Today we planned to take a truck and do a clinic in Lavis as recommended by Dr. Moise, by Lisa (a passing college student), and having met Mary, the aid post worker out there at the distribution of food for Samaritan's purse near Hebron. We were onshore at 8 am, but no truck came until about 10 am. In the meanwhile, we met a 35-year-old man with a leg wound who was walking to Lenakel for fuel. We dressed his wound and gave him Azithromycin for YAWS as he had many wounds. Then a group of school kids came walking from their villages to Lenakel. They each had many leg wounds, which were dressed and they were all given Azithromycin for YAWS. There were 5 16-year-olds, 4 males and one female. They are all the same, so no need for a chart on this one.
At 10 am the truck came and we headed off with intermittent rain. We got stuck a couple of times, got out, put leaves and branches under the tires, pushed the truck and got it up the hills. Then we had torrential rains while the driver and Jonathan were out walking the road to see if we could make the next hill. We decided it would not work, considered walking, but school kids told us one hour, but adults told us 3-4 hours walking in rain and mud carrying buckets with our supplies. It was 11-12 am, so we would arrive quite late that way and still not have a plan to get home, so we turned around.
At the village we passed (by the Bible College) there was a food distribution going on. People from Lavis were there to get food among many other villages. We saw a 7 year old with a wound on his foot. It appeared to be impetigo, so we recommended wound care and antibiotic cream.
We went back to the boats to try another approach. We got a man from Lavis at the food drop, put his food in the truck and brought him with us to the boats. We were feeling bad that we'd sent word to a town that we were coming, and we had not made it, so we took Lil' Explorers up to the cliff in front of Lavis with the local guide showing us where to go. We then anchored and took the dinghy to a reef where we offloaded into the water and walked on the reef to shore. We then hiked what felt like straight up a cliff on a narrow muddy, wet path, to join the main road. Once on the main road, it was muddy, but flat and we walked a while to the village. At the village, we met Mary, who we had given our "medical unit" pack to. We asked about her aid post and supplies. She has NONE except what we gave her. The houses here were very much devastated and everything standing is new construction. The aid post completely blew away (except evidence of a toilet from an outhouse and the front sign saying aid post). Mary lives right across the main road and does not hold regular clinic hours, but people just come to her if they need something. All her medications and supplies blew away and she understands that she cannot get more because she does not have a building. She has a case that she would keep them in and she can keep them at her house at this point until an aid post is rebuilt. People come to her house for help, but she has nothing to treat them with except our medical unit, which can treat wounds, but not a lot more. They have no building supplies and have been busy clearing roads, rebuilding their houses, replanting, etc. so the aid post has not been done yet. If we can help her get an aid post built ('Samaritan's Purse') and get a restock of medications ('Dr. Moise') I think we'll do much more good for her and for the community than seeing a few patients. Right now they face the same issues getting to Lenakel for medical aid as we faced getting to Lavis and they have no medical aid nearby otherwise.
We asked if anyone needed medical aid, but everyone had gone to pick up rice and meat at the food distribution site, so no one was in the village. Also, no one had gotten the message. These word of mouth messages so far are a huge bust! No wonder the Internet and other communications have thrived!!
We saw a 40-year-old man with a 5 cm laceration on his right anterior tibia region. It was 2 weeks old unfortunately. It was a clean cut from a machete, so could have closed well. It was not infected, but weeping. We cleaned the wound with Betadine, debrided some surrounding dead skin, dressed with neomycin and gauze. We then gave him neomycin and gauze to keep it clean while it heals.
Final patient, on our scamper back down the hillside, we took another easier path by the blue reef resort. Lisa's mother, Mary, works there. She is probably 50. She had a mass removed from her left jaw line one year ago in Port Vila. She thinks it was a cyst, but is not sure. It was supposed to go away, but it has regrown at the scar line. There were multiple smooth, nodular masses. 2 pre-auricular and one submandibularly near the far end of the scar. While they were well circumscribed, which is usually a good sign, they felt very firm and fixed, not freely mobile. They were not fluid filled like a cyst, so I do not want to put a needle in it to drain it. I have some concern that it potentially could be cancerous. She otherwise feels fine, but there is distinct swelling to that side also. We will give her Paracetamol when we return Wednesday since we were on the wet rocks ready to load into the dinghy and it would have been a disaster to be messing with pills. She was fine with that, but we told her she needed to return to Port Vila.
We decided to figure out if we could help them restock their clinic and set them up with a plan to rebuild it, that we would return Wednesday to do a clinic. We told Mary, our local guide, Lisa's mom, and as many people as we could to tell EVERYONE in surrounding villages that we were coming Wednesday. Maybe if we are not competing with food, there will be a need. Clearly they don't have many resources in this area.
At this point we gave up. We went diving in the Blue Cave, which was cool. At low tide you dive under an opening in the rocks into a large cave with an open top due to a cave in, so you can see light and trees above. We swam with many of the children there, and then motored back to the anchorage. Since we had the crew of Salsa (the Swedish family) onboard and were making dinner already, we had them over for dinner, and then we had a game night, which was a lot of fun. By 7 pm we were all ready to call it a night!!!
We had a fun fiasco trying to do a clinic in Lavis. We faced the issues the locals face in trying to receive care. We enjoyed the experience and will try again Wednesday. In the meanwhile, Jonathan has set up a clinic for us tomorrow by truck to go with the food distribution to Greenfield where there is a well-stocked aid post. Kim and I will be going to that.
Shannon
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