A Doctor's Mind :  With our minds we make our world

There was a knock at the window.  It must have been about one am and I had arrived only that afternoon on Manus. In those days there were about 30,000 people being served by the one doctor stationed at the Lorengau Hospital.

'Yes', I replied, leaning out of my bed towards the window, I saw the nurse in uniform looking towards me.
'Sister, what is your problem?'
There was a pause, and then she replied:
'I just wanted to check up to see that you were alright.……….'.

Manus people are generally very friendly and like to enjoy life. I spent two happy years as the District Health Officer for Manus. It was my first posting by myself after doing two years of residency training under various specialists across the country. The training was very practical and set me in good stead for being the lone doctor on a remote island chain. In 1972 on Manus there were no telephones and I had to travel to the naval base some 30 kilometres away where there was a radio I could use to contact the PNG mainland or Australia. There were also two naval doctors based there who could assist me if I had problems.

When I first visited the naval hospital the doctor in charge asked me various questions and showed me culture media to see what sort of medical knowledge I had! I must have passed his test for we got on all right after that, but they were not keen on doing any work outside the boom gate of the naval compound!

I was assisted in my work by a medical assistant who was a middle aged Australian who told me that it was his final posting in Papua New Guinea and that he would only be doing tasks that he specified. Most other staff at the hospital were from Manus. The Maternal Child Health Nurses ran the maternity ward and only called for assistance when there were complicated deliveries.

Part of my duties as District Health Officer was to visit all the health facilities across all the islands. These consisted of one-man aid posts and health centres staffed by nurses. At one health centre there was a particularly striking nurse, Mary Anne, who I got to know very well a few years later and she eventually became my wife.

One family took me in as one of their own and arranged for me to get a large out-rigger sailing canoe, onto which I also put a 25 HP out-board motor. I used this for travelling around to health institutions in the district. The canoe was big and had a central deck, which could be used for sleeping and cooking. I have vivid memories of sailing fast across deep blue seas and then over the top of beautiful coral reefs…….

For visits to the more remote islands government trawlers were used. These had small cabins for sleeping and dining areas. The seasonal monsoons could stir up high seas, which would cause these old wooden boats to lurch and pitch about and cover the whole craft in sea spray.

Nauna Island had no passage for ships to get to the shore through the encircling reef so we, the nurses and myself, had to swim with our medical supplies to the shore, through the breaking waves, to do our health clinic.

At one time a lady from Nauna was referred to Lorengau Hospital because she had twins. The medical assistant was called for the delivery and I was called after there had been a massive post partem haemorrhage. Unfortunately when I got there her blood pressure was already low and she was in a poor state. She had delivered two healthy babies. As there was no blood bank on the Island - blood was collected from relatives when needed - we proceeded to test for blood grouping and cross matching. I was the only one readily available with the right grouping. The poor lady survived the ordeal until the tenth day when she went into renal failure, presumably caused by the damage to her kidnies from the low blood pressure when she had the haemorrhage. Everyone rallied around to help the father look after the two babies. The District Commissioner's wife got a supply of infant milk to supplement the foster mother's supply. Many years later I met the father who happily told me that the twins had grown up well and healthy.

The only other clinical disaster that I remember was when a young child rapidly deteriorated with acute epiglottitis - a severe swelling of the back of the throat. Even though the child died the parents were very appreciative of the assistance given, but I was still very upset by the experience.

Fortunately I did not have to do many caesarean sections and I still can feel the anxiety that I felt on the first time I had to do one by myself under spinal anaesthetic! They all went well, however. I remember removing a large bladder stone, with the assistance of a visiting surgeon, and on my own resecting necrotic small intestine. One young man had his wrist slashed by a moray eel and I had to sew up the nerves and tendons. He made a full recovery which made us both most happy!

Manus waters abound with fish and the coastal people are expert fisherman. A year or so before I became the doctor for Manus I had been tuna fishing with the people of Pere on their big canoes using unbarbed, bait-less hooks on sago palm rods. Talai (sardines) would be first collected in the shallows and put into baskets. The canoes would then set off to find the schools of tuna and when found the talai would be tossed from the baskets to excite the fish. The hooks would then be pulled through the water and the tuna would snatch at them and be pulled into the canoe. Many of the fish would be smoked above the kitchen fires of the village and then traded with the inland people for vegetables or sold at the market in Lorengau

I once went fishing in the passage leading to Haringan Island on the north west coast of Manus. Haringan has a hill in its centre and is not a flat atoll as are many of the surrounding islands. It has a deep passage leading to the shore. On the adjacent shore was the home of the captain of the small coastal ship 'Sunam', with whom I had become friends. When fishing at the passage, the bait on my line sank to the bottom and became entangled with a sea anemone. Unbeknown to me the anemone had covered the bait with its poison, so that when I pulled in the line and detached the bait the poison came to cover my hands. The following day big blisters appeared on my fingers and on my stomach where I had rubbed my hands. I became quite ill and was well looked after in the village being fed on eggs and other good foods, and treated by my good friend the new Provincial Health Extension Officer, whose ancestors came from the island.

I spent two years as doctor for Manus. Two years of hard work and fantastic experiences, both medically and socially. At the end of that time my seniors in the Health Department thought I should go to study Public Health at Sydney and so I did, with many regrets at leaving Manus.

Quentin Reilly, Australia 2003

This article published January 2003 on MetroTown.info

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