Derek's Journal

July 25 & July 26

Sun, 05 Sep 2010 11:32:05 GMT

July 25 I drive back to Teluk Dalam to get the repaired spare tyre, and then back to Sorake Beach - to wait for the boat to Tello in the morning. On arrival in Sorake, we are told of a very sick man in the village by the village nurse. We travel with her to make a house call and find an ex military nurse around 45 years of age who has been sick in bed for at least two months. The illness started with a high fever apparently, and all of his skin turned red and hot and started flaking off his body. When I saw him, he appeared to me as an amazing survivor, so far, of Toxic Shock Syndrome. He had been unable to eat any food for two months so he was severely cachectic. We saw him twice that first day as he was very unwilling to go to hospital because of the expense, and he didn't trust the staff who worked there. We were able to give him medications both parenteral and oral, but by evening and our third visit, he was refusing medications and refusing to drink. We were sorry we were unable to help him any further - at his request. I could not see him surviving another day without medicines, and even with medicines his possibility of surviving is slim.

July 26 On the way to catch the ferry to Tello, we stopped at the Dinas Kesehatan, (Department of Health) to see if the paper is ready, that we had been promised two weeks earlier. Yes it was yeah! Instead of taking the six hour boat trip to Tello, we decided to drive to Gunung Sitoli Airport, and try to get seats on the next plane to Medan, to get important paper work to the Provincial Head of Health in Medan. Once he received this paper work, I am hoping he would write the requested letter to the police in Padang in the long journey to free up the purely humanitarian helicopter now detained for more than two years.

Fortunately, all went well and we made it to the Airport in time to get the last two seats to Medan. We took a taxi immediately to the Health Department, met a doctor who spoke good English, and who was well acquainted with the Head of the Health Ministry, and also with the subject of the helicopter - we were still there at 5:30 pm. The head of health is keen to help me find a way to benefit the people using the helicopter, and to bring the helicopter back from West Sumatera to North Sumatera.

Directly after this; we met Raymond and Ben with keen supporter Erik again in the Traders Establishment. Ben is an experienced Dentist from England, who has worked for some time in Australia, and has to volunteer. Raymond a TroppoDoc Board of Trustees Member is
in Indonesia for his 2nd time, and this time is making footage of Troppodoc work for a Documentary.

July 23 - July 24

Sat, 04 Sep 2010 07:39:58 GMT

July 23 Finally all the paper work is together with Melioni's Passport and application - I can now courier them to the French Embassy in Jakarta (in trepidation ). I wonder what chance there is of losing this very important passport in transit?
Immediately - we then look for a flight to Gunung Sitoli - going direct to the Airport – it is 1 pm - we are told there is a flight at 2 pm. The check-in is open, and the 3:45pm flight is full. So run, run, run, frantically packing at the Hotel to get back to the Airport with luggage for the 2 pm flight. We arrive at the airport at 1.40 pm to be told seats are now available on the 3:45 pm flight and the 2 pm flight is now full !! We relax in the cafe, Margaret, Jan, and I, until the need to run to check –in - but alas we were too late to get Jan's suitcase on the flight!! Bother!!! None the less we fly to Gunung Sitoli while Margaret stays in Medan to fly home to New Zealand. (Wow! - in Dr Derek’s rush he has forgotten Melioni – No)

July 24 While waiting for Jan's suitcase to arrive on the pm flight from Medan, Melioni, Jan and I visit St Alma Home. We hold a small clinic with donated medicines from Mt Maunganui Pharmacy (thank you Daphne for medicines – much appreciated). We drive to Teluk Dalam after uplifting suitcase from Airport at 6.30pm - at which time we developed another flat tyre. Thank goodness we were helped by a very friendly Indonesian man who lived nearby. He quickly changed the tyre in the busy street in Teluk Dalam which enabled us to drive to the Tyre Repair Shop - which had just closed. This gave us no option but to drive to Sorake Beach without a spare tyre – returning in the morning.

July 15 - July 25

Fri, 03 Sep 2010 20:24:51 GMT

July 15 Today we take ferry to Tello Island - long 6 hours with terrible techno music. We see Mr Ohay with chondro-carcinoma of his knee with Mr Given. Mr Ohay is agreeable to amputation of his leg as he is unable to move because of pain and heaviness of leg. He says he has had the problem for 2.5 years now and would have gone for the surgery long ago but he has no money to pay for it. He believes that he is unable to get the surgery done in Indonesia without having to spend lots of money and he is poor.

July 16 Danny, volunteer organizes over the course of a day a Kartu Miskin,so that Mr Ohay can have a reduced cost X-ray of his leg and this will put him within the rules of the governmental social health care system. This card costs 25,000 rupiah from the Kepala Desa for qualifying people, who are the poorest in the village. This card then allows these people - once they reach the nearest appropriate public hospital to get their treatment and surgery free. The medicine that they will need to pay for is the medicine that the hospital does not stock routinely. Danny took Mr Ohay to the X-ray at Pulau Tello Rumah Sakit and was able to negotiate a 33% reduction in the price of the X-ray from 300,000 to 200,000 rupiah for an AP and lateral X-ray of his L. femur. Unfortunately the family was not very assertive about getting the Kartu Miskin as the Kepala Desa said they had run out of the appropriate cards. Only by going through the Camat, were we able to finally achieve the Kartu Miskin for Mr Ohay, and by this time it was 4 pm. Meanwhile the rest of the team carried on with a medical clinic at BengHong’s house with minor surgeries and removing badly decayed teeth.

July 17 We are back on the 6 hour ferry to Teluk Dalam with Danny, Katie and Margaret (enthusiastic volunteers) Mr Ohay, Melioni and I. Mr Ohay stayed on a mat on the vehicle deck on this large inter island ferry that services Pulau Tello once a week. Once in Teluk Dalam we picked up the Troppodoc ambulance from Rumah Sakit Stella Maris and we drove to Gunung Sitoli - arriving there at 9pm at night.

Rumah Sakit Umum, Gunung Sitoli is a newly built hospital supplied by Malaysia Mercy NGO since the destructive earthquake of 2005. Beautiful facilities with a population of 800,000 – they have had no General or Orthopaedic Surgeon there for more than 2 years.

We arrived on Saturday evening and we agreed with the admitting doctor to keep Mr Ohay in hospital until Monday morning when the Administrative office would be open so that the appropriate stamp could be accessed and used on his referral letter to the Public Hospital in Medan ( Rumah Sakit Adam Malik).

July 18 While waiting for time to pass in Gunung Sitoli, we visited the Saint Alma Home for physically and mentally handicapped children (which are practically across the road from the Miga Beach Hotel). This is a new facility since the 2005 earthquake which has 32 children and their long stay care is being taken care of by three Physiotherapists, one Speech Therapist, and other Sisters from the Catholic Church. A lovely facility this is,and the children are well cared for. We also went to see Viktor, the burns victim from before the tsunami who I need to buy new oil for to soften his scars. I wonder what the possibility is of benefit if I was to perform repeated scar excisions under local anaesthetic to free up the movements of some of his severely limited joints. These joints are limited in movement by severe skin burns scarring rather than by joint disease.

July 19 We pick up Mr Ohay from Hospital Gunung Sitoli, plus the appropriate referral letter, which all takes considerable time but we are able to make connection with the plane to Medan in the afternoon and take the taxi direct to Adam Malik Hospital at 5 pm. Apart from driving slowly via peak hour Medan traffic, by the time we arrived at the hospital and usual procedure time, it was only at 10pm that he was admitted to the hospital. New X-rays were taken, exactly the same views that we had paid to have taken the previous day and had given them upon arrival!!! Fortunately all the paper work was in order, and he was started on cefoxitin/omeprazole/metaclopramide and opiate pain relief. These were all administered intravenously despite the fact he could eat and drink normally, and wasn’t vomiting!!

On the way back to the Pardede International Hotel we met up with enthusiastic volunteer Jan Beamish from Tauranga who had been met the previous day by our great supporter Erik Brandt, as she arrived into Medan.

July 20 Much time today is spent organizing Melioni’s Burkina Faso visa. The agreement for working beside SIM in BF has arrived but unfortunately I was unable to download and print the required form for the visa - I tried on more than one computer!! We saw Sister Stefani, Mick Stevens and visited the Dinas Perhubungan to work through the issues of support for the helicopter being transferred from West Sumatera back to North Sumatera. They were however, unwilling to write the required letter as they said they had no power!!!

In the evening Margaret and I attended a meeting with the Rotary Club, Medan Central, the home club of Erik Brandt, we tried to raise support for Mr Ohay in terms of regular visiting for him at the Hospital - every 2^nd day.

July 21 Today the paper work has been lost by the hospital and the hospital administration has called Erik Brandt to say Mr Ohay will be asked to leave the hospital in the afternoon if we cannot supply the hospital with his Kartu Miskin.!! So I return back to the hospital with Margaret. Fortunately we are befriended by a very kind Indonesian Doctor undergoing Paediatric Specialist training who speaks excellent English. We explain the situation to him and after some time he finds all the required paper work still in the Emergency Room. He makes copies of everything and he personally takes these to the Administration and Insurance offices as well as the Ward that Mr Ohay is bedded in. This enables Mr Ohay to stay for his operation in the near future. We wonder, with dismay, what would have happened if we had not been there to assist Mr Ohay, or had not met the enthusiastic Specialist -in training in this very important matter.

Meanwhile, we are also trying to track down the promised compensation for my guitar which was broken on the Lion Air airplane on a flight with Margaret from Singapore to Jakarta.

July 22 In the Pardede International Hotel and still sorting out Melioni’s visa application for the flight to Burkina Faso transiting through Paris (the cheapest option) and possibly onto Ghana if Burkina Faso cannot be accessed successfully. We need further letters from SIM for the visa application at the border. Meanwhile friends in New Zealand are telling me of the temperatures in west Africa is topping 50 degrees Celsius daily!! Finally we go to a Kentucky fried chicken outlet and use the free computer there which easily downloads the required visa application form and SIM support letters effortlessly, but there is no printer.

En route to see Mr Ohay in hospital -this is a 45 minute becuk (motorbike passenger vehicle) ride; we are able to stop at an internet café and at last get a printed copy of these forms!!!!

Please Register

Sun, 15 Aug 2010 21:24:52 GMT

Volunteers - Please register your travel details with www.SAFETRAVEL.GOVT.NZ - help them find you in an emergency, so they can check on your well-being or send you important information. Volunteers from other countries, please register with your own country.

July 12 - July 14

Sat, 14 Aug 2010 18:29:27 GMT

July 12 Today, wait 2 hours at Bupati Office for paper for Perhubungan. Visit Dinas Kesehatan again - to request paper for Padang Police. We can see Dinas Perhubungan after 3 pm. In between, we visit Lawyer to pick up Melioni’s replaced Birth Certificate, and Melioni’s Parents permission to travel with her outside Indonesia – it is granted. Then we visit Stella Maris to get pictures of serious goitre patients for Mr Mark Izzard to operate on - unfortunately Sister Gertruda not there today. Next we travel to Internet Cafe to post update. Walk to wharf with Melioni, and then back to Sorake for a beach swim with Melioni.

July 13 I did hope to receive all Bupati, Perhubungan, and Kesehatan letters – but ‘nothing’ ready! Three sick Surfers with cuts, abrasions, and infections from the Reef. One Surfer required sutures.

July 14 Visit Bupati Office again – closed at 11am. We are told letter sent to Perhubungan. I will await outcome and come back for Perhubungan letter Monday. At last the Perhubungan letter gets completed and signed off.

July 10 - July 11

Sat, 14 Aug 2010 18:23:57 GMT

July 10 Today, Clinic at Hilionaha - seeing 20 people. Melioni was able to spend some very valuable time with her father. Hopefully, I can put some lovely photos of Melioni with her father on the site.

Patients checked: 38 yr woman BP 195/128 with leg pain; 60 yr woman fever, stomach pain, dizzy, BP 192/12; 75 yr woman joint and stomach pains BP 203/105; 51 yr woman arm pains and dupuytrens contractures of fingers ; 50 yr woman stomach and joint pains BP 173/90; 41 yr woman hx of Diabetes Mellitus, a hot back BP 136/101; 43 yr man leg and neck pain; 53 yr woman leg and shoulder pain; 10 yr girl headache one week , malaria likely; 50 yr woman goitre, chest pain, gastro oesophageal reflux oedema L. Leg, hepatomegally; 8 yr girl infected insect bites; 3 yr girl 6 toes on both feet, requests removal of one toe; 50 yr woman itchy skin; 96 yr woman cough , chronic obstructive pulmonary disease (COPD); 64 yr man cough (COPD) BP 149/72

July 11 Dr Derek attempts to surf on Sorake edges – he loses a fin, and gets ‘a hole’ in his surf board . Surfer Ben - ‘teaches' Dr Derek to stand up on board in front of wave. "YES – FUN! - but am I hooked on surfing - not yet!”. Consultation today - Father of one of the Losmen Owners – Diabetic neuropathy – usual advice given and advised diabetes is often a lifestyle disease.

July 8 - July 9

Sat, 14 Aug 2010 18:17:22 GMT

July 8 This morning we visited the Camat Office in Tello, and had no problem in obtaining support letter for TroppoDoc activities in Pulau Pulau Batu. The Camat said he was very grateful for the medical assistance TroppoDoc is providing for the people in Pulau Pulau Batu.

At 12 am we were all on the ferry back to Teluk Dalam. However, while waiting for the ferry to sail, one of the local boys saw a sizeable squid swim into the harbour/ confines of the wharf. There was
a mad scramble to kill the squid. I figured, this reflected its nutritional value to the people - a

teenage boy was the victor in catching the squid, beating it to death with a stone. I presume he took it home for food – the squid approx. 8 kg.

We arrive at Teluk Dalam approx. 7 pm - after all the offices are long closed.

July 9 Today meetings with the Bupati’s Secretary regarding support letters for ‘release of helicopter’. The Dinas Kesehatan to confirm that Dr Derek Allen is recognised as a voluntary
medical provider in Pulau Pulau Batu - working for the people for free, and the Dinas Perhubungan
supports the use of the helicopter in Pulau pulau Batu working for the people in a medical service supplied by Troppodoc in the archipelago.

We visit lawyer, Kadar Dachi to enquire how we can get a letter from Melioni’s birth parents - giving me permission to take Melioni out of Indonesia even when she is well. Also ask how we can go about obtaining a replacement Birth Certificate - to replace the certificate misplaced in New Zealand. Next we visit, Sister Gertruda to enquire about visiting surgeons, such as Mr Mark Izzard using the surgical facilities in Teluk Dalam if required – then to the Police Station to report the loss of Melioni’s original birth certificate, before I can obtain a replacement – what a day of meetings!

July 1 - July 7 Nias Island

Wed, 21 Jul 2010 13:32:04 GMT

July 1 Yobana comes third in the initial count of election by 100 votes. Unfortunately there will now be a play off between top two as no one got mandatory 30% of vote to get Leadership. I picked up repaired surf board and organized ride to Sibolga tomorrow in charter car 800,000 rupiah. While walking up road to home with surfboard under arm, past police station, the policeman yelled out, "Where are you going?” This is a common greeting in Indonesia. We said our address and behold they volunteered to take us there in the police truck. They were standing in front of, when they said, "Just to prove, the police are not all bad”. That night we met new volunteer Katie from England, Medical Student.

July 2    The charter minibus got lost trying to find the house we are staying in, but eventually we connected, and drove the long day trip to Sibolga to arrive there at 10 pm after the ferry had left around 8 pm.   There is no day ferry tomorrow. We stay at Hotel Wisata for 750,000 rupiah and plan to catch ferry next night.

July 3   No turbo ferry today.   We wait until overnight ferry, 200,000 rupiah per person for a cabin that accommodated Katie’s surf board as well as another person, Real car leasing man - going to Nias.

July 4   Arrived Gunung Sitoli at 0830 hrs to find Sister Yulita who is minding the keys to the ambulance, had left for Sibloga for a week!!! Oh No!! However while waiting for the church service to end - trying to figure out another way - Sister Klara came and helped us look for the keys in the usual place of storage – without success.   After church one of the girl boarders came and brought us the keys and off we went.   It was after midday so lunch at Miga Beach, and onto Sorake to Manuel's Losmen arriving 7 pm.

July 5 Today we visit Dinas Perhubungan (Aviation Department) told that the Kepala (Head) back tomorrow - appointment made for 8 am tomorrow.   Next we visit Dinas Kesehatan (Health Department) Told the Kepala (Head) would be back tomorrow – made appointment for 10am tomorrow.
Next we visited Melioni’s family village at Hilionaha where Melioni was a little frightened by the quickly gathered crowd surrounding the ambulance and her. However we were able to make an appointment for Melioni’s   Parents and I to see the Lawyer the following afternoon.

July 6 Today we meet Kepala Dinas Perhubungan - we need fresh letter of support,
from Pulau Tello Camat before he will do anything. We go straight to the wharf - no boats to Tello today. Next appointment Dinas Kesehatan - Yes! - They could help but they need the Head to sign the letter and he will be in Jakarta until Friday afternoon!!! Oh well. The Lawyer said that he can organize birth certificate and travel documents for Melioni but this will take a week!! Cost US$200 cash, negotiated to US$150. He asked, "Do you love Melioni?” - negotiating the price. We took Melionis Parents for lunch. It was great to be away from the village crowd – for them to have quality time together, before I took them back to Hilionaha.

July 7 Today we all catch ferry at 10 am to go to Tello to get new letter of support from Camat. The ferry departure delayed until 12midday - we arrived after 6 hours, too late to get paperwork we needed that night. Hopefully we can arrange it in the morning before catching the ferry for the 6 hour return trip. A meal at Fitri's then Benghoks where we arrived to find only a small "monkey mess”. Going to sleep...we hoped there would be a boat back to Teluk Dalam in the morning.

June 24 - June 30

Mon, 12 Jul 2010 20:06:00 GMT

June 24 Today is the last public meeting for electioneering for Pak Yobana. Thousands of supporters meet in Pariaman for a rally where my medical clinic was a small appendix.

June 25    A busy clinic at a roadside Mosque - approx. 70 people examined.

June 26 Another Pariaman village clinic - with a late start as the village is far from Padang.   We went via an election meeting, for candidates at a football field. Eventually we get to clinic at village, next to a digger levelling the site for a new Mosque. Yobana and Yesika both come, and visit the clinic late in the afternoon.

June 27   Melioni is feverish today, unwell and this is probably malaria so we have a quiet day at Yesika house. Early in the evening we go via car to the airport to meet my loyal volunteer from N.Z. Margaret T. Unfortunately we hear on the way that Lion Air bumped her off at Jakarta so hopefully she will fly to Padang tomorrow. The people who took us to the airport also waited for a surfer who never arrived so we were home soon after 10 pm.

June 28 Back to airport by minibus to meet Margaret T, 32,000 rupiah to airport and 18,000 rupiah to return to Padang city by bus. Unfortunately Lion Air has snapped the guitar she brought. Melioni improving and no clinics today.

June 29 Melioni develops a rash so I wonder about the possibility of Chikungunya disease, also from mosquitoes. She is improving slowly and we go to the market to try to see if we can get replacement guitar, and to fix notebook so emailing possibility returns.

June 30   We go to town and up to Rick Cameron's place to get some additional medical supplies, and to ensure the best date for medicines he is safely storing. Perhaps we will get a plastic swimming pool for Melioni to cool down her now occasional fever. Today is voting day for Pak Yobana and we await the result.

June 21 - June 23

Sat, 03 Jul 2010 18:25:53 GMT

June 21 Today I am working in the Pariaman villages beside Dr Herman Shah from Malaysia. Dr Shah was born and trained as doctor in Indonesia. Pariaman is his home town. We saw 50 people ranging from Scleroderma, Tb, Malaria to more common diseases. Tonight, Melioni and I sleep at Dr Shah’s Mother’s house in Pariaman, part of the Kampung/Village.

June 22 The morning starts with a tour of Dr Shah's Pariaman - the schools, and finishes with a visit to the Fish Market where he buys fish to take back to Malaysia this afternoon. Fifty (50 )patients seen today in a different village - with 13 previously undiagnosed hypertensive patients.

Melioni starts a ‘love affair’ with Spiderman – his picture on the back of a local bus on the way back from clinic at 8 pm - after dark of course in tropical Indonesia.

June 23 Another busy day in Pariaman villages, seeing 80 patients today. Interestingly enough - Pak Yobana who is running for Bupati election is supporting: Plantation Experts; Chocolate making Experts, and Harbour building Experts. Pak Yobana wants to get Pariaman to catch up to the Western World quickly, in educational and technology advances. Another late evening finish, in this place of poorly medically serviced population. Pariaman District 360,000 people = 70 % in villages.

June 18 - June 20

Thu, 01 Jul 2010 17:39:26 GMT

June 18 Dr Herman arrives from Kuala Lumpur to help with the poor villages of Pariaman (his home district). Unfortunately the flights are booked solid for three weeks, and the ferry didn't run today so I am unable to meet him at Padang, or join him for his first three days. My clinic in Tello continues with consultation in the morning and small operations in the afternoon. I need to find new support for the first school drinking water tank that we constructed as it has broken or rotted away. Still trying to find Suriyani but I hear she is much better.

June 19 Saturday - wait for ferry to start the long overland trip to Padang to find out more about helicopter and to help Dr Herman in Pariaman clinics. There is possibly a ferry going to Simuk Island today, staying the night there and then going on to Teluk Dalam tomorrow. Surprise! – a large boat the Perintis arrives for departure to Teluk Dalam at midnight. I continue with clinic until 6 pm and then board ship at 10 pm to sleep on deck for overnight travel.

June 20 Arrive Teluk Dalam at 6 am - walk to Stella Maris hospital and pick up ambulance and drive to Gunung Sitoli. I buy first seat out to Medan in afternoon and last seat to Padang in evening - 600k +1.200k rupiah. Arrived Padang 6pm, catch bus to city, then becuk to Balanti Raya, arriving after dark - to prepare myself for busy clinic the next day.

June 15 - June 17

Mon, 28 Jun 2010 06:13:27 GMT

June 15 Morning flight to Tello via a 2 hour stop-over in Sibolga. It wasn't that easy though - despite my phone booking on Saturday. I arrived at the Airport and the Counter Clerk said, "No paper ticket! Sorry plane full and you two are not on the passenger list." This was at 8 am check-in for a 9.30 am flight. Waiting patiently at the counter, (such good character training for me!) for two hours as the scheduled departure time slipped by and the counter staff have all disappeared. Eventually at 10.30am - one attendant returns, and said we now had seats to Tello - Oh the joy!!!! Early afternoon we landed at La Sondre Airport (Pulau Tanah Masah) and caught the boat to Tello Island.

The room I stay in at the Penthouse - looked like a tornado had swept through it - "monkey problem" I was told. My camera was gone, the back to my non working electric keyboard had been unscrewed and the speakers had been taken, and one string and tension adjuster also unbolted and gone from my guitar. ...Monkeys!! Really!!

June 16 Clinic days resume 20-30 patients seen in the morning and small operations including tooth extractions in the afternoon. The X-ray at Rumah Sakit Pulau Tello is back working, but the Dentist has left. He was too expensive when he was there, for the poor people to afford.

June 17 Today’s clinic I saw Jutra – she is on Tb medicines and looking well. She has just run out of medicines – but fortunately I am able to give her the note from Dr Tan for more Tb medicines. Jutra should be able to get more medicines from the Puskesmas if they have any - otherwise she will need to take the 6 hour journey by ferry to Teluk Dalam Puskesmas.

I asked permission from Dr Yulia for TroppoDoc visiting Surgeons and Dentist to use the Rumah Sakit Pulau Tello facilities and this is agreed to. The hospital continues to have not a single inpatient!!

June 13 - June 14

Sun, 27 Jun 2010 12:07:00 GMT

June 13 Quiet day at pool with Melioni. However, the extra time in Medan gives me the opportunity to buy a new charger for the digital video camera donated by Matt, which gets the camera working once again.

June 14 My Lawyer's son communicates with me that I need letters of support from Departments of Health and Transport in my ongoing saga with the helicopter impounded in Padang. Melioni and I visit the respective offices and the Department of Health say they will only write the necessary letter for me if they get a support letter from the Department of Health in Teluk Dalam.

They phone - yes they will do this and fax it! By 12md the office is already closed for the day and the fax has not arrived !!!

The Department of Transportation were very helpful, - yes, yes, yes, - they understood the need for a letter but I must get a letter from Teluk Dalam first, or go to Jakarta. They can do nothing other than sympathize in this matter.... such is the frustration of Indonesia. Both of these letters will take, both time and money to secure....

June 11 - June 12

Sat, 26 Jun 2010 07:17:15 GMT

June 11 4a.m. start if Melioni and I are to make the 7.40 am flight back to Medan with the economical Air Asia ticket bought on line. Melioni, being over 2 years old is treated as an adult with adult luggage limits. However, I am aware of the stiff penalties for excess luggage from Air Asia. We have one hour bus trip to the Airport- Dr Shah kindly drops us at the bus terminal at 5am.

The check-in luggage is spot on, but the hand luggage is over the top I am told. I need to do some departure hall repacking - this makes us late for the gate - we arrive as it is closed. Lucky for us the stewards make some walkie-talkie calls and escort us to the plane some distance away, and another ground steward helped me carry the hand luggage. At last we are on board with all our luggage plus medicines with no extra charges, and soon enough we land in Medan.

The reason to fly into Medan was to get the lymph node biopsy results for Jutra, the 17 year old girl in Tello with likely Lymphoma. The haematologist was only available at 3 pm so we booked into the Pardede International Hotel, reasonable at 360.000 rupiah/night. My two Medan friends that kindly give me free accommodation usually, were both either out of town or about to leave that evening..... pity!

The results for Jutra showed Tuberculosis only, what a happy result and a very treatable outcome - if she completes the 6 month course of oral medicine treatment - reliably.

June 12 Last night I woke up in the middle of the night, realizing I needed Dr Gino Tan (Haematologist) to write me a letter confirming Jutra's diagnosis of Tb, so she can receive the rest of the 6 month course of treatment (volunteer Margareth had already bought the first month of medicine when the initial diagnosis was made on Chest X-ray} from the Tello Puskesmas or the Teluk Dalam Puskesmas. Unfortunately this means we were unable to go to the Airport in case of seats available to Tello today and next flight is on Tuesday.

There is an overland option of 2 days but Melioni has a cough and for her sake we will wait till Tuesday - we make a phone booking.

Melioni loves the hotel pool with her infant floatie arm assists. These devices mean that she can float with her mouth and nose only just below the surface of the water (ha ha, just joking!). Melioni's cough is slowly improving while staying at the hotel. The Bellboys and Housemaid staff come to me with their medical problems and those of their families and I give what medicines I can.

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June 6 - June 10

Fri, 25 Jun 2010 15:41:10 GMT

June 6 Today is spent continuing to pack and to make list of medicines that I am to carry, ensuring I am not carrying anything that is something that I cannot medically use and to ensure that the paperwork is correct for the 2 or 3 borders that I have to cross. The challenge is always to pack as much medicines a possible, as well as my toothbrush and not pay excess luggage penalties of $25 per extra kilo to destinations such as Singapore which is only part way to my work stations !!!

June 6 -Evening Flight to Melbourne for the 6 hour stopover in Transit Lounge - I ride by the most economical ticket back to Indonesia. Melioni takes the 6 hour stopover in her stride; well in her sleep really from 8 pm to 2 am in the Airport Lounge sleeping on chairs.

June 7 Arrive Kuala Lumpur at 9 am and with lots of hand luggage and a tired child, we take the bus to the city and a taxi to Dr Herman Shah' place. I met Herman just before I left for New Zealand. He is an Indonesian Doctor, cousin of Pak Hendry Final, my generous Host in Padang. Both men were born and grew up in Pariaman, and so they are both very appreciative of the work I do with the Survivors of the earthquake - last October that devastated Pariaman.

June 8 Visit to the Indonesian Embassy in Kuala Lumpur, where I apply for a 2 month visa to Indonesia. The requirements are photocopy of front page of passport and Malaysian entry visa (90 days given freely at incoming Immigration), 2 passport size photos, a return ticket number for Indonesia and 170 Malaysian Ringat.

June 9 The required paperwork is all delivered today, I am advised that the visa will be ready the following day. At Immigration, Counter Clerk says "Do I want to proceed if I am only given a 30 day visa with the possibility of extending for another 30 days inside Indonesia ?" Oh dear I thought, a 30 day visa for 170 Ringat is expensive and the right to another 30 days is not guaranteed and will cost more money, so I said yes, and am more than a little disappointed that I may end up with only an expensive 30 day visa... In the taxi back to Dr Herman Shah's house I see that I do not have enough money to get to the door so when the taxi meter reaches my limit - Melioni and I are walking the final kilometre with our backpacks in the Malaysian 35 degree heat and humidity.

June 10 A visit to Pilkington Glassworks where Dr Shah works as an Occupational Health Doctor for some of the week and on the way home drop into the Indonesian Embassy to receive a 60 day visa for Indonesia.. yay !!

May 31 - June 5

Fri, 25 Jun 2010 14:44:52 GMT

May 31 Fly to Queenstown to meet with volunteer Ngaire and meet up again with Tessa and Melioni (on the Tuesday) on a sparkling and crisp (very cold) frosty day in Central Otago. Icy streets but a clear blue sky - so unforgettable (and stunningly enjoyable).!!

June 1 Drive to Gore to meet stalwart ongoing volunteer Bronni, who regularly saves up annual leave and leave without pay, to take a family holiday , or is it a holiday away from the family. Bronni has worked in places from Africa to Indonesia, Kashmir and Bolivia with TroppoDoc.

June 2 Drive to Brighton, Dunedin to see my small house that has been recently broken into while I am away overseas working as a volunteer. I need to reclaim some abandoned articles that were handed into the police, discarded by the thieves and vandals. They also removed the hot water cylinder - apparently worth $100 at the scrap yard. Will cost around $1000 to replace including repair of pipes and plumber time... oh dear!!
.......... Then the drive back to Queenstown and a big thank you for the donated vehicle from Ngaire for those two days.

June 3 Today in frosty Queenstown, before the ski fields are open, Melioni gets to play in the snow on the Coronet Peak road. Jet travel from her tropical homeland, working through jet lag, and then taken to play in some place that resembles a giant icebox - must be so confusing for her rapidly developing mind. However, with lots of warm clothes, given and bought, she is surviving admirably (with no mosquitoes) very short daylight hours and a wonderful variety of food - Melioni seems to be over needing pain relief for her tooth middling sockets - thankfully.

June 4 Fly to Auckland, and met at airport by generous Tony who drives us to Orewa to meet my Aunty Mavis and onto Waipu to spend the night with my Stepmom Iris. It is so very warming to catch up with relatives, even if only with some of them..., we are all still family and it is really only possible through the kindness and generosity from volunteers, friends and TroppoDoc Trustees... of which Tony fulfils all three.. I'm such a nag it's a wonder I have anyone who talks to me still - while I harp on about the opportunities to come overseas - exit the profit making rat race, and help the poor... Ah... but I do go on....!

June 5 Drive to Whangarei, really the truth is, driven to Whangarei by Tony, to see Mag, Troppodoc supporter and a Nurse who spent her life with her husband John entirely on the medical mission field of Thailand working with the northern hill tribes beyond Chiang Mai. Mag' son Leslie was my first year room-mate in Knox College, Otago University, now a high flying professor in Zurich, doing valuable research - I think on viral infections like HIV. Then
back to Waipu and onto Auckland to Tony's place to start the big job of packing donated medicines for travel with Melioni and me - to Indonesia.

May 24 - May 30

Fri, 25 Jun 2010 13:04:28 GMT

May 24 Returned to Gisborne. Back working at Te Puia Springs Cottage Hospital that serves the southern half of the East Cape
May 25 Today working at Tokomaru Bay Community Health Centre while covering Te Puia Springs Hospital for emergency patients.

May 26 Today back at Te Puia Springs Hospital.

May 27 Today - Tokomaru Bay Community Health Centre with lunch taken at the local pub/ the only pub (not counting the Tokomaru Bay Sports Club) which has beautiful views over the crashing waves of the Bay.

May 28 Today back working at Te Puia Springs Hospital with an after work visit to the Tokomaru Sports Club, in some ways the centre of the Tokomaru Bay community and then on down for an evening meal meeting with some of the staff from Waikohu Medical Centre, Te Karaka and Robyn the Community Health Nurse at Tokomaru Bay.

May 29 After packing boxes of medicines for Overseas that Roger and Jen kindly sent to Auckland - I was on the bus to Wellington via Napier to catch up with post operated Melioni and Tessa. Melioni had her teeth examined by a Paediatric Dental Specialist who consequently removed seven teeth under GA and added fillings to two more.

May 30 Cheap afternoon flight to Christchurch to see TroppoDoc supporter Pam. Volunteers are a big part of TroppoDoc and at least 50 % of my energy and time is spent trying to ignite the flame in Supporters and Volunteers. Yes they can do it! – that is give a substantial part of their time and life - donate to the developing world - in a hundred different capacities - to help those who are much less fortunate than ourselves.

April 29 - May 23 2010

Wed, 26 May 2010 00:00:00 GMT

April 28 David and Lucy visit the poor community behind Hendry's and Yesika’s house where they find a severely cachectic 50 year old - who has been very sick for at least 5 months.

April 29 David and Lucy do a clinic in Kampung with Yobana. Melioni and I stay home so I can write a letter to President SBY of Indonesia to state my predicament as a humanitarian trying to help some of the very poor populations in Indonesia.

April 30 Today we all do a clinic together in yet another village with much and many damaged homes.... we start at 10am and continue until 6pm and this doesn't include the 1 1/2 hours driving both ways. Fortunately we are able to hire a becuk to take us to the Chinese quarter of Padang where we relax at a coffee house.

May 1 Today, David, Lucy, Melioni and I do a planned clinic at the Kampung behind Yesika’s house. The cachectic man had a chest X/ray, as we asked, it clearly shows TB. He finds some relief with aminophylline i.v. injections. We saw 50 people today, with a variety of problems. After the clinic David heads to the Airport and back to UK.

May 2 Lucy, Melioni and myself fly to Tello to meet Jutra with her Mother, Father and Uncle Taha at Le Sondrehe Airport and then we all fly to Medan - (flight paid for by enthusiastic Sponsor) to get a bone marrow examination to define her disease more. We all check into the Pardede International Hotel which is close to one of the best Drs in Medan who is also a Haematologist. Jutra with an Hb 7 would rather walk up the stairs two storeys to her room (with her family) they are too scared to use the elevator – they have never seen or heard of an elevator.

May 3 Today we walk across the road to Dr Gino Tan in the morning. After assessment Dr Tan thinks Jutra most likely has Non Hodgkin’s disease. He will do buffy coat examination of blood film to check for leukaemia and lymph node biopsy in local hospital to define lymph node disease.
We admit Jutra to hospital that afternoon and he takes blood test and Chest X-ray and needle biopsy of lymph node( this is suggestive of malignancy) and arranges for excision lymph node biopsy, for the following morning. Chest X-ray confirms Tuberculosis; her Tg antibody is negative which would fit with a predisposing lymphoma, ESR 125 Hb 7. Buffy coat slide demonstrates no leukaemia cells.

May 4 Excision biopsy done and we await Jutra's return to ward - after being done at our request under local anaesthetic. Lucy, Melioni and I go for a brief visit, overnight to Bukit Lawan Orangutan viewing area on the edge of an enormous national conservation area. A beautiful area not too far from Medan with regular buses there every day.

May 5 Lucy, Melioni and I take bus back to Medan to meet with Jutra and her family who have moved that morning from Hospital to hotel. Unfortunately family wasn't allowed to leave the hospital the night before despite me being told they were free to go after excision biopsy. This family is scared of hospitals but one nurse told them they could only leave for hotel after hospital bill fully paid! We immediately take bus from Medan to Danau Toba, Parapat to get them away from the overwhelming city.

May 6 Everyone is up early to enjoy a walk alongside lake front and then wait for bus to Sibolga. Lucy takes Jutra and her family by boat to Tello in the morning and I take overnight bus with Melioni to Padang for repeat police reporting time - next morning.

May 7 Check- in with Police as they put more pressure on to lower my price for the helicopter if I really want the Kapolda to drop the charge of illegal flying or stop the new charge of helicopter smuggling.

May 8 Melioni and I - fly back to Tello to check on Jutra’s progress, and to help Lucy with Clinic at Mr Benghong’s house. Today we have more dental extractions and small surgeries

.
May 9 Today clinics busy. Jutra is doing well on her anti TB medicine and she is more mobile, eating more, with little by little improvement.

May 10 We all fly back to Padang at demand of Police for appointment with Brigadier General of Padang Police the following morning.

May 11 Today, I talk with Brigadier General - he is still trying to buy my helicopter while it is impounded as evidence and while I am charged with an associated criminal offence that he has the power to drop the charges for.

May 12 & 13 Finally I get letter from Police to carry out much needed maintenance on helicopter. Lucy, Melioni and I go to Airforce Base and start my helicopter. Unable to start on 12th as too late in day but on 13/5 starting was possible. I was not allowed to take it off the ground but running it for an hour was a pleasure anyway.

May 14 Lucy, Melioni and I fly from Padang to Batam, and take ferry to Singapore, sounds a lot easier than it really is, eventually we arrive at friends Simon and Wendy's Apartment - fellow workers in a previous humanitarian trip to Myanmar after the flooding.

May 15 Today, Melioni and I spend in Singapore with Wendy and Simon, and organize bus trip for Lucy to Kuala Lumpur to meet up with her flight home.. In evening Melioni and I fly out of Singapore bound for Christchurch, New Zealand.

May 16 Arrive at Christchurch and fly with Melioni to Wellington where Melioni will get her teeth looked at and maybe fixed. I fly onto Gisborne to start a Locum the following morning.

May 17- May 21 I work for Ngati Porou Hauora on East Cape in special area short of Doctors after my arranged locum at Te Karaka was dismantled. This happened as I was passing through Batam Airport on the way back !!!

May 22 & 23 Meeting with past and future Volunteers in Tauranga. It is such a pleasure to see Volunteers as enthusiastic as ever over their previous volunteering and keen individuals wanting to make a difference in the life of the poor people.

April 23 - 28 2010

Wed, 28 Apr 2010 11:10:00 GMT

April 23 Tello all day clinic - usual sprains, fevers - Malaria and Ross River fever, and stomach pains. David removed a Lipoma from a man’s head.

April 24 Tello Clinics – plus monitoring of Jutra – 17yr old girl. Jutra is much more conscious so I think she had Cerebral Malaria on top of her long term life threatening Leukaemia or Lymphoma. Dental extractions continue at about 2-3 patients per day. These extractions take time but surely one of the best ways to relieve those in pain when badly infected teeth are present.

April 25 Sunday – David’s compulsory rest day. David and Lucy have been hankering for an Island visit so I man Tello Clinic for the day and they head off to Marit Pulau for a day's clinic.

April 26 I fly to Padang (Melioni is onto her 5 th biscuit) as I have been ordered to Padang by the police. We spend a day waiting at the airport for the flight. David and Lucy join me - as there is still much work to do in the Pariaman Villages, 90,000 houses destroyed and made uninhabitable.

April 27 I duly attend police station and as interrogation/ discussion progresses on how the present criminal charge of flying illegally is unable to be substantiated. They will likely change the charge to smuggling a helicopter into Indonesia. They asked, Dr Allen how much or rather how little will you sell your helicopter to my Boss the Kapolda - then I'm sure we can drop all charges...How about USD$20,000. Yes your helicopter is still impounded as evidence, and you still have a criminal charge against you ...
I now understand why the case isn't progressing from the Police point of view...

April 28 I am waiting for papers, for the promised freedom to maintain and fly my helicopter around the airfield. (Melioni - is onto her 6th biscuit). I need to give yet another copy of my passport and visa and find recognition from the NZ Government of TroppoDoc's existence as a working Organization....

April 18-22nd 2010

Thu, 22 Apr 2010 00:00:00 GMT

April 18 David and Lucy take day off to go to the beach while I tidy up a few patients at the Benghong house which becomes an all day clinic which places me in the unwanted limelight of becoming a potential workaholic for the sick !!!

April 19     In-between clinic work today we meet Aterri, a 20 year old man with a long history of weight loss and fevers and a 5 month history of swelling of his Left Parotid gland, and he is cachectic like a starved man.

April 20    In the afternoon we are asked to go to a prayer meeting by the uncle of a 17 yr old woman called Jutra. She is getting prayed for to release a demon from within her when we arrive at the church. After examining her we conclude she is at a high risk of having non Hodgkin’s Lymphoma that is causing all her symptoms and signs. She needs to go to Medan for bone marrow examination and so we start talking to the family.

April 21    Today on a house call David meets Ohei , who is a 42 year old man with an enormous hot swelling of his right distal femur for about a year and he is bed ridden as he waits to die. We also meet a 70 year old in chronic urinary retention who is catheterized by David and Lucy and then stays overnight in one of the Benghong lodging rooms next to the clinic for reassessment in the morning.

April 22    While working hard in clinic today, a seemingly endless line of sick people, we spot two monkeys cavorting in our open rooms above the clinic floor area. Possibly attracted by the bananas we had waiting for our supper. I guess it is all a matter of sharing, and maybe monkeys are better than rats... maybe!!