Farewell Levuka

RACH

My last day at the hospital arrived far too fast, I cannot believe that i have been working there for 4 weeks! The day began as usual with the ward round, but being my last day everyone was even more willing to give me jobs to do . Then I headed down to the clinic where I was the only “doctor” on as the other was on a medical outreach trip to the surrounding small islands. So i had a very busy last day working through the majority of my lunch.  But after a hectic day of fractures, infected scabies, a miscarriage and plenty of children with abdominal pain or asthma i was rewarded with a farewell tea party by the staff. Everyone was asked to bring a plate of food to contribute. I brought a cake that we had got our housekeeper Katherins daughter to make and make an England flag with Vinaka, the Fijian word for thank you, in it which they all found very amusing for some reason. Also after a long search round all the Levuka shops we realised that a Thank you card does not exist on the island. We also realised that even trying to find card to make our own was a very big task and we bought probably the only card in levuka! The night before armed with bracelet thread and a sewing needle I had the task of making 3 thank you cards, the hospitals, Katherins and one for the school as Toms artistic talent is lacking to say the least, especially with limited resources ( self recognised evaluation not just me being mean). 

It was a  lovely afternoon, most of the staff came along and they had a long speech saying thank you and i followed suit. After indulging on all the fijian cakes and doughnuts we all headed outside to burn them off with a big game of volleyball !! The sun was shining and it was great fun J I even think i have improved abit from the beginning , although i think my technique may be a little unorthodox !!

TOM

With a slightly less busy last day I was able to sneak out during the morning to buy a clock as a thank you present for the school. I had heard rumours of a ‘supprise’ for me that afternoon so a present seemed to be in order. During my whole time at LPS the only clock in the school had been tempremental at best so this seemed like a pretty appropriate present as a school definitely cant operate on Fiji time!

Bearing rach’s hand made card, katherins cake, and the clock, i headed into my lunchtime farewell party in the school staff room. Here the table was laden with all sorts of homemade food, the Indian women had brought in things like rotis and samosas while the Fijian staff displayed their repertoire of fruit pies. With all the 30 or so teachers present (no students) one of the staff made a speech thanking me for my time at the school which was really nice and thoughtful! The principal was then asked to present me with a big bag of presents (a bula shirt, an LPS sports top, and miniature Fijian drums, war clubs, and kava bowl and a caard signed by all the staff). Before eating the chaplain said grace over the food and was very moving in what he said about me.

That afternoon there was no lessons and i spent the afternoon playing tounch rugby with the students ! Great way to end my time at the school. After playing I went for what I thought was going ot be a gentle stroll up a hill with one of the teachers but it ended up with me tearing my chinos from seam to seam and completely breaking both flip flops while scrambling up a steep mountain. After an hour long almost vertical climb we made it to the top, knackered!! Great views but i did not know thats what i was in store for. After sliding most of the way back down on my bum the teacher gave me a lift back to  our cottage where rach and i quickly got ready to go for a farewell grog with the teachers.

 The teachers were all very welcoming, giving us priority seating in front of the kava bowl. After 4 weeks  it seemed we had advanced from the “low tide” bowls to what we’d call medium tide, still not  Fijian “high tide” kava drinkers yet.  After a few hours of drinking and eating some Fijian curry we then went on to have a final meal at Whales Tale. Before leaving all the teachers sung a traditional Fijian farewell song for us, it was a really nice touch, and very well practiced it seemed, with the males and females having different roles.
It was a lovely evening to top off our amazing and unforgettable month in Levuka Town. 

Caqalai

Organising another holiday on our holiday we headed to another small island called Calaqai (pronounced thangali ) for a one night stay. We were once again reminded of “Fiji time” as we waited for nearly 2 hours for our pickup! But once they eventually arrived we clambered into a rickety boat and set off on the beautiful boatride towards the island, seeing a turtle on the way!

Caqalai is the neighbouring island to Leleuvia where we had spent the previous weekend and was just as idyllic but with a more back packer style resort . The island has a small island called Snake island reachable by foot at low tide and as the name suggests is occupied by lots of big snakes !

The sandy beaches led out to beautiful snorkelling spots, full of colourful coral and millions of fish!

As has been a theme on this trip we made friends with the locals (or the staff in this occasion) and played beach rugby and volleyball with them!

We had another delicious lovo (Definitely the best type of food in Fiji) and after eating we were given a private tutorial on how to weave baskets out of palm tree leaves.

Before leaving we jumped onto a snorkel trip to honeymoon island with a couple of the guests we had been chatting to around the bonfire the evening before. This was the tiniest and most exclusive island we’ve ever been to- basically just a few palm trees and greenery surrounded by a white sand beach!

Reluctantly we headed back to Levuka late on Sunday afternoon. Feeling lazy we went to kims Chinese restaurant for tea and bumped into the two Fijian guys who had ‘captained’ the boat. We ended up playing drinking games and woke up for work on Monday feeling like we needed another holiday to recover!

Levuka Public School

Levuka Public School (LPS) has about 450 pupils from years 9-13.

 

The school itself looked amazing on first appearance, it is a world heritage site after all, having been built as the first school in Fiji. However, on closer inspection i began to notice that many of the wooden buildings don’t appear to have had much work done to them over the last 135 years!

The staff were all very friendly and made sure to talk in English when I was around, only occasionally slipping back into Fijian. I had my own desk in the staff room- although finding a chair was be challenging at the best of times, and in true style my desk was messy, stacked full of books and paper.

The school chaplain

One thing was clear, I stood out like a sore thumb at the school! Nooone has ever volunteered at the school before so all the students were amazed by the new white person. They were all so frtiendly though and just want to chat at every possible chance and find out about England etc. The students were also incredibly well behaved- I wasn’t that good at school. Maybe its because I was still new, or maybe the overarching threat of corporal punishment enforced by the school.

sneaky photo inside a year 9 class

I taught year 11A English, year 11B Geography and occasionally year 12 Geography. I found that I really enjoy teaching, which to be honest I hadn’t expected. I thought that I would be given limited responsibility, working more as a classroom assistant, but instead I was put in a classroom with 40 students of 16 or older and asked to teach. Intimidating at first when most of the class were bigger than me (typical Fijians), while all the boys (and some of the girls) also have beards.  

I was also allocated to a house, Ma’afu! This was the green house with the emblem of a neck braker club! Much better than Tanoa, Qio and Mara! My first 2 weeks were spent supervising/watching the students doing a Fijian Meke (a tribal Fijian dance with spears) during the afternoon as students prepared for the 135^th anniversary.!!!

Ma'afu meke dance practice

 Assembly was held every Monday (but also whenever there is any form of large scale announcement) and involved all students standing in neat rows on the grass outside the staff room. Here the Principle and Chaplain addressed the school before the Assistant Principle orchestrated some army style standing to attention and turning etc before the national flag was raised and students are dismissed.

assembly

Levuka Hospital

Levuka is home to the only hospital on the island of Ovalau with a population of 8000 fijians but it also caters for  Fijians from the surrounding small islands whom travel by boat to the hospital if their illness cannot be managed by their local nursing stations.

It is only a small hospital working more as a GPs practice with only a few admissions at a time on its wards ( around 10 patients or so). The building itself  is relatively new and has a fantastic coastal view. It has provided me and Tom with a very scenic walk in in the morning, which we are really going to miss.

View from outside the hospital 

The downstairs has a front waiting room where the patients get triaged by the nurse and pick up their 'notes', an A5 folded piece of card  with lots of past history sheets stapled in in no logical order.

 

There is then a daily general outpatients department where I spent most of my time manning one of the two consultation rooms. Here I spent my time impersonating a a GP :P taking histories and examining patients with an array of complaints, performing simple investigations when necessary (Xray , U/S, ECG & blood work facilities is pretty much all that the hospital offers & even then anything other than FBC has to be send to the mainland) medicate them ( again only a small  number of medications are stocked) and admit when necessary. Patients could also be referred on or choppered ( costing FJ$5000) to the well equipt hospital in Suva if out of the remit of the Levuka facilities & physicians knowledge.

  

The majority of my time seemed to be spent treating the  mannyyyy wound infections that come through the door ( it seems any cut gained in Fiji is doomed to need antibiotics). In addition to wounds and scabies there are even more patients just wanting sick notes complaining of "body pain", numerous rugby injuries, whilst i remain on the lookout for anyone that may have dengue, but generally just a mix of similar issues to that of the UK. Although dissimilarly from the chatty patients of the UK, taking a history from fijans is a million times more hard work! They always give one word replies, tend to just agree if you ask them a symptom and they seem to know nothing of their past medical hx and its not like their “notes” will help! Oh well adds abit more of a challenge i suppose.

A specialist clinic also runs daily fluctuating between Postnatal clinic, antenatal, diabetic and hypertension. The 2 doctors here have been great at getting me involved, however I would definitely call it being thrown in at the deep end. They let me run the antenatal clinic for  2 of the weeks, watching me with the first few patients and then telling me just to come and get them if I need any advice. With the hospital being so small it is usually pretty easy to find one of them when in need...luckily.

It took me awhile to get used to having so much responsibility, I definitely asked my fair share of questions during the first 2 weeks but gladly i did get more used to managing patients and having to advise patients on their conditions as the health education of patients here is very poor. I did feel a bit like i was playing doctor though, sat in my own room armed with a prescription pad. Gladly though i didnt feel too out of my depth as the doctors were never too far away to double check things with and the nurses were also a great and friendly resource.

Upstairs in the hospital they have the wards, ( womens, mens, maternal, paediatric and labour). Each morning the ward round is ran by one of the two doctors. However there only tends to be about 10 patients maximum so you get to know them pretty quickly.

They have a small operating theatre where they deal with minor wounds needing surgical attention and other simple procedures such as circumcision. My only visit was to assist when one of the prison inmates had slit his wrists. It was quite a bizarre scene. He was lying in his orange jump suit with a Bula shirt wrapped around each wrist whilst 2 prison officers stood watch in big boots and hats. I wouldn’t say it was the most sterile of procedures.... and the prisoner found it highly amusing when his wrist turned into a “sprinkler”.  Sadly the same man returned only a few days later having ripped out the stitches and lacerated his wrists further... With no one on the island fully trained to deal with mental health issues, once treated,  he had to be transferred over the mainland.

The hospital staff are all very friendly and I really enjoyed being part of their little hospital community. After a busy days work they end the day with a game of Volleyball or netball together on the court inside the hospital grounds which is always good fun. There is constant banter , although i can only ever understand half of it as its often in fijian! 

During an afternoon in the hospital one of the nurses was rushing round asking everyone what their blood group was as an inpatient had a Hb of 4 and was in desperate need of blood before they attempted to get her medically evacuated to Suva to stop the gastric bleed. I announced that I was O+ and was whisked away to donate the blood for the patient ! It was nice to think i was helping someone and i was overdue to donate anyway so why not in fiji !!

During my time I got to help with a birth which I enjoyed and was allowed to practice my suturing skills when repairing the ladies perineum following a tear during birth. The women here get no pain relief at all. Not even gas and air.

Other than that i have got to do plenty of cannulations and venepucture, speculum exams, suturing, casts on various fractures, catherisations, PR exams ( not the most enjoyable exam for anyone) and also an evacuation of retained products of conception after a miscarriage.

It was great being allowed to be so hands on J

Best wheelchair i have ever seen. Great improvisation.