I stared at the 10m sheer cliff face to get to the next village clinic and wondered why Griffith University hadn’t included rock climbing in their medical degree. I had 30kg of supplies in my pack, the WHO list of essential medicines, and I had no idea what ailments I was about to encounter. I was the first doctor to visit this village in their living memory, turning back wasn’t an option, there was nothing to do now except take a deep breath and start climbing…
PNG is known as “land of the unexpected” and you always need to be ready to be called upon for every situation as a doctor, regardless of specialisation. I travel with my smart phone as full as possible with resources, and my last trip was no exception. I was called to see a new born who the nurse was concerned about. On arrival the baby was quickly assessed as stable and I was soon distracted by the mother, pale, tachycardic and shivering. The nurse had been waiting for the placenta for 2 hours after the umbilical cord broke.
The nurse looked at me for guidance as I had to gather my thoughts. If in doubt, always return to first principle - this lady was in shock, the placenta was the likely cause - the placenta had to come out. I grabbed a pair of out of date sterile gloves and in I went. Unable to move the placenta, I panicked at the massive clots my examination had now revealed.
The nurse and my eyes met, she read my mind as two large bore cannulas appeared. I furiously massaged the uterus with my other hand as I asked for hgone? As I removed my hand to rummage through the drugs drawer – success! Per to call for help. Did we even have any Syntocin – we’d been desperately short, and I had a sinking feeling it was all placenta delivered. Mother already looking better, the nurse cheered, and I held the placenta in my cupped hands victoriously inspecting it for any missing sections – it was intact! I must have looked very pleased with myself as the nurses joked afterwards that they had delivered the baby, but the doctor had delivered the placenta, and asked what I would name it.
However, a lot of this work isn’t heroic. Often it involves long walks with heavy bags full of medication to conduct vaccination clinics, spending dawn till dusk reviewing malnourished children with respiratory or diarrheal infections, testing and treating malaria and referring adults with suspected TB for further testing. But these experiences have humbled me, brought me fear, joy, pride and everything in between. Am I a better doctor because of it? Obviously. Have I given something worthwhile in return to the health care workers and patients I have served, I hope so.
For those of you considering an elective in the south pacific travel with an open mind, be genuine, do not impose your Australian health care views on any community or health care worker, always engage with interest and be transparent with your level of training and you will always be welcome.
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About the author: Dr Mikaela Seymour, is a general surgical principal house officer at the Sunshine Coast University Hospital, who combines her hospital work with her role as an associate lecturer at the University of Queensland. Dr Seymour is also in service with the Australian Army as a Captain and does volunteer work in remote Papua New Guinea. She was the recipient of the 2018 AMA Doctor in Training Award.
Published: 03 Jun 2019