It has been several weeks since I last used this pen. I thought some of you might wish to know what has been going on across the Pacific. Tyronza and I are fine and enjoying our stay in Papua New Guinea. You have probably heard that we have had several earthquakes, which is true, but not much damage.
Last Saturday during the very early morning, I was in the OR for an emergency caesarean section and things started to move around. It was about 12:30 am here and a 5.4 magnitude quake hit the area. It lasted about 20 seconds and moved the OR lights and rattled some equipment on the counters, but did no damage. There was a short after shock and then all was quiet. When I asked Tyronza if she had felt it, she said, no, that she had been asleep. Then on Tuesday mid-morning we had another quake. This one was 6.7 and lasted about 30 seconds. I was standing outside the hospital and noticed a ferocious growling sound and then the ground shook. Tyronza was at home and said things rattled and shook enough that she hurried outside. I don't think there was any major damage on the station, but one of the neighbor's banana trees fell down.
We have been on several interesting outings since I last communicated with you; a church service at a home for HIV/Aids orphans, a service at a bush church, rafting on the river and a visit to a tea plantation. Tyronza and I met an Indian couple at the monthly English "lotu" service. The first Sunday of each month there is a worship service conducted in English at the hospital and people come from the surrounding area to attend.
The Indian couple, Priap and Elizabeth invited several of us to come for tea and a tour of the plantation. He manages the tea plantation and factory. We were allowed to visit the harvest and also were given a guided tour of the manufacturing process. It was quite an operation. All together they had over 2,000 acres of tea plants and harvested tea 281 days each year. This is the largest tea farm in Papua New Guinea and they ship tea in shipping containers all over the world. Our guide told us that their largest customer was Russia. The tea plants produce a new crop of tea every 25 days, so harvest and pruning goes on constantly. This plant produces black tea only. This type of tea is the most common tea product. There is only one type of tea plant (which is really a tree). The different types of tea you may drink: green, white, red are all just different types of processing. After the tour we went to their home and had refreshments and some interesting Indian cuisine.
Medical work goes on as usual. I have had several interesting on call days. Friday, a week ago, I had two routine hysterectomies for bleeding problems. The third case was a C/S because the baby had hydrocephalus. On pre-op ultrasound, the baby's head measured AP-21 cm and BPD-12 cm. It was a bit of a struggle to get the head out. The baby was very abnormal and only survived for a few minutes.
My fourth case was also a C/S for twins; two boys - both breech. I let the medical student, Andy Peters, do that one and he did an excellent job. We thought she would name them Scot and Andy, but no such luck!
I had one patient come into clinic late Friday afternoon that had not felt fetal movement that day. On ultrasound I could see fetal heart activity, but no fetal movement and there was reduced amniotic fluid. I called for a stat C/S, but was not able to get started for a little over an hour which is typical for PNG. The baby was very acidotic, with thick meconium. I hand bagged the baby for 30 minutes, but got minimal respiratory effort. We had to give up, as we have no ventilator. I feel the baby would have been badly damaged anyway.
Later on that same call day, I had a mother come in with active labor. She was complete and breech. The baby looked large and I called for another C/S. This time it only took 45 minutes to get ready and she did not deliver during the wait. I was on call with a Papa New Guinea resident physician, Dr. Imelda, and let her do the honors. The baby and placenta were delivered without problems and then she reached in with ring forceps to pull some membranes out. She pulled down a second set of toes! Both babies were healthy, again another set of boys. Neither of which were named Scot! Oh well, maybe next time.
Bye for now,
Scot & Tyronza
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