Day Eleven – Day Seventeen

Oh my gosh, I have so much to write!

Where to begin? On Thursday morning (6th Dec), I left Hanoi and flew to Kuala Lumpur with Air Asia (the Asian equivalent to EasyJet or RyanAir). Sally met me at the airport, and took me back to their house. It was pouring with rain (so my plans to lie by the pool and get some sun didn’t materialise!). Instead, we went to Bangsar shopping centre… I ate at Olio Dome, and looked around Cold Storage (memories of Singapore!)… Then in the evening, we ate at a food court, I had Roti Canai, mmmm!

The next morning, I had to leave to the airport at 4am!! I was flying AirAsia to Sandakan (Sabah, Borneo). My flight was slightly delayed because of ‘technical problems’ (great!!), and I landed in Sandakan at 11am. I was meant to be meeting Becky Davie (another Imperial Medic) at 12.45pm (she was flying in from Kota Kinabalu), so I just sat around at the rather sparse Sandakan airport waiting for her. At 12.40pm I went to to check the arrivals board only to discover that her flight was delayed until 3pm! So I had rather a long boring wait!!

When she arrived, we were met by a family friend who happens to be the chief vet at the Sepilok Orang Utan Rehabilitation Centre, and he informed us that we’d be living on site with one of the vets!! (I had no idea where we were going to be staying beforehand, so it was a rather nice surprise!) When we arrived at the centre, it was already after closing time, but the vets took us to the outdoor feeding platform and nursery to see some of the rehabilitated orang-utans! It was amazing! Tourists never get to go to the nursery, so we felt quite VIP-ish!

That first evening, there was a barbeque because one of the main sponsors of the project was in town! All the UK volunteers (on a 2 month programme in Sandakan) were also at the barbeque. The karaoke machine was blasting away (but I steered well clear after my earlier karaoke experience), and the beer was plentiful! Becky and I managed to make it onto the top table with the main sponsors (Rick, an American, and some other guy who owns a big hotel in Kota Kinabalu). Therefore, our table also had plenty of wine, and a big bottle of whiskey! It was a good drinking environment for me because we were outside in a dark garden, so my red alcohol face was well masked (plus most people in Asia go red when they drink too, so it was no biggie!)… It was quite an amusing, surreal night… We were suddenly in the jungle with lots of orang-utans, and having a loud unexpected party with a bunch of strangers (who were mostly hippie types who’ve ventured out to Asia for a life-changing experience cuddling orang-utans!)

The next morning, we went and did what the tourists do at Sepilok… basically watch a video about the centre, then go to the viewing platform where you watch the 10am feeding time… It was good, but there were lots of people, and the feeding platform was quite far away compared to how close we had been the day before. Will is going to be very disappointed with my photo’s… they were fairly crap! But it was still fun to watch the orang-utans having a good time with their banana’s and sugar-cane sticks! That afternoon we went to the Proboscis Monkey Centre. The vets knew the owners of the Proboscis Monkey centre (because they often have to treat any monkeys that get injured/sick), so again we got treated like VIPs! Here’s a photo of Cecilia, Me, Becky and Sen.

After that, the heavens opened, and we got drenched walking from the car to Agnes Keith’s house (Agnes Keith is a woman who lived in Borneo before and after WWII, and wrote several books including Land Below the Wind. Her lovely house has been turned into a museum). Here is a photo of Becky in front of Agnes Keith’s house.

In the evening, we ate a huge meal at a seafood restaurant… the prawns were enormous, and the oysters were CRAZY big! Check out the Oyster!!

The next morning we got to see some of the baby orang-utans having their baths. The centre rescues orang-utans that are being kept at pets, or who have lost their mothers for some reason. The orang-utans are rehabilitated, taught how to live in the wild, and then released when they are ready (e.g. have shown adequate nest building skills, able to find food by themselves etc). The whole rehabilitation process can take over 10 years. Some orang-utans will never learn how to build nests, and will therefore never be able to be released properly into the wild, yet some pick up all the skills easily and go off happily into the wild. There are numerous stages at the centre… newcomers live indoors, and they are allowed out into training areas (with ropes, tyres to swing on etc) to learn how to swing. The young newcomers are bathed, fed by bottle, and monitored closely by nurses who take the role of a mother. Here is a baby called Churrio having his bath! He’s 1 year old.

Once they get older, they can start to live in a semi-open area, and play on ropes leading out to the jungle (but they’ll still come home each night for dinner and to sleep in the enclosure). Then if they are ready, they can be released (but many of the released orang-utans still pop back to the feeding platforms each day to supplement their diet with some milk and bananas!) The jungle at Sepilok has now reached capacity, and so orang-utans are now being released into another section of jungle called Tabin. It’s a great set-up, and the orang-utans are well cared for. The vets deal with all sorts of problems… one orang-utan was recently electrocuted on a overhead power cable, which just shows how much damage humans are causing by encroaching on the orang-utans habitat. They also see a lot of fractures, diarrhoea, malaria and malnutrition. Here is a photo of me with Churrio at bathtime!

The weather hadn’t been too great during our time in Sandakan, but we still wanted to go on a jungle trek… One of the orang-utan rangers agreed to take us. We were originally going to do a 4 hour trek, but the weather was pretty bad, and parts of the jungle were flooded, so we decided to go on a 2 hour trek to the Water Hole instead. We were given leech socks, wellies and also wore raincoats, so we thought we were pretty well protected from leeches. We were wrong! Within 5 minutes on the jungle trail we already had at least 5-10 tiger leeches each on our boots and trousers. The ranger brought a spray bottle of dettol water, which makes the leeches curl up and fall off! We were spraying it non-stop. I think the ranger was also taken aback by the sheer volume of ravenous leeches. We realised that no amount of clothing, boots, socks were going to keep the suckers off us! During the trek, we must have sprayed off at least 100 leeches. I got one on my lip, and up my sleeve, Becky was worse-off, and managed to accumulate a fair number underneath her clothes! One leech bite on her arm bled for a good hour afterwards (they release an anti-coagulant). Here is her bleeding leech wound:

 

The trek was really good despite the devil leeches! The rainstorms had managed to collapse most of the bridges along the way, which meant there was plenty of wading through rivers (and at one point we had to wade across the top of a waterfall, which didn’t seem sensible, but the ranger went across, and we figured we’d better follow him!)… Originally we’d thought we would spend a lot of time looking out for jungle wildlife (hornbills, mousedeer, orang-utans, monkeys), but because of the rain, the animals were all hiding, and we were preoccuopied with leech annihilating and scary river crossings! This bridge behind us in the photo had collapsed in the middle, so it was falling to one side. We had to cross it one-at-a-time walking along the middle beam. We thought he was joking when he first suggested it, but he wasn’t! Lots of fun!

Anyway, on our last night in Borneo, Cecilia cooked up a local feast… really yummy. Becky and I watched copious amounts of TV… I think we watched 3-4 movies or something disturbing like that! It was pouring with rain outside, and so the sofa seemed like a good spot! I spent 9 ringgit during my time in Borneo! Sen (Becky’s cousin) insisted on paying for everything… and all the food at the orang-utan centre was free for us. We even got a free ride back to the airport because the taxi-man was also a part time orang-utan ranger!!

My return flight to KL was a bit frightening… We started taxiing along the little Sandakan runway, built up speed, lifted on the front wheels, then slammed back down on the ground before screeching to a halt (with very little runway left ahead… plane wobbling profusely as the pilot tried to bring the plane to a stop). Everyone’s knuckles were white, and our faces were a similar colour. It was so frightening. Then, without explanation, the plane turned around, built up speed and took off in the other direction. Once in the air, the pilot made the normal announcement ‘Welcome on board… approx flight time is…’ And then just at the end of the announcement said ‘Sorry for the departure’. That was it! No explanation! My only thought was that he was initially about to take off in the wrong direction, (scary thought: maybe into the flight path of an incoming plane?)… and then got shouted at by the tower, and quickly slammed back down and turned around. Anyway, it wasn’t fun… We also had some really shocking turbulance on that flight, where the pilot actually told the stewardess’ to sit down, and told everyone that under no circumstance were any of us to get up to use the toilets! Our confidence was knocked by this stage, and we all sat ashen in our seats!

Anyway, safe in one piece, I was back in KL, and went to the Islamic Museum with Sally, before going out for a fabulous dinner at Indochine with Brian and Sally. The next day, I had a lie-in, then packed my things and headed back to the airport for my return to Hanoi.

Today I was back in the hospital… Decided to go to Antenatal Clinic. The doctor only spoke French and Vietnamese, so I put my rusty French to use, and actually did okay! I met Annett for lunch, this time we went to a bakery (branching out from Quan An Ngon!!)… I leave to Singapore (and then New Zealand) tomorrow evening, and she told me that I’m missing some Xmas Expat parties, which is a real shame. Oh well… Tonight I’m going out for dinner with the Swedish girls. It’s our last night together… Really going to miss their company when I am here on my own after Christmas!

Managed to have a nice chat over Skype to all my family members and Will last night… There’s a fair few drama’s going on back home, and I felt very far away from them all last night. I would have loved to transport back to England for the night to be with everyone. I think I was tired, but I began to feel a bit upset at being so removed from it all. I’m feeling much better today, and am really looking forward to seeing Will in a few days time.

Day Ten

You might be relieved, or you might be very upset (probably the first one!) to hear that this post is going to be very short today!

I’ve had a pretty busy day. I was in the hospital all day, then I had a Vietnamese lesson with Linh, and now I’m frantically packing because I fly off to KL early tomorrow morning, and I need to leave a suitcase full of junk here at the hotel and just take my backpack with me to Malaysia…

I’m taking a very long long-weekend! I fly to KL, then I’m spending a night with Brian and Sally (Louise’s parents (Louise is my brother’s girlfriend)) before flying out to Sandakan to spend a few days with Becky (a girl from my course who is on elective in Borneo)… Should be a good trip.

Anyway, I’m not going to be writing my blog while I’m in Malaysia, so my next post will be on Tuesday 11th December… and it will be all about orang-utans, borneo, KL and other new, interesting things!

Until then, xxx

Day Nine

Really sorry, but this post is also going to be a medical one! I’m really getting into things at the hospital, and it’s taking up a lot more of my time… so there isn’t much else for me to write about! I’ll keep it quite brief today though.

For those of you who think I’m out here on a jolly, you’ll be pleased to hear that I was in the hospital from 8.30am – 5pm today!! This morning, I was in with Dr Hoi in the IVF department together with Emma and Matilda (Anna is still not well). We started out watching some ultrasound scans to assess patient’s follicle sizes after gonadotrophin stimulation. We also looked at sperm samples under the microscope, and washed sperm ready for IUI… Then we observed some IUI procedures (IntraUterine Inseminations). It was good to see all of those things, but we didn’t want to spend all morning doing that, so we decided to go back to labour ward.

On the labour ward, Dr Lien seems to have taken us under her wing… She went through a patient’s medical notes with us, showing us where everything is recorded in the notes, such as past medical history, examination results. It was really useful, and it was fun using sign language and diagrams to figure out the corresponding Vietnamese and English words for certain things… I think it will really help, because now we know where to look in the notes for specific information, so even if we can’t understand what’s going on, we can at least use the notes to figure out the basic plot. All the staff on the labour ward have gotten used to us, and are all really welcoming. It was slightly quieter on labour ward today, so we had plenty of time to chat to everyone… my Vietnamese-English phrasebook, and my Oxford Handbook of Clinical Specialties both helped to break the ice between everyone… One of the senior doctors was trying to persuade me to marry one of the registrars! I think they all find my half-Chinese looks quite interesting out here. They all say that I look a little bit Vietnamese, but different (Same Same, but Different!!!)… Anyway, everyone was laughing and joking around, and it was a really fun atmosphere. (And don’t worry Will, I told the doctor that I can’t marry him!)

In addition to all the laughing and joking, we also saw two deliveries today. One of the newborns was premature (35 weeks)… In England, 35 weeks wouldn’t be a very big deal, but here it is. One of the doctor’s told us that the prognosis is very poor out here for babies born under 33 weeks because they aren’t equiped for it. We decided to follow the little baby down to the baby unit, and one of the paediatricians showed us around the unit. They actually had a 28-weeker down there, who seemed to be doing quite well… he had been given surfactant and was having NG feeds. There was also a baby nursery down there, which is where they keep babies who were delivered by Caesarean while their Mum’s recover. It was like the nurseries that you see in old films… in the UK, babies are always kept with their Mum’s these days. Although I think the babies probably should have been with their Mummies, it was so nice to wander around the nursery and coo at the babies… Emma, Matilda and I were all very soppy and broody! Here is a photo in the baby unit:

In one of my previous posts, I discussed how common Caesarean’s are here in Hanoi. Today, Dr Lien explained that the women here are very tiny, but their babies seems to be getting bigger, and this is one of the reasons why Caesarean rates are so high. Today, one of the women labouring (who ended up being sent for Caesarean), was so tiny, she weighed less that me and she was carrying a full-term baby!! I’m really trying to be conscious of the fact that I don’t want to criticise the things I see out here without fully understanding why things are the way they are… I definately do not know best. However, I’m also not really willing to assist with things that I disagree with. One example: I’m a bit concerned about getting too involved with labouring women, because if I’m asked to do an episiotomy and I don’t fully agree with why the woman is having an episiotomy, I don’t think I could go ahead and actually perform one. It’s really tough, because I want to get hands on, but I don’t want to do things that make me feel uncomfortable, or that I disagree with. Oh well, I think they’re quite happy for me to get involved as little or as much as I feel comfortable. So I’ll see what happens tomorrow… All I know today, is that I really enjoyed my time in the hospital, and I feel really happy with my decision to come to Vietnam.

Day Eight

Those of you who dislike my medical posts… stop reading! This is all about obstetrics, and all about babies!!! 

I saw three little Vietnamese babies being born today! Two girls and a boy! I didn’t deliver the babies, I was just observing today to see how they do things over here… and the labour ward is very different to the West Middlesex Maternity Unit back in London! If you’ve read my previous posts, the labour ward is quite similar to the clinics that I’ve seen here – no pivacy, and lightning fast! I think the general rule of thumb seems to be that most women have caesarean’s, but if you are allowed to have a vaginal delivery, then you will automatically have an episiotomy, push, push, baby born, move to post-natal ward, change the bedsheet, next woman please!

All three women this morning were cut, and I think that only one of the women would have been cut if she was in the UK (and all three would have been consulted properly about it beforehand, whereas here communication is kept to a minimum). However, I don’t want to start to appear as if I’m criticising their methods. I just want to portray how it is and how much things differ over here.

Anyway, baby number one was a little girl who was born quickly and easily… The pain threshold of Vietnamese women seems to differ to that of British women, because not a sound came out of the lady during the entire labour and delivery! She just knuckled down, pushed, and that was it. The baby girl was straight away taken to be weighed and wrapped up and put onto a table top (no skin-to-skin contact with Mummy – in fact Mummy didn’t seem to have a chance to even look at the baby, and she didn’t seem to expect to hold or see the baby in the delivery room. I think the practice over here is to wait until you reach the post-natal ward). Emma, Matilda and I were able to coo over the baby while the Mum was being stitched up. Here is a photo of baby number one (I asked the Mum’s permission of course):

Anyway, shortly after baby number one, the other woman labouring in the room delivered, (yes, two women labour and deliver in one room, no screens or curtains, and the door to the room is a sliding glass door (left open), so the rest of the pre-labour ward and post-labour ward can see in too). The midwives and staff were getting to know us better and let us examine the lady, and use the pinnard stethoscope (never used one before because they’ve been replaced by hand-held dopplers in England, so that was cool!). 

Here is a photo of Matilda and Emma in an empty room so that you can get an idea of what the labour ward looks like, it’s a bit out of focus (sorry Will!), but you’ll get the idea.

After that, we moved to another room with two other labouring women. One woman was being monitored by CTG because of fetal distress. This lady seemed to be a lot more vocal, which was a relief, because it looked like it hurt like hell, and I would have been really shocked if she had stayed silent! She had a pretty massive episiotomy, and it took a lot longer for her to deliver (it was a big baby). The baby was very limp and blue when he was delivered. The midwife used suction, and rubbed the baby with the towel, and after a few seconds he made some noises and moved a little bit. No Paed’s doctors were present, and Matilda, Emma and I were left with the baby and some oxygen (they didn’t have oxygen face masks, just an oxygen tube, so we held it in front of the baby’s face wafting oxygen towards him). After being wrapped up and under a lamp for a few minutes, his colour improved and he was making spontaneous movements… After fifteen minutes or so, a midwife came in, and took the baby to be with Mum.

For lunch I took Matilda and Emma to Quan An Ngon, and it was just as yummy the second time around. We had Spring Rolls, pork and noodles wrapped in rice paper, banh ghoi (like a friend puff filled with meat, noodles and veggies), and a seafood noodles. I was so full after that! Here’s a picture of us all at Quan An Ngon:

In the afternoon, Emma and Matilda went to study. Anna isn’t well, so she was sleeping for most of the afternoon. As for me, I watched a disturbing amount of Grey’s Anatomy!! I know that I’m in Hanoi, but I was just feeling tired and lazy, and Grey’s Anatomy is so addictive! I did make it out of my room for dinner though… Wandered over to the north east part of the Old Quarter for some dinner with Emma and Matilda. Now I’m feeling stuffed for the second time today!

Really good day though!! And I can’t believe I saw three babies being delivered… In London, the midwives really made us put in the hours in order to watch the deliveries. Here, women are delivering every five seconds, and there’s no keeping the students out when the doors are made of glass, and left wide open! I think on the next labour ward session, we’ll be able to get more hands on.

Until tomorrow…