Aitutaki Hospital

Sorry for lack of updates! I will be slowly putting more information about Aitutaki.

My elective buddy, Ben, has left this afternoon, and now that I'm lacking a companion to hang out with, I have a whole lot more time to blog!

I figured it is about time to show you around Aitutaki Hospital. There is very little information about Aitutaki particularly for prospective elective students, so here are some snapshots of the hospital life...

Aitutaki Hospital site, looking from the driveway. Outpatient clinics and the ward are on the right hand side, and the far end on the left has the dentist, public health nurse and the hospital manager's offices.

The student bedroom - free accommodation at the cost of being first on-call during your elective (if you are on hospital grounds). You can get called at all hours of the day and night. Ignore the mess of the room, but there are two single beds (old hospital beds), two bedside cabinets and a really... iffy sink. Definitely not a five star hotel suite, but it serves its purpose. The nurses call it the "President Suite." Lol.

 Aitutaki Hospital is currently manned by one permanent doctor, Dr Koko, who provides 24/7 emergency services. It really should be run by two doctors, but other doctors have come and gone in the past, only staying for short periods. Hospital services are largely like a rural GP service, with clinics running Mon-Fri from 9am-12pm and 1pm-4pm. If there are any inpatients (usual number of inpatients are 0-5), ward round occurs at 8am during weekdays and 9am on weekends.

The outpatient department waiting area. Patients are often found waiting an hour before clinic is meant to start and expect you to start early (argh). Today I had a patient who turned up at 7.45am when clinics are meant to start at 9am. Patients wait here, and somehow figure out the order in which to see the doctor(s). You don't really get a chance to call the next patient in, because as soon as your current patient leaves, the next person comes in whether you are ready or not!

   Patients turn up with 'emergency' cases all through the day and night if need be. By majority, they are minor conditions not requiring emergency care (e.g. common cold, allergic rash), but emergencies do present themselves from time to time ranging from full-blown heart attacks to motor vehicle accidents. In my 6 weeks here so far, I've been blessed to not have had a cardiac arrest in the hospital but there had been one the previous week before my arrival.

The hospital has two outpatient clinics - one is often manned by elective student(s) whilst Dr Koko runs the other. Students can always ask questions if there are any doubts, but by in large, can run the clinic solo with full responsibilities of prescribing on the island (Dr Koko only takes final year medical students). Most common presentations are, (1) common cold, (2) skin infections/boils and (3) diabetes/hypertension/gout.

Our outpatient clinic room. It's pretty much a GP office.

Tuesdays and Wednesdays are the "NCD" or "chronic disease" days where patients with diabetes, high blood pressure, gout and etc come for their check ups (usually 2 monthly).

Hospital back yard with pawpaw (papaya) plantation. Students are welcome to help themselves to the pawpaws as they ripen. Be warned, too many can give you the runs!

 Patients often turn up well before the clinic is meant to open (e.g. 8:10am) and expect to be seen early. I've been given the funny looks when I told them I'm not starting until 9am just so I could check my mails and get the programmes started etc.

Computers are slow here, but it does work, and just fast enough for video Skyping. The hospital uses one of the older MedTech programme for patient records (a common GP software which is not very much liked), and because everything goes through Rarotonga and back, it is slow. It is not uncommon for computers to freeze or system to crash for half a day or more.

What is available at the hospital? Well, there is an x-ray machine and a new ultrasound scanner (only been here for 2 months!). Eteta is our super-pharmacist/radiographer/phlebotomist who runs the pharmacy, takes x-rays and does blood tests. She's only had 6 weeks training for all this! Aumate is the other pharmacist at the hospital.

In terms of medications, it is largely dependent on orders from Rarotonga, but selection is very limited. Everything else is based on donations from students who have gone by. Enalapril is our only ACE inhibitor and it annoys me greatly that many go to New Zealand and get put on quinapril and come back! We do have Metoprolol, Bendrofluazide, Felodipine, Candesartan, Digoxin and Nifedipine but it's about it! We have no antihistamines except Phenergan (Promethazine) so anyone turning up with allergic rash gets zonked to sleep with 25mg of Phenergan lol Only diabetes drugs are Metformin, Gliclazide and Insulin. When you are on Aitutaki, you have to learn to do without.

Commemorating my emergency call out at midnight on the ambulance... in my pajamas! The ambulance rarely gets used on the island.

I am currently self-treating myself for probable gastritis with triple therapy. Unfortunately, no Clarithromycin means that I have to use the old regime of Omeprazole-Amoxicillin-Metronidazole combo. But students can get medications free of charge if need be. But this is not the best place to get sick... I've been battling with this tummy ache for 2 weeks now <_<

There is also a dentist at the hospital who can manage basic dental conditions. Our public health nurse deals with sexual health clinics, antenatal things and immunisations etc - she's also one of two midwives on the island.

Sparky's (the dentist) clinic. This is all we have in terms of dental services.

I am running out of things to write about currently. Will update with more photos later!

More photos!

So... Gmail still won't let me upload photos. So here are a few more while we wait for more patients to turn up (we've started 20 minutes ago, and waiting room has freed up already!).

Anyway, the irony of being in the Cook Islands - you see your own Prime Minister here in Aitutaki. All the leaders came along for the 43rd Pacific Islands Forum today. Half the island scootered down to the airport (if you could call it one) to see them. I somehow managed to get the prime spot smack bang in the middle out the front! I have even better videos of John Key, but the internet here would never let me upload it before Christmas. Lol.

John Key! Followed by the Prime Minister of Samoa

All the Pacific Island leaders in one spot! Except Julia Gillard. Lol.

The Cook Islands PM, Henry Puta.

 

The entertainment crew.. I have videos of these for later...

John Key: Hmmm what's for dinner tonight?

Samade on the Beach

Hi everyone!

Sorry, I am getting very slack with these posts! I've forgotten to bring out my camera again, so photos today (it takes forever to upload them anyway), but I will add them in eventually to their rightful posts!

It's Sunday night here and I am running out of new things to try fast! It is a little worry when you still have another 10 weeks to go!

Today Ben and I were back out at Ootu Beach (it's my favourite beach now!). It's by the airport and on the other side of Aitutaki Lagoon Resort (which sits on its own tiny island). The beach at the resort is nice too, but they are now doing some major constructions all along the beach and have shut it down, which is ridiculous seeing as there are still people staying there. I'd be peeved off if I had to stay there and weren't allowed to use their beach and had to put up with forklifts going back and forth the whole site. It looks like they are trying really hard to clean up the whole place and 'stealing' some nice sand from the sandbars in the middle of the lagoon (it's joined to the end of their beach so forklifts can actually just go right across it - photo later) and putting it back on the beach. Our theory is that they are trying to do this for the forum coming this week - supposedly Hillary Clinton is coming on Thursday, along with Julia Gillard (Aussie Prime Minister) and probably other prominent figures. It certainly has the locals excited, since it's not everyday you get someone so significant visit here!

View of Ootu Beach across Samade on the Beach deck.

Forklifts in the middle of the lagoon... it's certainly something different to look at. lol.

Anyway, back to Ootu Beach. There is a restaurant / accommodation provider called Samade on the Beach there. It's further down from Koru Cafe (just around the corner), but the beach is just lovely here. You have the classic sandy white beach and turquoise lagoon water. You can see schools of lagoon fish literally about a metre from the shoreline. You can swim about 20-30m across to one of the sand bars and you'll look like you are standing in the middle of the lagoon!

Say hello to Ootu Beach!

Samade on the Beach provides meals / limited bar services. On Sundays, they do what is called the "All day BBQ at the beach" between 11am - 9pm (I think). Ben and I went last week, thinking it was literally a BBQ on the beach with something like "all you can eat" barbie. Well, how wrong we were. For $20, it was a platter of food cooked up in the kitchen (yeah, the BBQ was inside the kitchen). Food was nice, but I think we could have done with a bit more of a portion. I think we preferred the food at Koru Cafe for similar money (and they do good coffee there!).

The welcome sign...

The $20, All Day BBQ on the Beach Platter

 The manager at Samade, Adie, also lets med students who are here on electives to use their kayaks and paddles. So we managed to get onto one and get pretty tanned! They are currently fixing the kayaks so we were warned to check beforehand to make sure they had no holes at the bottom. So after a warning and checking the kayaks, we still managed to pick one with a hole. We went down about a 100m before we capsized in the lagoon. It was somewhat of a mission to get all the water out and then drag it back to where we started. We then managed to get an intact kayak each and had some fun. I managed to get a fair way out and saw some rocks with some coral, but didn't see a lot. It has been hot and humid the last few days and I was getting scorched out there!

I have been getting eaten left, right and centre since coming here. I think taking my antihistamines regularly is helping with the itch, but doesn't stop it completely! Now it's the heat keeping me awake at night. Thankfully we haven't been woken up too much since I've been here. I have done a few things, like stitch up someone's head half-asleep at 2am.

I think it is bed time for me. Rather surprising that bedtime has changed to around 10pm since arriving at the Cook Islands but I get pretty tired here. I think it's the heat. I don't know how I will cope later given it's only going to get hotter and hotter.

Take care everyone. Will update more later. Ka kite.

Tamanu Beach Island Night

Hi everyone!

Something to share that's worth reading - about time! I have a list of things I want to write about, but I keep writing these massive emails to people (about the length of a book chapter!) that I get lazy with the blog! But I will get there eventually and hopefully have reviews of most places in Aitutaki.

I thought I might share what Ben and I got to go see last Thursday night.

Here, every weekday, each resort/restaurant take turns in doing what is called an "Island Night." Usually a decent meal (often buffet / three course) followed by a local performance. They can be quite expensive usually between $60-85 NZ dollars. Tamanu Beach Hotel covers Thursday nights, and are famous for their fire dance show.

Luckily, we could go and watch the show for free (without the meal). Some people have said, we could go in and watch for free if we bought a drink, but they didn't seem to care when we asked! But we bought a drink each anyway :P The show itself starts around 8.30pm right by their restaurant on the white Aitutaki sand.

So this is the fire dance show. They switch in and out between traditional dances and fire dances. It's really cool to watch. I was too busy taking videos of them, I didn't see it properly. I will have to go again and watch for round 2! Mind you, there isn't much else to do on the island at night and I will shortly run out of new things to try! But it is definitely worth seeing it.

Some female dancers... Lots of hip shaking. Lol.

And guys seem to shake their legs here. Haha.

I can't obviously comment on the food, but it looked pretty nice. It was a buffet and with desserts included (because we saw the desserts get dished out as we arrived!). If I do get to go later (maybe after I get paid...), I will do a food review!

Got lots of videos of the night, but not many photos. I will post videos later if I can, because if I tried to do it now, it will be Christmas before it finishes uploading!!!

Hopefully this keeps you busy reading in the meantime! I'm off to another Island Night tomorrow - one of the more budget ones at Paradise Cove for $25 (yes with food!). Will let you all know what it's like later.

Ka kite.

PS - You need to book in for these Island Nights if you want to pay and go for the meals! They can book out fast!

Aitutaki - first 24hrs

Hi everyone,

I've arrived in Aitutaki safe and sound.

It's definitely smaller than Rarotonga, and much less things available around. You almost have to shop around all the different shops to find things. Some things are horrendously overpriced. I've seen chocolate go for $13+ in Rarotonga (but cheaper in Aitutaki) and peppers (aka. capsicums) go for $40+/kg!!! But you learn to do without.

Hospital here is small. Not surprising, huh? But it has what it needs to get by. A large part of the work here is rural GP type of work, with some inpatient services. I think there are 26 beds in total. It's funny how nurses refer to "Men's Ward" and "Children's Ward" when the whole inpatient part of the hospital is just one big room with different sections. So it's probably better to call them "Men's Section or Wing." Either way, right now it doesn't matter too much because there are no inpatients!

Ben (the other student here) and I were lucky to not get called at all last night. I heard he was getting called 2-3 times a night last week and with some more complicated things. But everyone is just lovely here and easy to get along with. I think I'll be having lots of fun over the next 11.5 weeks.

Student room is... not what I had exactly expected. I thought it'd be some form of accommodation block or room on the hospital site somewhere. Turns out to be a room right next to the ward (literally 5 metres away). The elective coordinators didn't quite plan it well and didn't realise they'd be having two strangers of the opposite sex in the hospital at the same time. We are having to share the room at the moment. We are both pretty chilled about it, so it has worked out ok, but certainly not ideal. My mother literally screamed out, "ARE YOU FOR REAL" when I told her. We just have to be a bit more considerate with each other. We are getting along pretty well so it's all good. Beds are terrible to be honest. I woke up with a flare up of my back pain. But hey, it's still free accommodation and we literally just sleep in the room.

I will write more about the hospital later. Photos are taking forever to upload here, so I'm actually typing this up on WordPad while I wait for it to upload for previous post. Internet here reminds me of how New Zealand used to be about 5-10 years ago. But by some miracle, I was able to Skype my parents last night, and video calling actually worked. Thank goodness I brought my webcam ;)

I think over the next 11 weeks or so, I'll be learning to do without and just improvising as needed. Things are limited here, so it's somewhat necessary to do so.

I am missing the nice stable hot shower in New Zealand though. Showers at the hospital is better than what was at Rarotonga Backpackers, and no cockroaches yet, but can go from Mordor to Antarctica quite easily (so I have been told - it was okay yesterday!). I have yet to go swimming at the beaches either. Apparently the good "swimmable" beaches are really only by the airport - i.e. other end of the island. We hired a scooter together so it might be something do to in the weekends.

There isn't a lot to do in the evenings either. We just had dinner at Mac Ned's and yes, they certainly make good burgers. I think there are Island Nights on in one of the resorts literally every night except Sundays, which will be good to go see. But otherwise, I don't think there is much to do.

Will update more later and actually get some photos of Aitutaki. So far, I only have a few on my phone which aren't ideal. Ka kite.

Contact Me

Hello everyone!

I figured that as this blog grows (hopefully), people will start asking questions. Comments are never really that reliable way of communication since you don't always get notified when I reply. Plus it's not very private either.

In an attempt to keep my privacy but also leave an option to contact me, I have created a new email address for any queries you may have. Why? Because I know elective planning is serious business and hard work! ;)

eunaliciousblog@gmail.com

 I am happy to answer questions at any time provided I have internet readily available!

Two more days of 'formal' med school and I'm flying out (to Auckland) in less than 72 hours!!! Eeee!!!

4 weeks left!!!

Hi everyone (if anyone even bothers to come to this probably-useless-so-far blog).

I just thought I'd make an announcement that I have 4 weeks left before my elective / finish my degree (minus the elective)!

It is very exciting and daunting all at the same time. I've done bugger all travelling in my life (if immigration even counts as travel) and this is all very new for me.

I just booked my flights a week ago at the whopping expense of $1700 (quite a lot considering it's like a 5 hour flight). I have yet to get myself a camera (it's coming tomorrow!) and some insurance. I've been jabbed far too many times this year for a healthy youngster (Tetanus, Hep A, Typhoid, Flu jabs and then my GP wants me back for another Hep A jab which is wise, and my mother nags me I need to get myself 3 shots of Gardasil when I get back). Anyway, it's all sort of going to plan (I think!).

I also got my GP to give me a stack of medications for personal use today. I came home carrying a giant bag of prescription meds ranging from antibiotics to antiemetics. My mother thought I was crazy taking so much, but this was also coming from the same mother who has been pressuring me to take alternative medicine supplements (Propolis if it rings a bell to any of you) on my elective. Yeah, I know. It's ridiculous.

It has been ridiculous getting hold of the medical elective coordinator, Dr Voi, but I have been assured earlier in the year that I have been 'booked in' to be at Aitutaki Hospital, so let us hope it is still the case.

Anyway, there will be more updates as I begin my travels in 4 weeks time :)

Ahoy!

Ahoy there!

Not sure how you stumbled onto this blog, but hopefully over the next few months, I'll have a few things to add that may be of use to someone.

I'm not an avid blogger when it comes to travelling. Not because I don't blog (check out my other blog if you're a crafty cardmaker/stamper), but because I never really travelled in my life. Unless you call immigration travel, I'm that Asian stuck in South Island of the home of the Lord of the Rings a.k.a. New Zealand.

Nevertheless, I thought I'd start another blog just for my medical elective which is taking place later this year. I've been an early bird and got a placement in Aitutaki Hospital (Aitutaki, Cook Islands) from mid-August this year for whopping 12 weeks (I got it organised 2 years early)! 

I've tried to look for information around places, but sometimes it's just hard to find the specifics about doing your elective there on the internet even. I've come across a couple of blogs that previous medical students have done and thought it'd be something I could do for anyone else keen on doing their elective in the Cook Islands. 

So this is Aitutaki...

Image Credits: http://www.cook-island-travel.com/images/aitutaki-island-aerial.jpg

 Isn't it just gorgeous? It's kind of obvious why I chose it... right?

Well actually, the fact that it was a beautiful tropical paradise didn't hit me until after I had the elective organised. LOL. I know, I know. Sounds impossible. But that's how it was. I read a couple of reviews on the Electives Network and thought, "do a bit of everything, a bit like rural GP - I am so going." So that was the real reason why I sent off my emails to do my elective there. The fact, that it was exactly on the opposite side of Hawaii (yes it is!), that it's that Pacific paradise you see on TV, that they use NZD (bonus!), have Westpac/ANZ banks (win!) and full of tropical fruits (I'd have them three meals a day if I could!), only sunk in later. Funny huh?

I haven't got anything sorted yet, except that I am going there for 12 weeks. I've just sent off another email recently to check they still had me on the books. They've had a recent change in the administrator for electives in the Cook Islands, so Elizabeth Iro no longer oversees medical electives. For those of you interested, leave me a message and I'll give you the details of Dr Voi who is now in charge. When you email, have a CV and a letter from your school/Dean handy.

So far I know I get free accommodation on-site at the hospital, under the condition that you are the "doctor" first on-call (yes, you'll get called for whatever happens overnight at the hospital too!). I am rather glad I am going at the end of this year. By then I should be at the level of a house surgeon (I graduate as soon as I get back from my elective!) so I should feel a bit more confident with what I'm doing compared to students from other countries who seem to do electives fairly early on in their training.

I'll try and update this as I get more information, and eventually fly off!

I've had so much great help on TripAdvisor forum so if anyone is needing info from people who know Aitutaki/Cook Islands well, it's worth going and asking!

But anyway, that's enough writing for one night!

I'm going to have to get some vaccinations done when I'm back in Christchurch next week $_$