Either the Samoans have tough skin...literally...or we the English are wimps!

Sadly......we leave Samoa a week today. At times it feels like it time has been going very slowly...but weeks have rushed by and now we are in our final week. It is now the 'last time' we do everything.....but im upbeaet as had a great time here...and would definitely consider coming back to visit....though not for another 6 weeks unless i was working in the hospital.......or they discover more tourist attractions lol!
We have hit the hospital hard this week and i have been doing paediatrics in the morning and A and E in the afternoons or evenings.
Now we have been on paediatrics for a while, the intern gives us a file and we go and see patients on the ward round by ourselves. It is scary as she often goes on what we say and find on clinical examination but it has taught me to trust what i think. Eg if i think there is reduced air entry on one side, then i say so. Whereas before i wouldnt have the confidence to and would think it was just me hearing things wrong. I need to get more fine tuned to paediatric heart murmurs but it is so easy to get distracted when you have cute babies staring up at you with their wide eyes and tugging on your stethoscope. I need to learn the Samoan word for vomit and diarrhoea though, as it has lead to some interesting sound effects this week when i try and take a history from patients and ask if they have vomited. It goes like, 'Have you been sick? (Blank Face)....'Have you thrown up/vomited?'...(Blank Face).....'Can you keep your food down?'...more blanks...i then have to precede to pretending to throw up and ask if that has happened to them! I get greeted with an amused/confused smile and they just say 'i dont know again'! So it looks like i need to either perfect the action or just find out the Samoan word!
We did an evening shift last night at A and E. It was suprisingly quiet but perked up a bit later on. We saw a lady who was having a spontaneous miscarriage, many kids with bronchiolitis, and a few patients who needed stitches following rugby incidents, dog bites etc. We watched the doctor do some stitches and he very kindly took the time to show us how to do stitches. The problem then was that there was no one left who needed stitches..so we resorted to practising our stitches with some thread around a drip stand! At about 10.30pm boy came in who had been fishing for crabs..i dont know what you call people who collect crabs...fishing seems a contradiction lol!.Seafooding or something! He had fallen and had a nasty cut on his foot and had severed a tendon, which meant that he was unable to lift his foot towards his body. The doctor repaired the tendon and then we got a go at stitching. Like everything.....when you arent doing it..it looks quite easy..however i soon discovered the toughness of Samoan skin when i tried to get the needle through, whilst trying to avoiding stabbing myself. Throughout my time here, i have commented to numerous doctors about the Samoans high pain threshold. While getting stitches they get given local anaesthetic but at home, if they were in pain they would give some more, here they dont, and just say, 'well it is painful', which leaves pts gripping the edges of the bed and biting their tongue as hard as they can. So they are tough skinned..and also because most walk around bare foot..their skin esp on their feet is very tough. The underside of my feet are literally black....as everytime i wash them...i then walk around and they get black again. I might have to bleach them when i get back!
One last hospital thing.......
We went to take a kid with meningitis..the one i mentioned a few posts ago..who we saw in Savaii. We went to take her for a CT..which is a recent addition to the hospital here in Apia. The doctor sedated the kid and then we took her down to CT. The only problem was we couldnt actually get into the CT room as the door had become jammed. The doctor we were with asked us if we were any good at picking locks..to which i had to admit that i didnt have any experience..apart from that fact that i managed to break the key in my lock on my bedroom door at uni this yr...its still in the lock..oops.
She then got a knife and tried to open the door..but she only succeeded in breaking off the knob! So we were stuck. We took kid back to the ward. About an hr later we got a call saying the door had now been prised open. The problem now was that the kid was no longer sedated and was very irritable and screaming. We gave her some more sedative and the CT was done. We don't know the results yet, as there was no radiographer there so it wont be intepreted until Monday which would be 4 days.
Also saw an emergency Caeserean Section yesterday, as we went down to be part of the neonatal resus team. The baby came out after a bit of tugging and we took it to the other room. We helped warm the baby, and as it was cyanosed the doctor bagged her, and she asked what the baby's heart rate was. It was pretty cool that i could feel the unmbilical cord and calculate the heart rate from feeling the umbilical cord pulsating..no need to even feel a radial pulse or the heart.
Sorry for not much non-hospital news
Mamma Mia was good the other day. The great thing about the cinema here is that there are no adverts. At the scheduled time, there is about 5 minutes of trailers for upcoming films and then the film just starts. This means you have to arrive early for the film as opposed to in England when one purposefully arrives late to avoid the adverts!
We are now planning NZ and looking forward to travelling there...though i am very sad to leave Samoa!
Faafetai (Thank you) for all your news etc while ive been here
hopefully ill be able to write once or twice more before i leave..but i dont know what will happen in NZ while travelling. You may just have to wait until i get back to hear about that....this could take years lol
I could start telling you about the Samoan tatoos! lol..just trying to think of non-med stuff as probably bored most people to death by now..and not there to resucitate everyone!
The men get a tatoo which is from thei belly button to their knees, literally like a pair of shorts. It takes approximately 48 hours and is done over a period of 1 to 2 weeks. It is worn as a sign of courage and manliness really. Some women also have them but they get a lighter tatoo with stars etc and not all coloured in like some men. Tatooing is massive here and its hard to find a Samoan without one.
There is also an fascinating cultural tradition here where if a family only has boys, the last one is brought up as a girl. They do all the womanly tasks...yes..like cooking, cleaning.....etc. for all the sexist men out there....Jonathan etc! not mentioning any names lol!
They try and look like women but they are not like the fafafinas here, who are transvestites. We treated a man in outpatients yesterday who was a man, but had female traits. So he was one of the ones who has been brought up as a woman. It said on the medical notes, Male, but i didnt know whether when asking questions to his friend, whether to say he or she, as i am unsure if they change their names etc. There are many of these men, who you see around town and though you can tell they are men, they aren't transvestites and will dress in t-shirt and shorts, but there faces are feminine and they will paint their nails and change their hair etc
An interesting point to leave on..and im going to try and find out more about it....
I better start getting my woolies out for NZ..though from what ive seen on the BBC website..the weather has been pretty good in England!
Much Love
Sarah xxxx