Jailolo - Epilogue

Jailolo – Epilogue
I’ve been back on the ship for a few days now and we are in a new location – Ambon. While I still have some day visits ashore remaining, Jailolo will be for me the defining week of the entire mission. It is one thing to go ashore in the morning, see patients, then return to the ship, and quite another to remain in the environment for an extended period of time. The latter situation intensifies the experience and makes it more intimate and real. Your experience is a more subjective one as you are a participant in the drama rather than the more objective experience of an outside observer. While the week was intense I do know that it doesn’t come close to what those who have gone to Haiti have experienced post earthquake. Conditions are far worse in places such as Darfur where the population is enormous and mostly displaced and where attacks on the innocent by the warring factions have been as deadly as disease and starvation. You don’t see people here lying around because they are so weak from lack of food as in some places in Africa where there is famine from crop failures or conflict. Still, it is difficult to see so many people with diseases that could be easily prevented with some basic public health measures or that could easily be treated in early stages before serious consequences develop. One of the recurring themes in my postings was my frustration in not being able to do more for the patients, especially those with chronic diseases or complicated issues. I wasn’t prepared for the limitations of what one can do when you pop into a location for a few days with the minimal supplies and personnel that can be readily flown in and flown out from a ship anchored out in the ocean miles away. I wasn’t prepared for the notion that seeing 100 patients in a day would be not only desirable, but encouraged. I wasn’t prepared for the ethical dilemma raised (in myself) by the conflict between the utilitarian goals of the mission, which is really to promote relationships to pave the way for more involved missions in the future and which translates into seeing as many people as possible, and the more individualistic goals of hands on patient care where each patient you see you feel a responsibility towards. I found it somewhat ironic that I had a hard time with the utilitarian goals of this mission as I have thought in the past, from a detached theoretical standpoint, that in our own system it doesn’t make sense we will spend so much time and resources to save a person, especially a child, in situations where the chances of success are extremely slim yet so many more people would be saved if that money were spent on basic prevention and early treatment interventions. Funny how having personal involvement can affect your thinking. I still think I did what for me was correct in spending the extra time with the woman with very high blood sugar or seeking admittance for the young man with TB but I do see and respect the counter argument that my approach meant others were not seen at all. Guess I will have to ponder this issue some more. Perhaps it is my own selfish desire to see that “I” have done something concrete that is getting in the way. We humans have trouble with those gray areas in life. I should point out that there were many other aspects to our mission that had readily identifiable concrete results. We did a large number of surgeries on board that had life altering results for a number of individuals (cleft palate repairs, etc.). There were teams on engineers in the fields redoing clinics and schools to make them safe and more effective, and digging wells to improve access to safe drinking water. There were veterinarians who went in the field to vaccinate animals and educate. I saw one picture of a baby deer that had been caught in a trap and the vets created a splint made of bamboo for it. There were teams of health educators who provided education and training on various topics. There were dentists pulling teeth (a widely needed treatment here). There were optometrists doing basic eye exams and dispensing donated glasses. There were people spreading good will and cooperation.