Update on 3/27/13

Update on 3/27/13:
Overall I had a pretty good birthday weekend. On Saturday, Delly (one
of the registrars), along with her husband and daughter- Evelyn, came
to pick me up. Our plan had been to go to the craft market but turns
out it isn’t till next weekend. Instead we went to the “mall” which
consists of a few shops and a grocery store primarily catering to
expats living in Port Moresby. The grocery store, Food World, was
actually quite extensive (compared to my time in other countries you
really can buy most anything here… just have to do a bit of looking).
I was able to find an ATM, drink a coffee, and get a SIM card with the
hope of WIFI. Evelyn was very entertaining and I am quite envious of
her energy.

Delly is considered a senior registrar here which is about equivalent
to my level of training. We spent my entire first week on labor ward
together. She is a very skilled physician and delightful person. The
training system in PNG is a bit different than the States- it actually
takes longer!! After secondary school (high school), trainees enter
directly into medical school for 6 years, then they become a resident
for 2 years (this involves rotating on all services, similar to a
general intern year in the US), then on to service years (which from
what I can tell involves 1-2 years working in an undesirable location
as a generalist), and then onto specialty training where one is called
a registrar- OB/GYN here is 6 years. After completion you are called
a consultant (equivalent to an attending physician in the US). I
still haven’t entirely ironed out whether everybody has to do service
years. Most of the registrars are married and the majority of them
start their families during training. Delly said that on average
physicians are in their early to mid thirties when they have completed
their training.

On Saturday night, Skanda and I were invited to dinner at Florence’s
home. Florence is a midwife working for the WHO teaching midwifery at
a local university. She is from Australia. Along with her husband
Filipe (who is French) and son Archer, Florence has lived in several
different places doing humanitarian work. The evening starting with a
riveting game of Go Fish (Archer is 5) and ended with a conversation
about Florence’s work in Darfur. I really enjoy talking with her and
feel as though we are kindred spirits. She and Filipe were actually
in Timor-Leste at the same time as me in 2010… she too got dengue.

Sunday morning (my 29th birthday) Florence and Archer came to pick me
up for a swim at the Aviat Club. Archer surprised me with balloons, a
birthday horn, and a present… I pretty sure it’s because I’m such a
good Go Fish player. At the Aviat, I was able to do some lap swimming
(which felt great as I haven’t exactly been able to go out for a run
here) and play with Archer. We then went back to Florence’s place for
lunch and so I could use the internet (I was able to get Wifi working
at my hostel for a short period of time but it is very spotty… and
slow). For those that were able to get through- I appreciate the
birthday calls, text messages, and emails from home!! Sunday evening
Skanda, Professor Mola, 2 of the registrars, and I went out for a
birthday dinner (and Mom don’t worry I was even able to have birthday
cake). I hope being 29 is as good as being 28… and that it lasts
awhile… 30 doesn’t seem possible.

I decided to spend my second week in the operating theatre… which to
this point I am happy to say has been an excellent idea. There is one
registrar assigned to the operating theatre (which is Frank currently)
and a different attending physician each day. There is supposed to be
a resident as well… but they haven’t seemed to show up… lucky me .
The operating theatre handles all of the obstetric and gynecology
cases. There are 2 operating rooms, each with a dedicated anesthesia
and nursing staff (however… they don’t show up till 10 AM sometimes).
Anyways, overall the facilities are basic but serve their purpose. I
have never seen supplies conserved to this extreme- who knew 1 piece
of suture could be used to do an entire tubal ligation from start to
finish.

Each day’s case list is quite long… Frank and I start at the top and
just power through. The consultants are present- sometimes scrubbing
in to help and sometimes not. The most common procedure done is tubal
ligation… I think we are single handedly sterilizing PNG. No, in all
seriousness, there is a huge push for family planning here given the
poverty, lack of education, and overcrowding. Most days there are
6-10 tubal ligations completed under local anesthesia with a bit of
sedation. The remainder of the case list so far this week has
consisted of several dilation and curettage, several exams under
anesthesia (primary for advanced stage cervical cancer), a few
cesarean sections, several exploratory laps for ovarian cysts (think
the size of a watermelon), and a few hysterectomies. (and it is only
Wednesday!) The registrars have great autonomy here and are very
competent. The general principals in the OR are similar to home… with
a few modifications (the most drastic- there are no emergent, or even
urgent, cesarean sections- but with no fetal monitoring I’m not sure
what I was expecting). Today a cesarean section which was being done
for “fetal distress” was postponed till after a hysterectomy (I was a
bit anxious to say the least… but in the end the baby was ok…
luckily).

Regardless, I am looking forward to the rest of my week. Oh and
Maureen arrives not tomorrow but the next day (Friday March 29th)… I
had the hostel attendants make up her bed and bring in extra towels 
Yah to not living alone anymore.