PNG - Hagen to Kompiam (Week One)

So after arriving in Hagen and chilling out for a night at the Kimininga Hotel directly next door to the Baptist Compound (and paying a retarded amount of money for a barely 3-Star room) it was time to go and do some shopping for the next 6 weeks up in Kompiam.  First stop was the best buy - and man, did I have some fun in there.  It was a fascinating mix of familiar foods, twists on the familiar and stuff which I had never seen before in my life!  Loved it though :) ... and probably went a little bit overboard with the food purchasing ... but there was no way I was going to starve while I was there!  I think by the end some of the workers were taking pity on me - haha - and came and helped me try to steer my way overloaded trolley.

Next stop was the Hagen Vege Markets - totally amazing place!  The food looked (and tasted) absolutely amazing .. and was ridiculously cheap!  It cost about 2kina for a 'pile' of broccoli - about 4 heads - which works out to about 90cents!  and that was one of the more expensive vege.  Piles of sweet potato, capsicum, zucchini, carrots, taro, kumu, peanuts, oranges, mandarins, sugar fruit (a delicious cousin of the passionfruit), bananas (and I had no idea how many different types of bananas there were - variations of cooking, variations of eating), apples and so so so much more.  You could buy a chicken, noodles and so many things!

After this it was time to head off on the actual drive out to Kompiam.  It was a beautiful drive - incredibly picturesque - and good company getting to chat to Dr Mills for most of the trip.

Bathroom Stop .... Not bad surroundings for it!

Ps Andrew taking a nap in the back of the truck during the ride! Actually ... I don't think it would be possible to actually nap in the back of these things while on the road .. its pretty wild with the crazy potholes!

We arrived at Kompiam a little after 5pm on the Saturday afternoon ... about an hour before it was going to be time for my first 'Bong Tea'.  Which is the weekly group dinner between the ex-pats in the compound as well as the doctors.  Seeings as it was far too late to do much else my contribution this first time was a block of chocolate - which was more than sufficient!  There were so many people to meet and to try to get my head around the families in the place.  The Mills family have a total of 6, and are looking after another 3 girls, another family - the Conwell's, have 5, the Bryson family are 5 also and the Totome's are 3+1, a week later another family - the Smith's - also arrived and they had a total of 5 also.  Once these people are accounted for - there is then the extras and add ons - like myself, and other students/doctors who are visiting for a time. So, a whirlwind of meeting everyone and trying to sort out names and faces in my head but a really pleasant night all round. 

The following morning was Sunday - and being at a little bit of a loss I ended up getting out and going for a wander around the compound.  Ended up running into a few of the Mills girls and Dr Mills and so ended up going along to church that morning with them.  It was definitely an interesting experience.  The service was in Pidgeon and Engan, went for almost 3 hours and it was spent sitting on a concrete floor ... yep - I was feeling it by the end.  The other catch is that there are only certain ways which you should sit as a 'lady' in church and so I wasn't able to sit in what would be the most comfortable for me .. with my knees bent right up against the wall ... lol!  Managed to survive it somehow though.  Later that afternoon I went for my first visit to the hospital - for a ward round with Dr Pete - one of the Aussie Drs who was over there for a short time (I think it was 9weeks all up).  Met some of the patients and staff and started to get orientated to the place.  

View looking up one of the wards,this is replicated in the other direction as well - this is Surgical Ward, and the Medical Ward is behind.  The Paediatric Ward (and current labour room) makes the downward stroke of the 'T' shaped building

Outside looking down - there is a storeroom, TB Ward and Postnatal Ward

Looking back and into the Paediatric ward - such cute kids!

New construction for the kitchen.  This hospital is one of the few which provides food for its patients.

Living Life
For the first week I was by myself in the house which I was staying in.  Which was quite nice, however also meant that I had a lot of small visitors in the children from the compound.  I would, most afternoons/evenings, have a knock on the door and a face or two outside asking if it was alright if they came and visited me.  Was quite a bit of fun - having a short chat about their day and what they had been up to and giving them a biscuit or two (which I think is what they really came for). I had also made the mistake of leaving my food out in its boxes (as I was only going to be in that house for a few days initially so didn't see any point in packing stuff away properly) so that also had many of the kids wide eyed at all the food.  Once I realised what was happening though - I moved that away as quick as I could! Out of sight = out of mind.

Shamiah - one of my many visitors

One of the excitements in the first week was the first game of State of Origin.  The people over here are equally - if not more in some respects - enthusiastic about the Origin than most Australians.  While I was down at Tufi one of the guys was making a comment (I don't know how much of an exaggeration it was) that in Port Moresby TV sales go up the week before origin .. and then the week after origin they go up even higher ... this is due to the fact that they take the game so seriously that when their team isn't winning all sorts of fights break out and the TV usually ends up being turfed out the window and breaks! There must be some truth to it though, as weeks later when I was chatting with some of the PNG National Medical Students they were commenting on how they were glad they weren't at the main hospital in Moresby at origin time as the ED gets crazy with injuries from fights.

Up in Kompiam the TV reception had only just been reconnected/satellite installed in the weeks preceding and so many people were still to actually purchase TVs for the event.  As a result there was a great gathering at the Mills' house as they opened it up for the first game.  It was a fun night ... even if the outcome of the game was less than ideal ..

Everyone on the edges of the seats for the game!

The first Friday night there was also a movie night over at the Mills' house where we sat down and watched an old war movie called - The Longest Day - it was not only the longest day but also a pretty darn long film!  Quite interesting though, especially if some of the stuff depicted was actually true.  Otherwise the week was spent in a flurry of visitors, cooking dinner, and generally settling into the place.

Hospital Stuff
My first week up in Kompiam was definitely eye opening.  There were patients arriving who had all sorts of wonderful infections with TB - and not in the chest.  Lumps n bumps and other infections all said to be from TB!  There was also a lady who had had a mastectomy due to a fungating breast tumor who had amazing (but not in a good way) enlarged lymph nodes and other lumps in places that shouldn't have them due to the cancer.  Another lady who was recovering from a chop chop injury to her forearm, and also a whole lot of gorgeous little kiddies who were quite sick.  One of the boys was a little one called Kurapi - he was gaunt and malnourished.  For a 10mth old little one he looked barely 3 or 4 months old - more on him in a bit.  There was also a little 1week old baby who had a very nasty chest.  His oxygen sats at one stage were in the 60s and we could hardly get it up to even the high 80s, let alone the 90s where it belonged.  And there just isn't the NICU or facilities to get invasive in your treatment and monitoring.

With all the patients you are going on observations, clinical exam, some limited investigations - such as haemoglobin level, BGL machine, malaria spot tests, syphilis spot tests, HIV testing, Hep B (I think) ....... no FBE, Electrolytes, Urine or Liver function .. or many of the tests that we all take for granted and usually order as soon as a person walks into hospital.  There is  an ancient ECG machine which they had recently got going, can do TB AFB sputum (but not serology), urine dipstick (but the dipsticks are too old so you don't trust them), ultrasound (but you are the person doing it so depends on your skill and confidence), and x-ray.

Now, X-Ray.  I was very thankful for my past as a radiographer.  It came in incredibly handy!  At the hospital they use a mobile machine, upright and table bucky, with film/screen combo cassettes and darkroom processing - but fortunately in an AGFA processor and not dip tanks.  I became the new x-ray tech and got to work in discovering how to get the best possible pictures out of what was there.

Kompiam Imaging Room .... Take a walk in the past :)

We saw so many pretty unreal things in the x-ray department there.  Day one I did a chest x-ray on one of the patients who had a respiratory problem, likely infection, and the image showed very typical TB picture complete with cavitating lesion in the lower segment of the L Upper Lobe and fluid level.  The very sick 1 week old baby ended up with a chest x-ray also and that showed that there was collapse of one of his lung lobes and it had pulled his heart over to the right side of his chest. This then explained why you could hear his heart so much louder over on the R side of his chest than the L.  The little guy was amazing though.  With antibiotics, oxygen support and a whole lot of prayer he pulled through and the infection resolved.  We took a chest x-ray afterwards and the heart was back in the middle of the chest where it belonged and you wouldn't have believed that it was the same person.

Little Kurapi (the Marasmic Child) also just wasn't improving all that well despite feeding him as best as possible.  One morning on ward round one we found out that the carer of the little guy mentioned that he was getting feverish overnight occasionally and also had a bit of a cough.  Even though coughs and being sick is pretty normal in someone his age, and state of malnourishment, the fact that he wasn't improving meant that there must have been something going on.  So, we decided to do a chest x-ray on him also ... low and behold - another chest which was highly suggestive of TB.  We started him on TB treatment and such an improvement!  He started putting on weight appropriately and developing into a real little character!  He was one of the highlights for ward round from there out.

Little Kurapi about a week before I left ... how could you say no to that face

Also that first week was quite busy.  Tuesday was spent out immunising school kids.  We drove to one of the villages about half an hour away and got ready to do some measles vaccinations.  The school was up these crazy steep dirt stairs which made me really glad it wasn't raining ... else I would have more than likely broken my neck slipping down them!

The building on top is the elementary school we went to first

The elementary school .. at the top of the staircase of death

Up at the Primary School

 Measles had broken out in PNG recently, and that week it officially was a problem in Enga Province with 66 cases being seen in the provincial capital Wabag.  A major problem with the vaccination program, however, was a rumour which had been going around PNG.  The rumour was that the 'white men' were going around and injecting children with '666' and that was what the vaccination was.  So .. what we would often find would happen is that you would rock up somewhere to do immunisations, and then half the kids would jump out windows and take off into the hills as quick as they could!  Did not make life easy, particularly as it was for their own good.

There was also a few theatre cases that first week.  I was lucky enough to get to scrub in and assist for one of the cases and do some of the anaesthetics.  I also got to intubate one of the patients!  Was quite a rush - particularly the part where the tube ended up in the right spot and the patient didn't die!

The Thursday was spent at a clinic in Aiyokos.  I decided that the clinics in these places should be called Extreme GP.  You see so many patients, with an interpreter who may, or may not, speak good English and so you're half muddling your way through trying to work out the story from the patient and then praying that you got it right and are treating the right thing with the patient ..... Gah!  But, got to do a few fun things as well, like insert a Jadel which is a cousin of the Implanon, except it has two rods which you put in in a 'V' formation.  Also there is this crazy bridge on the way to Aiyokos which had been broken a week or two before.

Great Bridge to drive across .... right? PS - love the PMV in the background - they are the main public transport between towns/villages in PNG.  Just pile on and pay and off you go.

For most of the part I walked back and forth across it as others got ready to actually cross it in the trucks.  Just need some precision placement of the wheels and the PNG cureall when in doubt .... 'Give 'em 60' ... to get across.

Just to finish the week of weird and wonderful things that I probably wouldn't do anywhere else ... That Friday there were a few cervical biopsies which needed to be done ... and I got to do one of them!  Crazy, and harder than what you would think!  But .. successful I hope (for the patient's sake!).

So that pretty much brings me to the end of the first week up in Kompiam ... I think!  Will keep on plodding through the next little while to try to remember and write about all the stuff which I got up to :) .

PNG - Tufi to Hagen

After waving goodbye to my new friends .. and the owner of the resort started half harassing me as to what I was going to be doing while I was there for the rest of my time .. I thought it was about time that I actually got out and about and saw what the place had.  I went on a short walk along the finger of the Fjord which I was staying on and met a few of the locals and learned a little more about the history and day to day life.  Also saw one of the butterfly farms (or at least pretty place to attract caterpillars to hopefully want to hang around and become butterflies) and down to a place called suicide point - stories of people accidentally - or intentionally falling to their deaths.

Coastal Hut - Normal local houses down these parts

View along another finger of the fjords

Shells often used as decoration

Crazy trees which they often climb up to get fruit and nuts from

Lovely locals setting up to sell me things ... how can you say no?

House under construction

View from the butterfly farm ... I'd totally stay here!

One of the caterpillars who thought that they would too :)

More of the fjord - just at suicide point

Beautiful place which I wish my pictures would even start to do justice to!

Coconut for the road ... don't mind if I do!

Later that afternoon I went for a bit of a swim/snorkel just off of the jetty at the resort - and met a whole bunch of people from YWAM who were there finishing certificates in Primary Health Care.  It was such a blessing!  One of the girls was actually the sister of a great friend from Adelaide so I felt an instant connection with them all - and it was so good to chat and get reminded of the important things in life.  They joined us for dinner that night at the resort.  At the same time another boat also came into stay at Tufi.  It was a big game fishing boat run by some American's and with a pretty multicultural crew including some Aussie's and PNG Nationals.  They also ended up hanging around at the resort - so while I was the only official guest of the resort for those few days - there were still heaps of people around to keep company with.

The following day I went for a  tour down to one of the other villages on another finger of the fjords and had a bit of a look around.  It was again great just to see everything and to get to know the people and their culture a little better.

Cabin along one of the paths

My lovely guide for the few days around the villages

They had made a dam to start a plumbing line to the village

One of the elders - busy translating one of the prayer books into their local language!

Another group of guys hanging around to chat with - all mad Queensland supporting Origin people!

And of course - everyone wants you to buy their goods

Beautiful little beach at the village

Funky looking trees!

After getting back from the walk it was time for some afternoon tea and to chill out a little more in my favourite hammock.  Such a hard life ;) .  Dinner again was with the group from YWAM and the American boating people and we enjoyed another sing sing from the local guys.  It was one of their birthdays and so the kitchen staff had cooked him a birthday cake.  It was hilarious - they finished their songs and then were having a chat with us when the cake came out.  After that - the little guy who's birthday it was pretty much was upping the rest of them to get out of there ... so they could go home and eat cake!  Fantastic.


Sadly - the next day was my last and it was spent hanging around the resort looking at a few bits and pieces and getting ready to head to Moresby.  I wasn't able to get onto the guy who was going to pick me up from the airport and take me to where I had booked accommodation at so I gave Cate a call.  I arrived safe and sound into Moresby and was picked up at the airport by a group called Black Swan with Cate leading the force.  After hopping into the car she then let me know that they had been discussing my accommodation situation and offered for me to come and stay with them at the Ela Beach Hotel for free!  I definitely felt that I couldn't turn that down - as I had no idea what the accommodation I was going to be staying in was actually like.  I ended up spending a lovely few nights there with another of the AEC ladies, Thelma, in her apartment and we enjoyed a lovely fancy night out for dinner the second night I was there at the 'Grand Papua' hotel.  Sadly I didn't even think to take photos of these lovely ladies while we were out for dinner (silly lapse on my part).  Was such a blessing and a great group of people looking after me while I was in Moresby.

For the day in between I went out and about with Debbie and thoroughly enjoyed myself.  We went for a sightseeing drive and to the botanical gardens, one of the big shopping centres, and out to the war memorial.  Was a great day spent with some good company!  The war memorial was certainly one of the more sobering stops along the way.  Unbelievable sacrifice was made there.

Pretty his'n'hers birdies

Cassowary and Baby ... Still would never like to meet one in the wild!

Funky bird of paradise

One of the many monuments in the gardens

'Peek-a-boo'

Its a hard enough life - just holding up this pole.

Pretty flowers .. no idea what they are though!

Totem Poles!

At the War Memorial

More War Memorial

War Memorial

At the War Memorial

War Memorial

War Memorial

War Memorial

Topographic Kakoda - at the War Memorial

Part of Moresby .. From a friend's veranda

After the unexpected fun (when initially realising and being slightly daunted that I was going to end up with 2 nights and a day in Port Moresby) it was time to head off for the main event of my stay over in PNG.