Dr Yvonne Wang's blabberings: June 2019

It had been approximately ten years since my first Christian short mission trip. This was my third short mission trip, but this trip was different from the others in that it was medical in nature.

3June

I bid Chris, my fiancé, goodbye this morning. He had pleaded to join the team multiple times since February but the nonmedical quota was already filled. However, I had a clear call to come to this trip, so I gotta go without him. And it was his birthday, what a poor thing!

My luggage weighed 27.5kg today. Good thing that Air Vanuatu has a 30kg allowance, and that another team member, Jenny, kindly took approximately 10kg of medical equipment/sample meds from me yesterday. The amount of things our clinic had to throw out during the renovation was unbelievable!

A foreign land it is… I had never seen so many Islanders in one location before. They are quite big, with dark skin and curly hair. Approximately 90% of the population is Christian (So why are we here? Seems like we should be the ones learning from them!). The plants are also different from that of Australia. Anyway, a photo speaks a thousand words, so I’d rather post some photos up and save the “thousand words.”

I had difficulty deciding whether to get the local sim card or not. I don’t really need the internet, but it might be a safeguard against emergencies. Plus, it’s only $10 (Australian). Furthermore, the hotel internet worked on my computer but not on my mobile phone. I was told that it is cheaper to buy sim outside the airport, so I think I will sort it out tomorrow.

Most people had to share the room with another person, but not me! Quite a large personal space! Just afraid I might get too bored though.

At dinner time, we met the other people in the group. This is a 33 people team. There are five doctors, four from Australia. Dr Hao is the most senior doctor who is a cardiologist from Taiwan and had the most experience with missions. Esther had been on a short mission to the Philippines after a natural disaster may years ago and had just sat the FRACGP fellowship exam a week ago, so she is up to date with her medical knowledge. The rest of the doctors are first-timers to short medical missions. I am the most senior when it comes to the number of years working as a GP, but Lawrence is probably the most "all-rounded" GP (ie. most procedural), since he’s practicing rurally. David is a junior doctor and son of the team pastor Rev. Ho. The final two days of the mission might be challenging for the doctors because two of the doctors will leave before next Monday when we go to this Napara (Paonangisu village)! Oh well, just gotta take things as they come. The Taiwanese immigrant church society is quite a small circle. There are two other people who came from Sydney, Jenny and Brian, who attend the church where I got baptised in 2004. In fact, it was Brian’s father who baptised me! When people talk, it seems like everyone’s got friends in common.

4June

At 9am, when we arrived at the tented area where we provide medical services, many Islanders were already waiting under the tented waiting area! This is a totally different world! Most people came for dental issues! Many people lost their teeth from decay because the Chinese merchants keep selling them sweets! Many people do laborious work and have lots of pains and aches. We had limited amounts of medicines and was mostly giving out analgesics. There were also some people with cough, most of them probably post-infective, although there were a few wheezing people. We could only give them Spiriva Respimat and oral corticosteroids as there was no Ventolin. We could only test people’s blood sugar today and might try and get the ECG machine donated by the Eastwood Village Medical Practice running tomorrow if it is needed. There is even a cardiologist on the team to read the tracing, how good is that? In the morning, the dentists’ mobile van was still being fixed so the doctors saw many patients. There is a cute little Chinese girl called Katherine who knows French that kindly helped do some translations.

We had a delicious mushroom soup and chicken during lunch. Uncle Paul, the chef of the team, is great! Some people went off to get sim cards after lunch. I finally got the hotel wifi working on my phone during lunch, and I thought the environment didn’t seem that scary, so I decided not to buy the sim card. This meant I would get very slow erratic internet connections and only get to check my messages and emails very occasionally. Some messages I sent might also get delayed in reaching people because of the unstable internet.

In the afternoon, the dentists were up and about, and the doctors didn’t have much to do. There was a person whose teeth was so difficult to extract it took one hour, with multiple changeover of hands to progressively more experienced dentists, before it reached the hands of Dr. Miao, who extracted it successfully! Quite a few Chinese people attending the Vila Chinese Christian Church came in to see the doctors. At one point, too many Islanders sat on a wooden bench and it suddenly broke! It was quite a fright for them, but luckily no one was hurt.

In the evening we had the super yummy coconut crab for dinner. They say this type of crab actually eats coconuts because it can climb trees and have extremely powerful pinchers that pinches through the coconut! If this crab gets your finger, your finger will get amputated! The locals don’t like eating crabs because they find it too difficult and troublesome to eat, so this type of crab is not that expensive. In Taiwan, this type of crab is protected as an endangered species. Chinese people are very different from the Islander people in terms of food habits!

Patient count: 186 people. Medical 80, Dental 86, Chinese medicine 20.

5June

I started having a rash on my arms, which made me suspect that I have allergy to the insect repellent. But still, I’d rather get skin allergy than be bitten by malaria mosquitoes. This morning, the tented waiting area was full again! Katherine had two friends with her today, Daisy and Rose. They seem to have great fun running around and building paper houses out of the gospel pamphlets. Daisy’s family owns a snack-making business, producing the yummy “Bungles” snack. The morning was pretty full-on. Quite a few people came to check their blood sugar, or “just a check-up.” When I tested the glucometers, it turns out only one of the five Accu-Chek meters I brought from my clinic actually works! And there are no test trips for the Bayer Contour next meter. I learned a new skill: doing finger prick BSL on people! I always got the nurse to do that in Sydney and never knew how to do it until now! The ECG machine was too heavily utilized in the morning and by the afternoon we had ran out of electrode pads! The machine is so old that some of the cords were peeling off, so I guess it can probably get chucked away after this mission. Towards noon-time, many parents were bringing in kids with earaches. We couldn’t proceed that fast because there was only one otoscope shared between five doctors. Many kids swim, so some had eustachian tube dysfunction. Some had ear wax impaction. Some had old ear injury with scarred eardrums. Some had otitis media. It seems like ear problems are common, and if we come again in the future, each doctor should bring their own otoscope and ear pieces! There are quite a few people whose BP was high in the triage area but when I measured it again, it became much lower. However, one teenager had really high BP despite multiple measurements, so I told him to go and see the local doctor for further testing. I encountered two women who got punched so badly by their husbands in the past that one of their eyes became blind, and there was nothing I could do for these old eye injuries which had already suffered permanent damage. There continued to be some people coming in with aches and pains, so we referred quite a few people to the acupuncturist and the physio. There was one man with “textbook picture psoriasis” and we didn’t have any highly potent corticosteroid cream available and couldn’t do much for him. Eric, the local missionary helping the team, got interviewed by the local news. I don’t know if that will create a flood of people tomorrow.

The afternoon became quite cruisy again. In fact, Esther changed into the role of “dental assistant” quite few times to help out her dad, Dr. Miao, one of the most senior dentists on the team. Brian the dentist conducted a “preventative dentistry” lecture to the kids. A toddler in nappies was wandering around in the garden of a house with closed gates across from our tent. There was a local lady I saw who was really into selfies, using her phone to take a picture of me and her during the consultation, and asking me to take a photo of her on her phone while she was getting acupunctured. I felt a little bored and a bit tempted to get a local SIM card. Then I took out pocket Talley and started to do some revision. Maybe I should be praying instead? Rev Ho, the mission team pastor, recommended I bring two of the mercury BP machines to the tent tomorrow. I sure hope these BP machines actually work!

Afterwards, some of us visited the local supermarket. The supermarket sells the “usual” supermarket things, many of which are somewhat expensive, because they are mostly imported from Australia and New Zealand. The only unusual things I saw were mango juice and two brands of local coffee. Amanda, one of the ladies on the team, stared at the snacks Esther bought, then looked at the both of us and said, “So many snacks, but I think you should be alright because you’re so thin. I used to be as slim as you two, but I gained 30kg after giving birth!” That sounds quite scary. I hope this won’t happen to me in the future! In the evening I went back to my room. My room has poor internet connection and the phone didn’t connect properly again, so I missed the message of “dinner at 6:15” and came down twenty minutes late. Good thing there was still food. Maybe I should have gotten a SIM card? Or maybe I should just wander out of the room a bit more just to get internet connection?

Patient count: 393 people. Medical 92, Dental 270, Chinese medicine 31.

6June

This is a rainy day. When we arrived, not only was the tented area full, but people came up into the tented medical area too! We had to ask them to go down. I guess the media had some impact!

The morning was quite cruisy for the medical team. In fact, it got so cruisy towards lunch that two or three GPs went to the dentistry team and helped hold the torch for the dentists! At one stage, there was a child who was so afraid of the dentist that a crowd of four began singing songs to try and calm her! The medical team also had saw quite a few people who booked to see the dentist but was found to have high blood pressure at triage! When I remeasured the BP of these patients, most became lower. I think they were just too nervous waiting for the dentist!

This was the first time I saw dentistry in action. It is violent! First, they inject the local anaesthetics, which creates a whitish bleb in the gum. Then they used this peeling instrument that peels the gum away from the teeth. Then they use this metal pincher instrument to grab the tooth! Blood is flowing out throughout the process, and there is no suction, so gauzes are used to wipe away the blood. They wiggle the tooth left and right multiple times to make it looser before yanking it off! The dentists say that the teeth of the Islanders are much more challenging to extract than the Cambodians. The Islanders have high bone mineral density and large teeth with huge roots! This reminded me that time in year 2001 when I had to decide between studying medicine or dentistry. I am now very glad I chose medicine. When I was in middle school, I played handbells, and the teacher said I have weak wrists, which is not good for playing handbells. It is Chinese etiquette to pour tea for other people before pouring one’s own tea and my wrists are so weak that I often try to avoid pouring tea for other people! I probably would have been an incompetent dentist if I had chosen dentistry back then!

In the afternoon, we see Eric being interviewed again. Don’t know what he said this time, but from tomorrow afternoon we will have one less doctor on the team because Lawrence is only here for five days! It was cruisy for the doctors again. The little girls started using the cameras to photos of people in awkward positions and giggled nonstop. I told them if they take photos up people’s nostril, it will look even funnier. Then I had to cover my nose, just in case they do that to me! A five-year-old Chinese girl joined in in the afternoon. She only arrived here recently and can’t speak English. She saw me and started drawing a picture of me! What an artistic little girl! By this stage, some doctors stated that they were not really feeling a sense of accomplishment. Many people have ache and pains, so we just give analgesics and refer them to the physio and acupuncturist. You don’t need a doctor to do these things. In fact, although the locals have poor dental hygiene, they are actually relatively healthy people (compared to Cambodians for instance). Maybe I have to try and shift away from the medical aspect of things and build a relationship with the people I encounter? Anyhow, I am not so fussed about whether I feel a sense of accomplishment or not. I have already seen how my aunt passed away from cancer despite having the most invasive and painful types of treatments. She still couldn’t cheat death and had passed away quite painfully. As humans, we are such limited beings. If God lets me do this much, then I do this much. If God opens the door for me to do more, then I just do more. I can only pray that in addition to physical interventions we do in this team, the Holy Spirit will influence the spirituality of the people in this nation too!

After dinner, four people got rostered to do dishwashing. Tim kindly helped out for quite a long time, even though he wasn’t rostered on. Dishwashing is a very strenuous activity! The plates and pots were very heavy, and my back started aching in the middle of washing. I can see why there needs to be a roster. You simply can’t have the same people doing this every day!

During the stormy night, our Gazebo fell down. Barry went and fixed it during the night so it will not affect the service we provide tomorrow. Although Barry is not a medical person, he is very knowledgeable, helps many people and does many important work behind the scenes. In fact, this trip wouldn’t have gone so smoothly if it wasn’t for him. Similarly, local missionaries Eric and Ann had been helping us plan this trip for a year, and things went quite smoothly despite this being the organisation’s first mission trip to Vanuatu. And let’s not forget our great cook, Uncle Paul, whose food gave us lots of energy! Anyway, there are too many people to thank.

Patient count: 302 people. Medical 116, Dental 143, Chinese medicine 43.

7June

The tent in the waiting area was so full, some people stood outside the area. The wind blew heavily, and the sky was cloudy. Sometimes rain poured in onto the doctors as our workstation is located at the edge of the tent and the wind actually blows towards us. The morning was relatively busy for the doctors. However, the afternoon became very cruisy. The weather turned very cold. We had to finish up a bit earlier than the previous days to pack up the place. A gentleman identifying himself as a local politician came and asked me to link him up with the organization of this medical mission group because he’s interested in supporting us for future trips and even shipping us out to the islands. Eventually we linked him up with Eric.

In the evening, a few of us went off to the fruit market. It’s a huge market and the vendors actually sleep there! There are many fruits which I had never seen before, such as a huge banana-like fruit. I slept much later than the other days, knowing that Saturday will just be a touring day.

I also started thinking about a major decision I had to made at the age of 14: what would my life had been like if I had chosen to return to Taiwan with my mom instead of going to NZ alone? To sacrifice family cohesiveness for greater freedom and an easier academic environment? This process had made me so independent that I have difficulty feeling a sense of “belonging” with any groups of people I encounter, always more like an observer looking in. Nevertheless, I believe I would have made the same decision if God lets me choose again. Who knows, I might not have had the chance to become Christian if I had chosen the other path, as I came from a non-Christian family and Taiwan is a non-Christian nation. I am thankful that my parents gave me the autonomy to make most of my major life decisions myself, as this is not a common occurrence for East Asian families where parents often try to live their lives through their children. However, the price our family to pay is the huge cultural and generational gap between my parents and I. They try to read me through “Asian eyes” and place many labels on me (ie. they assume that I don’t care about them). They can’t understand that I don’t express things the same way as they do. They assume that I know Asian values when I don’t, which is pretty frustrating and makes any attempt at communication even more difficult, so these days I just don’t even try anymore (ie. many times I am simply labelled as “disobedient” when I speak my thoughts). This is a bottleneck which I am praying for God to work on.

Anyhow, God equips each individual differently and I believe I have been equipped like this for a purpose.

Patient count: 312 people. Medical 100, Dental 166, Chinese medicine 46.

8June

Sunshine poured into the room when I woke up. That was a great sign! However, the morning began with a very long 1.5 hour car trip which made me feel sick. The locals were very friendly and waved to us whenever our van passes by them. We got to the Paonangisu village, to the location where the team will be providing medical services on Monday and Tuesday. This community health centre has quite a lot of medications and you can even place in IV drips in if you choose to! There were some coconut trees there and our team members were trying to throw a coconut up to strike down other coconuts. A friendly young local called Barry saw this situation and climbed up the tree to pick some coconuts and cut the coconuts open for us. Brian the dentist also tried to climb the tree and did a pretty good job!

Then we went to the Blue Lagoon and had a swim in the beautiful aqua water. There were many people diving into the water using a tree-rope. I tried to dive in like that twice, but my arms were too weak, and I fell into the water pretty fast. In fact, I even suffered a rope burn that made my index finger bleed! It was amazing to see our physio Kien learn how to do a somersault dive so fast!

In the late afternoon we went on a ship to Erakor Island. The water was very clear there and we saw many star fishes and sea cucumbers! This island was where the first missionaries to Vanuatu settled. We saw a rainbow as we walked towards the tombstone of Amanda Bruce, wife of missionary Rev. McKenzie, and three of their children who died as toddlers. Seeing the tombstones of such young toddlers made my eyes well up with tears. What a huge sacrifice to make. Amanda’s final words were: “I know that Jesus is mine and I am His.” It really takes a very special empowerment by the Holy Spirit to be able to make the decision to become a missionary. It is also amazing to see the transformation of a place which used to practice cannibalism turn into a nation with a 90% Christian population.

We ate at the island restaurant. There was happy hour alcoholic drink between 5-6pm so I got a “red bat” beer. Many of us ordered the beef burger for dinner because it seemed to be good value for money. The live music was great. Then the ship took us back through the dark water, and through the lights from the ship we could see fishes jumping up and down in the water.

9June

During spiritual devotion time, Rev. Ho told us stories about missionaries to China during the Victorian era. Many of these missionaries came out prepared to become martyrs, as the average life expectancy on the field was seven years. James Hudson Taylor’s first wife and several young children all died in China. The missionary to China with the shortest lifespan on the field got killed by robbers during his seventh day on the field! Personally, I am having a big internal struggle. I felt as though God had placed me under some usual circumstances when I was growing up to equip me as a medical missionary, but do not feel I got enough love for strangers in a strange land to make such a big sacrifice yet. Short-term missions only have very limited influence. It is the long-term missionaries that make the lasting impact. Short-term missions might help us learn more about ourselves and explore further about God’s call for our lives. This short-mission trip actually made me think a lot. I can only pray and see how God will open the doors for Chris and me. It is Pentecost Sunday today, a time to really try and listen to God.

We attended Sunday service at Eric’s church, the Vila Chinese Christian Church. On the way to the church, we saw that locals really abide by the Sabbath as all shops were closed. Dr Chen, the dentist on the team, gave the sermon today, using the passage about the prodigal son. The short-missions team sang the altar call song at the end. Then we had lunch before offering our medical service to the members of the church and their friends. The Chinese had better health and the consultations felt similar to the consultations I do in Sydney. It was quite cruisy as there were much less people than the previous days. After the consultations, the church people prepared tons of food for us, which tasted nice, but I felt so full I could hardly move.

Patient count: 99 people. Medical 37, Dental 36, Chinese medicine 26.

10June

Today, we went off to the Paonangisu village on a different road and the trip became a bit shorter, taking approximately one hour. Quite a few ladies became car sick, because this road has even more ups and downs. We arrived at the health centre around 9am. The nurse practitioner was still using the consultation room where the doctors will work in. A Japanese nurse was helping the nurse practitioner. Pretty soon, the nurse practitioner vacated the room. The consultation room is pretty comfortable. I even found an additional otoscope there, which was very useful because we had floods of school kids coming in to get their ears checked! Most of these children either had wax impaction, eustachian tube dysfunction from swimming or viral URTI, and otitis media. There is a sink in the consultation room next doors, so I could wash my hands easily. There is even a syphilis testing kit. We also saw some funny posters placed on the wall by nurse practitioners: “Doctors diagnose. Nurses cure.” “God found some of the strongest women and made them nurses.” The workload wasn’t overwhelming. However, there were quite a few people wanting to get their eyes checked and receive glasses, and our team doesn’t provide those services, so I gave some of these people artificial tears. I noticed that the kids here have better teeth than those at Port Vila, and the dentists had an easier time today compared to previous days. I found some boxes of Buscopan in the health centre and gave it to a lady with gas and abdominal cramps. The day passed along very comfortably and the whole team finished by 4pm. The trip back was even faster, taking just under one hour. However, whenever the van climbed up slopes, it made very strange noises and became extremely slow.

Patient count: 225 people. Medical 78, Dental 114, Chinese medicine 33.

11June

This was the last day where we provided medical services. It turned out that the van we were in was close to breakdown yesterday, so we went via the 1.5hour path. Most people were encouraged to go onto the good van, but many dentists stayed in the bad van. That van really broke down quite soon after setting off, so we had to “rescue” some people from that van. Most dentists chose to sit on the back of a Ute which was carrying equipment. Our van got to the health centre half an hour earlier than the Ute. The people in the Ute seemed to have enjoyed the ride, even though it made their bottoms sore. When we got to the health centre, many people were waiting under the tent. The morning was quite busy for everyone.

At lunch time, some locals gave us coconuts. However, we didn’t have a knife to cut it open. Jonathan, the dentist, used the equipment that dentists use to pull out teeth to open the coconuts (it was sterilised)! Many people were coming for ear checks. One family brought a child with global developmental delay, and there was nothing I could do other than to pray for that family. We went back via the quicker way and stopped over at a scenic point to take some beautiful pictures of the sunset.

We dropped the equipment at the Vila Chinese Christian Church and went to Pizza Hot (this is not a typo) for dinner. We had passed this restaurant every day and finally got to eat there. This restaurant actually lifts up aged lobsters from cages in the sea! I witnessed how strongly and lively the lobsters were when they got grabbed out of their cage! We were initially expecting pizza, but much to our surprise, we were served luxurious seafood platters! We became very full from all the lobster and crab meats.

Patient count: 269 people. Medical 104, Dental 114, Chinese medicine 51.

12June

It was time to pack up and go. All in all, I felt I learned a lot from these friendly and simple locals. I also learned a lot from about life in a community from the other team members because they are such great role models. It seems like people had been interceding passionately for this team, because everyone seemed quite mature spiritually and teamwork just happened quite naturally. It is very different from any other team activities I had ever participated in. I felt as though I had gone back into the New Testament era where the community of Christ lived together in love. During this trip, I felt a bit closer to where God wants me to be. However, I am already so used to living as such an isolated individual for most of my life, so the biggest challenge I must face when I get back to Sydney is that I still got a lot to learn about how to live within a community in my everyday life.

There is also a sense of “inheritance” during this trip. The previous mission trips to Cambodia organised by CMI comprised of very experienced doctors and dentists around retirement age. This time, the doctors and dentists are mostly under 35, and including several “parent and child” pairings. I can see a steep learning curve coming for me when it comes to the area of familial relationships.

Even on the last day, we had great fun. I knocked open the coconut from yesterday by placing it into a plastic bag and throwing it against the ground multiple times, which made it split beautifully into half! The coconut meat tasted great as it was in the right maturity! I discovered the fun of riding in the Ute. After returning more equipment into the church and the PCV Health Department, we went to the city centre and gazed at the beautiful sea. Got some award-winning chocolates and Tanna Coffee (coffee bean grown on volcano soil). Tried out the local Tanna Coffee, which has a nice aroma to it. Spent a bit of time in the airport business lounge before embarking on the plane trip back to Sydney.