the flight had been reverted to the original time.    So we were the last ones on the plane. The flight was un eventful, the landing successful, as was the take off.(not in that order). What was concerning was three meter wall of earth at the end of the runway, to catch the ones that didn't stop.

Imaginary photo of the landing showing whirling propellers.

We were collected  at the airport, but had to wait the longest time for the one luggage trolley to unload the outgoing luggage into the plane, and then collect our luggage from the runway to the arrival 'lounge'  (shed)

It was, to our experience, a very civilised drive to the accommodation, paved road, no more than five horn honks a km, all windows intact, 80% or more travel on the correct side of the road and the volume of traffic was somewhat light.   

The accommodation is a large house, one k or so south of the compound, in the town of Kusuri. There is a New Zealand couple staying there too, but we get the impression that they seem somewhat overwhelmed by the new arrivals..... Even more than reserved than Andrew, who is one of the quieter of our group.  Well that's life.    

The compound is amazing.  There is the clinic, a 14 or so bed hospital, a school, an orphanage and lots of stuff.  The tour also encompassed a visit to the TB seclusion huts, the completely separate compound for the long term residential HIV, leprosy and TB, patients and some with their families.

Met Peter and Esther, who are the directors of the mission.   

At the hospital we were all introduced to all the patients, bed by bed, it was almost like the grand  rounds. In a description, dispell all your concepts of what a hospital looks like.  The beds are quite old with a bottom white sheet and then the rest is Indonesian.  Rarely are the guests dressed in P.Js and never under any covers other than their own clothes.  The whole (and I mean whole) family are often staying in the ward as well.  This is because often the patient's home is many many hours away, and there is no money, nor infrastructure to permit movement between hospital and home often. 

Some of the conditions are HIV, burns, ulcers, abscesses, stroke, T.B. Fractures, urethral leak, seven cases of Malaria, and some long term patients, particularly 16 year old wheelchair bound young lady and a three year old developmentally delayed boy.   The boy, who I will call 'Lexie' has virtually been left to the care of the community.  The last time the team visited, he had not ever been moved from his back. Whilst still not verbal, he is now sitting, supported walking, and lying on his tummy.  The aim is to get him to crawl during our visit.

Dinner and lunch are eaten in the communal open hall, but the bule (foreigners) have their own table and unfortunately we feel that we are being given the better food. The staples are rice, a bean curry, and an orange coloured potato like dish.  Thee is also a coconut and juggery (Palm sugar) drink with slabs of coconut flesh in it.  I am sure that there was a bit of fermentation happening  there too.

Now it seems the staff have been threatened that Sandie is on her way,  and apparently they have been scrubbing the place silly.

After dinner there was a religious service, where the team was introduced, and like wilting flowers we borrowed the missions vehicle , Andrew driving, and went back to the house, showered and bed.  And they drive on the correct side of the road. 

The first day!,,,",!

Up at 0637 hrs for a quick breakfast and dash to the Compound for morning prayers then Nathalie was off to the Klinik, and Andrew was gifted grade three maths, and prep reading, to lunch time, then 

After lunch Andrew and Lisa's father Kevyn, took to fixing the doors falling off the linen cupboard, in the hospital, which is a work in progress.  There are so many minor maintenenance tasks which will be very well serviced by kevyn's enormously diverse areas of expertise.  

(Not and imaginary picture).  Part of the Klinik (r) hospital centre and the TB seclusion ward on the left. Building in the back ground with the pointy roof is the eating hall.  

Don't know when the next blog will be as internet here is horribly unreliable and very expensive.

Hope all youse down there are well.  We haven't caught malaria, dengue, or Japanese encephalitis.

"You made me soil my armour"

Silk Air flight to Manado was un eventful, though it was a pretty old, steam driven, Airbus.    Imagine, if you can, no personal video screen on the seat,  nor DVT socks.  Plane not very full so all of us managed to stretch out on three seats.  Having been going for 30 or so hours the rest was grand for an hour or so.   The approach to Manado was quite wobbly, and the runway(post touchdown) was pretty bumpy too.   Any landing you walk away from is a good one. There was a queue (counting us) of one plane at the airport, so the milling crowd was a major issue.   

Not that we were doing anything unlawful, or sneaky but due to prior experiences of Sandie and Lisa, we had been expecting legitimate  close attention from Customs  because  of all the medical supplies we were carrying.   Andrew even ' fessed up to his narcotic'medication.   

Now in the context of Monty Python (The holy grail) we had all figuratively 'soiled our armour' expecting the legitimate Customs enquiries, demands for Duty...   

Well 'someone' was looking after us.  It was described by Sandie  to the effect that 'it was like we were invisible'.  The Immigration  and  Customs, were relatively quick, friendly and not the impact we had been anticipating.

Outside the airport was pretty typical of many Asian airports, the apparent mayhem, noise, and smells. After Melbourne heat, the humid 27 deg over cast day was blissful.

We were met by Epen, who is the Manado representative of the Hohidia settlement.  He finessed the obtaining of taxis for us, and negotiated the ~$15 fare for a Melbourne $100 distance.

The monsoon floods of the last few days are well evidenced, on the drive from the airport, with debris high up in trees, mud lines several metres up walls, and for several kms a brown slimy mud covering everything.  Absolutely treacherous for the motor cyclists, two of whom we saw slip over. Whilst it is interesting for us to witness, it must be heartbreaking for the locals, who have 13 dead and many missing, and obviously many of the houses we saw won't  be habitable for many weeks. The town is big enough for our presence not to put any adverse effect on their recovery.  

Slick slimy mud...everywhere.

Epen, a local man, having lived in Melbourne for a time has excellent English, patience is better.

He would have spent nearly an hour trying to sort out our mobile phone SIM cards.  He will be our guide and educator tomorrow, so we are looking forward to it.

We have rooms at the Aryaduta hotel, which is (to our travel standards) pretty posh, hot and cold water sheets, lifts, a restaurant, and 24 hour reception, and a no cockroach policy. Must be getting soft!    

Yes it is a maccas! Just beside the KFC

We are on the 8 th floor (7th really because they don't have a floor 1), with pretty good views, of the harbour, and ferry terminal.

James, this is a test to see if you have read this far....if so can you copy and send to your PGF.

Very big day, so goodnight