May 2002 - Annette Culpan

Month one of life in Bali is complete. We've had a phenomenal month. First finding a home and getting orientated, then doing village visits to central, north and northeast Bali. Often working over 12-hour days in 30 degrees heat.

I have been shocked at how different this 'island paradise' is since the bomb. The trickle down effect is most apparent in the rural villages. In Yeh Sanih Village (Sangarajah area) 5 of the original 7 hotels have closed down over the last 8 months. This has created unemployment and hardship in an already impoverished village. The feeling in these communities is desperate and primary health care has been hit particularly hard. What has amazed me most is the spirit of the people amidst extreme loss.

Over the last month Sue Cowie (NZ trained physiotherapist) has been working for the Trust in Bali as a volunteer. Over this time we have made great steps forward, creating links with key medical organisations (seeing where we can partner and work together instead of doubling up), aiding with the rehabilitation of bomb victims (supporting a local physiotherapist) and recording patient histories in the central, north and north east villages. Sue has been simply incredible both as a colleague and as a friend. Having worked in Vietnam after the war and now for starship in Auckland, her experience was perfectly suited to the work out here and her pediatric skills were in high demand. Sue is a great lady with loads of passion and humour which is crucial on those long, hot and difficult days.

Over the last month we have laid the building blocks for future work, as well as providing immediate relief for some patients. The mobile clinic visits to the villages has been an eye opening and rewarding experience for me personally, having never been exposed to illnesses such as leprosy and TB before. Medical care in Bali is hugely expensive and most villagers can not afford to even visit the doctor. Serious medical conditions are often left unchecked.

Recently we came across a lady in a northern village with severe leprosy. Ningachadri was hidden away from the world in an old hut. Her feet were rotting and her family was afraid to approach her hut. She was an 'embarrassment' to the family and clearly not meant to be seen by visitors. When Sue and I approached Ningachadri we found her feet were hidden inside a fly-ridden sack. Once removed it revealed infected wounds and deteriorating flesh which had not been cleaned in a very long time. The smell was horrendous. Approaching this hut and dealing with the stench was the most difficult thing I have done so far.

Sue spoke at length to the family and Ningachadri about the importance of regular washing and how best to keep the infected wounds clean. Also about measures the family could take to minimise the risk of infection to other members of the family. As Sue spoke the family relaxed around Ningachadri. They were clearly surprised by our interest in helping her. The next day we returned to give the patient new clothes, detergent, buckets and soap (to enable her to independently wash herself and her clothes), fresh cotton coverings for her infected wounds, ointment and food.

On this return visit the family scene was a very different one from the previous day. The family were nearer the hut and clearly socialising with Ningachadri. She had washed, was smiling and her hut smelt clean! It was incredible that our visit the day before had changed the way her family perceived Ningachadri and treated her - through education the fear was gone!

Last week in Taienya we came across an 80 year old man, also with leprosy and also hidden away in his hut. No one would come with us so we could meet 'Made' and put together his patient history, everyone was very afraid of infection. He was paralysed by the illness with open (and hence infectious) wounds on his arms. Initially he tried to scare me away as he'd clearly been told that no one was to approach him. I held my ground and after I gave him some new clothes and calcium biscuits he completely changed his tune and began waving at me with his elongated arm and a huge smile to match. I don't think he'd had fresh human contact for years. He is the skinniest man I've ever met, yet a man with such great spirit.

Meeting Made and making him smile has been my best moment so far. Made is the man in the picture in his hut lying down and waving with a very skinny and malformed arm. We have met some real characters and hard cases. I've had many a cup of tea on the side of the road yarning with the village elders, both sides trying to be understood by the other. The people in the villages have LOADS of character and CHEEK. It's a delight to learn this language.

My Indonesian language is coming along well, which gives me a big edge when negotiating. This can be the difference between paying 100% of the price asked and 10%. Scrounger is in her element! The environment here is a great training ground for advanced negotiation. It's incredibly FUN. With the language, although I have the basics there is no room for complacency, if I wish to advance I have much to learn.

On a personal level things are really good. I've given up running and taken up surfing. I'm definitely a beginner and it is the most difficult sport I've ever attempted. I've done some brilliant 'wipe-outs'. Last week I ended up with three deep fin marks on my back which turned into purple bruises after being dumped by a particularly impressive wave. The sport is very much about facing fears and getting through it, especially when a wave is crashing on your head and you don't know what way is up and what way is down nor if you'll ever see the light of day again. It's great relief from work and gives me balance at the end of a long day.

Annette

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