Tuesday, October 21, 2008

The Baluta Experience

(dredging up some Indonesian stories now, have a few of these forthcoming)

Our work on Pulau Pulau Batu was mainly focused on the central island Pulau Tello. Tello is a transport and social hub to the hundred or so other, and often larger islands around it. It commands the trade routes from both Nias and mainland Sumatra. While Tello itself can safely said to be out of the way the outer islands are another step into the void.

Mother, baby and protective face whitener

It was a Wednesday, we had finished morning clinic and we were still thinking about going to Baluta. The stars had aligned and there were 14 of us, a Troppodoc record. We weren't going to squeeze into the local boat Dr Derek had lined up, it was only really a canoe with a small shelter, and it was already piled up with supplies and locals. Dr Derek and the sick baby Leone squeezed in, along with Bronwyn the nurse, Johanees the physio, and their children Rose and Brianna.

Bronwyn and Leony, ready for a voyage!

“Maybe you can find another boat, or maybe tomorrow” Derek suggests as they putter off across the bay.

I agitate along the wharves, “Baluta”, “Baluta”, “Saya harus pergi ke Baluta”. I'm getting funny looks. Back on the main street, the ripples have spread and a tout approaches.

“You want Baluta?”

We bargain and I drive him down a bit, then he drives me down to the boat hiring mafia on the Chinese side of town. It turns out his boat is broken but maybe we can hire the speedboat, “berapa (how much)”

Twice what we agreed. His boss shows up, and everyone else. They debate. I try my indonesian on them “We medicine to Baluta gratis, Dr Derek already gone, me medicine have here need to go to Baluta”, they're not looking keen, “Arrghh we help your wives, your daughters, now we help Baluta please”, still double, “Arrghh, I'm healthy I don't need to go”, they laugh,

“We'll take you for the petrol money”.

I race back to Hati Saro's and grab the others. The two young translators Udi and Denny are coming to. We find Kate and Eban passing back through town,

“Be there in five”

We are stoked at the boat, massive single hull canoe, and bright blue with big curved outriggers. You want to be at the front though. The girls in the back get soaked as we pick up speed through the chop. The boat steers through some narrow channels between smaller islands before we emerge in the open ocean the long green mass of Tanah Masa, Pulau Pulau Batu's largest island, stretching away to our left. Baluta refers collectively to a stretch of coastline maybe 7km long including 13 or so villages. Our first problem arises, we don't know exactly where on Baluta Dr Derek is. Or where for that matter we are, as the speedboat drops us off in a sandy bay and we wade ashore

We walk straight into a village. Wooden houses with intricate carved framing surround a large rectangle. Wealthier houses have corrugated iron roofs and maybe even a tiled floor. Pigs and chickens forage in the jungle behind each row of houses, sweating and clucking in the watercourses. Villagers unsurprisingly stare at us, white people emerging from the sea. Regrouped we ask around for the Doctor...blank expressions the only response. They gesture that we head south along the coast and we turn that way, a line of porters. Suitcases of medicine slung over shoulders.

We pass through several small villages, creating much excitement, but the team is increasingly sceptical of our chances of finding Dr Derek. In the end it is Penny and myself sent ahead to find him. We walk several miles of beaches and tracks through coconut palms, before stumbling into the village Derek had chosen. They are already engrossed in a chat and clinic in one of the larger houses. As always people fill the room and those only interested peer en masse through the windows. The locals look amazed as we struggle in one by one, although Derek assures us this is nothing compared to when he put down in his chopper on his last visit (to recap Dereks chopper is currently being held hostage by the Indonesian police following a dramatic rescue of an Australian surfer from the distant Siberut). After a night time foray to the next door village we had secured enough instant noodles to feed the team. Penny slaving out back over the fire did us proud. Noodles and rice a great 2 carb meal.

We figured for our one whole day in Baluta we would try and cover as much ground as possible, maybe stopping in every second or third village relying on sick people to visit us at the neighbouring village (this is only about 50m to 500m distance). Baluta isn't that simple. At te first village we came across we told the head honcho that we were setting up a clinic at the next village,

“No, that is bad, that village is no good, no good, have clinic here”.

Turns out the villages aren't on speaking terms. How crazy is that, such a small world they live in, yet they make it even smaller. We split the team, half going to the next village. The patients were generally old woman sick, way too hard a life in a place without good drugs. Although one very malnourished baby was presented. The mother couldn't feed her and they hadn't managed to figure out the milk powder properly. The mother and baby went on the list for temporary removal to Tello for a bit of education.

The clinics moved on down the beach, not before we had our lunchtime feed (crackers and crappy biscuits) and swim in the gentle surf. We had plenty of Doctors and Browyn the nurse and Johannes the physio and we also had a great distraction team. Penny Bond (Dr Nicks Penny) led the way in engaging the local kids, drawing and chanting and all kinds of carry-on. Rose and Brianna, 12 and 10 years old, backed up in this and the nursing and the pharmacy. Kate Willimans (a friend of ours come to visit) and her friend Eban also chipped in where there was need. There was not really much for me to do apart from set-up and look dangerous. So once this was done at the 3rd village for the day I went exploring.

Penny Bond reading with the kids

The idea was to find the next village, so I wondered off into the hot sweaty jungle (why I didn't choose the beach I don't know). Thankfully after only ten minutes or so I looked out towards the beach and saw some sheds and fences. I slipped into the village the backway , through the snuffling pigs and scruffy chickens. It was a small place only maybe 5 houses and I found some people playing cards in the biggest. They were somewhat surprised to see me and it took a while for me to explain that I was here with a bunch of doctors and nurses down the way and was there anyone sick in the village. Eventually though ther message got through and I got to do some preliminary diagnosis. Reading back in my journal its is quite amusing,

“my diagnosis of elephantitis in the testicles turned into a hernia, while my infected foot was in fact coated with betadine, the coughing guy that didn't make it to the clinic got a penicillin injection with a blunt needle for his trouble”

Dr Derek and Bronwyn returned with me to this little village that Derek hadn't visited before and it was a very enjoyable clinic watching Derek work for the first time. Very fast and informal with the group. Focusing on the genuinely sick people . Derek walks a borderline with his medicine, by abandoning the western practice paradigm and focusing on the very sick, but so to do the young doctors if they can't move beyond what they have learnt to what they could do, right now with the resources available to them.

We left this last village late and walked fast back along the coast, but not fast enough, the rain engulfed us. The others had left earlier and made it back dry but Bronwyn, Rose, Derek and I slithered back to our accomodation, saturated. It would be pushing things to say our hosts were stoked to have us, but they put up with us, and Penny again joined them out back creating some delicious instant noodles. It reminds me of the best ever Australian movie, “The Castle”....“whats this love?. For some more "The Castle Quotes check here

The next morning we were due to leave and word had got round that the boat guy from the village was going to try and make some money off these “bulli”, white people. We were a little bit pissed off. I tried some calm negotiation with the offender, then a bit of evil stares and co-ercion but nothing was going. Some of the others thought they had found a boat as well but this turned out to be a false lead. In the end we decided that the simplest solution was to walk 50metres down the beach to the nearest village and bribe them with free medicine for a fairly priced boat trip. It worked. The lunancy in these two villages not talking was not lost on any of us. The boat drivers were happy until they realised we had to go up the coast and pick up the mother and baby and an old lady with TB. They through a bit of a hissy fit but we managed to feign enough Indonesian incomprehension to get everyone on board. There must have been about 20 people on board this tiny boat, a very very slow boat. At less than a knot we putted across the pancake like open ocean (fortunately it is the doldrums) pausing occasionally when the motor died and more permanaently when we ran out of fuel, fortunately in the vicinity of a friendly fishing boat. Eventually we made it back to Tello, what an experience!!!

No comments: