Travel with Dr. Harte

Hi all,

Our next day at the clinic introduced us to East Timorese politics &
bureaucracy.  After our clinical rounds (fortunately the woman's hand was
looking much better), I was informed that a student and I needed to come up
with a treatment plan for the drug resistant TB patient, then go to the
Ministry of Health to ask for their "guidance" & help in
procuring the needed medications.  We waited for several hours until we
got word that they were ready to meet with us. The med student, Belynda,
interpreter and I drove about 30 minutes in the Bairo Pite Clinic ambulance (a
converted Land Rover). We met with the head of the Health Ministry and a few of
his military staff (one seemed to have some decent medical knowledge.).
 They were very nice but had no intention of letting the clinic have the
required medication nor keep the patient. They decided to send the patient to
an isolated outpost where he would stay for the next 8 months getting
appropriate therapy.  Their drug recommendations and isolation precautions
were appropriate given the lack of resources at Bairo Pite. They asked us to
drive the patient to the main hospital for a new chest x-ray, then for the 2
hour journey to the isolation clinic.  When I inquired about suggestions
for appropriate precautions during the transport, the Head of the Health
ministry replied, "Just keep the windows open. You'll be fine.".
 This sounded like a great assignment...for someone else.

When we returned to the clinic & briefed Dr Dan, he wasn't too happy.
 He wanted to keep the patient and treat him there so he'd be near his
family (2 blocks away), and because Dr Dan wanted to take the lead on treating
resistant TB in East Timor.  He also
didn't trust the health ministry or main hospital since they had an ongoing
rapid turnover of docs & bureaucrats.  Those of us at the meeting
tried to explain that it would be safer for Bairo Pite and better for the
patient to get him transferred...grumble grumble grumble. "I'll sleep on
it".

After the clinic, we walked the 35 minutes back to the hotel since we couldn't
find a taxi.  At least it wasn't raining.

After a welcome cold shower, we got some dinner from the hotel's crappy
restaurant.  By now, we figured out that if we sat to eat when the
restaurant opened (7PM) then we could finish before all the other diners lit up
their cigarettes which seemed to accompany their dessert/espresso.

More to follow.

Jon

Hi all,
Another clinic day, but we left @ lunchtime so we could explore the city's
attractions.  More cool cases and the woman's hand I drained was much
better so we decided to send her home tomorrow on oral antibiotics. When we got
to the resistant TB room, Dr Dan translated from the patient that he would
likely run away from the distant isolation clinic.  None of us thought Dr
Dan did a particularly rigorous job trying to convince the patient, which was
confirmed when he started going off about trying to get the needed drugs from
other sources or donations.  After another round of everyone trying to
convince Dr Dan, then shockingly, Belynda got all up in his face too!!!
 After rounds, Belynda found the TB masks we had brought and had them placed
outside the patient's room.  We're not sure how long they'll last or if
they'll be stolen, but it's something.  As Belynda & I departed the
clinic for the final time, a decision still hadn't been made.

The remainder of the day was spent exploring Dili.  From the clinic, we
asked a taxi driver to take us to the most famous exhibit in Dili called,
"Chegas!".  He had no never heard of it and couldn't seem to
find it based on the map we showed him.  After driving around the city for
a while, we had him take us to another tourist spot that he had heard of.

After a surprisingly good lunch at a nearby restaurant, we took a taxi to the
isolated Christo Rey, a huge Jesus statue on top of a small coastal mountain.
 (Like a smaller version of Corcovado in Brazil). It was a sweltering one
hour climb up stairs to the top.  On the advice of the medical students,
we climbed over a fence halfway down to navigate a very steep path to the
prettiest beach in the area, dubbed Jesus' Backside Beach.
 Sure enough, the treacherous decent led to a beautiful beach with Jesus'
Backside towering high above you.  Our rubbery fatigued legs finally got
us back up the trail then eventually down to path steps to the base.  One
thing we didn't count on, is that during weekdays not many people drive all the
way out here, so there were no taxis, or anybody else to get us back into town.
(About a 30 minute drive).  So started a very long walk back along the
lonely coastal road.  About 30 minutes into the walk, we were fortunate
enough to have a taxi drive by us in the opposite direction gesturing that he
would return after dropping off his passengers.

Sure enough, he returned about 10 minutes later to pick us up.

This is a good time to mention the odd taxi rates in East
Timor.  There are none.  You pretty much pay something
at the end of your ride.  There is no request from the driver. There is no
debate.  In general, within Dili, 1 or 2 US dollars is recommended. To the
airport or Christo Rey, about 5-10 dollars.  (US dollars are the official
currency of Timor Leste).

Anyway, after a dip in the hotel's mosquito swarmed pool (dengue? malaria?) and
another bad hotel dinner, we packed up in preparation for tomorrow's flight to Bali, Indonesia.
 Belynda was finally looking forward to something!

One last note on Dili:  If you wonder why we kept eating dinner in our
horrible hotel restaurant, it's because taxis don't operate after the sun sets
and it's not considered safe to walk around Dili after dark.  I felt like
Dili was overall a very safe city, so maybe the warning was that it's a good
chance you'd be hit by a car at night since there's no traffic lights, few
street lights and no obvious stop signs. (And no acceptable trauma care should
you get hurt.).

Well, off to Bali!

Jon

Hi all,

It's time to go to Bali! I'm sure everything
will be wonderfully uneventful from here on in.

OK. Not yet.

While waiting in Dili airport, a young man walked into the passenger area with
his female companion and he started screaming and ranting about something (in
the Tetun language).  Local security & UN police appeared to be trying
to talk him down, but he was having none of that.  A guard had to hold him
back from going after somebody but there didn't seem to be a specific target of
his anger. He then stood on one of the check-in counters to scream some more.
 Nobody other than foreigners seemed to be concerned.  I asked an
airport shopkeeper what was going on and she just said we should ignore him.
That he was Timorese and upset.  The Commander of the UN police force at
the airport came over & added that the guy didn't have his identification
badge to go with his female friend thru immigration screening onto the
departure lounge. I was unclear if maybe he was an employee since they seemed to
know him.  After more screaming, then crying uncontrollably then more
screaming, his female partner made her way thru immigration & he left.
 She seemed completely unfazed by this.  I'm pretty sure if this had
happened in any other country, he would have been tackled, shackled, and
arrested.

Our flight on Batavia Air (an Indonesian airline) was fast & efficient but
had less leg room than ANY carrier I've ever flown.  It's one of the times
where Belynda & I are thankful that we have legs not much longer than an
Oompah Loompah.

The flight attendants were very helpful & patient with all the
non-Indonesians since the Customs form that everyone had to fill out was only
available in the Indonesian language.  Stupid.

Arrival in Bali was more chaotic than I would
have expected for a major tourist destination.  First key point if you're
planning a visit.  Don't rush off the plane since you have to board a bus
which brings you to the terminal. (Last on is first off).

Next advice is that you need to purchase a "Visa on arrival" sticker
for $25 USD from a booth before heading to the Immigration line that also says
"Visa on arrival".

After clearing immigration we moved down towards Customs where all bags had to
be x-rayed.  Just as we were approaching the x-ray machine 2 members of a
large gathering of official looking blue-shirted men came over to grab our bags
& place them onto the conveyor belt. They had us hand our Customs
declaration form to the airport official. They picked-up our bags on the other
side of the machine, but rather than handing them back to us they walked
quickly to a nearby money changing booth. (One of many lined-up while still in
the secure Customs area.) It was then that I noticed a tag on his shirt that
said "Porter".  I became infuriated, yelled NO, and grabbed our
bags and walked away without acknowledging his request for a tip.  I'm
amazed that Indonesian airport officials are so corrupt as to participate in
this scam.

The way it works is that Porters are allowed to be in a secure area, target
tired tourists then deliver you to their preferred money-change booth. The
money changers charge high fees, porters get a kick-back and a personal tip
from the tourist and the customs agents get a cut of the action.

Tip of the day: At Bali & probably other
airports, don't let anyone take your bags and don't feel obliged to tip or use
a service you didn't ask for.

We were expecting hordes of taxi drivers to descend upon us as we entered the
arrivals hall...and they didn't disappoint.  We sidestepped them to find
an ATM machine which is much better than using the money changing booths.
 We then found an official Taxi booth where we easily prepaid for the ride
to our hotel. (With a very reasonable price).

During our drive to the hotel, I noticed Belynda was unusually quiet and she
had a look as if something in her brain had finally snapped. (I was wondering
when that might happen). I asked her if she would like to get some lunch after
checking in.  Silence.  Then, in a slow, simmering, deliberate voice,
she uttered, "I...can't...talk...to...you...now".

Her eyes looked cold and dead inside.  I think I broke her.  Oops.

Thirty minutes later we arrived at the fortress entry of the Four Seasons
Jimberon Bay.
 Our taxi was searched for bombs in the trunk, under the car (mirror on a
pole) and circled by a bomb sniffing dog.  We passed all the tests.
 The pearly gates finally opened and we were let into this little slice of
heaven.

Upon arrival we were escorted to a couch and presented a much needed cold wet
towel & refreshing lemongrass iced tea.  A gentleman from reception
came over and somehow knew our names.  Amazing!  I'm still trying to
figure out how he did that!

Courtesy of booking with American Express, we were upgraded to a Beach view
private Villa, received 2 complementary massages, daily continental breakfasts
& guaranteed late check-out.  Thank you, Amex!

I could see Belynda finally starting to come back.  The Four Seasons was
like CPR for her soul.

Our first task after having the complimentary beer was to walk to the Spa &
see if they had anything available for today.  "Is something in 15
minutes OK for you, Mr & Mrs Hartay?"

We had a Balinese couples massage, and I got the sense that the remaining
demons were being exorcised out of Belynda every time an elbow was shoved into
her tight shoulder muscles. You could almost hear the twanging of a tight
string being played by her masseuse.

So far, I have no other drama to report.  Belynda has decided she's not
leaving the confines of the resort to tour Bali,
visit Ubud, or do anything else.  I think that's for the better.

Hopefully not much more to report.

Jon

Hi all,

Our time at the Four Seasons was very nice & unstressed.  Nice
infinity pools, villas with personal plunge pools & a great spa.  I
was most entertained by the huge lizards roaming the property attacking fish in
the Koi pond and swimming in the pool to attack unsuspecting doves resting by
the pool side.  (Supposedly smaller relatives of the Komodo dragon
elsewhere in Indonesia).

There are a few caveats to consider if you're thinking about choosing this
resort.

Don't go here if you're looking for a beach resort.  Most of the resort is
actually above a short rocky cliff. (Built on a fairly steep hillside).
 The beach part of the resort requires a short chauffeured golf cart down
a public street to their Coconut Grove compound.    Although it's a
lovely sandy area above a sea wall, the beach is almost inaccessible at high
tide.  There has been so much beach erosion that the stone stairs leading
from the property to the beach itself (about 8 steps) don't actually reach the
sand.  They've placed piles of sand bags at the end of the stairs to
complete the journey.  Worse, is that due to the erosion, high tide brings
huge crashing waves against their sea wall.  You have to time it perfectly
to descend the stairs then sprint about 50 yards to a safer open part of public
beach.  If you don't time it right, a huge crashing wave will pummel you
against the wall & possibly suck you out into the violent surf.  Low
tide is supposedly safer.  Severe erosion problems are evident down the
entire beach of Jimbaran bay.

My advice:  Look elsewhere for a beach vacation, but the Four Seasons is a
great choice for their superb service, lodging, amenities and proximity to the
airport.  There's the convenience of a "no tipping policy" since
a fixed service charge is included with all services & resort fees.
 Food was overpriced & mediocre, tho' B will argue that they serve
good bread and fruit. (I think her standards have fallen because of Timor).

There was definitely the sense that the employees were always trying to up-sell
a particular service, product or menu/bar item.  Reminiscent of a scene
from the movie, "Truman", a smiling person would come over and offer
to clean your sunglasses (an appreciated free service), followed by an awkward
rehearsed pitch that "the cleaning spray is available for purchase in the
gift shop".

My favorite new tip on Southeast Asia is to
consider using Air Asia, a discount Malaysian airline.  When booking
online, the experience was quite frustrating since the low advertised fares
quickly went up with a la carte add-ons. (Baggage, choosing seats, early
boarding, etc...In fact not much different than what US carriers have devolved into).
The prices tho' are cheap compared to US flights.  The amazing part was
that for $35 USD, you can get "red carpet service."  What that entails at the Bali
airport is: special line for check-in, then your ticket agent personally takes
you to a private immigration office for clearance (bypassing all lines) then
escorts you to their private lounge.  Near boarding time, they come to
escort you to the gate, then board you before any boarding announcements are
made.  In fact, he put us on the plane before the arriving flight crew had
a chance to get off the plane!  All that for $35?!!?  Do it.

Due to flight schedules, we stayed overnight at the Crowne
Plaza hotel @ the Singapore
airport (in terminal 3).  It's the nicest airport hotel I've ever been to,
with a great pool, dining & spa.  Terminal 3 has 24 hour dining
options, a huge shopping mall in the lower level, a large kids slide that goes
between different levels of the terminal, and a train that goes to the city
center.

The Cathay flights home were very nice
although the planes/cabins are showing their age.

We just got home & are ready to crash after 28 hours of travel.



Things I Learned and Gear I Tested From this Trip

1. Singapore is perfect place for novice or nervous travelers that want a multi-ethnic, multicultural introduction to Asia.

2. East Timor may be an amazing place to visit for beaches, diving, snorkeling
& Eco-Adventure...in about 10 years.
(Only the truly adventurous should go now, but there are pearls to be found
with some patience and fortitude).

3. I'm OK with Belynda spraying down beds in all lodging with Permethrin, but
I'm less OK with her new ritual of stripping off the bed linens to check for
bedbugs on the mattress.  We found stained disgusting mattresses in every
hotel during our visit (...even the Four Season).  I've decided that I
would rather accept the small risk of bed bug bites than certain knowledge that
my mattress is disgusting.

4. Belynda does have a mental breaking point, (as does everyone).
The important part is if you're able to come back from that dark place. I'll
let you know if or when she does.  (Kidding).

5. Coffee beans that have been ingested then pooped-out by the Civet cat of Indonesia are for sale all over SE Asia at astronomical prices.  For the amount of
tourist shops I saw selling it, there's no way it's all authentic unless
someone is force feeding coffee beans to pissed-off Civets.

6. Beautiful things can be found in bad places. Bad things can be found in
beautiful areas.  You just have to open your eyes.

7.  There are plenty of opportunities to donate your time and skills all
over the world.  Try it.  (It's far more rewarding than donating
online).


Tested Gear for this trip:

SteriPen: Used it on the tap water in Timor
Leste & didn't get sick, so it must work.

Black Diamond Orbit LED Lantern: An amazingly bright/small/lightweight lantern
which worked great during the blackouts in our East Timor
hotel room.

Perfect for tents or emergency lighting.

Fenix LD22 flashlight:  brightest flashlight I've ever seen in a small
package. 2 AA batteries.  Only available from online sites.

Kuhl Tornado Shirt: Quick Drying, very breathable, doesn't wrinkle even after
washing in sink.  Arms a bit tight for anyone with biceps bigger than a
Muppet.

PackTowl nano: A small packable/ absorbent towel slightly bigger than a
bandanna. Pro: very thin & dried quickly after washing. Cons: texture was
too grippy to actually wipe my sweaty head on a hike. It made me feel like I
must have been sweating molasses.   Better for dabbing moisture.


Hope you enjoyed the ride with us!

Jon




 



 


South East Asia

Hi all,
Now seems like a fine time to start typing my travelogue, since I'm currently
in a plane that just made an aborted landing attempt into Dili airport in East Timor.  Should I have my Blackberry on during a
flight approach?...no, but then again, the pilot is the one who changed his
mind to land, so technically we're not landing yet...

So, how did I get here, watching Belynda with a death grip on her arm rest?

 It seems that the only routine thing about where we find inspiration for
a travel destination is that it's never routine. Sometimes, it's a snippet in a
newspaper or magazine, sometimes it's a medical conference, occasionally a
brief TV news clip or TV travel show.  This time, it was...Facebook.

Months ago, I found a nice travel med conference in Singapore. Never been there, but
they tell me it's nice. (To quote Joe Walsh). It sounded a bit sterile &
safe so I decided to peruse some options in the region.  My initial
thought was Myanmar (Burma), but
despite international relations thawing with them, the tour prices were still
astronomical, and the itinerary was still government controlled with financial
kick-backs to the military.
I looked at a few other places in the region, then one teeny little place I saw
on a map caught my eye.
Well, the pilot just announced that he's gonna try landing again, so I'll
continue later... if alive.

Jon

Hi all,

Rewinding back to the planning process; I started to read up on East Timor after I saw the little speck of a country on a
map and was amused at the name of their capitol, "Dili".  (It
elicited some kind of juvenile chuckle.)

While researching the country, I accidentally came across a Facebook page for a
charity clinic/hospital called the Bairo Pite Clinic.  It had some
interesting info and directed me to their website where I learned more about
them and their medical director, who's an American expat physician. After an
email exchange, he invited me to visit, provide some educational help for the
local docs/staff, assist on patient rounds & bring some much needed
medications.

I was sold on the idea, and just needed to convince the wife by showing her
pretty website photos of Timor beaches and
Mountains.  Let's just call it Bait & Switch, which she just realized
a few minutes ago.  More about that later.

The hardest part about the planning process was making hotel/flight
reservations since few hotels had online booking, and very few airlines fly to
Dili plus they have very few flights.  Also, the only guide book for Timor
Leste (its official name) divided the hotel categories into "crap or not
crap".

Packing for the trip was challenging since I had to pack for business casual,
leisure/resort clothes, hiking and clothes for patient care.  I was able
to fit it all in a 22" carry-on wheelie bag. The hard part was packing all the
intravenous antibiotics donated by my office & from Sky Ridge Medical Center.
(Many thanks to the pharmacy and CFO of the hospital!!!)

We opted to pack all 50 pounds of drugs into 2 additional wheelie bags
(22" & 25") to make the load more manageable and so I could have
the wife be a pack-mule.

We had 2 old crappy bags that we intended to leave in E
Timor...if they ever got there.

We made our way to Singapore
on our usual choice of carrier, Cathay Pacific, via San Francisco.  My only update from
prior travelogues is that they moved the Business Class lounge further away
from the gates and no longer have a private entry onto the plane. Flying out
from SFO over LAX is still a good idea since the airport is much easier for
connecting flights, however Cathay flights out of SFO only use a noticeably
aging 747 fleet rather than the more spacious and newer 777's being flown from
LAX. (Business class seating is definitely more spacious on the 777).

The flight & transfer thru Hong Kong'
airport was uneventful.  For those connecting thru HKG, after disembarking
make sure to look for the poorly marked security line that you need to navigate
before proceeding to the terminal & your next flight.

The segment from HKG to Singapore (SIN) was on the 777 with the newer &
more spacious business "pods".  The SIN airport is wonderful,
modern, well-marked and with abundant ATM machines after clearing customs.
 For those of you unaware, Singapore
has some of the strictest laws around, and forbids importation of chewing gum,
prescription sleeping pills, narcotics, valium, Sudafed, & a whole host of
other things I like to use. (Semi-kidding).  You can obtain a waiver to
bring these in for personal use if you apply online thru their Immigration
& Health Service. (10 day advanced notice). I did get a special waiver
& letter to bring all the antibiotics with me. However, I forgot to ask for
a waiver for our personal stash of Ambien & Valium, so we smuggled it in by
putting the pills in bottles labeled Imodium and Pepcid, since the pills look
similar.  Of course, now that I've said that, I can't send out my emails
til after returning thru Singapore
since I suspect someone reading this might take joy in informing Singapore
authorities that I should be caned and cavity-searched.

Next up, the spotless sweltering city of Singapore.

Jon

Singapore 

Hi all,

I'm not sure why Singapore
gets a slightly bad rap for being "just" a large sterile city with
harsh laws. The fact is, it is ultra clean with very punitive laws, such as a
$1000 fine for riding your bike on a pedestrian underpass...but that's part of
what makes it an amazing city to visit, especially for novice travelers to Asia.  Some of the benefits of visiting: The city is
spotless, safer than most American/European cities, fully English-speaking,
great public transportation system, organized w/ great signage, honest citizens
and even taxi drivers, fixed prices (no haggling!), amazing variety of great
food, a safe food & water supply, vibrant safe nightlife and lots of
air-conditioning.  Would I want to move here? No.  The real estate
prices are very high & foreigners can only "own" a 99 year lease.
To control road traffic, car ownership will cost you about $80,000 for a 6 year
old RAV4.  A new BMW 328i will set you back $250,000!!!  For me, the
biggest drawback to living here would be the astronomical cost of doing laundry
& showering, since you are going to sweat...a lot...like a pig...tho' I'm
not really sure if pigs sweat. (I'm from NJ. We wouldn't know such things...)

A good way to acquaint yourself with the city, like many places, is to start
your visit with a Hop-On Hop-Off bus tour.

Singapore has about 4 companies, so look for the details that are important to you.
(Cost, hours of operation, route, bus frequency, etc).

Lodging choices are plentiful in Singapore for any budget. Hotel dining options are outrageously expensive, so travel a short distance to get amazing & reasonably priced food from a local mall, food stall/hawker, or riverside bistro.

A quick tidbit I stumbled upon: At the hotel where I stayed for my conference,
The Grand Copthorne Waterfront, for a slightly higher room price, I was put on
a Club level floor which included unlimited beverages, full breakfast @ the
private Club level lounge, happy hour with unlimited gourmet snacks &
booze, 2 items of laundry per day, and more. Basically, you could minimize any
dining or alcohol costs if you used their services...a great cost savings, even
with the slightly higher room price.  Take home message: When booking
online, don't just look for the lowest priced room. Look for any benefits to
upgrading.

The conference itself: Not too bad & met some nice doc's from around the
globe.  My only gripe: Lots of Australians at the conference with
respiratory tract infections. I can't comment about the medical system Down
Under but it seems like the concept of covering your cough/sneeze hasn't yet
been translated into their textbooks. Another observation, based on evening
strolls along the riverwalk bistros & bars... Alcoholic beverages don't
seem to kill the Aussie virus.

The only odd event in Singapore
occurred while I was at the rooftop swimming pool of the hotel.  A Middle
Eastern family arrived for some pool time. The wife was conservatively covered
and stayed on her lounge chair while Dad & the 3 kids went over to the
pool. The 2 young girls jumped right in, while the young boy (maybe 6) walked
down the steps, disappeared under the water, followed by both hands above the
water kinda flailing, but almost looked like he was just waving a double
bye-bye. There was a bit of an awkward pause, followed by another adult male in
the pool swimming over. Meanwhile the boy's Dad quickly strolled over, but by
no means was he running. (Obviously taught well by pool lifeguards in the
past.). The dad hesitantly walked down the steps & pulled the kid up by his
arm.  I can see where the child learned his excellent swimming skills.
 End result: child was stunned but fine.  Good thing the child didn't
need CPR...I don't even like hugging kids.

More to follow.

Jon

Timor

Hi all,

Sadly, my time in Singapore
came to an end.  It's definitely worth another visit.

The arrival back to the airport didn't quite have an auspicious start since the
friendly greeter asked us for our airline name & flight destination,
causing her to draw a blank, not ever hearing of Air-Timor nor Dili.
 Fortunately, there was a huge jumbotron display behind her & we were
able to educate her on some new facts.  Not that she was totally wrong in
her confusion.  At the check-in counter, we figured out that Air-Timor
doesn't actually exist. It's a shell company that charters a plane 3 times a
week from the local Silk Air airline. The plane, agents, flight attendants and
pilots are all from Silk Air, but you can't book a flight thru Silk Air, only
via the Air-Timor website. No...this doesn't make sense to me either.

The flight itself was fine up until where I started this travelogue: With the
plane attempting to land in a severe tropical thunderstorm followed by a sudden
hard acceleration and climb...and an eventual apologetic announcement from the
pilot.  I'm pretty sure "B" may have left a fingernail embedded
in the arm rest.  Oddly, I wasn't scared but actually amused by the
thought that my family in NJ would likely have to draw straws to see who would
claim our bodies from this desolate "paradise".

The Plane landed safely after circling the area for 30 minutes until after the
worst of the storm passed thru.  It's a torrential downpour so the airline
staff were thoughtful enough to give everyone an umbrella to walk down the
stairs and across the tarmac. I've made my way thru the chaotic immigration
which is patrolled by United Nations police. It's nice that each UN member has
their country of origin flag on their sleeves...kinda like a "made in _____"
sticker.  Just coincidentally, most were made in China.

I'm currently in the terminal and the power is out, so the entire plane of
passengers is crowding around the 1 silent luggage carousel. Lucky for us that
we're the only arriving flight today...I'm starting to understand why.

After an hour of waiting for our luggage, we made our way thru immigration (a
$30 entry Visa) followed by Customs where all bags are x-rayed on arrival.
(Something about not bringing weapons into a volatile area, blah blah blah). My
bags all got thru but Belynda got flagged. Her suitcase of medications was
opened by an agitated Timorese screener who presumed we were smuggling
something bad and didn't accept our explanation that these were meds nor did he
care about our letter from the local clinic. Eventually he had a supervisor
review the letter which was finally followed by a smile of understanding from
the head honcho.

After clearing Customs, a taxi driver stalked us until we acquiesced to using
his services. We walked a 100 yards thru the down pour and wading thru
ankle-deep water to get to his cab. Our drive out of the airport was thru
flooded streets with water half way up the tires.

Mud was everywhere and the poverty was just mired in it.

Did I mention how happy & relaxed B looked?  I think she would have
killed me if she wasn't in catatonic shock.  Little did she know, it was
about to get worse.

More to follow.

Jon

Hi all,

After arriving at Hotel Timor, we checked in, or we tried to, since they
couldn't seem to find our reservation.  Fortunately we had a copy of our
online reservation which they gladly accepted. Not that we would have been
turned away since the hotel appeared to be mostly empty. The machine that makes
the magnetic room cards was "temporarily broken" so the receptionist
asked if she could bring us to the room with her Master Keycard & bring us
our cards later. Without any other choice, we happily accepted that option. Our
walk to the room was up one flight (no elevator) and accompanied by 2 baton
wielding security guards. Once in the room, all of our bags were piled high on
a bench, while the receptionist took a spray can of insecticide and sprayed down
the floors, walls and furniture.  They left us alone in the dingy room
with Belynda repeating over and over, "I hate you. I hate you. I hate
you..."

Did I mention Belynda soon discovered the hotel doesn't have hot water while
she was in the shower? "I hate you. I hate you. I hate you..."

After cooling down, we went downstairs & suffered thru a cold beer while
sitting in what appeared to be a " smoking-only" bar.  It was
filled with Portuguese & Australian businessmen, expats, NGO workers &
UN workers...all of whom seemed to smoke. The scene was like something out of a
bad Film Noir or Spy Novel.  Since the hotel offered wireless internet, we
tried to log-on but needed a code. I went to the front desk to get said code,
but was informed that it would cost $15 for 2 hours or $50 for 10 hrs. I was a
bit shocked by the costs so I left empty handed.  After a few more minutes
in the smoky bar with B getting progressively more miserable, I offered her a
compromise. If the weather or our experience at the clinic tomorrow was bad,
then we would try to find the first flight out to Bali, Singapore...anywhere.
 We went back to the reception desk to pay for the 10 hours of internet so
we could search for flights & to kill some time web-surfing.
 Unfortunately, like the room card machine, "The internet is broken.
Come back later." (I wish they would have mentioned this to me the first time I
inquired! Grrrr!). Well, there went B's early escape plan followed by "I
hate you. I hate you. I hate you...)

More to follow.

Jon


Hi all,

We survived our first night in East Timor with
the help of Ambien, Valium & Heineken. Best sleep I've had in a while.
 I think I'll call this cocktail "Dutch AmbiValence".

We got an early taxi today for the Bairo Pite Clinic with our 2 suitcases of
drugs in tow.  We asked our driver for Bairo Pite Clinic who seemed to
understand and acknowledged our request.  He took us instead to the middle
of the Pite Barrio slum before wondering where to go. We showed him the
clinic's location on the map & received a stare as if he'd never seen a map
before. After some suboptimal communication, he took us to our intended target.
(Most people here only speak Tetun, some Portuguese & occasional
Indonesian. English...not so much). Apparently, he didn't know it as the Bairo
Pite Clinic, but rather as "Dr Daniel". (Referring to the head of the
clinic, Dr Dan Murphy).

Our taxi guy actually got out with us and kindly helped us search the complex
for Dr Dan, then came back to get us at the end of the day, & actually waited
around at least 2 hours until we were done.

Dr Dan was very welcoming & appreciative of our drug donation and offer of
clinical assistance. He whisked us both away to start morning rounds, where we
met up with several medical students from Australia
& the UK.

The next few hours were spent seeing some crazy pathology & mysterious
diagnoses.  I felt like a medical resident again, slapping up the x-rays
on the viewbox, being quizzed by the students and being educated by Dr Dan.
 I got the sense that Dr Dan was testing my knowledge base at first but
then the questions evolved into earnest requests for advice.  Apparently
the clinic has the ability to check creatinine (kidney function), Liver enzymes
& that's about it. There is 1 chest x-ray machine on the island in the main
hospital 30 minutes away. They do have a CT scanner there too, but it's been
broken for 2 years. (A gift from Korea, without tech support.). Some
other crazy things: On the island, there is no ability to culture anything but
they can do simple staining of samples looking for bacteria or TB organisms.
 There is, however, a high tech TB PCR diagnosis machine at this clinic
but the main hospital refuses to send samples or support it. (Politics).
Lastly, nobody on the island can perform a basic CBC (hemoglobin white cells,
platelets, etc) since the island ran out of chemical reagents to run the
machines about a year ago.  Crazy!!!

To cap off the insanity on day 1, as all the students, staff, Belynda and I
followed Dr Dan into a room with 8 beds, he announced that we were now in the
Tuberculosis ward.  No masks, no precautions, just open windows and 2
ceiling fans.  Apparently they ran out of TB isolation masks a long time
ago. When I offered to bring the TB masks over that I had intentionally packed
with our suitcases of drugs, nobody was interested since the med students had
been rounding in this room for the past month or so without protection.
 Belynda's face got all twisted up and I got the expected, yet whispered,
"I hate you, I hate you, I really hate you, I'm gonna kill you if I get
TB...".  You get the idea.

Other fun things I did that day: Surgically incised & drained a large
abscess in the palm down to the bones. Also saw malaria, mysterious masses of
various body parts, tropical pyomyositis, actinomycoses, 10 different
presentations of TB, HIV, malnourished kids, 2 cases massive hepatomegaly of
unknown origin, etc etc.   The only case we were able to get some factual
diagnostic information on was their first case of multi-drug resistant TB.
 The only precautions he had was private room. The windows were open, but
on each side of his room were the malnourished child ward on one side & an
advanced untreated AIDS patient on the other.  Oh, did I mention that none
of the clinic staff wash their hands or have hand sanitizer. Oh, and the first
day I was at the clinic they ran out of all gloves except size extra small.
(Thus all procedures for the rest of the week were performed by female students
w/ really small hands).

By the time Belynda & I got back to the hotel, we were exhausted and
Belynda sheepishly apologized for being shallow when we first arrived into East Timor.  She actually felt we did some good and were able to help some people.

After a crappy dinner in the smoke-filled hotel dining room, we enjoyed our
cold shower and needed less Ambien than the night before.

More to follow.

Jon