Alcohol

Beer is relatively expensive a bottle of Bintang – the only one worth drinking will cost around 25,000 Rp. A 750 cc bottle of spirit in Bali will cost around 600,000 Rp however a 1,000 cc reused Sprite bottle of the locally distilled spirit will only set you back 30,000 Rp. As it is somewhere between 50 and 60% proof one bottle goes a long way. There is a local wine which I had the misfortune to have to drink on three occasions – as I was not impressed I never thought to find out how much it cost.

It is very unusual for women to drink and if they do it will be discreetly at home. Men tend to sit around outside in communal groups. The alcohol for the night will be on the table in front of the bandar – sort of bar tender – along with one glass. The bandar then pours a shot and downs it in one. He then pours the next shot and gives it to the person on his right and so on around the group. As you can imagine you do not want to join a small group as the glass returns rather swiftly. It is not acceptable to opt in and out but once you have had enough you can sit back from the group. Drinking continues until the bottle (or as at one party I was at the ewer) is empty. Some form of food is provided; this can range from peanuts to a whole BBQed chicken via fish and mango. You normally eat after you have had a drink each round.

Whilst out here I started brewing my own wine again and have got one of the locals hooked as he liked the result so much. At least I do not have to worry about what to do with my kit and spare ingredients.

RIP Arthur 6 months 1 day

3 February 2010

After an illness of only 5 days Arthur Leopold Christian died in VIP ward at 14:30. He was the only child of the principle pharmacist who lives in the mess opposite my house. Her husband had been home for some time but had only gone away again to work last Friday – leaving a healthy son. Arthur is thought to have died of aspiration pneumonia; but we have no post mortem facilities here. The hearse took his body immediately to his father’s family home the other side of Baa.

 

As I was going out to eat one of the other neighbours came over to tell me I would be collected later to go to the house for prayers. I was very touched that I was seen as part of the wider hospital family and it was just assumed I would want to go. About 20:00 a group of us set out on motorbikes. At the house Arthur was laying on a double bed sized dais surrounded by drapes. With the immediate family around him. There were prayers and the rest of us were sat around outside the house but with chairs angled to see in through the door and window. After this we had cake and coffee before filing in to pay our respects.

 

5 February 2010

Today was the funeral and again it was just assumed I would go. Desi came round to tell me the service was 15:00 and that was the real time so we would be leaving at 14:30 sharp not jam karet – literally rubber time – which means anything up to an hour after the time stated. Just about everyone from the hospital went and transportation was a logistical nightmare with helmets and motorbikes being borrowed from anyone and everyone. The service was again at the house with us all sat outside under tarpaulin which kept the worst of the sun off. At the end of the service the coffin was finally shut up – this was rather traumatic as the mother her sister-in-law had to be pulled away to allow it to happen. The funeral procession then moved to the top of the garden where the family members were buried and Arthur was interned. As I am sure you can understand I did not take any photographs although the number of flashes from mobile phones indicated that it would have probably been quite OK. As we had cake and water the male members of the family filled in the hole with stones and then concrete.

 

7 February 2010

The final formal act of morning was a requiem mass this evening. The grave had been built up and decorated with what looks like crushed coloured glass. Lots of candles were being lit and being put on and around it. This time the service was followed by a large spread of food. However since then there has been a candle lit each evening outside the families room at the hospital. They are yet to come back but colleagues have been in a removed all Arthur’s things.

 

Work

With my date for leaving rapidly approaching I am finding work spilling over into leisure time as I try to finish all the things I have set myself to do. I have now had two meetings with the hospital director, head of nursing, ward and department managers having a final check through Standard Operating Procedures (SOPs) and getting them authorised by the hospital director. I decided to group the SOPs and to concentrate of finishing all those in one section at a time. So far we have had 24 approved covering, observations, catheters, nasogastric tubes and infusions. There are another 15 covering medication ready to be presented. I am trying to finish the group on infection control but this is very challenging due to the limited resources the hospital has available. These will all be bound in a book before I leave. I have also been working on the audit tools and have agreed a programme of audit and review for all 61 SOPs we have identified.

I submitted a grant proposal before Christmas and was successful in securing 10 million Rupiah which has been spent on books. These will provide reference material for the remaining SOPs as well as many other aspects of patient care. We have bought 98 books that will support all the departments in the hospital not just nursing. I have found the majority of staff have a great thirst for knowledge and have been looking through all my resources even through the majority are in English and anything I provide in Bahasa Indonesia is read from cover to cover.