Blood Pressure, Beaches and a Hidung Mancung

My trip to Sumba began with an auspicious start – I got stuck in Kuta.

When you hear stories about flights being cancelled and delayed, it sounds like an amazing adventure: maybe you’ll meet a guy and re-enact ‘Before Sunrise’, or sleep in the airport and people watch through the night, or chill on the beach and enjoy the extension of your holiday…

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In reality, it kind of sucks, even if there are nice views. Especially being stuck on your own when you have no idea what to do. Horror of horrors, I had to sort everything out for myself. No Baba to find a hotel, no Mummy to make sure I ate all my meals. Instead I found a cheap hotel near the airport by myself and spent seven hours over two days in the Garuda Office trying to sort out rescheduling my flight.

On the upside, I also ate the best pizza I’ve ever tasted.

That pizza, warm, cheesy and delish, makes my stomach hurt. Because staying in a convent and a hospital in Sumba means one thing: only Indonesian food. Which in turn means three things: nasi (sticky rice) for breakfast, nasi for lunch and nasi for dinner. I don’t think I’ll be able to eat rice for months after I go home! Of course, now a week in, I am so hungry that I seriously do not care what I eat as long as I eat.

I won’t deny dreaming about warm lasagne though, or maybe a really big bowl of Sainsbury’s own Crunchy Nut Cornflakes with full fat milk…

Still, Sumba is amazing which more than makes up for the rice overload.

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That’s a photo from Ratangaro, a place famous for its tall traditional houses and megalithic tombs of ancestors. In Sumba people follow an interesting mix of Christianity, supplemented with traditional animist beliefs in Merapu, the ancestral spirits.

And this is from my trip to Waikuri Lagoon with some of the other doctors. The water was so clear and beautiful – one of only two inland lagoons in Indonesia. You could even see coral reefs!

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Unfortunately that trip also ended with a visit to another beach, where I was dragged under the rocks by the waves – one of the most terrifying three seconds of my life. Expect to see photos coming up on my Instagram, at the moment they’re all on someone else’s camera!

So Sumba: a complete world away from Bali with its never ending stream of tourists. In fact I haven’t seen another foreigner since the airport. Of course, this means that the main method of communication is Bahasa Indonesia which makes life quite difficult, very funny and, sometimes, a little bit lonely.

My first day at the hospital had me sitting with a group of nursing students, attempting to hold a conversation. Imagine your first day at a new job, exhausted and trying to pretend the constant staring doesn’t matter and then having a group of 18 year olds pointing and laughing every time you said anything. It didn’t help that the one person who did speak English, Dr Charles (pronounced Char-les) kept asking me impossible medical questions. I felt like I was an intern in ‘Grey’s Anatomy’, minus the hot doctors. If this is how intense being a medical student is, I need to brush up my game!

Luckily for me, things improved very rapidly. My second day saw a new batch of students, ones I am very definitely friends with. The female students have even been trying to set me up with the boys – think of my inability to flirt in English and then imagine me trying to understand what was going on in Bahasa Indonesia! The biggest compliment I was given: hidung mancung – You have a long nose.

Um, thank you. I think?

And I’ve even gotten used to dealing with Dr Charles’ questions, ish. At least we’re friends now. Still the questions means I’ve learnt a crazy amount and made a whole pile of notes about everything I’ve seen. It’s so interesting!

So what have I actually been doing?

Unlike my time at Budi Kemuliaan, Rumah Sakit Karitas is perfect for actually being given the opportunity to try out some new medical skills – I can now measure blood pressure!!! (After lots of practice and wrong readings). I’m also pretty good at counting – heart and respiration rate are my new favourite things to do while chilling in my room.

This week I’ve been based in IGD (the A&E) which allowed me to see a huge range of patients. Massive cuts from falling off motor bikes, high temperatures and difficulty breathing, anaemia and, of course, malaria.

Sumba has one of the highest occurrences of malaria in Sumba with an estimate of 20% of children under 10 dying or becoming severely brain damaged each year. My first malaria patient was a little girl, only three years old. She has cerebral malaria, which affects the brain. Typical malaria symptoms include fever, myelgea (aches and pains of the joints) and epigastric pain. It also causes anaemia, which in turn caused a severe increase in respiratory rate. She was given a blood transfusion and kept in the hospital a few days for observation and, as far as I know, is ok now.

Tuberculosis is also a major problem and the reason behind the first real emergency during my time. Dr Charles received the Code while we were sitting discussing the Glasgow Coma Scale. Next thing I know, we’re running across the hospital to perform emergency CPR on a patient. The tuberculosis had reached the brainstem and infiltrated the medulla, the area in the brain that controls breathing. When we left, the patient’s heart was beating but he was not breathing. In Sumba, without the proper equipment, there was nothing more the doctors could do.

In such a rural area, patients often can’t get the treatment they need at the hospital. At the moment there’s a patient with a heart problem and a kidney problem. In England, the doctors would be easily able to hook him up to a dialysis machine and let that take over briefly for his kidney, possibly solving the problem within a day. Here, the nearest dialysis machine is in Bali or Kupang, both an hours flight. For large families with little money, the costs all too often outweigh the need for treatment.

Money constitutes a big factor in patient care. There’s no NHS to rely on when you start to get sick and, if you don’t have the money, you can’t pay for treatment. However, there is a government insurance scheme: BPJS. This allows patients to pay in to one of three classes, the only difference being the level of comfort in which you stay in – so for Class 1, VIP rooms. Theoretically, healthcare is of the same quality for each. Unfortunately all too many Indonesians in rural areas do not know about the scheme – although Sumba seems to have a surprising number of people who are registered, thanks to the tireless work of the nuns and the doctors.

Being at the hospital is exhilarating, if not very tiring. Which makes chilling in my room in the afternoons so much nicer. I even have AC!

Staying with the nuns is lovely – it’s like having thirty grandmas looking out for you. If I wasn’t so in love with the idea of love I might even consider becoming one – there’s a certain charm to the feeling of community and knowing exactly where you stand in the world. It’s like one large family: lots of laughter, talking and, of course, singing. I feel like I’ve been teleported in to the ‘Sound of Music’. How do you solve a problem like Maleeha?  There’s singing in the chapel and singing on the stairs and singing at breakfast. I don’t understand how they can all sing so well! And then the names: Louisa, Brigitta, Martina, Rufina. It literally is the cast of the film.

In fact they’ve even roped me in to singing today at the party to celebrate the opening of the new convent so I should probably go learn the words…

Check out my next post for a low down of my whole second week and my journey back to Jakarta. Showering in my own bathroom – I can’t wait!

Sampai jumpa.

 

 

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One comment

  1. Daniel · November 18, 2015

    Hi Maleeha…
    Nice post you got here. Very describing of Sumba. But very unfortunate of you, that you can’t stay here any longer. You only saw a very little of Sumba’s beauty.
    Anyway, I’ll ask Sari to send some photos of you at Weekuri lagoon and Mandorak.

    PS: when will you come to the OR?

    Like

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