I mentioned breakfast as a social event earlier in this blog - occasional downside is that people effortlessly flow into work mode when with certain colleagues so even that traditional sloth-like time of day requires alertness and perhaps sitting up straight before coffee.
Quite a proportion of socialising seems to involve colleagues - a lot of people are flying in/out for short bursts, more in R's line of work than mine (my colleagues don't afford this hotel usually). A sort of exception was last night when we attended a quiz night held as a fortnightly fundraiser for the clinic. R and I invited along a friend (actually originally a friend of my sister but we like him too, and she isn't here to be his friend). We were joined by other clinic volunteers after we had eaten dinner, then discovered we were several cafes away from the correct one so the second bunch cancelled their dinner order and we moved on. Very noisy cheerful place, the Dili Beach Cafe, pizzas looked good but they only had strawberry flavoured icecream. Anyway, our group had to split up to have the correct table size so R, friend and I, plus the new volunteer doctor, joined an Irish couple, also novices in this scene. Quite a bit of arguing with the quiz mistress (?), not just our table, and we came third. Mercifully only four rounds or we would possibly still be there. How many of you know the capital of Burundi? - I confess, have forgotten already, apologies to all Burundians. Ended up taking a complete stranger home (very respectable, dropped him at his apartment gate, no taxis after dark in Dili).
I am lucky enough to have a little car to drive around, makes a huge difference to my comfort and independence, and social attractiveness I suspect. Driving here has its challenges: potholes; poor lighting; lack of road sense in people and animals and drivers; UN power junkie drivers in 4WDs; one way streets without signage; lack of signalling of lane change or turn; torrential wet season downpours..... I gave a cowboy yell the first time I crossed a particular 'no right of way' intersection by nosing out the car with rapid escalation of adrenaline and bravado and impatience, and suddenly, I was on the other side. Certain young men in my family/life crave exitement when they drive - they might find it here, even when only going 40kmh - India would be far more challenging but there are thrills to be had here - and quite a few accidents too, not surprisingly. The taxi drivers can be very particular about washing their cars (not a habit of mine) but apparently they are less concerned about seat belts.
Dili has many restaurants. 'Old timers' tell me they rapidly change in character. R and I have already a few favourites. the Paradise seafood restaurant on the east side of town does wonderful fish but service is very slow (though not slowest in town apparently) when you are at a big table. There is a little Thai Kitchen just down the road. Not fancy but tasty food and very nice woman running it. Today is 'Loy Krathong' festival day and we have been invited to join in the festival this evening, to float lights in a leaf cup and join in some food. I hope the rain has finished for the day. An interesting local delight is chocolate milk and avocado juice, a little overpowering for me though one of my fellow clinic volunteers is almost an addict. The pineapples are great and there are reddish bananas which are reliably tasty.
Today is also a public holiday in commemoration of the Santa Cruz massacre which happened in 1991, when pro-independence East Timorese were killed by the occupying Indonesian forces. I did not organise myself to get to the cemetery for the ceremony, though some other women from the hotel did go. The horrible things in Australia's history seem so long ago, and still so fresh here - That massacre has had many more horrors after it.
(I know there are many things about Australia which need to be addressed, but we have not, in our recent history as a nation, had this sort of thing to contend with and recover from.)
Tuesday, November 11, 2008
et health at the clinic
Working at the clinic is addictive, so much to do, lovely people to work with and for. Not possible to describe the setting as beautiful, desolate and poor would be more appropriate. Very well regarded and trusted by the local people, principally perhaps because of the work of the doctor in charge who has been here since 1999 through the highs and lows of this young country.
My initial reaction was to judge by the standards of the comfortable Australian health system - yes it has its problems, but by golly, not like this. I wondered "why don't the nurses do this or that? are they lazy or incompetent?" But I have never been the sole nurse looking after 46 patients, and I am used to having a pretty regular supply of goods, and back up and training. The nurses (and patients, and other staff) are understaffed, under-resourced and under -trained. They have recently been given oxygen cylinders but no training and incomplete delivery devices. Apart from the language barrier (the nurses' English is way better than my Tetun) it took days to obtain proper delivery devices, then the main valves were too tight so we had to go back to the central supplier to have them fixed, no spanner at the clinic to tighten connections so I had to find a hardware store and buy one (tetun for adjustable spanner is kunci inggriss if you are wondering and the hardware store has the most effective ceiling fans I have come across in et, a pleasure doing business there though staff were surprised to see a malae woman as a customer.) Anyway I have now taught a couple of nurses how to safely use an oxygen cylinder, a wonderful colleague from my last job is sourcing some training materials for me, and this task at least, has progressed. Also need to find a safe but accessible storage space so a passing member of the public doesn't stub out a cigarette near a leaky valve.
The patients of all ages, male and female, are on beds or trolleys side by side. Only the TB patients are segregated but I wonder who is as yet undiagnosed - the clinic does have the lab facilities to test for TB and malaria but often lab staff are short of gloves and masks. Sheets and especially pillows are optional and there are few plastic mattress protectors for anyone to wipe down between patients. the power supply can cut out at any time, the windows are small, high and closed. Some rooms have ceiling fans, and a few floor fans.
The national hospital is cleaner and better equipped but the clinic remains popular. Care, medication and meals are free to patients - I am not sure what the system is at the hospital. The clinic is certainly friendlier than the hospital.
My initial reaction was to judge by the standards of the comfortable Australian health system - yes it has its problems, but by golly, not like this. I wondered "why don't the nurses do this or that? are they lazy or incompetent?" But I have never been the sole nurse looking after 46 patients, and I am used to having a pretty regular supply of goods, and back up and training. The nurses (and patients, and other staff) are understaffed, under-resourced and under -trained. They have recently been given oxygen cylinders but no training and incomplete delivery devices. Apart from the language barrier (the nurses' English is way better than my Tetun) it took days to obtain proper delivery devices, then the main valves were too tight so we had to go back to the central supplier to have them fixed, no spanner at the clinic to tighten connections so I had to find a hardware store and buy one (tetun for adjustable spanner is kunci inggriss if you are wondering and the hardware store has the most effective ceiling fans I have come across in et, a pleasure doing business there though staff were surprised to see a malae woman as a customer.) Anyway I have now taught a couple of nurses how to safely use an oxygen cylinder, a wonderful colleague from my last job is sourcing some training materials for me, and this task at least, has progressed. Also need to find a safe but accessible storage space so a passing member of the public doesn't stub out a cigarette near a leaky valve.
The patients of all ages, male and female, are on beds or trolleys side by side. Only the TB patients are segregated but I wonder who is as yet undiagnosed - the clinic does have the lab facilities to test for TB and malaria but often lab staff are short of gloves and masks. Sheets and especially pillows are optional and there are few plastic mattress protectors for anyone to wipe down between patients. the power supply can cut out at any time, the windows are small, high and closed. Some rooms have ceiling fans, and a few floor fans.
The national hospital is cleaner and better equipped but the clinic remains popular. Care, medication and meals are free to patients - I am not sure what the system is at the hospital. The clinic is certainly friendlier than the hospital.
et early days - the bare bones
I have been in East Timor two weeks and loving it, even though the heat is hot! It is also beautiful, desolate in parts, and terribly poor. Actually they do have money from the Timor Sea petroleum resources and many international donations, but it is taking a while for things to improve (roads, power, health etc). But work is in progress.
I am working in a local health clinic as a volunteer three days/week, and will start a two day/week consultancy with a health provider soon. R is working for a government ministry and I will leave him to tell his own story if he wishes.
We are currently living in the Hotel Dili which is comfortable, clean, well air conditioned and friendly. Breakfast is a mammoth networking opportunity (someone I met told the manager of the health provider I was a nurse, then I had my second job - one of many examples apparently). When lucky there is muesli or similar cereal but we are occasionally reduced to coco pops and chocolate shredded wheat (don't touch it). a gecko has just taken up residence and I suspect a small black mouse also - it moved more like a mouse than a cockroach in the half light of dawn. The sea is just across the road but we can't swim there because the sewerage outlet is also across the road into the sea. In the early morning the sea and sky merge into a gray sheet and the boats actually look like they are floating on air rather than water. We have arranged to move in to a one bedroom apartment on Dec 1, a mixed blessing in terms of social life perhaps. Most of the other apartment people seem to be Portuguese, so may be just a change rather than decrease of contact. And there is a swimming pool, only small but inviting. R is even more pleased than I, plus he does not have to maintain it. I am even starting to look forward to cooking again, though not every night!
I am working in a local health clinic as a volunteer three days/week, and will start a two day/week consultancy with a health provider soon. R is working for a government ministry and I will leave him to tell his own story if he wishes.
We are currently living in the Hotel Dili which is comfortable, clean, well air conditioned and friendly. Breakfast is a mammoth networking opportunity (someone I met told the manager of the health provider I was a nurse, then I had my second job - one of many examples apparently). When lucky there is muesli or similar cereal but we are occasionally reduced to coco pops and chocolate shredded wheat (don't touch it). a gecko has just taken up residence and I suspect a small black mouse also - it moved more like a mouse than a cockroach in the half light of dawn. The sea is just across the road but we can't swim there because the sewerage outlet is also across the road into the sea. In the early morning the sea and sky merge into a gray sheet and the boats actually look like they are floating on air rather than water. We have arranged to move in to a one bedroom apartment on Dec 1, a mixed blessing in terms of social life perhaps. Most of the other apartment people seem to be Portuguese, so may be just a change rather than decrease of contact. And there is a swimming pool, only small but inviting. R is even more pleased than I, plus he does not have to maintain it. I am even starting to look forward to cooking again, though not every night!
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