Derek’s Support in Tello.

 I am now using Tello islands as a temporary base for my operations while I gain helicopter and flight approval for medical operations that will serve the Tsunami and earthquake ravaged areas of west Nias and the poorly serviced remote Tello Islands. I am currently sleeping in a boarding house where my simple room costs $2.50 per night and my room for medications costs $1.50 per night. This price includes 13 hours of power from 6pm to 7am, free water for washing and clean sheets. I share a communal toilet and shower with other guests (not at the same time)!!. Here you need to bring your own mosquito repellent as malaria and Dengue fever are prevalent, already Julie, a NZ nurse who had donated a year of her time to work with me has returned home suffering from Dengue fever. My Day generally starts with a visit to the local Catholic Mission – St Andreas, which provides free of charge an operating theatre, only during night hours while power is available. This theatre has air conditioning, operating table and lights and some surgical tools are available here which are supplemented with my own. The mission supplies 2 patient rooms with 3 beds each and the registered nursing nuns are happy to care for my surgical patients around the clock with IV therapy, IV medications and ongoing care between my twice daily visits. After checking on my post operative patients or any patients that the nuns are concerned about, I head off on my day’s clinics on the many islands. There are 27,000 people on 45 islands on this small sub province. However to get to the more distant inhabited islands that I have not yet gone to, it involves at least 6 hours boat ride each way dependent upon wind and waves and costs significantly more than the 200,000 rupiah I presently now pay for the islands I visit which are up to 2 hours away. On these islands I provide free clinics with free medicines and free public health advice for anyone who wants to make use of this service, and there is usually an unending queue until I have to leave to return to Tello by night fall. On occasions I sleep over in the islands and return to Tello island the next day. I hope to be doing more of this as I try to encourage the villagers to provide transport for myself, my medicines and any voluntary workers. Of course, along side this clinic work, there is a strong need for operative work, such as appendectomy, caesarean section, amputations and these are often required urgently if not immediately. For this reason I am still exploring possibilities of better communication such as Satellite phone which I do not have and the helicopter for urgent transport which is still on the Belawan wharf. Once every 2 weeks I will carry out a clinic at the Tello Puskesmas, which is the local government health facility which I wish to support and make stronger for the longer term service for the people of Tello. This clinic is another endless queue clinic where I must take compulsory breaks for food and drink. I am also happy to work along side volunteers who help me in the dispensing of medications and keeping the crowd orderly and entertaining the many children. People attending the Puskesmas are charged 1000 rupiah compulsory by the staff for writing their names on a list !!! Recently I had a master brewer volunteer – Tony, who helped giving out donated spectacles to the many islanders requiring visual aids to help the many vision problems here. Interspersed among these activities is the constant stream of people at the boarding house wanting to be seen for both acute and chronic health problems and for the medications which I dispense free of charge, or requesting glasses. After starting operations for acute and chronic appendicitis I find emerging a pattern of a number of people suffering from significant pain from chronic appendicitis. So much so that there is now a waiting list for appendectomy. Sad to say, I have no radiological, laboratory or anaesthetic support, having to give my own anaesthetics. Small luxuries such as a pulse oximeter, haemoglobinometer and blood glucometer are simply dreams at the moment. Food for myself comes in the form of fried rice (nasi goring), fried noodles (mie goring) or fried bananas from various street stalls around the town, and cost $3.00 a day. As I try to follow my own public heath advice and drink 4 litres of water a day, this also adds to the living costs at 5000 rupiah per litre bottle, about 50 cents. At present every month I am compelled to leave Indonesia to renew my visa to continue this work, which entails a trip to Penang, Singapore or Kuala Lumpur… all come at a small cost of maybe around $275 or so. Support for me for a month will include: Accommodation in US $ 80. Medication Storage $ 45 Food $ 100 Water $ 60 Telephone $ 40 Translator/ Pedicab $ 70 Transport to islands $ 250 Visa for 1 month $ 25 Transport to get visa $ 250 Computer maintenance/ servicing/ replacement costs due to difficult climatic conditions and no air conditioning/ email and web page instalments. $150 Personal expenses/repellent $25 Any contributions or sponsorship towards any of the above costs, individually or collectively, or any of the individual projects that I list, would be enormously appreciated and would ensure that this work carries on. Every three months, because of the 24 hour/ 7 day nature of work here, I travel home to New Zealand, to see family and friends, to participate in speaking engagements for volunteer and financial support at churches, clubs, schools or wherever.

 Givens Story:Given is an 18 year old boy from Tello. His father died 10 years ago and he struggles daily to support his mother and 4 siblings. He does this by driving a pedicab on the streets of the town of Tello for locals. Given pays 50 cents a day to hire this pedicab from Chinese business people in the area but as there are 50 pedicab drivers in this small town he is lucky to bring home $1.00. Pedicab fares are 10 or 20 cents per ride. and tourists are few and far between here. To give an indication of the poverty of this family – rice which has to be imported, and is the staple diet of this family costs Given 90 cents a kilo. Given has been able to supplement this diet with fish in the past week as we have bought a small 2 man canoe that he can use in the evenings to catch fish and which Derek can also use to travel to close islands for clinics. Given and his family live in a 1 roomed wooden, thatched roofed shack with no toilet facilities, no running water and cooking is done over a small open fire in the corner Of the house, indoors. Given has just been informed that the owners of the land the shack is located on has been sold and he and his family have to vacate it by the end of July. But where will he go? Given has taught himself English from the surfers who come and go through these islands and is currently making extra income from Derek as his translator while he works here. Derek pays Given $3.00 daily for his services which include translator, transport with his pedicab, sourcing boat transport for island clinics and he is on call day and night to find Derek when emergencies and urgent medical home visits are required in this town of 5,000 people. $1000 is all it would take to buy a small block of land in the area and construct a house for Given and his family which could include a storage room and free accommodation for Derek, his medication and volunteers willing to visit Tello and help with Troppodoc’s services here. CAN ANYONE HELP? So little to so many of us can do so much for Given and his family.

Viktor: I would like to have Viktor assessed by the doctors at P.Siantar on September 1st. As you may recall, Viktor received horrendous burns to 60 percent of his body around the time of the Tsunami 2004. Red Cross paid for his life saving treatment in Singapore General hospital for 4 months, at which time Viktor wanted to return to Nias. Unfortunately Red Cross has chosen not to continue funding for his ongoing treatment, subsequently Viktor is trapped inside his own body, due to contractures over his elbows and knees, which is limiting the use of these important joints. Treatment in Singapore is relatively expensive and far from home. If I can take him and one of his parents to get treatment in north Sumatra at a cheaper price with their full consent, this would be ideal. I intend to take him to P.Siantar rehabilitation unit and see if the plastic surgeons there can improve on his ability to function and if we can send him there for 2 weeks each year so they can continue his ongoing rehabilitation. Transport will be double due to Viktor needing his mother to accompany him. Approx. cost US$450.00. I have a genuine commitment to sending home regular photos of Viktor’s treatment and rehabilitation.

Baginoto’s Update: 8 year old boy who I saw incidentally on the side of the road while driving from Gunung Sitoli to Teluk Dalam. He had horrific scars over his face covering the areas of his right eye and his mouth affecting his ability to close either. These burns occurred when he was 2 years old and were due to pulling a container of boiling water off a table onto his face. His family is very poor and unable to afford any treatment and he is the second youngest of 5 children. I would like to be able to transport him also to P.Siantar along with a parent to have him assessed for repair of his right eye and mouth. This surgery would allow Baginoto to resume some kind of normal life, as at present his scarring and the grief he receives from his disabilities means he is not allowed by the school to attend. Costs involved would be as with Viktor as he requires a parent to travel with him to North Sumatra.