Something was wrong. The place was deserted. It was
supposed to be full of people, sick people who had been waiting for the dokta to come on one of his regular visits
to their little corner of the island. Andrea and I had arrived at this rural
health outpost, but nobody else had. Normally we drive up to a long line of
smiling and waving patients but today the line was conspicuously absent. Even
at the best of times the number of patients outside the clinic is only a
fraction of what we wind up seeing when it’s all said and done. Once word gets
out that we’re visiting, others start to trickle in leading to seemingly never
ending requests for, “Just one more patient dokta.” This however was unprecedented. A couple of
days prior to the visit we had tried to contact the nurse aid who mans this
post to let him know that we were coming on the scheduled day, but we had never
heard back from him. This is not unusual though because many here often can’t afford
the cost of making calls, even though they may own a cellular phone.
We waited around for a little while and the nurse
aid did eventually show up. He hadn’t gotten our message and consequently had
not arranged for any patients to come to the outpost. We visit a different
rural outpost every Thursday and these outings are one of the really fun parts
of our job here. Sadly problems like this came up all too often, negating all
the work we put into prepping our medical supplies and everything else we need,
not to mention the time it takes to drive there, often over some of the worst
roads I have ever seen anywhere in my travels. When someone on Tanna tells you
that there is in fact a road to where ever it is you want to go, take it with a
grain of salt. It often just means that somebody, at some time in the near or
distant past managed to get a truck in there and that’s all. I have however,
grown to love the fact that the #3 item on my list to of supplies for these
medical visits, behind only my stethoscope and my medicine bag, is my machete.
On his way here the nurse aid had managed to
scrounge up a few patients that needed assessing so we set to work. It was
nothing too demanding so it wasn’t long before we were finished. He then told
us of an older fellow in one of the nearby villages that he had heard about.
Apparently he might have broken his hip, or as one says in Bislama, his hip was
buggarup.
You have got to love this language. It’s only a little over 2000 words altogether and is sometimes derided for its lack of complexity, but there is no doubt that sometimes simpler is clearer and often it cuts to the point in a way that English doesn’t. For example, the word storian (story on) is used to describe a kind of discussion between people. It refers to one that’s more than a casual chat, one that likely involved the exchange of stories in a light, unhurried way and implies that you connected somehow with the other person over them. Another great example, and one of my absolute favourite terms in the language is the word wantok. It’s an amalgamation of the phrase one talk meaning one language. Its breadth is larger than that though, referring to someone with whom you share not only a common dialect, but also a common sensibility and friendship as well. Often a wantok comes from the same geographic area as you, but not necessarily so. There are about 30 different local dialects on Tanna alone, and many more in the other islands of the country. The triumph of Bislama is that it provides a common language to allow people from different areas to communicate with each other much like the language of Swahili in Africa.
So this patient’s hip was apparently buggarup and sore bigwan (big one) so the nurse aid wondered if we could we
possibly go and make a house call. He said the village was close up (nearby) which instantly made me suspicious. Close up can be an extremely fluid term. Adding to my hesitancy was our plan to go to
the nearby surf beach after the day’s clinic. My board sat strapped to the top
of the truck and beckoned to me insidiously. In the end, my sense of obligation
won out and I agreed to go see the patient, though I still wasn’t convinced it
was as nearby as I was told, or that the road was a passable as he described.
As it turned out the road was not too bad. It led downhill for a few
kilometers and eventually into one of the largest and prettiest villages that I
have seen here. Huts were scattered up and down either side of the valley but due
to the thick cover of the jungle you would never be able to tell that unless
you were standing among them. We stopped, got out, and made the short walk to
the man’s hut. His little homestead was typical looking; a thatched roof hut, a
pen for pigs, a small banyan tree to sit under nearby, and the surrounding
earth flattened smooth and hard by the thousands of footsteps it had seen. The
hut had no door. Once inside it took a few moments for our eyes to adjust to
the darkness. Though it was the middle of the day, his hut, as is the case with
most of them, lacked any windows and was quite dark. He lay on a hard wooden
raised platform, softened by a few thin blankets and pillows. He grinned widely
as his son introduced us and then he excitedly extended his hand for a welcoming
handshake. He was nearly bald. What teeth he had left were severely stained
from years of kava drinking. He wore layer upon layer of old tattered clothes, and
had the moderately unpleasant odour of someone who hadn’t bathed in some time.
He was also however, completely and utterly delightful. He happily told Andrea
and I about his fall a couple of weeks earlier, about how he could not walk for
quite a while afterward but that he had just recently started to take a few
cautious steps with help. I wanted to examine him but he didn’t want to be
moved at all so we didn’t get very far with that. By the end I was pretty sure
that he had indeed broken his hip and urged him to come to hospital, which he
cheerfully declined to do, though he was very grateful for the pain medication
I left with him. Afterward I talked with his son who agreed to do his best to
change his father’s mind. My hopes were not high though. We left his hut and
strolled back to the truck.
We had been told that there was a beach just a
little further down the road and we thought we might have lunch there. After a
few minutes of driving we arrived at what I now consider the most beautiful
beach that I saw in my whole six months in Vanuatu. An expanse of fine black
sand lined the edge of a beautiful serene bay with a gentle point break to one
side. The water was as clear and inviting as could be. It was lovely and we
lunched from the tailgate of the truck before departing for a different beach
that we had targeted for the day. As we pulled away I eyed the point break and
knew I would be back, hopefully with the paddleboard.
As it turned out it would be a few weeks before I
had another chance to return. Our time in Vanuatu was winding down and there
was much to do to prepare for handing over to the new doctor arriving from
Canada, but on the next available weekend off call we packed up the truck with
provisions, and the paddleboard and set off. On the way down that same narrow
road I recalled the old fellow with the broken hip. He never did turn up at the
hospital and so I thought I might pay him another visit to see how he was doing.
We stopped at the same place in the village. People were burning piles of brush
and swirls of grey smoke filled the air, making tangible the sunlight piercing
through the dense canopy of the jungle. Andrea was entranced by the effects of
the light and the smoke and she remained behind with the kids to capture some
photographs while I made my way through the village to the old man’s house
again. None of his sons were around this time but one of his granddaughters
greeted me and invited me inside the hut. The old man sat reclined in the same
position, in the same dark corner and I think wearing the same clothes. He
greeted me excitedly and shook my hand for a considerable length of time before
he finally let go. He was so surprised and delighted that I had remembered him
and come to check on him. It was in stark contrast to another house call I had
done the previous week at another village. The fellow there was so afraid of me
that he pretended to be unconscious the whole time, only breaking into laughter
at the end when it was clear I was about to leave without hurting him.
The old man sat up and was eager to share how his
hip had improved. “Pain go down. Hip ia sore
smol still. Me walkabout smol” he said, laughing as he stamped his good
foot down on the hard compacted ground, making it resonate like a drum. I was
able to converse easily in Bislama with him and we talked enough for me to know
that he would not be coming to hospital, despite his polite assurances that he
would if warranted. I knew his broken hip would eventually heal in some
fashion, albeit with reduced function most likely, but he would probably still
be able to get around somewhat and like so many Ni-Vans do with so many other
problems, he would just live with it, almost certainly still finding as much
joy in each day as anyone I have ever met.
Before coming to Vanuatu I got this notion in my
head about a benchmark for knowing when I had gone deep enough into the whole
experience. We had seen many pictures of the people, the poorer, dirtier
conditions that many endured, and it all seemed so different. They seemed so different. I thought I
would know that I had reached that mark when I could sit with someone like this
elderly fellow, talk to him in his language, and as I listened to his problems,
think of him not as someone different from me, apart from me, but as a brother.
My visit with him that day was a delight, but it was not so unusual. My time
here has been rich with many wonderful patients. I can’t tell you why. Maybe it
was just a function of the amount of time I’d finally accumulated here, or
maybe it was the setting, but as I sat inside that dark hut, the smell of smoke
from the village mingling with that of the old man, enjoying his marvellously
stained smile and radiant happiness, I knew that I had reached that moment. It
only took 5 ¾ of the six months I had, but beyond a doubt, I felt it, as sure as I felt the tendrils
of smoke in my lungs. This man was a brother. We were wantoks. I stayed a while longer to storian.
Sean
