A Doctor’s Perspective

By Doctor Vicky Adams

The Picton Castle had planned to carry out medical clinics on three islands in Vanuatu and we had some donated and purchased medical supplies with us to give out. On previous visits the ship had found people in real need of medical care and medications. On this occassion, happily, this no longer seems to be the case. Myself and Shawn ran the clinic and distributed the supplies. All three islands had access to and education in malaria testing and treatment. All the clinics had single use finger prick testing for malaria that gave results in 15 minutes. Educational posters about malaria, family planning, sexually transmitted diseases – including HIV – and healthy diets covered the walls. All were written in Bislama and the local pigeon english. People pay for medications, but not the consultations. The three clinics were very different.

The first clinic in Banam Bay, Malekula was held in their clinic building which had a consultation room and was managed by a nurses aid. They had a doctor visit every few months from the closest hospital. The hospital was a three hour drive away and cost 600 Vatu ($6) to get there. All expectant mothers went to the hospital to deliver their babies. Our day started with Shawn cleaning the facility and putting away our supplies. The population appeared healthy here. The most common complaint was painful knees and painful backs from carrying the heavy loads up the hills that make up their local area. On the first day we saw one expectant mother and on the next day we saw six!

In Bwatnapne Bay, Pentecost the nurse was away and the clinic building locked so we conducted our clinic in the church. The health education of this village seemed much greater than the previous. Lots of people asked to have their blood pressure checked and requested blood sugar checks. There also appeared a great need for dental services – lots of tooth decay and cavities were seen, but unfortunatly besides pain relief there was little we could provide. One kind gentleman made Shawn and I beautiful colored baskets saying “Shawn Canada” and “Vicky England” in green, yellow, blue, purple and pink as a gesture of thanks. He also wanted to us to ensure he had first dibs on frying pans the next trading day.

Asanvari Bay, Maewo had by far the best fascilities and staffing. Olivette is the registered nurse practicing there and she also carries out all of the low risk deliveries in the labour suite in her basic, but very clean facitlity. As the announcement regarding clinic was put out at the trading event all our patients that first day were women. A lot of chronic ailments were seen. We checked one lady’s hemoglobin using the basic chromographic method they had available. Another lady had a thyroid goitae and with no facilities for blood tests or scanning we advised her to attend the local hospital on hour boat journey away on Pentecost Island.

The clinic was very interesting for us and we have been able to deliver medications and give supplies to the villages we visited. Highlights of the clinic were watching Shawn delightedly weighing babies in the make-shift scales (fish scales hanging from the door frame), hearing a fetal heartbeat for the first time through a Pinard Stethescope (we always use Dopplers at home!) and discussing medical issues with Olivette. The places and facilities we both work in are very different, but the problems and issues relating to human behavior are still very much the same!

*Thank you to Vicky and Ali for some of the pictures with this log.

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