Passport and Visa

Finally got my passport with my visa in it. I feel relieved and glad with my passport in my hands. It's quite a boring looking visa. I was expecting something nicer I guess. I guess all visas look quite boring. Now there's hardly any blank pages in my passport. Well I'm due for a passport renewal next summer.

I have one week before I leave to go to my cousin's wedding in Singapore before heading out to PNG. I am looking forward to it as I will be seeing some family I hadn't seen in a very long time. We're not staying in Singapore long as there's not much to do there but eat and shop. After that we are heading out to Vietnam for a small holiday before Ingo and I will say our goodbyes. We are staying mainly in southern Vietnam--Ho Chi Minh city (previously known as Saigon) and Mui Ne Beach where we can windsurf. We hadn't gone on a long holiday since our honeymoon last year so we are looking forward to it. Ingo really needs it as he has been working so hard.

This morning I went to the lido. I had to psyched myself up to going to this outdoor unheated pool. I've been doing this for years here in the UK and you would have thought I would have no problem. I hadn't gone all summer and for the first time this year, I've been thinking why torture myself so I don't push myself to do the things I normally do. If you've never been to a lido you might not understand, the pool water is very very cold even in summer time b/c it never gets that hot to heat up the pool unless you get a week of very hot weather which is unusual here. So this is usually the drill, I bring my long spray vest (not exactly a wet suit--easier to put on and take off--it's like a thick long tshirt. The drill is I prepare myself mentally, sitting at the edge of the pool debating if I should go into the pool or not and why I do this to torture myself. Then I plunge into the pool and hyperventilate from the cold half the length of the pool, then swim my lengths. I can usually tell how cold the pool is by when my toes and fingers are frozen and how slow/fast I swim. On a good day my toes and fingers don't freeze until the 4th or 5th length. The colder it is, the slower I swim and it also takes longer for circulation to come back to my extremities. I'm sure I won't have this problem in PNG. But they don't have a pool but a crocodile infested river.

I went to the GP yesterday to get anti retroviral medication in case I get a needle stick injury and need to take these medication to prevent from getting HIV. These medication are expensive and technically the GP could have said no b/c it's not part of NHS what I'm doing. The GP was really kind and prescribed it for me. A friend of mine said that cost about £600 if I was to pay it myself. So I'm very thankful. To tell you the truth, all the doctors I've come across has been so helpful ie the consultant who read my Chest xray that I needed to apply for my visa. We don't get that much perks working for the NHS and this is the only time that we do so I'm eternally thankful.

Suturing

Today I went over to my friend Sam's place for a lovely lunch. It was really great catching up and she gave me a crash course on suturing for dummies. I feel so much better now. See as a medical student I was taught how to suture by other doctors, never from a book. So it was wonderful to have Sam go over that with me again. We also discussed surgical cases, how to suture what when, when not to suture and leave wounds open..etc... This has made me feel psychologically better and maybe slightly more confident. The surgery book Sam has recommended is on its way (I've ordered it) and it has lovely nice pictures to show you how to operate and what to do in resource poor setting. Sam has been to Nepal doing doctor work so she knows what it's like out there.

Things are coming along. Tomorrow I will go to Papua New Guinea consulate to see if my passport is ready. Didn't realise but needed visa for Australia--very easy to get--via internet and credit card, it was approve in 30secs. The next two weeks is jam pack with trying to meet up with friends, reading, appraisal for GPs, tax return...etc.... I also got the sonicaid which I bought from ebay.

In the midst of all of this, I nearly forgot a good part of yesterday and this morning, I was talking to police, car insurance, car rental co... because our car was stolen. It was parked right outside our house and the next day it was gone. No broken glass found. We didn't hear anything funny in the night either. Ingo and I are a bit baffled why anyone wanted our car. I mean it's 7 years old Volkswagen Golf, box standard silver car. I mean you see this everywhere in UK. I hadn't even wash it for 6 months or more. So it's a bit dusty but I always told Ingo I do it on purpose to prevent theft but obviously that theory is out so now I have no excuse to not wash the car. So tomorrow on top of everything I will go to car rental to pick up a car. The police suspect that it was taken for scrap metal as demand for metal in China has increased. So there you go, that's what can happen if you live in the city. Makes you feel slightly vulnerable though. It's also very inconvenient. Nothing compares to what all those people up north of Uk having to go through with flooding and all.

About Kikori

Some of you may know this already about Kikori as I have put it on my leaflet.

Kikori Hospital is located on the South west Peninsula of Papua New Guinea, near the capital city of Port Moresby (2hrs by plane). The region is marked by tropical forest, and the hospital is on the banks of a River. There are few roads, and most travel is by boat or by air. Average temperature is around 30C (86F) and varies from about 22 C (72F) to 40C (104F) with high humidity. An anthropologist who lived in Kikori in the early 1900s described Kikori as a place of great darkness where every conceivable evil practice was carried out. An early Scottish missionary and his English co-worker was cannabalised at Kikori in 1901.

Gulf Christian Services is an interdenominational evangelical mission which runs two hospitals and trains health care workers. Kikori Hospital is the larger of the two hospitals.
I will be the only doctor in an 80 bed rural district hospital, run by Gulf Christian Services but government owned with 41,000 patient episodes a year. There are about 250-300 deliveries a year and deal with whatever comes in. Emergencies can be sent to the capital 2hrs plane ride away (if they make it). The nursing staff see the vast majority of patients. Most people understand English and speak it with varying proficiency. The other two main languages are Pidgin and Motu.

According to the previous doctor :
--There is a phone but can be out of action for several months at a time--even when it works it cannot cope with even a plain text email
--beautiful river but has rather large, active crocodiles
--There is a generator which runs a couple of hours in the morning and again in the evening and goes off about 10pm
-- Strong dependence on sorcery and witchcraft and all the immoral activities that goes with it....

Plane ticket

I finally got my plane ticket. I really wanted to meet up with some missionary friends in Jakarta but it would have cost me over £2,000 British pounds. It would have been cheaper for me to go back to London, and then buy a completely different round trip ticket to Jakarta. So it looks like I won't be able to meet up with them for new year's. I will fly from Singapore to Cairns on Aug 26. Tomorrow I will be meeting with Marie who will help me try to get some cheap equipments ie sonicaid (listening to baby's heart sound), sphygmamometer (blood pressure check), glucometer (glucose check)...etc.... As I have all my vaccinations done, all I need to do is pack my bag. I need to get a LED torch to help if ever I need to suture in the middle of the night. Yes I will not have electricity. Apparently there is a generator that runs two hours in the morning and two hours at night. I am going to sweat to death at night. I don't think I have ever slept without a fan in tropics humidity. I vaguely remember one night as a kid in Malaysia when the electricity got cut off and our fan didn't work and I could not sleep a wink from sweating. Perhaps I shall get use to it and acclimatise to such weather or exhaust myself eventually from sleepless night that I will sleep in whatever condition. I suppose if I had to choose to be in sweating heat or freezing cold, I'd rather be in sweating heat. We'll see I might change my mind later.

Awaiting Visa

My very first blog. Quite exciting. Visa is approved on the Papua New Guinea side (Port Moresby). Just waiting for the stamp in the passport. Meanwhile looking into flights--summer holidays have begun. Singapore airlines and cathay pacific is completely booked from london to Singapore or Hong Kong throughout July and most of August. Wow. There are still some flights left for Quantas but not in July. So plan is to go to my cousin's wedding in Singapore and Vietnam and then flying out to Cairns to catch the chartered flight to Papua New Guinea. There is an oil company not far from Kikori where the hospital is, so plan is get on this charterd flight which is once a week from Cairns to Moro (flight time is 2.5hours). Then from Moro base catch another flight to Gobe base (1 hour), stay overnight at Gobe base and then there's a 3hr drive on oil company road from Gobe to kikori. Phew. I thought I would be in a canoe for hours and hours so this sound quite luxurious really.

I got the shock of my life after talking to Dr.Andy a couple of days ago. He is the doctor that was in Kikori for 2 years. I think I am a bit hung up on that I may need to do a caesarian section. Not only the surgery but also the anaesthetic. I have never done one but I have assisted c-sections a few years ago during my obstetric rotation. To tell you the truth, I can't even remember how to suture. Thank goodness I was very keen when I was a medical student and sutured as much as I could. After talking to Dr.Andy, I was filled with fear and impending doom. Since then I have had the weekend to process the reality of where I would be going and the type of medical problems that may arise.

I had to hang on to God's word--Isaiah 41:10 So do not fear, for I am with you; Do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand. This helped dissipate the fear and the feeling of inadequacies. A constant reminder to myself that I am doing Papua New Guinea not only for the tremendous experience of a lifetime personally, medically, but most importantly spiritually. I personally wanted to thank God for bringing me this far in my life and helping me through medical school and providing everything. As some of you may know how miraculous it was financially to get through medical school. I no longer have any school loans or any other debt (ok exc for mortgage now). So I can give back what I have received.