Monthly Archives: June 2014

Travels Continue

Travels continue this week with Graham making an unexpected trip to Gizo escorting two patients. The sea was rough and he returned in heavy rain, arriving back at the hospital cold and very wet!
A police investigation into a missing person/murder, prompted by the finding of bones on a beach on the island of Rendova. , led to the request of a medical officer from the hospital to accompany the expedition. The Munda Royal Solomon Island Police were supported by R.A.M.S.I. officers based in Gizo (Regional Assistance Mission to the Solomon Islands). Dr Katy volunteered to go, together with Sereima (a tutor from the college of nursing) and a recently arrived U.K. medical student Peter. The witness on Rendova was not available, so the team combed the beach looking for a new witness and a place to land. Finally they arrived at the correct place only find that the remains had been washed away! The local police took this in their stride, but the R.A.M.S.I. officers were bemused as they had expected that the crime scene would be secure. Katherine and her team thoroughly enjoyed the day and returned with the anatomy book not used. Not the usual day at the office!
Back at the hospital, it was good to have fellowship with the Lale Ladies with Bronwyn Frazer as guest. She is the Pacific Representative of the Australian Uniting Church. The ladies, mainly nursing staff, felt free to share stories of how God was working in their lives and encouraged one another.

Touring in the West Province

At last the outbreak of gastro-enteritis seems to be settling and the hospital is much quieter. This allowed Drs Jenny and Katy to have a day tour to one of the local clinics in the Vonavona Lagoon. Our new Director of Nursing is doing supervisory tours to all the clinics to familiarise himself with them and if possible we combine it with a medical tour. In fact we saw very few patients, partly due to the mourning process following the recent death of the spiritual leader of the Christian Fellowship Church. This was a break-away movement in the 1950’s which became a recognised church and has a strong following in many parts of the West province. A new leader has been chosen but they await instruction from the headquarters. We noticed the rolled up mats in the church in Buni village and we learned that the village people all come together in the evening to sleep there.
Today Dr Katy has gone to Agagana village on Rendova Island to join a W.H.O. team which is currently investigating our cases of Typhus. The main purpose of their visit it to do a mass treatment programme for Trachoma – a major cause of eye disease which can cause blindness. They are taking samples from the patients that were admitted to Helena Goldie Hospital in May to confirm the diagnosis and they are also looking for any new cases in the area. Big rain and stormy seas yesterday have given way to a beautifully calm sunny day, so we hope that she has an interesting and fruitful trip.

A Few Thoughts From Katherine This Week

After three weeks in the Solomon Islands I am into a routine and working as “Dr Katy” on the paediatric ward seems quite the norm now. The number of children coming into the ward with diarrhoea & vomiting has slightly reduced and this week we have had many babies with fever and breathing difficulty, a child with a high fever (the cause of which I have struggled to get to the bottom of) and a third child with persistent fitting.
The maternity ward has kept us busy and we have had two sick babies, the first was a baby born around 30 weeks gestation weighing 1Kg, the second was born with vacuum-assisted delivery after a prolonged labour who was severely compromised at delivery. Managing these babies in such a different setting has encouraged me to think things through from first principles and with the aid of Nelson’s paediatric textbook and some creative thinking we have tried to do our best for these babies with what we have. In the U.K. both would have been on a neonatal intensive care unit, intubated and ventilated, with the second baby cooled to prevent further brain damage. There are no such facilities here and the staff do an incredible job with the facilities available. Practices that are now “old fashioned” and no longer used in the U.K. are crucial when there is no alternative. The attitude to life and death here is very different: parents and staff are far more accepting and ready to let nature take its course when all possible has been done. I have found them far more accepting than myself!
At the end of the day, Mum and I have been swimming in the lagoon to cool off. I have loved being in the water as the sun is setting over the distant islands and we have been kept company by the jumping fish and the fishermen out in their canoes.

Problems with Infection Continue

Fighting for the life of a 1Kg baby born at 7 months gestation and a disturbed night to attend another victim of the gastro-enteritis epidemic left us exhausted at the end of this week and relieved to be able to sleep in a little this morning. There have now been several deaths in children from D&V and last night’s 1 year old was the most recent. It is quite frightening to see how quickly they become very sick. There has been very little data collected but we do know that some of the cases in Honiara have been confirmed with Rota Virus. The child that died last night was dead on arrival at the hospital, but the parents said that he had been breast-feeding in the canoe on the way here: he was still and without any pulses when first seen on Children’s ward.
Katherine continues to be a star and we can only hope and pray that this epidemic will settle before she returns home. Her skill with intra-venous cannulation in babies and children is a great help to us all. We also hope that she has chance to relax and enjoy something of Solomon Island life over the next month.