some photos!

this is my current house










this is the view of the river from my veranda.









this is the view on a sunny day!










this is the MAF plane parked outside my house
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I've had another busy couple of days at the hospital. Update on the fish situation is that the governor came (in the middle of a staff training vasectomy role-play) to look at the dead fish in the fridge. I personally found the whole situation very funny, and had to try hard to keep a straight face! It actually turns out though that he is also a paediatrician (not sure what the relevance is of that and fish, but anyway) so we got him to see a little boy on the ward who has been very sick and we're not sure why. He has some kind of haemolytic process going on (for medics: he had a HB of 2, then a blood transfusion got it up to 10 and 3 days later it was 5 again) and has gotten weird soft swellings on his skull and his eyes have become very prominent, suggesting a tumour in his head is pushing them out. Anyway, mr governor suggested a differential diagnosis of a particular tumour related to osteomyelitis (Pott's Puffy tumour if anyone is interested). He also took a blood sample for doing a blood film which we can't do here as he was going to the capital later in the day. Anyway, little kiddie is basically very sick and was essentially only for palliative care, which is some comfort with the following situation development...The parents have been saying for a few days that they want to take the boy away and 'do customs' which is basically traditional spiritual and magic rituals. However, as a Christian hospital, the hospital has a rule that patients cannot receive treatment and also go do customs. They have to choose to either put their trust in God (through the hospital care) or in customs. So if patients choose to go do customs, they are not then allowed to come back to continue their treatment. The family left the day before yesterday, which is sad.
Yesterday (Thursday) I was on the maternity ward ward-round and saw a little girl be born, then learnt a bit about snakebite management, which included looking at some preserved snakes in jars! I then learnt some more about Buruli ulcers. I was feeling a bit low in the evening - just a bit tired and emotional for no particular reason. I got some nice messages from friends and family though, and made some caramelised vanilla bananas (new combo. verdict: YES) and got an early night. Have felt better today, so thank you everyone for your prayers and support.

Today I spent some time with one of the teachers at the CHW (community health worker) school attached to the hospital. So I learnt about what they do etc. I also examined a lady with a huuuuuge spleen! She is the very anaemic lady after a ruptured uterus, who now appears to have malaria, with tropical splenomegaly. She also gave me a new record BP reading, of 60/20. My other record here is 200/140 in a lady with renal failure who was in clinic earlier in the week, having run out of her medication a month ago! This afternoon an adorable little boy came in with a fractured/dislocated/both shoulder. This happened 3 days ago, but today he came to us by a 3hour canoe trip! As our xray machine is broken, we sent him off to another hospital for xray before returning to us later to fix it. We heard that he was on his way to us by radio from one of the outstations earlier.
This weekend I will be moving from my current house into accomodation with one of the missionary doctors, (my house's family are returning on Tuesday), and hopefully next week our MAF pilot will be returning from a conference, so that will be good.
Much love xx

Sunday-Tuesday

Hi all!
So Saturday night and Sunday it rained A LOT. I couldn't believe the sky had any left!
Sunday morning Church was a special ordination service for 10 pastors. This was actually really cool, and I enjoyed singing along to some Pidgin songs too. However it did mean sitting on the wooden floor for nearly 4 hours - ouch! I also had to use the worst toilet ever! It was a standard icky hole in the ground, but so much worse: 1) because it was mildly flooded, 2) because someone had just pooed next to the hole, and 3) because I was not wearing shoes!! (you rarely do here). I used water, a handwipe and antibacterial gel to wash my hands and feet, then washed and changed as soon as I got back to the house!!!! I then sorted out a bit of an ant infestation where they had gotten into a box and chewed through some foil wrapping. I do not like the ants.
On Monday (yesterday) I had my first proper day at the hospital! I went on the ward(s) round and saw lots of patients - lots of TB, pneumonia and various ulcers. One old lady had a very advanced ulcerating anal cancer, and there is a young boy who came in fitting a month ago with TB and meningitis and is yet to regain consciousness. Other interesting patients include a couple of albino people, and a little girl with a congenital heart defect (ASD and VSD for any medics! and she has amazing clubbed fingernails!). The ward round is actually pretty amusing as there is no privacy at all - all of the patients in the ward are involved in each patient's consultation! The hospital chaplain is also on the ward rounds, which I think is cool, as he then knows the patients' situations and is able to chat and pray with them afterwards.
On Monday afternoon I went to a staff TB meeting as they are going to start doing 'treatment supervisors' for when patients go back to their viallges and need to make sure they keep taking their medication. After this I helped to hang up a guy's arm in traction for overnight, as he has broken and dislocated it but it is really swollen. Our xray machine is broken, so he had to go elsewhere the next day, but the swelling needed to go down a bit first to help with the fixing!
Today I went to market at 6.45am!! I managed to buy some bananas, pineapple, potatoes and some kind of pumpkin thing that resembles an odd-shaped marrow! There were not the usual greens for sale because they grow on the riverside, and apparently people are not eating those right now. Which leads me onto the promised update on the fish-river-fridge situation: Currently, the company responsible for the leak has said they have tested the water and it is fine (but they would say that...), but the local people are saying it is not ok and they should get compensation (but they would say that...). The doctors say that the fish shouldn't be in the outpatients dept. fridge (but they would say that...!)
My main wildlife contamination worry is that this morning, I found an ant on my toothbrush. not cool.
Anyway, back to today. I had a very good day in theatre! I was scrubbed in assisting on a little boy having a skin graft onto his arm as he had lots of flesh cut away due to a Buruli ulcer. This was my first experience of doing a skin graft, my first experience of a ketamine anaesthetic, (indeed, my first experience of anaesthesia being done from a textbook!). It was also my first surgery done with an insect crawling out of a bundle of supposedly sterile instruments, and my first surgery done in a theatre with a fly-swat on the wall! It was a long and tricky procedure, but really interesting and a great experience to assist in! There was then another skin graft on an ulcer (done under spinal block), then a clear-out of a uterus of a lady who had miscarried at about 12weeks pregnancy.
All very interesting and stimulating stuff so far, and so varied. I'm enjoying getting stuck in and being able to get involved :)
Lots of love to all xxx

update

Hi all! Sorry for the delay in getting an update out, but i am now on a laptop and ready to update you!
So my journey went smoothly (London -> Abu Dhabi -> Manila -> Port Moresby -> Kiunga -> Rumginae!) and I arrived here on Thursday morning (9hrs ahead of UK here). Highlight of the plane food was probably the tuna and raisin pasty I had for breakfast on one of the flights....hmmm!
It is very warm and wet here!
For my first couple of weeks I am staying in a missionary family's house while they are away on leave. All the houses are sort of bungalows on stilts, and I have incredible views over the river. The other lady missionaries have their houses next to mine in a row, and I have been dining with somebody different each day so far! There are tiny ants EVERYWHERE, so I've been making all my food ant-proof in tupperware boxes (they can chew through packaging!). The first evening I thought I had seen a snake in the grass [read: swamp] but it turned out to just be a wiggly stick. Smooth.
I have an MAF plane parked outside my house! [www.maf.org] However we won't have a pilot this week until the MAF family return, so hopefully there won't be medical emergencies requiring evacuation to here (altho planes elsewhere can step in if needed). I'll hopefully get to go up on a medevac at some point though! Last week, 2 of the doctors went on a medevac to a guy who had been shot with a bow and arrow. He wasn't brought here in the end, but they have had news that apparently he is doing well.
The hospital is just over the little airstrip, and is also on stilts with wooden walkways! I had a bit of a tour on Friday and will get stuck in this coming week. A little gem for you: [note: a 'billum' is a string bag, a 'pikinini' is a baby] a 'bladder' in pidgin is 'billum for pisspiss' and a uterus is 'billum for pikinini'! Also, there was a big dead fish in the outpatients fridge because there has been some kind of leak into the river and people are worried that fish are dying, so the fish is waiting to be seen by the authorities. I'll keep you updated on the fish-river-fridge situation!
This morning a lady showed me around the station a bit more, and showed me how they collect rubber from rubber trees! I also met some of the Community Health Worker students, who come here for 2years training before returning to their villages to apply what they have learnt.
One of the missionary doctors gave me some homegrown peanuts, so I was impressed with myself for successfully shelling and roasting them! Yumyum. I was also pleased that my plan to keep ants away from my pineapple was successful! (in a bowl sat in a dish of water. genius!)
I can pick up internet on my kindle here which is unexpected and rather cool! I can't do big messages or blog updates on there (use one of the dr's laptops for that), but am very much appreciating picking up various messages! Thanks everyone!
Lots of love xxxxx
(will try to upload some photos soon!)