Taking a Battering in Papua

Proper mine doctoring gear is essential if not unflattering

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November, 2008.  Papua Highlands.  Indonesia.


....................................Only two weeks of work left for me here. I’ve been counting the days since before I arrived. The difference between one’s duty and one’s wishes becomes more clear every day I work in Papua.   Here, more than any other place I've worked, the clearly bizarre becomes the clearly usual.  Loneliness and isolation here is palpable and painful. When I took this job it was for the adventure, now it is definitely for money and bragging rights. 
Last night I came home from the hospital, cooked dinner and watched TV.  I'm trying to come up with anything to make the time pass more quickly between now and when I get home to see my wife and son. Here at the mine campsite our satellite gets Discovery Channel and I'm thinking how ironic it is that I'm working in a place more bizarre and isolated than the one on the program.  It's just past ten o'clock when I get the call from the ER.  The doctor calling me is calm and has a thick Indonesian accent.


"Doc, can you come down to the hospital?  We have a woman with an eye injury.  She has trauma."


I sweared, rolled off the couch, and through on my coat.  It's raining outside. It's always raining outside.  It rains fourteen hours every day, starting at lunchtime.  Everything stays wet in the Freeport Highlands.  You never get used to it.  The hospital is a five minute walk through mud and gravel.  I try to kick as much of it off my shoes as possible before going into the Emergency Room. 

Erik Travels is a tall man in Asia

A Papuan woman was lying on the stretcher in Emergency  Bay number one.  She was dark and her hair was pulled back in a bun.  She wore a green, yellow and red beaded necklace and a leather bracelet  and ring.  Half of her face was burnt, swollen and blistering.  She lay there staring at the lights on the ceiling, lips pursed tightly together, not making a sound. She was opening and closing her fists which seemed to be her way of dealing with pain.  In the waiting room a woman was on the floor crying and screaming.  She was the burnt woman's sister.

Four hours ago her husband had come home drunk and asked her for a divorce.  When she refused he took a stick out of the cooking fire and hit her in the face with it.  The flaming stick had caught her square in the right cheek and the right eye.  The right side of her face was swollen to twice it's normal size and a charred black streak went from her forehead, across the eye and down to the corner of her mouth.  Her eyelid was purple and swollen shut.  She could not open it. She had walked with her sister for almost two hours to get to our hospital. I told the young doctor on duty to give her some morphine right away.  There was no way we could examine her without it.  In the room behind us her sister  still screamed.  She spoke in one of the eight hundred Papuan dialects.  None of the staff could understand her, but they knew what she was screaming about and it was revenge.

What'chu looking at, foreigner?

When the chance came to work in Papua, Indonesia I jumped at it.  For medical workers  working off the beaten path, Papua is the tricked out Cadillac of remote lands.  The idea of working there had National Geographic written all over it.  Four flights, three armed checkpoint stops and fourteen hours later I had arrived.  My company managed two hospitals at the mining site:  one for the employees and families,  and a second hospital for the local Papuan villagers living near the mine.  The head physician was an old American doctor I'll call Dr. Bob.   Dr. Bob had never gone home after the Vietnam war.  He was weathered, fit, crusty and didn't say very much.  He'd been up in the Papua Highlands for almost ten years. I figured all that time in the middle of nowhere probably does something to you.  When I introduced myself he just looked me up and down and grunted.   Though I was well into my 40's and had experience in 25 countries, he gave me all the collegial respect of an unshaven first year medical intern.  He told me I'd be looking after the local's hospital down the hill and that since I did not have my mining drivers license, I should catch the local bus down at six AM.  When I finally arrived at the hospital the next morning at 6:30, the young doctors asked me why I'd come so early.  Dr. Bob usually shows up at 9:30.  I just rolled my eyes and quietly said,

 "Dick."  

Two years later Dr. Bob was retiring and the company offered me his position.  I politely turned down the offer feeling like Scrooge after he'd seen the Ghost of Christmas Yet-To-Come.  Dr. Erik did not want to become Dr. Bob.

One bed fits all

Once the Morphine began to be work we tried to pry her eyelid open to see how much damage she'd taken to the eye.  The eyeball surface had been scraped and abraded.  It was cloudy, opaque and probably burned. Her pupil moved in random directions searching for any kind of sight. She could still see shadows, but she was probably never going to see much more.  She was two countries away and about one hundred thousand dollars short of the corneal surgery she would need to improve her vision.  We gently cleaned the charred skin from her cheek with  saline soaked  gauze.  There was some bleeding, but the wound had mostly been cauterized by the fire. The exposed tissue was red, angry and raw, but fortunately  hadn't burned down to the bone.  A third degree burn to the face would have been more than our little hospital could handle even though we were the only medical facility within five hundred miles best equipped to deal with it.  The local doctor was young, but he kept his cool and didn't show his inexperience.  Aside from me, at 25 years old, he was the last medical word on anything that came in through the night.  He handled himself well.

After cleaning her face as best as possible I started antibiotics both into her eye and through an intravenous line.  I hoped  that we could keep infection from destroying what little was left of her sight.  She lived in the most basic of Papuan villages and slept on a dirt floor in one room with the rest of the family.  I would have to try to keep her in the hospital for as long as possible to keep her wound clean.  It was the only way.  

"Freeze, Suckah!"

We worked on her face for almost two hours.  When we finished I realized that she hadn't made a sound the entire time.  No weeping and not a single word.  It was almost like she'd anticipated being in this situation and had accepted her place.  On her fifth day in the hospital she was well enough to be moved from the "high care" section of the hospital to the general ward where 20 beds filled a single room.  In the bed next to her was a woman who was barely a week past emergency surgery.  Her husband had kicked her so hard that her spleen had burst. Her 2 children stayed with her and they all slept in the same single bed in the general ward.  She would return home to her husband in one more week.  I learned that this is just a culturally typical way of expressing domestic anger in Papua.  I asked the head nurse if there was a policy of reporting this kind of domestic violence to the police.  She shook her head.  There was no precedent.  It's usually left up to the tribe and the family to dish out justice.  Most of the village men that I met walking on the road carried a three foot machete and a six foot bow and arrow.  I called them Judge and Jury.  The last word we got was that our patient's husband had run away that night, but that her father was hunting him down.  The nurse said that we were lucky that the husband hadn't tried to get in the hospital and finish the job.  That had happened a few times before.

I walked home that night after the woman was stabilized.  The rain was just lightly drizzling so I took off the hood of my raincoat.  I had to use a flashlight to find the path home and avoid the huge puddles of water that were in the road.  There were a lot of things there that I would rather not step on.  When I got into my apartment Discovery Channel was still on the TV.  I turned it off and put my jacket over the back of a chair next to the space heater.  I hoped it would dry by the morning.

There's gold in there somewhere