Notes from TDY, Part 2: Singh

SMEE time!  The name makes me think of the hapless first mate of Captain Hook in Peter Pan and the adjective “hapless” is not entirely inappropriate.  The situation is borderline ridiculous- here we are, not speaking the language AT ALL and entirely at the mercy of the hired drivers and translators.  And, as it turns out, we have an Indonesian military and police escort!   I’m not sure if they are watching out for us or watching us but either one is fine.  

So, yesterday, we left Manado around 1900 and arrived at Sanghe shortly thereafter.  I think the ride is 3 hours although I definitely have no real idea.  We mustered this a.m. at 0630 (classically, I underestimated my rounding time so I was almost late).  Then we waited around for a bit then headed out on the Bandaid boat.  This time on the bandaid boat, I was completely fascinated by the driver who was this MMC guy who was the screensaver on all the command computers for about 5 days.  In that picture, it looked like he would knife you and then take your cash, even if it was a known fact that you were carrying less than $5.   When driving the boat though, he looks pretty different and is wearing glasses.  This alarms me.  I mean, is it that easy to disguise a person’s nefariousness with glasses and a safari hat?  Apparently, for me, yes.

So, we arrived in Singhe, milled around on the pier and were taken to the helipad/MEDCAP site.  There, we picked up too few bottles of water for the six days we’re here (this was mildly disconcerting).  Next, we went to the hotel which is actually pretty nice.  There is AC, clean water, no bed bugs and two separate beds!  (I’m rooming with another resident).  

We had breakfast/lunch downstairs which was pretty good.  Then, we went to the beach.  It was awesome!  It was a black sand beach with some pretty good snorkeling.  The water felt amazing.  The beach was beautiful and we were definitely a spectacle.  White people in bathing suits on the beach are a pretty uncommon sight.  Although the island is gorgeous, it’s pretty remote with little to no tourism.

Then, our civilian OIC brought us to the pier to pick up the rest of the water.  Great news on the water, not so great showing up in our beach gear.  Le sigh.  But now we are set with water and I’m pretty stoked we’re here.  We’ll go to dinner in a few hours and then go to the lecture hall tomorrow.

Dinner was pretty good.  It was at a seafood restaurant just down the street.  There was rice, fried whole fish, noodles and a delicious egg drop asparagus soup.  Dessert was fresh fruit, which was pretty awesome!

Oh, I also learned that we were WAY underdressed at the beach.  Apparently next time, we should wear gym shorts and a tank top.  Ooops.  Fonne, the health ministry person working closely with our group said in reply, “People fool around in more than that!”
SMEE, Day 1.  So the SMEE started on Monday after a fun Sunday.  There were about 140 people there.   The intro lectures were fine, but then our OIC launched into a pre-made talk from the USNS Mercy that was so awful and awkward.  The translator had difficulty with a lot of the scripted flowery phrases and for whatever reason, she did not paraphrase.  Yikes.  Fortunately, the next lecture was way better with a nice ice breaker.  Dr. Medina greeted the audience in Indonesian which they loved.  

 When the conferences were over, there was an extended photo taking period and some time to talk with local physicians.  One woman asked about a child with a cleft lip/palate and another asked if we fixed VSD (ventral septal defects) on the ship!  That’s crazy!  While there is lots of state-of-the-art equipment, we are definitely not set up for CT surgery.  It’s interesting how many people think that the Mercy is a miracle ship that can fix anything.  This was also apparent at the MEDCAPS as well.
After the SMEE was over, the group headed to the MEDCAP site where we had heard we were desperately needed.  The obnoxious AOIC of the group asked us what we were doing there, but everyone else was happy to see us.  Melissa and I saw several patients and then I watched a few dental extractions.  After the MEDCAP, I did a yoga DVD in my room and then headed to the restaurant down the street.  

After dinner, I headed out with a group from dinner but then soon joined another that included one of the peds resident. 

If you ever asked what I thought I’d do in my life, singing karaoke in Indonesia would not be something that would have rolled off the tip of my tongue.  But after a delicious dinner and wandering the town, we ended up back at the dinner place and started in on the karaoke.  It was so much fun.  A few of the guys from the MEDCAP and I hung out and it was awesome.  
MEDCAP day 2.  While the rest of the SMEE group headed to the conference, I went to the MEDCAP since I wasn’t lecturing and I had been asked to screen a potential surgical patient.  There were SO many patients.  There were several easy-to-treat problems, but there were  many patients that we couldn’t treat effectively.  Just like in the States, it seems hard to convince people that chronic medical conditions are not curable with 1 month of medication.  In addition, some of the “miracle worker” expectations carried over with people bringing their children (peds and adults) with cerebral palsy, Down’s Syndrome and epilepsy.  There was also a woman with a huge football size, fungating, necrotic left breast cancer mass.  It was really sad.  Apparently, they don’t do breast cancer screenings, even the practioners.  There was a right infraorbital mass that was eventually brought on the ship (she underwent a huge cervicofacial advancement flap after excision of the biopsy-proven basal cell cancer two days ago).  The translators were uneven in quality- Dr. Patricia was wonderful while Desmi flat out made up symptoms up to fit her vocabulary.  It was a long, tiring day and very interesting.  After dinner, I reviewed my lectures and went to bed on the early side.   
Day 3, SMEE: I gave my lectures on pediatric airway and burns.  It went really well.  People were interested and some even took notes!  The funniest moment was when the translator “translated” my impression of a stridorous baby.  We had lunch at the Chinese noodle cafe which was pretty delicious.  Then we went to the internet cafe, I wrote Rob through another girl’s email (cue my jealousy ;o).  We didn’t go “swimming,” much to the disappointment of the security detail.  I went shopping instead and bought two recorders!  One for Melissa and one or me.  We played many songs and have several song title!  That afternoon, we hung out and ended up getting “caught” with an open beer by the bitchy AOIC.  She went straight to the OIC for the MEDCAP who told CAPT Medina, “Are you going to handle this or am I?”  Buzzkill!  We were pretty distraught at the time.  We were worried that somehow we’d ruin it for all the residents.  Fortunately, when we got back, both of our bosses were like, “Wait, how is that a problem?”  There wasn’t a policy for the SMEE, boo-yah!  They also intensely dislike the AOIC.  Yes!  That night (back to Day 3), we went to the same restaurant and had a lighter dinner- I was getting tired of fried food.  That night, there was a culture show with a batik bamboo instrument band and really good Church singers.  Miss Indonesia 2010 made an appearance.  She really wasn’t trying very hard.  While a woman doesn’t have to wear make-up, you would think if you made your fame and fortune on your beauty, you’d try and work it while you had it. 
On Thurday, we finished up at the SMEE.  We toured a nursing school, went to dinner and then decided to go on a mini-Blue Bus as a group.  The first van had no sound system so we switched vans and went into our “Club Techo” van.  We toured around Singhe with our police escort close behind and bumped to some totally bitching music.  It was hilariously fun!  When we came in, Melissa and I were first and the AOIC was SO pissed that it looked like we were having fun but we made sure that she knew we were “chaperoned” and accompanied by the rest of our group. 

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