Today's post is a story and a Q/A for our enquiring minds out there.
Q: How do we handle our medical care in remote areas of the world?
A: Like everything else, with patience and tenacity.
We sailed from Maumare and spent several nights anchored off a beach where monkeys play in the shallows and climb the ridge together to watch sunset.
Then, being mostly out of all groceries and becoming perilously low on my maintenance medication for a low thyroid, we head to civilization to try our hand at acquiring provisions. We have been casually popping into pharmacies for the last two months, as I realized my stash of medicine stocked up last year in New Zealand was about to run out. The story was always the same: “it should be a very easy medicine to get out here, as it isn’t even prescription, but unfortunately, we are all out. Can you come back in six weeks?”
Maybe in Labuan Bajo? We anchor near a beautiful Eco Resort, one Australian couple’s hand-built dream. All our guides indicate they welcome sailors to the resort. We putter Grin the distance to the beach then climb welcoming wood planks built over a butterfly and bird preserve.
We are indeed welcomed with smiles and offers to help. Captain Andrew immediately put them to the task of finding more Diesel for our sailboat that operates more like a motorboat these days, then we order a taxi cab to escort us around for a large grocery shopping and prescription excursion. We explain to the woman at the desk the prescription we need, and she says it should be no problem. “It’s a very common medication here, and it doesn’t require a prescription.” I’ll believe it when I see it, I think. She hires us a taxi (best leave this to the professionals) and translates where we should go. Filled with the sparkling hope of achievement, we enjoy cool air-conditioning of a new Toyota mini SUV.
We stop at one Pharmacy. I show them the bottle with the prescription name. They squint and scowl. “Sorry, no, finished.” Finished, being the English term most commonly used here for “we are all out.” He sends us to Pharmacy No. 2 across town.
We try Pharmacy 2. Finished, but the pharmacist tells me the name of the medicine isn’t the same here in Indonesia. I should ask for PKU. Okay…I have a vague recollection of the term PKU, but I can’t quite place it.
Pharmacy 3, I still show them my bottle, but also spell out the letters: PKU. Finished.
Try the old hospital? We pull up next to a small one story building and dilapidating 1950s medical resources. Finished. (Probably in 1972, I thought.) They suggest another pharmacy to try.
Pharmacy 4, doesn’t seem to understand what I am asking for.
Pharmacy 5, Finished.
As we drive to Pharmacy No. 6, a man on a moped wearing a helmet pulls along side the taxi and starts beeping frantically, waving us over to the side of the road. What is this? The man removes his helmet and I recognize him as the Pharmacist from Pharmacy No. 2. “I’m so sorry, I told you the wrong drug. PKU is for high thyroids.” Yes, that's true; I remember now. We thank him, and I marvel a little bit that this man would care enough to hop on his moped and chase us down to deliver this revised bit of information.
Pharmacy 6, “Finished, but you should try the big hospital, they have everything.”
To give you an idea of Labuan Bajo’s layout, it is a city of 14,000 people set upon a hillside, overlooking a bay filled with pirate ships. There are a handful of wide roads built on the top of the hill, but most of the businesses are on a circular path near the waterfront — which is only a one way road. This means our trek to each new pharmacy is rarely linear, but involves doing another one way circle until we reach the new place we intend to go.
You should also understand that these conversations are not held in English, exactly, because very few people here speak good enough English to converse about medical issues at length. Nor are they held in Bahasa Indonesian because I do not speak enough Bahasa Indonesian to speak about medical issues at length. So, per the usual, our interactions are a mixture of English, Indonesian and Charades.
We take another loop and head up the hill to the “big hospital”. This hospital is white, several stories and has a large driveway like one might see leading to a hospital in America. But, as we step out of the taxi, we step out next to a chair designed to carry a person who cannot walk: nothing more than a wooden table chair set atop two parallel carrying bars made of 2x4 planks. These people make do with what they have.
We go to the pharmacy counter and ask for help. “Oh yes, we have that medicine. I can give you a three month supply.” SUCCESS! I almost can’t believe it! “…but you need a prescription.” My heart droops, knowing that while we are standing in a hospital filled with doctors, there is no chance getting a prescription will be easy.
“Can we meet with a doctor here?”
“No, you need to go to a pharmacy.”
The humor in this response is not lost on me, nor lost on our taxi driver. He laughs a little, but then apologizes. “I’m sorry. This is Labuan Bajo. If you were in Bali or Jakarta, it would be no problem.” Somehow, though, I still doubt this.
We take another loop until we land at one of the pharmacies we already attended. The doctor is out until 6:30 p.m. I make an appointment at 6:30 p.m., but I feel a bit suspicious that the doctor will not arrive at 6:30 p.m. What doctor doesn’t come into the office until 6:30 p.m.? This seems like it could be a translation error, but when the pharmacists writes me a little card, it says 18:30 —- 6:30 in the evening.
I give the news to the taxi driver and he shakes his head. “Doctors are never in at 6:30 p.m.” I'm satisfied with the accuracy of my prediction until he continues and says, “it might be hours later! Let’s do your grocery shopping.” Everything is so different from what I know…
We stop at the grocery market and fill the back of the taxi with canned goods, soda waters, pallets of beer, and CHEESE! (wonders never cease). We continue to the traditional fruit and veggie market where we find greenery and chickens (not yet dead).
On the way back into town we pop into another Pharmacy, and find the Doctor in. Our taxi-driver is jubilant! $2.00 and 10 minutes later I have the prescription. We circle back to the hospital, and after a grand total of 6.8 hours and 100 Labuan Bajo Circles our mission is accomplished.
Where the hell is my “easy button”?
One might be annoyed with the difficulties involved in a 6+ hour Odyssey picking up what amounts to be a bottle of Ibuprophin here, but we just can't. Everyone is so friendly, we got a nice tour of the city, and at the end of the day, the Travel Magic offered us one of the nicest sunsets we've seen yet. Sometimes life gives you the runaround, why not make it a grand tour?