Layover in Guam

14 hours in Guam, instead of 2. It is 4:30 AM and am looking for something fun to do. So I Checked by luggage at the Westin and explored.

Faciing west, this is the reflection of the sunrise on the clouds.

Sunbathing: Japanese businessman style.

 

 

 Interesting flotation devices. Appear to be attached to waist.

 

 

 

 

Outrigger canoe. Some very strong women.

How many people can fit on a paddle board? One, two?

 

 

 

Three?

 

 

Four. Four can fit on a paddleboard.

 

 

 

 

 

 

Rainstorm on the horizon.

 

 

 

Cows on Parade.

 

 

10.1.14 Chuuk

Am in Chuuk, another state of Micronesia, for the leprosy conference. It is a world apart from Yap. Everything is in relatively poor repair, including the hospital. Things going well internet speed quite slow, so will upload pictures from here and Guam when Iget back to Yap or find a faster connection.

09.27.14

One of those days to get chores done .... and a haircut ............ a short one. A beautiful sunset with the tide coming in and the wind blowing from the west. And a heavy downpour just before that. Not the rainy season yeet.

In the early morning hours I am departing for Chuuk, another state in Micronesia. There is a conference on managing disabilities from leprosy,a  problem that is still identified on the island. Will be bringning back ideas on how to manage the wounds and extremities. Flight leaves arouond 3:30 AM, with a transfer in Guam, then a hop to Chuuk. Really, at that hour, we all should be asleep.

Gunnarr is on the left, Fionnegan on the right. I miss my boys!

09.27.14 Who am I? Number 3.

An easy one. Common in Micronesia. All white. Tried to get as many angles as the bird would allow.

Found a buddy that also posed for a while.

09.25.14 Young school children, more smiles and some tears!

More meetings today. One case of dengue is now an outbreak, so the island is in high gear to destroy mosquito habitat, isolate the sick, and a campaign to avoid the daytime mosquito bites. From a rationale point of view, to avoid mosquito bites one must wear long pants, long sleeve shirts/blouse, and socks and shoes to  minimize exposure during the daytime. (Bednets are used to semiquarantine the afflicted to keep mosquitoes from biting carriers of the disease.) That is so far from the cultural norm here as women wear skirts or pants that go just below the knee, no one wears long sleeves and very few wear shoes and socks. (Yes I am an oddity here for many reasons.) A lot won't wear repellant either. Stay tuned. The Center for Disease Control (CDC) is an integral component of outbreaks here.

Back to school. My last day doing the early school children. It really is good to have the parents there as I can examine the child and ask about soft drinks and snacks. Too many decays.

Here are a couple of pictures from today:

Talk about a small world. This child was watching a movie on a computer while his Mother was in the dentist's office! Sounds like home, except the child and computer were alone on the bench  with no concern for safety or theft. I sat with him for a while because I wasn't that comfortable leaving him by himself. Most likely a grandparent or auntie was around the corner, but I  wasn't that sure.

I turned around and here was a visitor on her computer. We are all linked.

School exams:
Cute little girl. She was four.

OK, here it is. Over 80 degrees and 100 percent humidity. Pouring down rain. And he is wearing a hoodie! I was "glowing" perfusely and he is having fun with the hood.
Hot. Hot, Hot. But reduced risk of mosquito bites!

 

Another set of twins. This is the fourth set in four days.

Bigger student showing the little one how blood your finger is picked for blood drawing. You guessed it, the bigger one cried, the little one didn't!

The staff are so good with the kids. They are  kind and gentle and effective. I like watching them in the schools and public health office. The lady and man are wearing a mask because each has a cold. They all do that when they are sick with colds. No one comes in to work with the flu. More people at home should do that.

After lunch, all of the children brush their teeth. The teacher has a tube of toothpaste and she applies it to the brush for them. They use the sink - not that red bucket in the picture! He was just keeping an eye on us. No shoes inside for anyone.

Waving good bye after singing a song. Kafel!

Met with the Yap Comprehensive Cancer Control Program director and staff and we are moving forward on a breast health awareness program. Now I have to get back to completing the culturally specific brochure (I really like making them) and then begin the Knowledge, Attitude,and Practice assessment of the doctors, nurses, community health workers who will be involved in breast cancer screening. There is no mammography here - yet. But we are at the point of where awareness, clinical examination, ultrasound and a biopsy are the primary components of an assessment. Time, it takes time. The interest is there, the dollars are in short supply. We will do as much as we can for a sustainable program. Martina leads the CCCP, no doubt she will work to continue it after I am gone. She is married to Dr. James, Ob/Gyne and informed me that she will inform him that I will teach him how to perform breast cancer surgery. So I will!

On a really fun community note, I now see some of the kids in town that were sailing or paddling a canoe on Saturday. It always surprises me to here Hi Dr Rosemary as I walk down the street. Hoping for a nice day Saturday to help with the practices for the canoe festival. I did volunteer to help with the door to door campaign for TB with the PH office, but alas they need someone who speaks Yapese. So Saturday for helping the kids with racing it is YES!!!!!!!!!!!!!!!

School exams in Colonia

Another morning with the kids! We went to the early education center just across from where I am living in town. There were two sets of twins in this class - o those poor teachers! Such energy in the classes and the kids are really well behaved!

This little girl was such a joy. As soon as we walked in she was very enthusiastic, shook my hand, and had many, many questions. She also volunteered to be the first for the medicines, exam and blood test. God bless her little heart.

Everyone is wathching her and she was a star. Took her medicine and washed it down with a drink of water.

Here are the students. Aren't they adorable? Healthy and happy children, nice to see.

Finger sticks for hemoglobin. Few tears, but not many. Most were really quite good.

 

The rest of the day was spent organizing a breast health program. We will model this after some of the work I did in Nicaragua. There is no mammography here but of course there is breast cancer. We will start with a knowledge, attitude and practice exam, instruction, and repeat exam of the PH nurses and community health nurses and health workers involved in patient care. Then once they can perform an exam, they will begin doing them routinely on the patients. We are making instructional brochures to complement what already exists here. And the one surgeon in the hospital is on board.  It will work.

 

A special thank you to Mrs. DF who sent me a card. I really am enjoying the mail and the cards are taped to the wall in my office.

 

Tonight I made breadfruit! Boiled one half and baked the other to see what I like best. A little breadfruit, a little tuna and cucumbers. Not bad. :)

A very special thank you.....

... to a very special person. Mrs. Gibson - all of the boxes arrived and some of supplies have  already been delivered to Father Kelly at St. Mary's. More wll go there tomorrow. Some of the school supplies are on their way to North Fanif via another Peace Corps volunteer teaching there. I will also take some to the early education centers when we do their exams.

And I am sure God's little creatures will also appreciate the treats. This one found a cool spot under the pew during Mass.

09.23.14 Dalipebinaw Early Childhood Education

Another fun day with the kids. We did 20 exams and only a couple with real tears. The ages ranged from three to five. They sang songs and recited Twinkle twinkle little star! I am impressed with what is available for the children. The toys are the type we had as kids - legos, blocks, and playdo. Things that let them use their imagination and they do. There were a lot of creative playdo sculptures.

This is Ivan and his daughter. He works in Public Health and she was here ofr her immunizations. healthy and cute little girl.

Another little cutie for his shots, too.

Here is the class, singing for us.

She is only three and really wanted her grandmother. Such a precious little one.

Parents including one Dad, grandparents, and aunties were there for the children. This was a great help as kids cannot give a history and it is always nice to tell them that everything is normal. There was one chikd with a problem and very helpful to have the parent to discuss follow-up.

Yes, the staff sat on the floor to give medications and do the hemoglobins. I was somewhat concerned that once down there for a while itmight be tough getting back up.  Back they got me a child size desk and chair and it worked!

 

 

This week we have been working on the breast cancer screening program. It was added to the manual that screening for breast, cervical and prostate cancer should be a part of the physical examination.. I carried the message from PH to the doctor's meeting. Also started drafting a culturally specific brochure for breast health. One step at a time.