Betel juice

24 May. Lae, PNG. Finally went ashore in PNG to work. Like many industrial ports, the area around the docks is rough and certainly not scenic. The country-side really is beautiful - lush, green, very high mountains, most of which are tree-covered. However, some of the ranges are green but have no trees, perhaps more recent volcanic ranges. The cloud formations hanging over the mountains add a dramatic effect. The rain showers offer many opportunities for rainbow sightings.

The people are very nice and friendly. But it’s very poor. It’s a 1-hour bus ride on the Lae Highway to the Wampar Clinic. There are many roadside market stands, and although there is bus service, there is a near constant stream of people walking along the side of the road. We travel the roads in a convoy with armed national defense and local security. An American woman confirmed how unsafe it is in this area - armed robberies, carjackings, roadblocks set up by armed thugs. The reports of violent crime seem such a contrast to the smiling, waving throngs yelling “Hi” and flashing us the index finger (meaning we‘re #1 good). I watched a video of the Opening Ceremony made by one of our attendees and noted that the ceremonial dancing in PNG is much more primitive/less refined than the dancing in Tonga and Hawaii. The traditional dress is interesting and rather minimal - the women are topless (and the effects of gravity are obvious) and the men’s loincloths are skimpy.

The Wampar Clinic has 2 small buildings, which we augment with 5 MASH-type tents. The people do hard manual labor, so most of the adults have complaints of back and knee pain along with other medical conditions. Malaria and tuberculosis are not uncommon. Some children have serious hearing loss due to untreated ear infections. Dental hygiene is minimal, so the dental team is busy with extractions. The teeth of many adults are a bizarre red color due to chewing betel nut (do you remember “Bloody Mary” from Michener’s Tales of the South Pacific?). The darkest teeth I saw were the color of red beets! The betel quid that they chew is a mix of betel nut, mustard stick (a type of pepper plant), and powdered lime produced from coral. It’s a stimulant, stress reducer, and hunger suppressant. We saw a man on the roadside spit a giant red stream during our return bus ride - yuck, betel juice!! But they also grow healthy tropical fruits, and the patients bring us delicious coconuts, papayas, lychees, bananas, guavas, oranges, and sugar cane. Our work days are unbelievably hot and humid, and after seeing over 900 patients/day we are totally drained. But some of our Aussie colleagues, ever the party animals, turn on tunes on their iPhones and entertain us with sing-alongs on the return bus ride. Our day-on/day-off schedules are paced, and we’re encouraged to rejuvenate on our day-off (meaning do your laundry and take a nap). We had a treat the other night when we couldn't return to Cleveland by the LCU and they brought us back on the 2 RIBs (rigid-hulled inflatable boats) - what a blast, those puppies fly through the water! The wild wind on our faces was a huge relief from a very hot, sweaty day.
Cheers to all!

Lae, PNG Harbor

20 May Lea, PNG. The 5-day passage to Lae, Papua New Guinea (PNG) went quickly (I mistakenly thought our destination would be Port Moresby). We kept busy by entering patient data from Tonga and Vanuatu into a computerized database, attending meetings (including a refresher session on wound care with emphasis on a condition called “Yawls” - lesions in children caused by an infectious tropical agent similar to syphilis), and packaging medications for the PNG mission. I had a tour of the ship’s bridge - the navigation and steering center. I assisted in the ship’s medical ward by assessing patients, giving injections, dressing minor wounds, and removing sutures. But there was also time for relaxation - movie night on the flight deck. Yes, they set up a giant screen on the flight deck and showed “Just Go With It”. When was the last time you watched a movie under silvery clouds (that gave us a brief shower) and a full moon lighting a silvery sea, steaming along at 12 knots? The ship celebrated the 103^rd birthday of the Navy Nurse Corps, along with International Nurses Day. All of the nurses on board were proud to stand for speeches, pictures, and cutting of the cake with a ceremonial sword by the ship’s captain and the mission’s commodore.
We arrived at Lae on a rainy day with 0.5 mile visibility, which was considered unsafe for anchoring, so we circled outside of the anchorage for more than 24 hours before setting the hook on a beautiful clear morning. The port is busier than I expected, with numerous freighters present. The temperature and humidity today are lower than in previous ports so we’re encouraged that climatic conditions might be more tolerable for work here. The scenery in the harbor is beautiful - steep, rugged mountains with cloud-shrouded peaks (I was told that the tallest peak in PNG is 10,000 ft and gets snow). I’m imagining epiphytic orchids in the tree tops being kept cool and moist by the cloud cover. The ship’s liberty scouts visited a botanical garden today as a possible tour destination, but a tour there will not happen for various reasons. My contact told me that only a few orchids were in bloom - by his description probably Dendrobium - so I’m not as disappointed to not be able to visit as I might have been. My first work day isn’t until Sunday so I’m limited to the lovely harbor view until then. Some pictures will be on Flickr.
Cheers to all!

New Calédonie - très chic!

15 May somewhere between New Caledonia and Papua New Guinea. We had about 10 hours of rough seas during the passage from Vanuatu to New Caledonia (and apparently we were also nearly over the epicenter when the recent earthquake struck), so we were especially glad to reach our liberty port. Picture 2.5 days of French chic in the South Pacific. It’s a French colony of 300,000 residents on a path to independence, its residents are French citizens, and the official language is French. Nearly everything is expensive, and the food is magnifique. The downtown area of the capital city Noumea near the commercial port where we docked is a mix of shops, nice buildings and slums. It’s vibrant during the day but not a desirable area to be after dark. The ship had also arranged for frequent free bus service from early morning to late night to the lovely beach communities, so there were plenty of interesting places to go throughout the day and evening. I got a darling French haircut and hat, a few other stylish clothes within my meager budget, tasted gelato second only to our friend Massimo’s brand “Gelato Massimo”, and ate the most divine French pastries. Unable to stand another cup of the ship’s coffee, I bought a French press (here labeled a ‘coffee plunger‘) and some good coffee, and I’m gaining a fan club in the officer‘s mess. I enjoyed the city tour arranged by the ship, which also included a French wine and cheese tasting. The tour guide, one of only 17 Americans living in New Caledonia, pointed out the many reminders of WWII. The weather was a pleasant change from Tonga and Vanuatu - humid but cooler. Liberty in NC was good for the body and soul.

We said our good-byes in New Caledonia to personnel who had joined PP 11 for only the first rotation of the mission, and we were joined by fresh new faces for the next rotation. Three HOPE nurses arrived, plus a family practice physician and a pharmacist. They’re trying to get their sea legs during a rough start to the 5-day passage to Papua New Guinea (PNG). There is some apprehension about the upcoming mission as Port Moresby in PNG is considered by travelers to be one of the more dangerous places to visit, and we're unlikely to be allowed any liberty. A shame because there's a botanic garden with an large orchid section, and PNG is the center of the orchid universe. But we’re hoping that the humanitarian purpose of our visit affords us a peaceful time in PNG.

Cheers to all!

RAS

10 May somewhere between Vanuatu and New Caledonia. The RAS (Resupply At Sea) is quite a complicated affair. Today’s RAS was performed in clear weather with winds of 18-20 knots. The Cleveland approaches parallel to the supply ship and shoots 2 guide lines to the supply ship. A measuring line is threaded along the forward guide line to keep the 2 ships a specified distance apart (looked like 150 feet), and the refueling lines are then suspended from the aft guide line. The cargo to be transferred has been placed on palettes, netted, and arranged on the aft deck of the supply ship. Cleveland’s 2 helicopters take turns hovering over the supply ship’s aft deck while the supply ship’s crew attaches the cargo net tackle to a hook on the underside beneath the cargo bay. The pilots then swing the helicopter over Cleveland’s flight deck, set the cargo on the deck with guidance from the flight deck crew, and then the heli’s crew in the cargo bay release the tackle. The helicopter pilots and crew seem like ordinary mortals when you meet them but they must be adrenalin junkies to do that maneuver over and over until all of the cargo has been transferred. Actually the cargo crew is also a rescue swimmer, and he said rescues are even more exciting than cargo transfers. Cleveland’s flight deck crew dash around on small forklifts to bring the dropped cargo forward, and then the ship’s personnel form a human chain to pass the chow and mail boxes into the mess deck. It’s a happy day to see boxes of mail, fresh fruits and vegetables. Pictures will be on my Flickr site.
Cheers to all!

Coral, and fishes, and wrecks, oh my!

9 May departing Santo, Vanuatu. I spent a couple of days of liberty going ashore to explore the sights. I’m accustomed to traveling alone so it’s annoying to me to comply with the navy security requirement to have 1 or 2 liberty buddies - you must be within eyesight of your buddy(s) at all times except in the bathroom. So finding someone(s) who want to leave and return to the ship when you do, and do what you want to do ashore can be a challenge (switching partners after departing the ship is not allowed). But we’ve all got the same rules so cooperation is necessary. The first day my liberty partner mistakenly changed too much money into local currency, so we shopped until we dropped, meaning that I bought a cacao pod and a papaya at the fruit market, a hand-painted sarong, tea, toothpaste, chocolate cookies, and a Cadbury chocolate bar (I was in major need of a chocolate fix!). Shopping is limited - despite there being many small variety shops in Luganville, they carry nearly identical merchandise. My liberty partner the second day wanted to go to Catholic mass before the snorkeling trip. Men and women sit on opposite sides of the main aisle and the singing was beautiful. We then met up with a group to go to a lovely resort for Sunday brunch and snorkeling. There were Cattleya and Dendrobium orchids growing on the trees at the resort. The Dendrobium were blooming with pale green and purple flowers. I asked a couple of local women what they call the flower, and after conferring with each other they responded “orchid”, so there’s no interesting Pidgin name for an orchid. The sky had turned cloudy and the breeze had kicked up by the time we got out on the water but the snorkeling sights were still great. Not as many fish as I expected but very good quantity and variety of corals, most of which looked quite healthy. Pieces of wrecked airplanes from WWII were visible, including propellers with and without engines, and assorted pieces of fuselages. Coral growth on a cross-section of fuselage resulted in an interesting structure. We finished off the day with my second trip to the excellent French restaurant for escargot appetizer and warm chocolate souffle dessert.

We’ve finished the first segment of the 3-part mission, and left Vanuatu today. We’re heading for a few days of liberty in Noumea, New Caledonia, which is a former French colony. Some personnel will be leaving for home and will be replaced by new faces. Santo was a great experience - lovely people, very long lines of patients, remote villages, helicopter rides with spectacular scenery, good snorkeling. The most unusual medical condition I saw, probably for most others as well, was leprosy lesions on a woman’s face (as pointed out by an Australian physician who has seen previous cases of leprosy). I’ve started spending a couple of hours on my non-work days shadowing the ship’s independent duty corpsman (medic) in the medical ward, which is similar to an urgent care clinic, to get additional experience. He’s a good instructor and I’m enjoying it.
Cheers to all!

WOW!!

5 May Espiritu Santo, Vanuatu. Saturday and Sunday were 2 of the best days of my life. I was part of a 16-person medical team that went by 2 helicopters (MH-60S Knight Hawk) to work remote clinical sites. The 2 villages are on the coast and otherwise accessible only by boat (beach landing) or foot/horse. Some logistical complications on Saturday led to the helicopters landing on the black sand beach some distance from the originally planned site. So we hiked with the supplies about 10 minutes to the village nearest our landing, and set up clinic in a tiny church, with registration outside under a huge mango tree. A member of the tribe used a shell to call the villagers to the church to announce that the clinic would be held there. The people were shy but after the first brave ones stepped forward we had a steady stream of patients all day. I collected childhood vaccination and malaria infection information for a country database. In the process I started learning some Pidgin English spoken by the locals (“Wanem nem blong you?” means “What’s your name?”). They served us a lunch of yams, manioc, taro greens, pork, plaintains(?), and coconut, which we sampled to supplement our MREs. Their ailments were similar to those we saw in Tonga - ear infections, joint pain, repetitive motion injuries, skin infections, dental and eyesight problems. Lack of dental hygiene results in rotten teeth, and the working conditions for the dentists and dental techs were difficult because the patients needed to be seated in folding camp chairs that we carried in. The landing logistics were solved for the second day and the helicopters landed on a grassy plot at the originally planned site. We hiked a short distance and set up clinic in 2 thatched huts and a church under large trees in a village common area just 40 yards from the breaking surf. The patients were waiting for us that day and there was no hesitation to stepping forward. You couldn’t wipe the smiles off our faces all day long. Again our hosts prepared a lunch for us, and we shared a few extra MREs with them. We were fortunate to have a vacationing young couple from Tasmania assist us as interpreters - they had heard while in Luganville that we would be coming to the area and they kayaked in to help since they’ve become fluent in Pidgin. At the end of the day there was a kava ceremony where the tribal chief presented our team leader with a 7-foot long carved barbed spear to honor our visit. I’m sure that the villagers, like the medical team, will talk of these days for years.

The 30-40 minute helicopter ride each way was awesome. Santo is primarily rugged mountains, with the tallest peak 6000 ft elevation, and covered with dense jungle. The pilots gave us thrilling rides zipping around the ridges and out over the ocean, but the photos through the windows aren’t as great as the actual view because the doors to the cargo/personnel compartment had to be kept closed due to the cargo. Dense clouds on one of the trips made finding a safe route through the mountains a challenge for the pilots. The propellers stirred up the sand for a free dermabrasion during the first day’s beach landing not more than 20 yards from the breaking surf, and it took a while that night to clean the black sand out of our hair and ears. I’m fairly certain that I saw blooming epiphytes in some of the tree tops but I can’t be certain that they were orchids.

Monday was a liberty day and I went ashore with some of the dental folks to a lovely resort to relax, swim in the pool, and have a massage. Dinner at a French restaurant was a treat - escargot appetizer and warm chocolate souffle for dessert were divine. An adventurous person in our party ordered the “flying fox” (fruit bat) entrée, which was served with head on and big teeth showing - looked like a pterodactyl on a plate. She said it tasted like chicken, of course.

I worked patient registration/triage on Tuesday and Wednesday at the hospital in Luganville. This hospital is larger and has more services than the hospital in Vava’u. The days were draining as we saw nearly 800 patients on Tuesday, the weather was oppressively hot and humid, and I was coming down with a massive head and chest cold (respiratory illness seems pervasive on the ship). But the Navy rock band showed up on Wednesday to play for a couple hours near our outdoor triage area, and that definitely added a cheerful touch - my patient and I sang along together to Van Morrison’s “Brown-Eyed Girl” as I took her vital signs (I'm surprised that she seemed to know some of the words), and the patients in the registration queue laughed as the nurses and corpsmen played air guitar and danced the twist and bump.

I’m laying low for a day with this respiratory crud and hope to enjoy shore leave the next day or two.
Cheers!

Santo Opening Ceremony

29 Apr Luganville, Espiritu Santo, Vanuatu. The Opening Ceremony on Santo was quite different in many respects from the Closing Ceremony in Vava’u. The ceremony was held outside of the chief’s community hall. The hall was built of all imaginable materials - the roof was corrugated plastic covered with dried palm fronds secured by chicken wire, the walls were solid wood, lattice wood, woven pandanus, bamboo, and cloth, and the floor was concrete. I thought the simple but rich textures were a lovely contrast to the dull gray concrete block buildings erected in the former East Germany during the Soviet occupation, which Hilarie, JoAnn K, and I saw 3 years ago on the Christmas Nutcracker Tour led by Helga and Jack of Posh Journeys.
Today’s ceremony started with a tribal dance by native ni-Vanuatu (Melanisians) wearing loincloths, palm fronds, leaves, headgear, painted torso and face, and performed in a tight cluster facing inward while chanting and pounding the ground with long sticks. There was also a pig on a leash, and from Michener’s description of the importance of the boar in ceremonial tribal culture in “Tales of the South Pacific”, I had a feeling that it wasn’t going to be a good day for the pig. And so it wasn‘t, as the pig was sacrificed to honor the occasion while we watched. I believe it would be served at a feast in the evening (I‘m eating fish onboard Cleveland, thank you). The sun then broke from behind the clouds, and there were many speeches honoring the hosts and guests. The people of Santo are still very grateful to the US Navy and Army for defending the island during WWII, and for the lasting improvements they made to the Luganville area that are still enjoyed today, e.g. fresh water catchments and filled marshland that reduced the mosquitoes. The ceremony was concluded with a reception line in which the Pacific Partnership personnel formed a line and the locals walked the line shaking the hand of each of us. Thus I got to say hello to all of the local attendees personally. Compared to Tongans, the ni-Vanuatu Melanisians are much darker, shorter, and thinner, and seem more reserved although certainly friendly. I’m putting some photos on my flickr photo stream http://www.flickr.com/photos/babs-pp11.
Cheers!