Wednesday 14th July 2010 Melsisi Village, Pentecost 15 44.43 S, 168 08.19 E

The medical folk conducted a brief clinic this morning and after a short walk down the road to view the land diving tower it was back to sea again the short distance up the coast to Melsisi.

Looking at the mass of logs, sticks and vines which makes up the 20 metre tall tower you have to wonder how an otherwise sane person can summon the courage to climb to the top of this thing with the sole purpose of then jumping off.  But I suppose that’s the point really – to demonstrate courage and to overcome fear.  With the rickety looking tower on top of a hill below which was a paddock cleared of coconut trees for spectators to watch, the whole thing had an air of a coliseum.

Up at Melsisi we anchored in a slightly rolly spot a short distance off the “beach”.  From a distance it looked like a beach, but up close and personal it was really a collection of white rounded stones.  Maybe it’s a beach-in-the-making and we’re just a few million years too early.  Upon arrival we met the founders of the eyecare program, Don and Meg MacRaild and after a meeting with the director of the clinic here at Melsisi, plus others in the medical team, a program of activity was worked out for the next 10 days.

To give you an idea of the medical facilities available to the Ni-van locals, here are a few lines written by our trusty crew member and nurse – Lanie …

Lanie:  “A unique perspective”

Imagine arriving in a village where you’ve heard that there is a hospital with newly born twins, a premature baby, a term baby and 2 patients one with multiple lacerations following a vehicle accident and one dehydrated needing 48 hours of intravenous fluids. This in itself would be an ordinary day in a midwifery unit and a surgical /medical ward for a Registered Nurse in Australia BUT for Morrie the NI-Van- Nurse Practitioner in Pangai it is a totally different kettle of fish! Morrie has been on call for 24hours a day since Sunday and her co-worker will be off island for 6 months.

Chief Luke’s wife takes me on a guided tour of the village we head past the school, walking past the administration building we spot the CLINIC! I peer into the clinic and the day has begun.  Morrie is attending to the injured man. He is seated on a step in a very small room surrounded by a doctor (our Dr Graeme), nurse (our Shirley) and some children and his wife. In the adjoining room there are supplies and stores, only Morrie enters this one! I stop awhile and wander through the other rooms. Bob the “dentist” is out the back the room separated by a door with flywire,  in the middle room Robyn (our doctor) is taking medical histories.

The clinic does not have any lighting nor ventilation. I don’t recall seeing any running water. I note that wounds are cleansed with “a cotton swabs held by an artery forcep and  dunked in “fluid”. The fluid drips onto  the concrete floor then after several wipes with a few dry swabs the forceps holding the swabs are returned to the tray for the next patient.

I am curious to see the hospital. Kathryn (chief’s wife) takes me to an adjoining room where there are three timber beds lined up 2 with patients and one with just wire framing. A intravenous pole stands in a corner with an empty plastic flask.  There are mosquito nets above each bed and there is one window – the room is dark!

I ask Kathryn if I can meet the new mothers and their babies? We go outside and around the corner. There is a  room equivalent to the size of a study. My first impression is it is so dark, it was difficult to see the mothers and babies. Once adjusted to the light I noted that the first bed did not have a mattress just a woven mat on a wire base for the mother of the twins. On the floor between the two beds against each wall were two tiny twin baby boys. The women present told me that the first twin weighed 2100 gms and the second 3200gms .

In the second bed against the wall was a mother with her baby  and a woven mat to sleep on.  A square canopy of mosquito nets surrounded the twins and the second mother and her baby. Another small room adjoined this main room where the third mother and baby lay on a bed with a mattress this time. This baby had been born at 32 weeks gestation and weighed 2000gms. I looked around the room and noted delivery instruments they were clean but not sterile in a stainless steel tray. Oxytocin, vitamin K and an aspiration kit were at the ready!

I return to the first room and family are there to assist with bathing the twins two plastic baths and two women have the babies washed and bundled up before I could blink!
Concerned that the first twin was jaundiced, sleepy and not feeding I assisted the mother with hand expressing we successfully gave the little one a couple of mls of colostrum via a syringe! All present were please to see the little one had some food!
When I asked  Morrie how she managed low birth weight infants she  explained that the women are encouraged to breast feed 3 hourly and sometimes are given sterile water if they are dry! They are survivors! Every morning the babies and mothers are taken outside into the sunlight for jaundice treatment.

I returned in the afternoon. A new shift of family had arrived. Robyn, Shirley and I introduced twin feeding and with some prompting, perserverence  and laughter,  both babies were feeding well and at the same time!!!!
Congratulations to the mothers, women and Morrie for the mothering and care that is given in a very challenging environment!

Smooth seas, fair breeze and well done Morrie

Robert Latimer