This entry may or may not be the last entry for my Micronesian excursion. Yesterday was our first day of work in Yap. On every island we have had a liaison meet us at the airport to inform us of the plan and work schedule (including an idea of work load). We flew into Yap rather late and expectedly met with no one other than our hotel personnel to drive us to the hotel. Monday morning came, and like the other islands, we planned to begin work at 0900. We got a call at 0845 from the hospital wondering if we were still coming. Apparently, there were already 30 patients screened and ready to go. We worked diligently throughout the day and had a mini 15 minute break to call lunch. After lunch, we were told there were still 28 people waiting to be seen. We asked about the possibility of having some people be seen tomorrow (today) or possibly the new, incoming people be moved to the next day. The staff said they would oblige and would ask incoming patients to defer to the next day. 19 patients after lunch, we asked for the new total number of patients and it was a staggering 22. Unfortunately, we had to defer 12 of these patients until the next day. On day 1 in Yap, we evaluated 58 patients.
I was really surprised on how compliant the patients were. Most were really good about taking their medicines every day (or month) and had not deterred from their regiment. There were a couple of patients who did not take their medicines as scheduled but when presented with the option to either restart prophylaxis versus no meds and seeking immediate medical attention if sick, all patients chose to take the prophylaxis. I feel this is the reason why most of the physical examinations/echocardiogram studies yielded normal or mild abnormalities. Kudos to compliancy!
As the day progressed, the patients were starting to blend into one big blur. When reviewing the notes, I couldn’t remember who was who. There were a few patients that did stick out. For example, there was a 5 year old boy who needed an echo. He was seen by our good doctor, then had to wait in line for his echo. When he returned for his echo, he had something in his mouth that was clearly visible (not to mention he was a chatterbox when examined by Gira and now he was quiet). Any who, Lyndsay asked that he spit out whatever was in his mouth so that she could start the study. He looked at his mom and she walked across the room and simply stuck her hand out, palm side up. He spit into her a hand what looked like candy but upon closer examination, it was a beetle nut!
Beetle nut chewing is not allowed on hospital grounds as per the numerous signs that have been posted all over the campus. Yet, I see nursing staff, patients, and even the doctors all with beetle nut in their mouths. According to our guidebook, the Yapese are quick to shower foreigners how to properly chew beetle nut and indeed they were as they showed Lyndsay exactly how to make a “good” beetle nut concoction. The trashcan is a constant red because of all the spitting that happens. I guess it’s a good thing the trashcan is red and not the walls or ground. Nevertheless, it’s still a gross habit that rivals conventional cigarette smoking.
Of the four islands we visited, Yap is by far the most untouched as far as westerners. There is obvious western influence (mini-mall, tourism, etc.) but the culture of the indigenous are still very traditional. You are not supposed to pat children on the head here (not that I do, but it’s something you have to be conscious of). It is considered rude to walk over someone’s outstretched legs or between two people who are talking. Locals also dislike having their pictures taken (hence my lack of photographs). The weather has been hot, humid, and rainy so most pictures did not turn out well.
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