Grace Chew’s Blog

12/2/2009: Day 1, Kapuna Hospital

First whole day in Kapuna. Talking with Ruth, we
realize that this is a place of relativism –
relative cleanliness, relative health, relative
heat/coolness; everything is just about okay, and
they’re okay with that, especially since there’s
nothing much that can be done about it at the
time. There are reasons for that though. For
these two “housewives” who bustle about cleaning
everything, even some things defeat us. For
example, starting the fire today took a good 1
hour, so cooking 2-minutes Maggi mee took about 1
½ hours. Boiling water with the same fire took
another ½ hour or so. And in starting the fire
the kitchen which we had conscientiously swept
just minutes before became littered with debris
from dead leaves and split logs. By the time we
finished eating, we weren’t too bothered about
that mess, and just swept it to one side – we
were going to repeat the mess again the next day
anyway! Feet just grey from traipsing around were
clean, compared to them getting black. Hot and
cool become relative terms separated by
estimation and mood (and clothes – hot in
t-shirts becomes bearable in sleeveless tops, and
unbearable when you’re hungry).

Health decisions are relative too – with very
little or no diagnostic tests available,
diagnosis is clinical-based or trial by therapy.
If you have a fever, you probably have malaria so
let’s put you on anti-malarials just in case. If
you have a fever and a cough, you probably have
TB, but you may have malaria too, so we could try
treatment for both. That actually seems like an
unfair description of how they work here, and I
can assure you that the thought processes in Dr
Valerie Archer’s mind are more refined than that
above. The end result for most patients is still
the same though, and the TB ward is never empty
and anti-malarial drug names are bandied about like the letter ‘e’.

But with the relativism, there are also
absolutes. No betel-nut chewing whatsoever,
leaving the premises nice and non red-stained.
Best care for everyone who comes, so each
patients sees Dr Archer on ward rounds, and their
care is tailored to their needs (within reason,
or they are convinced to modify their plans
somewhat). Friendliness from everyone around, so
two Chinese girls always find smiles and laughter
and people to talk to. And best of all, a very
Christian attitude permeates the place, and God is an absolute here.

One day and a bit seems like forever, partly
because we’re awake from before 7 am till after
11 pm. And there are long periods in the
afternoon where one just doesn’t want to do
anything but sit and wait for any breeze to pass
by. But there is potential for this place to feel like home. Somewhat.

13/2/2009: Day 2, Kapuna Hospital

Let’s devote this day to the products of this
place. We’ve been picking from this garden of
plenty and will probably never be found wanting.
There are row upon row of banana and pineapple
trees and papaya (or paw-paw) trees are scattered
around. The ma’a trees serve up mini jambu air
(what’s this in English?) which are more tart
than their large Malaysian counterparts but just
as juicy. The guavas (jambu batu!) here grow
small and cute and with sweet pink interiors.
There’s starfruit as well, but they’re called
five-corner fruits here (it figures). Dry
coconuts fall from the trees, and the locals
grind them to make coconut cream/milk, but to
save time and life, we buy fresh green coconuts
from the market to drink and eat. Eggs can be
picked from just near the doorstep, perhaps under
the longbean vine, and if the chickens that gave
us those eggs were ever to grace the table, we’d
have the best free-range (kampung) chicken
around! With the river a stone’s throw away, we
have seafood abounding available from the market
– fish, prawns, shrimp, and crab, all sweet and
succulent, only needing boiling/steaming. They
have an abundance of sago as well, it being their
staple, and they make it like a chewy thick
pancake (think oa-chien – oyster omelet,
Penang-style, without the oysters), which is
quite pleasant, especially with the crunchy crust
from baking on a woodstove. They also mix it with
coconut (which may become like the Melanau
tebaloi – must observe how they cook sago!); and
Dr Calvert has extolled to us the many benefits
of sago and coconut cream, especially as baby
food, which even newborn infants can tolerate!

One very important product of this hospital are
the community health workers. They run a 2-year
course here, taking in between 20-30 students,
one intake every 2 years. I think they’ve run 3
cycles now (?) and many of the graduates are
working in Kapuna itself. These CHWs are always
smiling, and are the main caretakers of the
patients with the nurses. They are like
mini-doctors, maybe even like F1s/HOs, as they
are taught everything about the main diseases
here so that when they go out alone to man their
own aidposts, they would know how to treat the
myriad ailments of their patients, and when to
refer on. Isn’t that like F1s? Except that most
F1s don’t do that alone, and would try not to put
themselves into that situation, my future self
included. It’ll be good to learn from their
education, hopefully to become a more independent F1!

Related to that is the end-product of the
people’s health and education - it is a hospital
after all! There’s music and computer lessons in
addition to the run-of-the-mill health and
general education: Ruth has taken a keyboard
class already (while I slaved over the stove -
another 1 hour of smoke-making), and the sounds
of recorders puncture the air. If kids are of a
schooling age, the most likely question they’d be
asked by Dr Valerie is “Why are you not at school?”

So, what will Kapuna produce in me? Or will I
just be going back with lots of its fruit in my belly?