I left the Solomon Islands on a high.

The week following the South Pacific Nursing Forum had been amazing. I held a three day workshop with all the nursing supervisors, the aim of which was to create a sense of responsibility in them. We wanted to encourage them to be the change champions needed to pull the nurses out of this hole of doom, gloom and helplessness they seem to have fallen into. It is so hard to break through, to gain trust and confidence in people of the Solomon Islands. They are very reluctant to share their wants, needs and expectations with you but I finally felt that that something was happening. It was slow and at points, pretty bloody painful. A bit like sticking pins in your eyes if I’m honest. However, there were times when I could see a spark of enthusiasm. Interest slowly started to grow and people were voicing ways in which they could become more involved. We spent the days talking about the importance of research, of Evidence Based Practice, audits and reflection. I wanted to show them how, despite not having much, they can start to think about changing and developing practice, making a difference to the quality of healthcare they delivered. Mostly I wanted them to understand that doing anything was better than nothing. I wanted them to believe that they have a voice and if they use it, they can be the change, they can make the difference. Thankfully the light bulb was beginning to glow. And then I left. I am hoping there may still be a small light burning on my return and everyone is not sitting in complete darkness again.

When I booked this trip back to Australia, I thought that I would be in desperate need for some time out. I had been dreaming of good steak and red wine, posh dinners eaten from china plates on top of linen tablecloths, cold drinks with ice cubes, bare feet on plush carpet, warm showers and fluffy robes. Mostly what I needed was restful sleep. Quiet nights free from the wild dogs and the rooster symphony orchestra. Quiet nights free from wood sawing, house building and kwaso fuelled parties till the early hours. Quiet nights on a thick mattress in a cool, dark room. Bliss, bliss and more bliss.

As the time got nearer though, I was having such a great time I felt slightly reluctant to leave. Not reluctant to leave, of course I was super excited but was now the right time? Things had just started going great and I worried I would lose it.
So, off I trundled to Australia. I was in a good place, pretty bloody proud of myself to be honest and I couldn’t wait to share all my crazy tales with my dearest friends. These are the friends I grew up with, the ones that can never be replaced. 

We come from the same soil, shared puberty, first jobs, first loves, heartbreaks, marriages, deaths and births together. We have laughed, cried, fallen out and made up more times than I care to remember. These are the guys who I run to every time I have nowhere to go, who I call when I’m feeling lost and alone, who I laugh with until I ache and the tears run down my face, who I think about every time I find myself in a crazy situation, who I talk about constantly, who are always, always there and most importantly let me be the me that I feel so comfortable with and never question it. In a nutshell, my bestest and dearest friends.

That is why nothing prepared me for the loneliness I felt, for the giant ball of anxiety that grew in my belly daily, for the iron fist that clenched my gut so tight at times I found it difficult to breath. It wasn’t my friends, they were the same people I had always known and loved, it was me. I behaved badly, like a sullen, petulant teenager. I stropped when I didn’t get my own way and I hated myself for it. I told myself to stop, to buck up, to enjoy myself and thankfully, at times I did. I began to feel relaxed but there was a part of me that was lost, that didn’t belong and I guess my biggest fear was, had it gone forever?
It has only been four months. Could I have removed myself so far from my reality that I had forgotten how to behave? Surely not. Unfortunately time flew and all too soon I was dropping my friends at the airport. The guilt was immense. I don’t think I ruined the holiday and possibly I didn’t behave as badly as I beat myself up for. There were still some amazing moments, more great ones than not. We still laughed until we cried, gossiped like teenagers and put the world to rights like old times. But I could not shake the anxiety. This was not the way I wanted it to be and more than anything, I felt lost and afraid.

I decided to take myself off and spend a couple of days with me, myself and I. Some may think that this is my downfall. Maybe I spend too much time alone and have forgotten how to behave in company. My marbles had already been lost though and it was disaster after disaster. I won’t bore you with the details but it was 48 hours of madness that I never wish to have again. One shining light was I got to see my beautiful friend Jade at the beginning of the greatest adventure of her life. It should have been for longer and for that I am sorry.
So I got on the plane and came back. I nearly didn’t. Part of me wanted to run away but I had no idea where to run to. Besides, I had nothing to run away from and I didn’t (still don’t) understand why I was feeling like this. It was unnecessary.
I’ve been back a week and I’m doing OK. 

I’m still totally self absorbed and self obsessed but I’m talking to someone now and that helps. I realise that everyone else has their shit to deal with, some of it actually real shit, not made up shit. I try everyday to understand why I feel like this and where it came from. But like I said, I never saw it coming.
Let’s hope it leaves just as quickly.
Thanks to all those amazing friends who have put up with my whinging, whimpering and my whining. And to those who have encountered my tears, my tantrums, my strops or have been on the butt end of my bad decisions and terrible mistakes, I am sorry.
#self-centered #arrogant #selfish #egotistical #narcissistic

It’s onward and upwards 

In my last blog I asked: “do I do it for me or do I do it for them?” Last week was definitely a week for me. 

 Everybody made a real effort to show pride in their culture, everyday dressed in the traditional clothes of their nation, the conference room awash with bright tropical colours and native flowers. It was refreshing to hear all the great changes and improvements in nursing care that is coming out of the South Pacific. I was especially blown away by Tonga. These nurses just seemed to get it. They were getting involved in politics, economics and policy making. They had enthusiasm, they had vision and they had motivation. They were making a real difference in many ways. I only hope it was catching as the Solomon Islands could definitely benefit from an injection of The Tongan Nursing Spirit!

Making friends and building trust in the Solomon Islands is a mammoth task and one which is expected to take at least three months. We are informed during our cultural training that this part is actually more difficult, yet more important than the work you manage to do whilst here. Building successful relationships is the highest mark of achievement in a volunteer. It is the reason why we are here.

It is important to note that what would normally be interpreted as a simple platonic meeting between a man and a women (either in a working or social environment) may take on unwanted significance. This is especially significant for unmarried women (i.e me) 
Being seen in public with an unmarried member of the opposite sex or being affectionate with a member of the opposite Sex (ie holding hands) is significant and is considered “showing out”. Showing out can have wider implications since it is effectively seen as announcing your relationship. These implications differ depending on the tribe and your gender, but may include accusations of being “loose”, compensation demands, expectations of marriage or threats of violence.

Not so much fun now, is it?

This week, albeit fantastic has made me reflect on the vast differences between our two cultures. I have been pondering a lot about love and life and pretty much everything really. I have always believed that you have no control over love and emotions, that these were unconsciously felt and more often than not, irrational. Perhaps naively, I expected this to be the same the world over. However, I am now beginning to understand that maybe what we feel varies widely and how we interpret those feelings changes depending on your culture. Nature/nurture?  I wouldn’t have a clue. All I know is that I am looking for the things that I think I need and hoping to get the things that I think I want. Makes sense?  I feel as though I have stepped into a whole different mind field. There are bombs going off all over the place.

Just a note on the roles of men and women in the Solomon Islands: 

There is a strong sense of male privilege and an equally strong belief that men have and deserve a higher status than women.
In some cultures, men still pay a bride price. Traditionally, this was to compensate the bride’s family for their loss in labour but today, it is more viewed as an ownership of their bride. It is publicly acknowledged that significant levels of domestic violence, alcohol abuse and gambling are key concerns for women in addition to most husbands openly conducting extra marital affairs. Unfortunately this a tale both I and my fellow volunteers hear often, spiking an unhealthy trust in the males about town. 
Women do most of the work. Those in paid employment not only have to spend a long hard day at work but are then expected to clean, feed and care for the home in the evenings and on weekends. Some rigid practices still remain. For example, the woman is considered “unclean” during Menstruation and child birth and is segregated during this time. 

It is back to earth with a bang! I may be unsure on what it is that I think I want but I’m pretty sure it is not this. 

Oh, and did I mention I did a Kustom dance at one of the forum dinners! 

I don’t think anyone noticed that one of the girls was not quite like the others (except for the announcement) 

So, the week was rounded off with trip to a deserted island in the Langa Langa Lagoon. Great food, great friends, great fun. It’s the stuff that money can’t buy. 

As we sailed home at dusk, bellies full, skin burnt and eyes tired, I watched as father and son dropped lines for fish from their dug out canoes, young children splashed and played in the shallows, fires burnt with big pots of rice boiling in their embers and washing billowed in the evening breeze and I thought that maybe this week, life was pretty awesome. 

Now, let me talk to you about foreign aid.
So this week we had some amazing new machines donated to the hospital.
We have got two vital sign machines (blood pressure, tympanic, oxygen probe), we have three oxygen concentrators (amazing), two nebulisers and an all singing, all dancing monitor including a 5 lead ECG (wooooooeeeee), the first ECG machine for the hospital. This is great news.
Ready for the bad news: Most of these machines need replaceable parts in order to make them function and to keep them sterile. We have tympanic’s delivered with a box of 20 ear probe covers, we have ECG leads with electrodes attached, but none spare to replace them. This means we can safely do hmmmm let me think? 1 whole ECG! Thanks so much. Where’s the paper to record all this data we’re now able to collect? We have oxygen concentrators and nebulisers, but where are the masks? And do you think nebulisers are on our essential medicines list?? This is a hospital in one of the top 10 poorest countries in the world. They can barely afford to maintain it with electricity and running water. People need to think about that before they donate these wasted machines.
And there’s more… Nobody knows how to use them. Just to digress, I was cleaning out the training room the other week and came across lots of expensive, precious equipment sitting there, gathering dust. Why are these in here gathering dusts I ask? This is vital diagnostic and therapeutic equipment that, and I don’t wish to sound melodramatic, but equipment that can save lives people. Save lives!
Because nobody knows how to use them or how to care for them they get left or broken. Wasted in a system that needs all the help it can get. It’s not that I’m ungrateful but the excitement fades to frustration as I slowly realise that all we’re going to gain from this generous donation is the need for a larger store room. My heart breaks.
Luckily I do know how to use them and I will do my upmost to try and get the supplies we need. I will dust off and send forth these vital machines and I will endeavour to teach as much as I can in the time that I have. That is my promise and it is the best I can do.
This is not an isolated tale. I see and hear the terrible ways in which aid is donated almost every day. I hear stories of project after project failing due to a lack of evaluation, education and maintenance. For example, a large number of toilets were fitted into a community. Job done, money well spent, you can all go home with a pat on the back.  The following year, everyone is still defecating in the river and the nice toilet blocks are used to store rice. Why? Nobody thought to include the villagers in the project. Nobody explained or educated them and nobody, most importantly, listen to their story. My heart breaks.
A fellow volunteer managed to get a grant and has spent the best part of last year helping to build a fantastic library for a community school that has pretty much nothing. It is nearing its opening date and this week, boxes and boxes of donated books arrived. Excitedly she opened the box. This was hopefully going to be her legacy. Something amazing that she did. So she could say, after two years of (not always, but mostly) frustrating, hard, soul destroying graft, I did something for the kids. Excitedly she opened the box……..
Hundreds of out of date medical journals! Are you kidding me???
I don’t even want them. Medical and nursing practice is already in dire need of pulling out of the dark ages. What use is research on infectious diseases from the 1950’s, thank you? What a waste. Not only in the books themselves but in the thousands of dollars it will have cost to ship them over here. We don’t need your rubbish. My heart breaks.
I see it in the t-shirts. All the unwanted clothes that you guys donate to charity are sent here and sold for next to nothing. In a country where illiteracy is rife, especially in the older generation, here is an example of what I see every day: a little old lady sweeping out a stair well with GET FU@KED blazoned across her chest, another unsuspecting citizen with “I’m a gynaecologist, open up and I’ll take a look”, seriously? I could go on. Ok. Ok. So I’ll admit it. It is funny at times. But is it appropriate? Is it ethical? Would you let your child go to school with it on? I think not.
The lead nurses from around the province were in town for their annual committee meeting. I was asked to talk about research and evidence based practice. So I did. I talked about on-line data bases, critiquing literature, writing standards. Why? These people run clinics without water, electricity, phones or internet. They deliver babies by torch light. They have umbrellas up inside when it rains. How are research methods going to help? Find out the best angle of the torch? What colour of umbrella best promotes health and well being? Do we need to learn to walk before we can run? I heard about clinics without walls, ambulances without tyres and nurses without homes. Out of the 67 cold chain fridges in the province, less than half are functioning. Thousands of vaccines have been lost. Why? They are unable to get a reliable gas supply. My heart breaks.
What is happening out there? I question my reasons for being here on a daily basis. Do I do it for me? Or do I do it for them? More than that though, I question the reasons for any of it, all of it? Do we help or do we just show them that there is a better way, only it’s still way out of reach. Is it a better way? Who says? I spend many an evening pondering what would be the fate of the Solomon Islands without all this aid, without everyone thinking they have the best way, the right way, the only way. Would it crash and burn as we all think it would or would it manage to grow, in its own way, the way it should? I don’t pretend to know anything about economics and I sure as hell don’t have any answers. Do you?

In other news this week:

Hospital closes when water pump is stolen to “teach community a lesson”. Despite a new pump being donated the following day, the hospital decided to remain closed for a week until the thief was brought forward.

Education authorities live in fear of being stabbed. Extortionate travel requests are finally being refused on the grounds of.. policy.

Schools winding down for Christmas. Teachers starting extended leave (in October)

Guest House owner looses the plot. It appears to be the final straw for Masoud as he makes a very disturbing short film to teach the rats a lesson on what happens when they eat his coconut biscuits.

In the face of adversity, volunteers still manage to fun!

Bare with me, I am about to have a rant.
This week I started off lonely, it had developed into anxiety by midweek and by the weekend I had peaked at angry, really bloody angry. Sunday night was a cocktail of all three. The previous week was by far, my best week yet. Doing some actual nursing was a real breath of fresh air and I didn’t realise how much I missed it. Was this the reason I had such a terrible week? I don’t think so. Maybe I’m sinking into the three month pit of despair we were all warned about.
So, now it is Tuesday and I am going to let this all spill out to you and then hopefully I can move on to a better, calmer week.

Breathe.

I’ll start with work. My to-do list is a mile long, which is great. I am constantly asked about writing policies, competencies, nursing standards and completing audits. We want to be just like Australia, they say. This is great and, I never thought I would hear myself saying this, but they need it and I’m happy to help. I work hard creating programmes which are engaging and interesting. At least I try to, let’s be honest, it is the part of nursing that we all find boring and tedious, the part that takes us away from the work we trained to do. But I try. What I am beginning to realise though is that they don’t want to learn how to do it. They want me to do it for them. I don’t blame them, I would be the same. But that is not what I am here for. I am here to build capacity, to teach them how they can better improve their nursing care.
If I were to do it for them then what would they learn? What will happen when I leave? I can tell you what, nothing. Then in 5 years time they’ll ask for another volunteer who will arrive to the same tale I did: We started to do that, but we don’t do that anymore. Back to square one again. 

Breathe.

My Pijin is improving. I think, after three months I am doing pretty damn good. I can listen to a whole training programme and understand and I’ll happily chat with anyone who passes me by in the street or greets me at the market. I still have to think about what I need to say and in the work context I still find this difficult and exhausting, but I try. Every day I feel I get a little better, gaining a little more confidence and yet I am constantly asked: Why nao u no spikim pijin? Give me a break, I’m trying. 

Breathe

On Friday, I was walking to catch the bus and a man threw a rock at me. He was angry and I’m pretty sure he was drunk, on kwaso (the illegal liquor), betel nut or something. This I can handle, it’s not personal, it’s fine. It was the man who found it so hilarious he had to go and tell all his friends who also found it so hilarious. Not one person tried to help or defend me. I wanted to confront them. I wanted to ask: Why is this so funny? Do you think I deserve to have a rock thrown at me? But I didn’t. I stood there and took it, like a wimp. Then I got on the bus and cried all the way to work. I’m not sure who I am madder at, them or me. 

Breathe

That night we had a fundraiser event at the local “night club”. Having spent my “yoof” earning money working in various pubs and clubs, I offered to run the bar.

 Breathe

Maybe it was a mix of these but I have started to feel angry about everything:
I feel angry that I can’t go for a walk in my shorts, a run in my tights or a swim in my bathers as I will be judged. I feel angry that yes, we raised a lot of money on Friday but were we taking the food from children’s mouths as their dads drunkenly tried to pick up girls? I feel angry that I have to sit through a public service lecture on alcohol and betel nut at work whilst everyone else is outside chewing the stuff. I feel angry that I am first in the office and last out, yet I am constantly asked to do more. I am surrounded by corruption, theft, adultery, drugs, alcohol and abuse, yet I am judged for not going to church. I feel angry that I am a good person, I don’t steal, I don’t hate, I care and I love and I work hard but I enjoy a cold beer on a Friday night, yet I am judged. 

 Breathe.

I understand it is culture and I respect that. I am happy to live by their rules, I want to. I just feel angry that nobody else seems to, yet it is me that is judged. I feel like I’m giving so much of myself that I have forgotten who I am and yet they still demand more. 

Breathe

I want to be remembered for the work that I do, for the little positive changes I make, not for the skirt that I wear.

Just Breathe.

We climbed onto the back of the truck at 1am. It was already piled high, bodies packed into every space, legs and arm dangling from all sides. Even the roof of the cab was taken by two young boys. The 10 of us managed to cramp into a space the size of single mattress, which was twice as much as any other passenger. It was 2:45 am before the boat had finished unloading and the convoy of trucks started to move out into the black night. We were heading to a remote village in North Malaita about 5 hours drive away.

I was clinging to pinches of sleep, constantly jolted awake as the truck lurched and bumped along the dirt road, swaying over unfinished bridges and plunging through rocky rivers. As the darkness lifted, a gloomy glow revealed thick jungle and sky high coconut trees. Every so often the there would be a gap in the dense foliage to reveal a small leaf hut village or powder white sand against the turquoise water.

We arrived past dawn and were greeted by the whole village. Young girls, over half my size, grabbed heavy loads from the truck and set off through the villages to what would be our home for the next week. 

“We” are a group of volunteers. There are a few nurse educators from Honiara, a doctor, a pharmacist, a sanitation adviser and a few others who have come along to help out. We are staying with Willy, the chief of the village, his wife and their son. I thought I was there for a holiday, maybe a bit of education, who knows. To be honest, I was just tagging along for the ride. We were informed that night that we would be holding a clinic the next day and all the villages, far and wide would be coming. Oh dear. I think we were all a little under prepared and overwhelmed.

Do you know what? It was brilliant. The place was packed and we did what we could. I took triage outside and the patients were divided between the pikinini (children) clinic and the adults. We ran education sessions to the waiting room and played exercise games with the kids. It reminded me a lot of what I did in India.

The older generation were worn, ravaged by aches and pains and riddled with arthritis brought on by a life of hard manual labor. The kids though were fat and healthy, a happy sight to see. We saw a few sick people, some we couldn’t help which was hard. 

This clinic is run by a nurse aid, no doctor, no ambulance, no help, no phone, no internet, no books, no guidelines and barely any education. Peter (the nurse aid) takes it all in his stride. They do what they can. Mostly though, I think we were entertainment. A friendly smile, encouraging words and just a sign that someone, somewhere cares can do a lot for a community.

The next day we headed up to the local school. In true Solomon style we were whisked onto the stage in front of the whole school. 

One by one we were introduced, our topic of teaching announced as if we had already known and planned for this surprise event. Again, it went well. Another nurse and I acted out our DRSABC assessment with the teachers being made to re-enact what they had learnt. I was highly impressed with our ability to deliver an impromptu education session that was both amusing and informative. However, I believe I may have caused great offense when I corrected a male teacher in front of the school in addition to standing over a man laid on the floor. Double whammy with a dollop of cringe on the top! Luckily, despite the gasps, nothing was said but I think I also learnt a few lessons that day. Oops.

Of course it wasn’t all work and no play. We were treated like kings in our time off. 

 We went swimming in the river, took a trip out to Lau Lagoon where we rested on untouched white powder beaches and swam in crystal clear warm waters, played games with the children from the village and ate buckets of vegetables delivered by happy villages fresh from their garden.
We spent the weekend at Serah”s Lagoon Hideaway, an artificial island set in the Langa Langa Lagoon.

 The story goes that hostilities among the inlanders of Malaita forced people into the lagoon. Over time they built their islands on sandbars after diving for coral. The islands in the lagoon are renowned for their shell money minting process, their “shark worship” beliefs, their shipbuilding skills and tourism. It is a beautiful place and amazingly, we had the whole resort to ourselves. We stayed in huts over the lagoon, snorkeled, ate and drank cold beers. It was the perfect end to an amazing week.
Monday morning back at the office and I am duly informed that I am to organise a fundraising BBQ and dance to help send nurses to the South Pacific Nursing Forum.

I will also be expected to participate in a South Malaitan cultural dance (coconut bras and grass skirts at the ready). Cringe!  and can I organise a three day workshop for hospital supervisors next month to help them prepare for big changes in 2017! Plus we have two new toys………

And guess who gets to do all the training? All in a day’s work here in the Solomon Islands.

I know I only posted yesterday but thought I’d share this with you. I’m not sure what it means? 

This is the view from the balcony of Jess, Jackie and Susanne. Three fellow volunteers in Auki. On a Friday we like to have a sneaky Gin and lemonade (no tonic) and debrief on the weeks events. At night, when all you can see is lights, all I can see is the view from my childhood home in England. I can make out the house where the Pinder family lived and the Fish family next door (real name). I can see the gap between the houses to Burnley Road and the play park beyond. I imagine the road that heads up the steep hillside behind towards Sourhall and the opposing rocks that jutted out from above the terrace where the Pringles lived. Further down I recognise the post office where my best friend Rebecca was and the shop on the corner where I would spend my hard earned pocket money on penny sweets.  I know, I know, it’s madness but now I’ve seen it, I can’t unsee it. It makes me feel comforted and somehow closer to home. Three Gins in though and I’m home sick, filled with a longing to be back there. That’s when I know it’s time to stop and head to bed. Funny old life.