This whole week Ruth and I have been giving
keyboard lessons to some of the staff and their
children. They've actually been getting recorder
lessons from Dr. Valerie (who's teaching herself
to play recorder and keyboard!) and are pretty
good! Ruth and I started off with high
expectations because of that fact, and also
because they seemed to pick things up fast, but
they're used to learning things by rote (sounds
familiar… ;P) so getting them to understand the
theory of things has proven quite difficult.
They're okay with treble clef notes (thanks to
their recorder experience) but are clueless about
bass clef! So we've scaled things back and are
taking things one step at a time now. The lessons
have also transformed into two classes, Ruth
taking the older ones and me taking the younger
ones (and their school teacher!). The early
enthusiasm they had for wanting to learn the
keyboard seems to have worn off since we've
started teaching everyday and giving them things
of substance to learn and remember, but they're
bright kids and we'll get there in the end.
The people here are actually very musical! They
readily and regularly harmonise when singing
songs and hymns, getting most if not all notes in
tune, and are not shy in singing out, which makes
listening to them very enjoyable. A whole group
of men have taught themselves to play the guitar
and now compose songs in their various languages.
When I first heard them play for Sunday worship
they sounded really professional (although tuning was a tad off).
Then there's this guy who likes to think of
himself as the musical man. I think he started
off playing the guitar, and wanted to learn the
keyboard, so asked God to give him the ability.
And in a few days, he could play the keyboard! I
wouldn't really have guessed he was self-taught
at first listen, then I realised that he plays
keyboard like a guitar – all chords and no
individual notes. Yet he manages to hold it
together to play for Sunday worship. And after a
few days in Ruth's class, he developed some
note-playing skills, although still not fully
comprehending the theory behind things, and could
play "Twinkle twinkle little star" with left-hand
chord accompaniment, and play little decorative
runs on the right hand. He's also got a little
piece he plays on the recorder that sounds like
he were a lone piper on a cliff in Scotland or Ireland.
So there's definitely raw and untapped talent
here. Just needs a bit of coaching and
instruments, which are unfortunately in short
supply. What Ruth and I can do is small, but
hopefully will set them on the road to making wonderful music!
21/2/2009: Day 10, Kapuna Hospital
We had the 48th graduation ceremony for the
community health worker trainees today. I didn't
realize that the school had been going for so
long, but they have – started in the 1950s,
they've had the titles of the graduates change
from nursing assistants to maternal and child
care workers to health care workers, to suit the changing times.
They had been getting ready for it all week, and
probably before that too – building the shelters,
getting logistics ready, etc. Yesterday night was
the big "kenduri makan", or muu muu as it's
supposedly called here, a big dinner to celebrate
their success and to welcome their guests. Before
dinner a group of their mentors and teachers
gathered to pray and minister to each one of the
12 graduates in front of the large dinner party.
Dinner itself was alright – there were chunks of
wild boar, and crab, and rice in coconut milk,
and sweet potato in coconut milk, and greens in
coconut milk (you get the picture), some Maggi
mee with chicken, round yellow buns that reminded
me of the butter buns from Terengganu, and of
course, sago. Didn't eat much as there were still
a lot of guests, and how our stomachs would agree
with the food was quite circumspect (indeed, a
few of us not really used to it got the runs a day or two later).
The weather was cool, thanks to the rain earlier
in the morning. What a blessing, because if we'd
had sun all morning we'd have been baking under
the coconut leaves-covered shelters. Each
graduate was introduced by a song of their own
choosing (very individualized) and as they walked
from their shelter to the guest shelter their
relatives would come up, some dancing and
prancing, to circle them, hug them, hang garlands
on their necks, and take pictures of and with
them. Some mothers/grandmothers brought gifts for
their child/grandchild and the teachers – one
danced about holding a long rolled-up mat (a gift
for Dr Lin), another was clutching a small chick,
which was given away later. Many of the female
graduates (there were 9, and only 3 guys) were
given brooms made from dried grass (lidi!), as if
they were going to set up home somewhere. But all
the gifts and garlands were lovingly handmade,
fruit of the earth that they work on daily.
It was a very intimate graduation ceremony, even
with the masses of patients looking on from the
verandahs of the wards (the shelters were built
in the yard in front of the wards), and was full
of little human touches. Very PNG-like, we heard
Dr Lin (Grandma) say, and very unlike the
graduation that Ruth and I will be attending in
June (if and when we pass hehe). Our graduation
would pale in comparison, I should think, with
the mass of our year (5-year and 4-year graduate
entry program together!) all shepherded up then
down the stage, probably to the grand but
slightly dreary "Pomp and Circumstance" march.
It'll be up to us to make the time special, and
with grandparents and family coming up, I hope it'll be!
22/2/2009: Day 11, Kapuna Hospital
Sunday again, and a super-long service in the
morning, lasting from 915am to 1pm. Perhaps it
was a special service because of the joy of the
graduation ceremony and the special guests who
were here, but we had a lot of song presentations
from various groups. We also heard more amazing
stories from Rita, a CHW who'd spent 6 months in
Australia attending and working for several
churches and NGOs, and broadening her horizons a bit.
However long Sunday worship seemed though, our
time spent over the stove today was longer! And
it's probably the only day we haven't gone to the
hospital for any medical-related work. What
started as an attempt for a small fire for lunch
and rice for dinner became a struggle to keep the
fire big enough for lunch, and enough rice to
make pineapple rice for dinner for 8 people!
Thankfully we'd experimented with cooking fires
before and have a good routine now – I'm usually
the one manning the fire, making sure it burns
properly and doesn't die out, and Ruth rules the
pots and pans and churns out delicious food. Our
lunch of porridge with sweet potato (called kao
kao here and much sweeter than sweet potatoes
back home!) turned out fine as it was the first
thing we cooked on my merrily burning fire. Then
we tried cooking rice. We'd already been educated
about the perils of cooking rice on a stove (the
first time I cooked rice on a stove was in
Crawley and ended burning it, and the first time
I cooked rice here I made porridge instead) so I
left it up to Ruth, and almost got it correct! I
say almost because it was rice, just a bit more
gunky than usual, like when you've put too much
water with the rice in the rice cooker. All that
rice cooking took 3 ½ hours, with me continually
checking and stoking the fire! We took a break
when one of the Uncle Johns from the treehouse
came over for a talk about missionaries and
colonialism, and let the fire burn out a bit, but
since Dr. Valerie came over soon after to check
on dinner, we got her to restart the fire. She
was pleasantly surprised at the quality of the
embers in our fire, surprised enough to award us
brownie points for being the only medical
students to try and successfully light stove fires!
The next 1 ½ hours was spent cooking up the
pineapple rice, pork omelet and vegetables, the
last 45 minutes or so in semi-darkness, so much
so I had to train Ruth's headlight on the eggs so
that she could see to cook them! It was a good
meal (even if the pineapple rice was more like
sticky rice with pineapple, beans and carrots),
all from our hard work, and the sense of
satisfaction from cooking up a storm on a
woodfire stove is quite a nice feeling to have.
All this starting of fires has led to several
observations – you've got to get everything ready
on the stove and around you, so that you only
have to strike one match to get a fire going, and
are prepared to feed the fire appropriate fuel.
There's a progression of fuel to feed the fire
too, from fast-burning palm leaves to the trusty
coconut husk to the solid wood planks. You've got
to pick your fuel wisely, in order to get a
long-burning fire that won't go out easily. It's
all very well and good to get a lively
red-burning fire with palm leaves and twigs, but
their flames are short-lived and unless you
graduate to more substantial fuel, you'll be left
with ashes and the need to strike another match.
Best for fires are the coconut husks which will
always produce embers once burnt, and blocks of
wood which burn merrily then become glowing red
embers which help set fire to the next block of
wood. And sometimes you need to blow out the
solitary flame you have going in order to bring
the embers alive and start flaming again. It's
enough to get me philosophical, but I'll leave
you to decide what principles of fire-starting are transferable to life! heh
24/2/2009: Day 13, Kapuna Hospital
Along with settling into the ward and patient
system in the hospital, we've been trying to
attend and perform deliveries. Ruth had gotten
the first one, so when we heard there was another
lady going to give birth, I thought I could give it a go.
She was primiparous (it was her first baby), and
had felt her first contractions the afternoon
before. She was progressing slowly but surely,
and to try and speed things up her membranes were
ruptured for her at 10 pm. At this point she was
about 7 cm dilated. The cervix should dilate at
about 1 cm/hour, so she was scheduled to deliver
at 1-2 am or thereabouts, and I decided to hang
around and read a book or two to monitor her
progress and hopefully deliver her baby.
Unfortunately, her progress still remained slow,
and my progress through the book too fast, and at
2.30 am she was examined again and found to be
only 9 cm dilated! By this time my patience and
that of the night call sisters was wearing thin,
and the mother was quite exhausted from the pains
as well. CHW Rita decided to start delivery at 3
am instead of waiting and letting the mother tire
more, and on hindsight it was probably a good
idea as mother was quite uncooperative! She
couldn't push properly, either being too tired
from the long pain-filled vigil, or not listening
to our exhortations. The situation was
complicated by the fact that she could only
understand her local language which her mother
and only one of the nurses could speak, so to her
whatever encouragements the rest of us gave her was just mumbo-jumbo!
Half an hour into the delivery, she still wasn't
really progressing so Rita decided to assist with
the vaccum pump (the classic hand-operated
version), but even then, the cup wouldn't hold
properly and she had resorted to pushing for
several seconds then expending her energy in
crying and flailing about. Instead of bearing
down, she would push her legs into the handholds
of another nurse and I, and arch her back and try
and push herself off the narrow table she was on.
To make matters worse, she had a full rectum and
a full bladder (which both contributed to the
slow progress) and each ineffectual push was
moving the faeces, not the baby, out. What little
sterility we had quickly went out the window!
Once the poor girl got so dispirited she started
jerking her arms about and her eyes rolled into
her head, and we almost thought she was going
into seizures. Thankfully she hadn't, but by that
time her energy was well-spent and she had to lie
quietly for a few minutes before she could be
roused to start trying to push again.
Finally, with Dr Valerie arriving at the scene,
she diagnosed an OP presentation (unnatural
presentation for the baby, which also explained
the slow progress) and properly sited the vacuum
cup. It was still hard-going, but soon the baby's
head was out. Meanwhile, a lady had arrived some
45 minutes before and we heard the cries of her
baby in the adjoining room, born by torchlight.
The baby was fully delivered at about 4.15 am,
alive and kicking, leaving 3 nurses, 1 doctor, 1
medical student, and 1 mother quite exhausted.
I got back past 5 am, guided by starlight, but
was awoken by the chickens about 3 hours later.
So much for getting my first hands-on experience for a delivery!
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