Work

24 November 2008

Well I am out here to work so though I ought to let you know what my daily work routine is about. We do a 6 day week, 08:00 - 14:00 Monday – Thursday, 08:00 - 11:00 Friday and 08:00 -12:30 Saturday. My desk is in a large shared office - which with flash looks so clean! There is one power source and one computer - I however have my laptop and we just use multiple adaptors to get electricity to everything that needs it.

Each day I go round the wards with Ibu Ellen the matron for the wards. These are VIP, paediatrics and general adult wards; these is also the maternity department and A&E. During my first two weeks the busiest the wards have been is 10 patients but outpatients was very quiet due to the rain - it makes travel from remote areas almost impossible and locally very unpleasant. I am meant to just be observing practice, practicing my language skills and finding out how the organisation works. However Ibu Ellen asks my advise about the patients each day and on a coupld of occassions I have found I have had to make suggestions for the sake of the patients. I am doing a lot of reading and spending time translating documents to try to understand what is happening. It is going to be a long time before I understand the paper trails - especially those associated with charges.

At the end of a hard day we relax - some more than others!

New Home?

18 November 2008

Well we made it to Rote this morning and eventually to the hospital. The island will soon be voting for the Bupati - the head of the local regency government. Today there was a rally for supporters of one of the opposition parties. It seemed as if every lorry on the island had been commondered to carry supporters to a rally in the centre of Baa - we were trying to travel the other dierection and failed.

We discovered the housing arrangements we though we were coming to had fallen through. I should have been sharing with two doctors but the access to water there was so poor they were struggling with 2 of them in the house and did not feel it would work with a third person as well needing to wash etc. John and I therefore had to move into the other sparsely furnished 2 bed-roomed hospital house together. It has 2 beds, one wardrobe, one TV (which is not connected to the cable so does not work) on a small cupboard, a desk, fridge, two folding chairs and kerosene stove. It does have a porch with two wall on which we can sit out. Unfortunately it gets the full afternoon sun so is rather hot. It has running water for about 2 hours a day but the well is almost immediately outside so water is relatively easily available at all times. The hospital staff had found a room to rent in a house immediately opposite the hospital which is well furnished with sofa, table, chairs and cupboards but has shared kitchen and bathroom and no private outside space. We spent quite a bit of time deciding which we would prefer and then negotiating as we both had the same first choice but for different reasons. We then went to both saying we would move to keep the piece. We however managed to have a very sensible discussion about it and eventually it was decided that John would move. We have a spare room and we will accommodate whose ever guests visit here. The house will be my home but our house - to give John a bolt hole if needed and access to football once the TV cable is sorted. Although the hospital staff had done some cleaning areas like the kitchen sink still needed a lot of work. The big ratan bush in the front garden was decimated by hatchet and fire.

My Fellow Volunteers

10 November 2008

Our last week all together in Bali and I realise I still have not told you any thing else about the other member of our group.

Sam is a great guy who is very generous and would do anything for you - as long as he remembered. He has only ever lost his passport twice. He managed to leave his laptop in the hotel reception in Kupang and had it held to ransom. Here his foot is in a bucket of water as he managed to stand on a spent sparkler and burnt the bottom of his foot. He is however very knowledgeable about computers but not a bore with it - useful friend to know. He is an excellent linguist and has made us laugh a lot during lessons. He is working in the medical records /IT departments at the hospital in Kupang.

Dorothea - Doro or Thea - has overcome her apprehension about riding a motorbike despite burning her leg on the exhaust on her second day of training here. She is quite with a wicked sense of humour and I really enjoy talking with her. Unlike the rest of us she is only on a 12 month placement and will be based in the VSO office in Bali developing a database to match disabled people to job vacancies.

John is thankfully more serious and sensible than I am and will try to curb my more risky persuits. He is a football fanatic and follows Blackburn Rovers. He also likes watching a lot of films. So seemingly not much common ground for conversation - however we seem to be able to chat for hours. he enjoys analysing situations and is very astute. He has several feminine characteristis which with my masculine charactersitics mean we should be able to rub along quite well together on Rote.

Back in Bali

2 November 2008

Well I am back in Bali for two weeks to compete the last of our in Country training and language lessons. Will also take the opportunity to do shopping for all those things that are either difficult to get or expensive on Rote.

There were two things that struck me on my return. One being the smell;and not in a bad way. Bali is a predominently Hindu island and offerings are put out twice a day. Each home, office and shop will have at least one temple where the offerings will be made in addition offerings are put in cars, on motorbikes, in the street outside buildings - well almost anywhere. The smell from the flowers and the incense sticks that are burnt can be quite over powering.

The other thing I noticed was the difference in the traffic. The volume of traffic in Denpasar is so much greater than in Rote or even Kupang and because the roads are better the speeds are much greater. It is not jsut the volume though but the unpredictability of traffic - although a few things are certain. If an indicator is on it means the bulb still works. If there is a space someone will go into it. Expect the unexpected because it will happen.

First Visit to Rote

26 October - 2 November 2008

Sunday saw us flying out to Kupang with our partners and Dinnia - very convenient as yet again my luggage was over weight; I will leave most of it on the island. We had to stay over night in Kupang as the feryy leaves at 08:00 in the morning. We managed to catch up with Sam whilst we were there.

On Monday we caught the new fast ferry to Rote – only 2 hours once it gets going; we were only 40 minutes late leaving. We are seeing the island at its’ brownest as the rains are due to start any day now yet it was still beautiful. It is hillier than I had anticipated so with the intense heat I may have to rethink my plan to get a bicycle. We dined in a restuarant with the magnificent view before being taken to the hospital to meet our collegues and to have the grand tour.

I am finding it hard to find the right words to describe the hospital. It is relatively new and has lots of building work going on. The A&E is being extended, an ITU is being built and a rehabilitation ward refurbished. There are beds for 48 in patients and an out patient facility with 4 examination rooms. They have an X-ray facility, laboratory, pharmacy and kitchen. There are also 2 ambulances. There are 50 nurses/midwives, 6 doctors - but no specialists and a dentist along with lots of support staff.

There is limited running water in the wards, many of the beds do not have mattresses and what there are leave a lot to be desired as they have no plastic covers, the range of equipment is very, very limited. They do have a few packs of sterile gloves and once these have been used they are then washed and reused when the nurse or doctor needs to protect themselves. A&E is not very busy – Friday saw the most patients – 15. The inpatient wards were more like crèches with more of the nurses' children in them than patients - due to lack of child care provision. The most inpatients last week was 7 and one day there were none. The malaria and dengue season will start with the rains so this may see a change in level of patients. All inpatients seem to get a drip – what ever their condition and caring for this and doing observations appears to be the only direct contact nurses have with patients. They do however keep amazingly detailed records. I accompanied Ellen on the daily ‘matrons’ round – we spoke to the staff read the patient records then went to see the patients – I was expected to ask relevant questions to the patients. Ellen would then want to know how we cared for similar patient in the UK. I am trying emphasise the similarities as I know they are not going to be able to offer half the interventions we do.

We stayed down the hill in a hotel in central Baa - the main town on the island. As you can see the main shopping street is not very busy but despite this has a one-way system.

During the week the doctors took us to a couple of beaches on the island to get a flavour for the real beauty it has to offer. Ths included a visit to Nembrala the West coast tourist 'resort' on the island. The area attracts dedicated surfers during the dry season but the main hotel was closing up that week prior to the rains. The manager invited us to used the sea water swimming pool and we saw the most amazing sun set. The picture at the start of my blog was taken here.

We also started to experince what life on Rote was going to be like - power cut are a regular part of life. We were lucky the hotel had a generator so we could sit outside to read by the light of a single bulb.

John and I have been offered a 2 bed roomed house in the hospital compound. I have also been offered the opportunity to share a house with two of the female junior doctors. I think I will probably choose the second option as it will give us a spare room for visitors, give us separate identities and make seeing each other a treat rather than an irritation. It also means if it does not work out living that closely with Indonesians I can move to the other house whilst we sort out an alternative.

On Saturday we travelled back to Kupang prior to our flight back to Bali on Sunday.

First VSO Beach Games

25 October 2008

This week Bali including Sanur had been host to the First Asian beach games. Anne the Country Director decided that VSO could add an international element to this by holding their own games on Saturday afternoon. Dorothea, John and I joined staff and their families on the beach. (Sam had already left for his placement visit.)

The games started with towel volley balloon. A team consisted of 4 players and 2 towels. The aim was to toss a water filled balloon out of the towel over the net and the other side had to catch it in one of their towels. John, Dorothea, one of the husbands and I were in the winning team. I managed to get a little wet. The next game involved threading raffia through your clothes and then through the next persons etc until the whole team was threaded together – my team just came second. The final game involved having plastic beakers tied onto our heads and then the first one was filled with water and this had to be emptied into the second etc. Again the team I was in came second amidst a lot of joviality and most of us were very wet. We then all sat down to a picnic made up of bits that everyone had brought; it was a very pleasant afternoon and a great way to get to know the staff a bit better.

Employer Conference

22 - 24 October 2008

On Wednesday afternoon we were taken to a rather nice hotel, with hot water, flushing toilets and two swimming pools. Here we had a three day workshop where we met and worked with representatives of our new workplaces. The first evening the table was set out for us to meet our new partners in an 'informal' setting.

Dr Rina who is head of support services and Ellen the matron for the wards came from the hospital in Baa. We had to interview each other in Indonesian and then introduce our partner to the rest of the group in Indonesian. There were lots of sessions where we either worked with our partner or the partners and volunteers worked as 2 groups. This was about developing trust, cooperation and understanding. John and Dr Rina one the competative session and received their price from Tjeed another volunteer who facilitated the event. Everything was translated so if an English speaker lead a session it was translated into Bahasa Indonesian and visa versa.

Thursday night we all went bowling – the partners were a little apprehensive as they had never bowled but everyone had a great time and it again elped ot break down barriers. Ellen has a bigger English vocabulary than I do Indonesian but her grammar is about on par with mine. All four of us volunteers were complimented on our level of Indonesian – apparently we are more confident than most groups at this stage.

On the last afternoon John and I sat down with Dr Rina and Ellen with Dinnia the VSO programme manager to go over the hospital's expectations of us and to discuss the practicalities of our visit to Rote next week. We rounded off by writting important things on each others backs and posing for a group photograph. The commitment I have made in volunteering is starting to feel real at last.