It’s been a tough week for our community with back to back “hevis”. There have been a number of injuries, a serious sickness and a death in a nearby village and we’ve had a week of being medically involved more than normal.
Since our focus is language learning we try to keep our medical contributions to a minimum for two reasons.
Firstly we’re limited in what we can do; if antibiotics and wound care can’t take care of it there’s not much else we can offer – apart from a helicopter ride to hospital (and for that to happen it needs to be a genuine emergency and the flight schedule needs to work out just right).
Secondly we don’t want to get a reputation for being quick to help so that everyone and their dog (or pig) come for plasters (band aids) and bandages. Examining patients is time consuming, and there’s only so much language we’re capable of gleaning (at our current level) from asking about their sickness.
We do however want to help when it’s needed and when we can do something. We often agonize over the wisdom of giving medicine and so sometimes it’s nice when it’s nice and clear. Our “Where there is no doctor” book is getting a workout!
First up was a little girl with a fever (according to her mum, but none on examination) and respiratory distress. The little one was working to breathe and coming in at 80 breaths per minute. We suspected pneumonia and seeing that this 9-month-old girl only weighs 4kg we went ahead with antibiotics. We didn’t want to take chances when she’s so small and has the potential to become very sick very quickly.
Happily, her vitals improved the next day, the breathing rate came down and after finishing her course she was ready to go home (2 1/2 hours hike away).
Next up was a young man who’d had his hand cut open by his friend. They were hunting a rat (presumably by digging at its hole). The rat ran out and he went to grab it. Unfortunately his friend went to hit it with his machete and got the hand instead! (I never asked if he had the rat in his hand actually. I’d be super impressed if he grabbed the rat, got hit with a machete and held on to it nonetheless!)
He came with his dad 2 days after it happened and it looked like this:
What’s nice for us is that being 2 days old it was too late for stitches. We aren’t offering stitches yet (remember point 2 above) and so it was nice to not be in a position of knowing what should be done, but not being able to offer it. The right treatment is to clean it up and cover it – possibly with a course of antibiotics to guard against infection (as it’s a deep, dirty knife wound). We went with clean and cover it with no antibiotics (we recommend them, but they need to do the 6-hour hike to Pal to get them).
We gave some pain killers and half an hour later had him come up to our sink and scrub it clean with soap, squirting water out of a syringe at high pressure to get at all the fleshy bits and clean them out as well as possible. Another happy customer.
Next we had one of our older guys ask us to look at him. He got caught out in the rain and since then his cough (which he always has) has flared up. Unfortunately, after a life of chain-smoking, it seems he’s got bronchitis. All we could do was to advise to stop smoking – which he was happy to hear actually as he’d come up with that conclusion on his own (every time I smoke a lot my cough comes back!) and was happy to have confirmation.
Tragic news though was that a village an hour and a half away from us had a teenage boy die. He was climbing a betel nut tree when it snapped under him (they range from thigh to forearm thick and are many metres tall). Down he fell and landed on top of a sapling stump. It’s very common for our guys to cut jungle saplings and leave the base about a foot high, usually pointed. He fell and landed with his windpipe on this protruding sapling stump.
Friday last week actually (2 days after the fall) his dad came to see us to tell us about it and to ask for any medicine we could give. We apologised that it didn’t sound like this was something medicine could help much with, and in any case, we had to see him ourselves. We didn’t grasp the severity of the boy’s condition from the father’s message, he seemed so calm and unconcerned by it, and listening to his description of it, it sounded like a minor injury.
2 days later our community got the news that the boy had died in his sleep. Our community was shocked. “We don’t know why this happened, he was a young man, he shouldn’t have died – can you look on your computer for us and find out why this happened?” one of the older men asked. “Sorcery caused him to climb up the tree and sorcery killed him” said a young woman.
The next day, while visiting the body, a member of our village almost had his neck chopped open with a machete. The boy’s immediate family were furious and started breaking houses and threatening people.
All of this is hinting at much deeper things that we’re not ready to learn about yet. There’s sensitive secret knowledge, fears, taboos and beliefs that we need to know about – but need to investigate carefully (i.e. not now).
Our community were shaken and they were eager to be reassured by us that the message we’re bringing will have answers. They would understand we told them. One of the older guys insisted on giving us a history of the church group in our village (I guess it might be because he wants to make sure he’s not hiding something that could cause bad things to happen to him and his family).
We told them that it was just like the group who came before (40 years ago) and worked had cut a garden for them and were giving them the food from it. Shortly after, though, they left and they didn’t leave any of their tools behind. You’ve been trying to look after the garden, but you don’t have a machete or an axe.
We’ll cut you a new garden, but we’ll also leave you with the tools so you can continue the work of the church. We’ll teach you to read and write and we’ll translate the Bible into your language so that you’ll be able to work — you won’t be dependent on others to do the work.
“Our livers are good” is the response they had to that.
And to risk this blog becoming too super long, here’s the latest one. One of the teens in our village has been sick for a while but over the weekend took a dramatic turn for the worse. I went out to learn language on Monday morning, only to find that no one was around. Everyone was resting because they’d had an all-night meeting to ‘finish the heavy’. They concluded that he must have been big-headed towards his parents and thus this sickness came up. Everyone gathered and declared that the sickness would be finished soon; a pig was killed and everyone ate the meat (we also got a chunk later).
Hearing about this, I decided to go and check on the boy to see whatwas up. On my way down I was told that ‘the sickness was finished now’ but seeing as no one was around up at our end of the village, I hiked down. I was surprised to find that the boy was severely ill.
Fever, sweating, shaking, mental confusion, high pulse, high laboured breathing rate and wheezing between breaths. I suspected pneumonia and as quickly as possible went home to prepare him some medicine.
Today I’ve checked on him again and given his second dose and am delighted to say that he’s still sick but all his vital signs are improving.
There’s just so much here. No one asked us to examine him and there’s this night-long meeting to ‘finish the heavy’. Since he’s on the mend, we feel it’s more appropriate to get all the recordings and stories we can about this. There seems to be a thing going on where they agree on a certain thing and that agreement makes it actually happen.
When I slipped a bit on the way back home, my Kovol friend cried out “Don’t fall down!”. I asked him about that and, sure enough, there seems to be something there — he cried out and as a redult I didn’t fall down.
Suddenly our landowner’s constant refrain while we were milling ‘stand up strong and walk about’ seems less like a funny little phrase and more like something pregnant with meaning…