2/22/2010

Filling you in on the last week…

On Sunday (Valentine’s Day) Eva and I met the two Australian medical students (Dan and Liam) at Hotel Timor for lunch, dessert buffet, some pool time, and the hope of free wireless internet. As usual things did not go quite as planned- lunch and the all you can eat dessert buffet were amazing, we snuck into the pool area and lazed around for hours no problem…. the internet however was of course a myth (thus the delay in the last posting and no new picture). I have realized how much I take internet access (on laptops and iphones) for granted at home.

I returned to clinic Monday morning after basically recovering from dengue (although my legs were still covered in a rash for a few more days). I spent last week traveling to a few mobile clinics- seeing around 50 patients in 2 hours at one Eva and I went to together which was a 3 hour drive west of Dili (the evaluation at mobile clinic is very brief and really serves as a means of identifying those few patients who are very ill needing to be brought into Dili for further evaluation/treatment as well as to ensure these communities feel their health concerns/needs are supported). I was able to assist in/observe a few deliveries this week which was also exciting. I have been a bit disappointed in the amount of obstetrics Eva and I have been involved in… the midwives at the clinic handle the majority of the deliveries and it always seems our days are filled with other tasks- unable to just hang out in maternity.

The malnutrition program continues to function and has been greatly aided by the addition of a pediatrician from Australia. Her name is Maggie and she will be spending several months here in Dili. She was excited to work with Grace and I on the program and (as I have hoped to see other parts of the care provided by BPC) she has basically taken over coordinating the daily efforts. We continue to have a large inpatient population of tuberculosis (TB) patients which has been quite interesting. The advanced stage TB presents in Timor Leste is basically unheard of in the United States. Eva and I are both learning a great deal about the varied presentations, treatment, and prevention strategies. Aside from malnutrition and TB patients there are several cases of malaria, dengue, pneumonia, pylonephritis, urinary tract infection, pelvic inflammatory disease, leprosy, mastitis, and gastrointestinal worms.

Last Monday Eva and I were invited to dinner at Tracy Morgan’s home by Dan (one of the Australian medical students). Tracy Morgan is an expat living in Timor Leste working for an NGO… she is fairly well known due to the length of time she has been active in the country/Dili community and because she owns a large home where she houses many foreigners traveling through Timor Leste (Dan is currently living there). The dinner party was in honor of one of the Irish girls living with Tracy and Dan as she is leaving the country to return to Ireland. It was a wonderful dinner and I write about it only to give some insight into the diverse group of foreigners we have met who are here in Timor all working on various projects. There was the Irish girl working for the UN, an Australian working for the police force in Dili, an Australian working for the education system, an Australian working for Marie Stopes Clinic (a family planning center), a Japanese girl working for the office of immigration, a Tasmanian pediatrician, two Australian medical students, two American medical students (Eva and I), and Tracy who is a lawyer by trade. Needless to say dinner conversation was interesting as we enjoyed pasta with marinara and feta, egg plant, garlic bread, red wine, and mango crisp with ice cream for dessert (definitely the best we have eaten since our arrival). It has been great to interact with so many individuals from varied backgrounds.

Now… for the highlight of this blog… and possible the entire trip!! Eva and I spent the weekend in Atauro, which is a small island about 30km north of Dili. The island is 140 sq-km, has a population that totals around 8,000, and only two small cities with occasional electricity. Dan, Liam, Eva, and I all decided it was time to get out of Dili for a weekend and explore Atauro. We boarded a ferry on Saturday morning for the two hour ride across the Wetar Strait. Upon arrival we walked to our accommodations for the weekend called Nemas. Run by an Australian named Barry, Nemas, includes 5 thatched huts right on the beach. We were fortunate to stay in the largest hut which actually had sleeping space for around 8 people and open air bathroom facilities in back. The other huts were occupied by a group of 3 Australians, 2 Portuguese, and a group with 1 Australian and 2 Portuguese. We all enjoyed each other’s company as we dined together in the main hut where Barry and his extended Timorese family live.

After arriving on Saturday, eating a bit of lunch, and getting settled in we spent the afternoon enjoying the beach, reading in the hammock, and playing a bit of Frisbee on the beach. Dinner was served again in the main hut and then the majority of the guests at Nemas returned to our hut for some music. Dan is a talented guitar player and singer (Eva joined in on a few songs and experimented with the harmonica which was great). It was really the perfect ending to an excellent day.

On Sunday, after breakfast and a café Timor or two (East Timor is known for its wonderful coffee), most of us guest loaded in Barry’s small boat for some snorkeling. Having never snorkeled before I was a bit apprehensive but let me just say it was amazing!!! The coral reefs around Timor are supposed to be some of the best in the world and I was reminded over and over again by the other guests how fortunate I was to have this be my first look at life in the sea. We spend several hours flipping around the crystal clear water looking at all sorts of sea creatures… just long enough for both Eva and I to burn our backsides. The remainder of Sunday afternoon was spent in the same manner as Saturday afternoon. I finished another wonderful book in our hammock, the title being “What is the What” and recommend it to anybody looking for something to read. The only downside of going to Atauro for the weekend is the only way to return to Dili is by fishing boat on Monday morning (the ferry only goes for the day on Saturday leaving around 3 PM- not enough time to enjoy the island). So at 3:15 AM Monday morning the alarm went off, all of the guest from Nemas enjoyed one more cup of café Timor together, and loaded in the back of a truck at 4 AM to head to Vilo to catch our boat. The fishing boat was better than I anticipated (we had heard horror stories of foreigners scooping buckets of water out of the bottom of boats as waves crashed over the edge wishing they had a life jacket). Our boat was much different than the image I had in my head. The majority of people stretched out on the deck and slept during the 3 hour trip back to Dili. I stayed awake, saw a few dolphins and flying fish in the early morning light, enjoyed the ride/breeze, and watched the sunrise over the water and Timor. It was truly a wonderful/perfect weekend- great atmosphere and great company. Eva and I returned to BPC refreshed for another week.

This week looks to be very similar to those previous. Eva and I plan to head out to several mobile clinics after morning rounds and spend our evenings with the friends we have made here. We went to the US embassy this evening as a birthday party was being held in George Washington’s honor- turned out to be a standard BBQ by the onsite pool. Eva and I enjoyed a cheeseburger, Diet Coke (for me), and a beer (for Eva) while chatting with several military personal who are working with the Mercy Ship (a naval boat with first class facilities that travels to foreign countries providing medical care). Turned out to be an interesting evening… the US embassy grounds are almost embarrassingly extravagant compared to the surroundings (not sure what else I expected). On Thursday we plan to go out to dinner, maybe Thai, as both Liam and one of the Australian doctors we have spent time with will be returning home on Saturday. Friday is Dan’s 31st birthday (Australian medical student not Dr. Dan) … the plan was to celebrate, however Dan became ill after returning from Atauro… so we will have to wait and see how he is feeling by Friday. Regardless it should be a good week.

Eva and I have booked our return tickets to Australia. We will be spending some time in Darwin and Sydney both before heading home on March 13th. Hope this message finds everybody well... and for those in Iowa while it is scary to say… I miss the snow.

(PS- I apologize for any typos/improper grammar as I have not been proof reading)