Saturday, June 11, 2011

Work, Work, Work...and the "Sanitarium"

When you live where you work it becomes very hard to separate the two. Lately we have been doing WAY more work than living life. There is so much to do on the island and so many things need trouble shooting. We spend a majority of our time fixing and cleaning up mistakes made from past decisions, faulty equipment, poor installation, misguided notions…I could go on forever. In the mean time we operate the hotel and accommodate guests. It makes for a very long day!!

In addition to our new 24 hour work schedule our bodies are still adjusting to the climate and new surroundings. Right around mid May we were trekking along the rocks around the island and both got small cuts. We cleaned them as usual but little by little they just kept getting bigger. In addition to the wound growing in size, the areas around the cuts (my right foot and Trevor’s left ankle) began swelling to very unhealthy proportions. Finally after over a week of painful walking and nights of raising our feet over our heads as we slept, we had a doctor come to stay as a guest. She said we probably needed I.V.’s with antibiotics and needed to go to the doctor ASAP. So began our experience with a rural 3rd world hospital.

More and more being here has helped me to appreciate many things I took for granted at home. The hospital was probably the most extreme example of this new found appreciation. The Culion Sanitarium is on the island of Culion, about 45 minutes to an hour from Mangenguey. Culion used to be a Leper colony and is apparently a very interesting historical destination. We never made it to any historical sites.

Lucky for us, Filipinos are very kind, hospitable people. When we made the decision to head to Culion for antibiotics we immediately contacted Hermie, a local pastor and tour guide who we do business with, to guide us to the hospital. He got us in touch with Zoriada, a very sweet, wide eyed 19 year old student who also gives historical tours in her spare time to earn extra money. We were greeted in Culion at the banka by Zoriada (Raida for short). Raida got us a tricycle and took us to the “Sanitarium”. I only put it in quotations because there wasn’t much that sanitary about it. She assisted as our translator and led us thru the check-in process as well as caring for us during what ended up to be much more than we had bargained for when we set off that morning.

We checked in with the first nurse for 40 php (just under a dollar) each. They took our blood pressure, weight and height; the basics. We were then directed to another nurse at the head of the room to provide more information about our symptoms. Keep in mind all of these transactions were conducted in a room about the size of the typical doctor’s office waiting room but instead of being white and pristine the room was gray and dingy. The walls covered with pictures of all kinds of scary tropical diseases consisting of insanely enlarged limbs and the room full of sick adults and children, all packed together in rows of metal chairs, we couldn’t wait to get our meds and be on the way! The right side of the “waiting” room consisted of 4 rooms separated from each other by 6 ft walls and from the waiting room by sheets hanging from a shower rod. Despite the fact that most seemed to have been waiting for awhile, for whatever reason (being American/white possibly?) we were very quickly ushered together into our own separate room.

From the intense pain, the growing wound, and inability to kick the horrible swelling we already knew it was a bad situation. However, we were still under the impression that the swelling had a lot to do with the heat and our constant walking and we would be given a prescription for antibiotics and be on our way. Trevor got examined first. Immediately after uncovering the wound the doctor took one look at it and was astonished. “This is terrible! What happened??” We proceeded to explained we had both gotten cuts while trekking on the rocks of the beach, the wounds never healed and in fact continued to grow in size. We worked on our feet all day so we were never able to rest them enough to just let them heal right off the bat, we slept with our feet up, blah blah blah. When I removed my bandage, she let out a small gasp and stated: “Yours are beyond oral antibiotic control. You will have to get surgery because the infection may have spread to your bones. You must be admitted immediately for an I.V. with antibiotics in the mean time. Don’t worry though; you probably won’t lose your foot.” I of course began to tear up, and her response was “I totally understand, I wouldn’t want to be admitted or have surgery here either.” I thought to myself, “Thanks a lot bitch, just what I wanted to hear…the part about probably keeping my foot was enough fantastic information for one day…” but what could we do? We were assured that we would be taken care of and put up in a room together and they proceeded to send us to the ER.

One thing that seems to be a constant issue here is the loss in translation. Lucky we had Raida or we would have been totally lost!! Apparently in the hospital here, they do not have an abundance of medicine on hand, even at the hospital. For each different item you need (from the antibiotics down to the gauze for your bandage) you are written a separate receipt and somebody has to go the hospital pharmacy and buy you whatever you need. Still not sure how that system works if you happen to be alone but who am I to question, at least we had Raida! Upon arrival in the ER we were seated in wheelchairs. I was greeted by a nice gentleman who reviewed with me the documents needed to sign to admit myself. The documents were very vague and primitive and essentially just said I agreed to admit myself and be subject to the whims of the doctor…hmmm, but again, no choice. After about a half hour, Raida returned with my gauze, bandages, I.V. and antibiotics. In the meantime, I was driven in my wheel chair to the X-Ray room to assess the damage. The whole time we were given little to no explanation of our impending fate and still nobody had approached Trevor.

After X-Rays a man approached me to draw blood. He sanitized my finger with rubbing alcohol then placed the cotton on my dirty pants. When the first prick didn’t produce anything he picked the cotton up from my pants, rubbed it all over the needle and gave it another go. I just sat there in mild shock, praying it would not result in any new infections on my finger. I was then pricked with a sample of my antibiotic to test for allergic reaction (nobody had ever questioned if I had allergies to anything; I had to mention my sulfa allergy to them). By this time almost an hour had passed and still nobody had approached Trevor. We decided it was time to pose the question ourselves. Apparently, they thought he was just waiting for me. Again Raida was sent to get supplies and medicine, and we continued to wait in the ER waiting room in our wheelchairs.

After Trevor endured the check in process and antibiotic test, approximately 2 hours later we were both set up on our I.V.’s but still in the waiting room. We were told the hospital was under construction and that it would be another hour or two before our room in the surgery ward would be ready. We were offered lunch then instructed to tell Raida what we would like. A bit confused we said we will eat almost anything, gave her a little money and she left. Not sure what to expect, she returned shortly after from the local street vendor and had brought us back some lukewarm chicken stew and rice on plastic dishes. Despite the temperature of the food it was very tasty. The nurse set us up a table on the same surface where they placed all the back-up bandages, needles, etc for us to eat our meal. Delicious. We made our best efforts not to spill so that the next person being admitted didn’t end up with chicken rice stew injected thru their needles.

After all the excitement of the morning and the boredom waiting for our room we began to drift off in our wheelchairs in the corner of the ER waiting room. I am a very light sleeper and awoke to see a young man being wheeled in with a serious foot injury, dripping a trail of blood across the ER waiting room floor as he was brought in. I dozed off again and after about another hour we were wheeled up to our rooms. The blood trail had dried and was never cleaned off the floor by the time we left.

Our room in the hospital was located in the surgery ward since I was to be closely monitored until my surgery. The ward was split down the middle. Half of the room consisted of small rooms similar to the ones in the original waiting room (short walls and sheets for doors) and the other half was just open beds. We were escorted to the first room which had no “door”. One bed was undressed and one had a single white sheet draped over it. There was a window with open slats instead of glass and 2 small tables serving as night stands in the middle. This was to be our home for the next 2 ½ days. We laid in the dressed bed together, being cautious so as to not tear out our I.V’s. About 15 minutes later a woman came and set up our “door” and also placed a sheet on the other bed.


Bed 1 (after clean sheets from Raida)

Sweet Raida had gone home after delivering our lunch in the ER but graciously appeared after an hour of us living in our new room. She had brought clean sheets from her parents who were concerned with us being admitted to the hospital without proper preparations. She also offered to go get us snacks and more food. We gave her some money and she came back with a tasty assortment of chips, Filipino ding-dongs, twinkies and crackers. Perfect food to keep you healthy while in recovery ;-) She brought water bottles as well which, had she not, we would have had NO water during our stay. She also brought us “hamburgers”. She seemed so certain we would be thrilled with the hamburgers being Americans and we didn’t have the heart to tell her otherwise. They also were far and away better than the gruel the hospital had provided for dinner! The “hamburgers” were made from pork and a bit sweet, almost like a breakfast sausage. They were served on pandesal (a Filipino salted sweet bread) and dressed with lettuce, tomato and sweet mayonnaise. We have learned very quickly that most Filipino food, especially replicas of other cultures food, all have a sweet twist.


Breakfast is served!!


Mmmm...lunch!!

After delivering the snacks and food, Raida ran two more errands; first, pain killers and second, toilet paper. One would think the hospital would have such things, but no. As for the painkillers, she returned with 3 regular aspirin. The pharmacy was out and that was all they had to sell. As for the t.p., apparently rarely do public restrooms have it as most non-metropolitan natives find it unsanitary. They also don’t have toilet seats. Instead of the paper there is a bucket full of water with another small bucket inside it. One is supposed to do their business then use the water to clean themselves as well as “flush” the toilet. Imagine trying to do all these while holding an I.V. above your heart in a sanitary manner, then leaving to find no soap to wash your hands. Ahhhh…..but there was a small bottle of Zorox (bleach, for washing the metal trays the hospital food is served on) so we figured better than nothing.


The Bathroom

After a draining and somewhat scary day, we attempted to lighten the mood and entertain ourselves with a rousing game of squares. We were visited twice throughout the night to have more antibiotics administered thru our I.V.’s but never saw a doctor again that day or heard anything about my surgery. Despite my concern, I wasn’t especially eager to get surgery anyways and my foot looked a million times better after the I.V. and a full day of rest. While Trevor was able to sleep most of the night (and also most time we were there given his amazing gift he has to sleep anytime, anywhere) I spent the night tossing and turning, being eaten by local bugs, drawing, and reading (thank god, we happened to have a book).


Squares!!


Sucks to be in the hospital...

Especially with open wiring at your feet!!



And bugs for roomates!!


The Bandaged Injuries

We woke up around 8 am. Curious about our morning dose of antibiotics (they were supposed to be administered every 6 hours but we never were wakened at 6 am…) we were about to inquire as the doctor came in. He spent about 30 seconds looking at the size of our swelling then said he would be back. About 2 minutes later somebody came in to clean the wounds and change the bandages that had been on since the previous afternoon. When doctor returned about 5 minutes later, he was obviously frustrated. “He cleaned the wounds already, huh?” he said, and then threw up his hands and left. Guess that meant we were getting better?? Still nothing about surgery….but I wasn’t about to ask!

Raida showed up shortly after to check on us and also brought us some fresh mini bananas from her parent’s house where apparently they grow like crazy. Trevor spent the day mostly sleeping and I entertained myself with my book and drawings. About mid day I decided to inquire about our stay and was told we would be released later that evening or the next day. I explained our transport situation and the fact that we had no money. I also tried to get an estimate of our bill but was totally unsuccessful. I then told the nurse that in that case we would prefer to stay until the next morning. We had already purchased additional I.V. antibiotics anyways so I figured might as well make sure we were better. At that point, we text Raida to bring us some toothbrushes and toothpaste!


Local Mini Bananas


Twin I.V.'s


Sleeping Trevor

At 6 pm, to our surprise, they came in and removed our I.V.’s. When I asked about the antibiotics we had purchased I was told we could return them to the pharmacy where they were purchased in exchange for our new prescription.

After another exciting night we woke up early, excited to go home. You must be signed out by a third party so Raida came early to help. After completing the paper work she went to a pharmacy to return our unnecessary prescriptions and get our new prescriptions. This resulted in us actually getting money back! We were given an oral antibiotic and a painkiller (with no explanation of potential side effects of either, just take every 6 hours). I researched later to discover the antibiotic was for basic staph infection and the painkiller was a hormone to reduce swelling. Jun Jun (the boatman) showed up shortly after with money (we were not allowed to leave our room anymore until we paid) and we were on our way.


Jade (one of our co-workers) enjoying the bed while we waited to pay.


My wounds...after hospital healing!


Trevor's Wounds, also after the hospital

After all the care (ER attention, my X-Rays, all of our meds, food and board) it cost 12,500 php, approximately $300. Crazy.





Yes, we are still wearing the same clothes...but happy to leave!!




We returned to Mangenguey thru a rainstorm to prepare for our first full houses of guests.

May 28th a Filipino lady rented the island for 3 days and brought along 11 of her friends and family members. They were very nice and quite entertaining. The family ran a travel agency as well as a ladies shoe business. They stayed up late dancing, drinking and singing Karaoke (they had a program downloaded on their computer so they essentially had a travelling karaoke machine :) In the midst of all the fun we were preparing for our most important guest since we have been on the island and 2nd full house. The last night the group was here, they all returned to their rooms when the house closed at 11 pm and the generator shut itself off.

By the time the group of 12 left we still did not have the generator working. The excessive load has been too much for the generator for awhile and combined with the faulty wiring of almost every electrical installation on the Island things are coming to a head. We immediately began to search for an electrician to help the situation.

In the midst of the generator failing, so did our main freezer. We also received massive shipments of goods from Manila to accommodate our VIP. Needless to say, it was a fun couple days!! We did get everything up and running...at least temporarily! Welcome Ms. Kris Aquino.

Kris Aquino is apparently one of the most famous people in the Philippines. Younger sister of the president and well know T.V. actress and show host, she is quite the big deal, politically and entertainment wise. She chose Mangenguey as the location to celebrate the birthday of her 16 year old son Joshua and brought along her 13 person entourage of family, friends and security to join for the 3 day celebration.


While still maintaining diplomacy and not taking too much more time with this blog I will say this:

- Kris Aquino left very pleased; tweeting and spreading the positive word about Mangenguey

- We met awesome Miss Betty, Helena’s long time friend who came out to help us with the Aquino visit

- And finally…we are still unsure about the good that can be done here by our presence. We are not sure if our help is desired by anybody besides Helena and are unsure how long it will benefit anybody for us to stay if they don't want change!! We are still trying and making small gains little by little (we think) but there seems to be major resistance (potentially another loss in translation??) from the natives and we are not trying to disrupt the way they choose to live life!

Hopefully so much hard work will not go to waste...

Some new roomates and another beautifully colored sunset...