History Tour

The Windfarm at Woolnorth. NE Tasmania
(The white things in the distance are huge rolls of Hay, not sheep)

I am having a week off for a road trip around Tasmania, an island which according to our Guide on the Arthur River Cruise ( more later ), was originally one big Prison - colonisation of Tasmania began with the establishment of a convict settlement at Port Arthur not long after the first one was established in Sydney, in 1788. Yesterday, overlooking a huge lake in the centre of the island I saw a single grave, a monument to an explorer Pioneer described on his tomb as the "first person" to set eyes on the lake.

Except that there was an Indigenous population here for millennia, ignored by the people who thought they would use the island as "one big prison" and by the Explorer who stupidly believed he was the first "Person" to see the lake.

On the first day of my trip I went to the extreme north western tip of the Island where there is a huge wind farm that I wanted to see. Unfortunately, it can only be visited by Tour groups, and none was running the two days I was in the area, but I drove out there anyway and saw from a distance about 50 of them lined along the cliff tops facing into the roaring 40"s. A notice at the locked gate gave the history of the property they were on, called "Woolnorth", founded in 1829

"Its the kind of place that would defeat most people and yet its here, at Woolnorth Station that one of Australia's oldest companies continues to work the land, turning the grey sands into milk and beef"

The West Coast looking north to the Wind Farm

They make it sound quite magnificent, as all colonial history is meant to sound in Australia, but one clue to another truth is in its name - the property was initially intended to be a sheep station - wool!  It didnt get off to a good start so two things were done to try and keep it afloat - displace the indigenous people from their ancestral homelands, and get rid of the animal that they thought was attacking the sheep, the Tasmanian Tiger.  

What a Beautiful creature 

An extraordinary animal, correctly known as a Thylacine, they disappeared from the mainland of Australia 3000 years ago. They are not a tiger or a wolf but a marsupial, like the kangaroo  the koala and the possum, animals which are almost unique to Australia, and are distinguished by the fact that they give birth to their young at a very early stage of development and then keep them in a pouch, attached to a nipple until they are big enough to live independently. 

But in spite of these measures the business venture was a failure and eventually Woolnorth gave up on sheep. 

And the Tigers?  A bounty was paid for their hides, and inevitably they were hunted to extinction, the last lonely one dying in the Hobart Zoo in 1936. Click here  to see a sad You Tube video of the only known film of a live one. 

And the indigenous people? They were all "deported" to an offshore island (Flinders) and most died of European diseases there.

What a horrible but all too typical story of how indigenous culture and the environment so often are ruined by Capitalist Exploitation. And in a few days its Australia Day, also called Invasion Day by Indigenous activists, but they will get little if any coverage of their feelings about the arrival of Captain Cook in 1770 and of Captain Arthur Phillip and the First Fleet of Convicts on 26th January 1788. Instead it will be wall to wall Flag waving, boozing and a a day off to celebrate.

Eight Thousand Seven Hundred

A Japanese Twister

When I came back from Ethiopia the first time I was 8 kg lighter than when I went three months before.   I was quite pleased to have lost that weight but was amazed at how quickly I regained it all.  I lost a couple when I was in South Sudan last year but again, quickly regained that when I got back - and then some!  My cholesterol and my Blood pressure were borderline when checked, so I have been taking a bit of notice of my weight and my diet over recent months, stimulated also by the attention in the Press to the "Obesity Epidemic" that is overwhelming the west.

I am sure the main cause  of this epidemic is not our sedentary lifestyles, though they are part of the problem,  but the sheer volume of food we eat. Simply put, we eat much more than we need to, and our bodies store the excess kilojoules of energy as fat. We are encouraged to do this by a constant barrage of advertisements for food and drink,  the endless parade of cooking shows and competitions on TV, the Takeaway food industry and the proliferation of "Convenience" foods. Even take-away coffee is served in a huge cup unless you ask for a "small" one - which used to be the standard size. And why is it that people cant watch a movie unless they have a massive bucket full of buttercoated popCorn, a litre of Coke and an ice-cream?

All I actually wanted to write about this time was an advertisement seen dozens of time by anyone watching the test Cricket on TV last week, for a KFC product called a "Twister". Its promoted as a fun tasty snack. I wondered how much of an adults daily recommended energy intake would be supplied by one of these things - so I looked it up.

Now, you need to know one thing, and this is your fact for the week - the average daily energy intake for an adult, is 8700kj (kilojoules) - if you only ate at three meal times that would be 2900kj per meal.
But remember, as we have an obesity epidemic on our hands this average is probably too high. And its much much too high for kids, the ones who are eating this stuff.

I predict that if you ask any one who has seen the Twister ad to guess how significant a contribution one of those would make to their daily energy requirement, they would answer "not much" and generally regard it as a minor food item you consume  to get through to the next proper meal if you're feeling a bit peckish. I haven't asked anyone so I might be wrong but thats my guess.

From a Blog that Compares what they advertise with what you get!

Well, if we are to believe the KFC website, a BLT Twister on its own supplies just over a quarter of your daily energy requirement (2273kj)  It costs $6.95 in Melbourne, but for three more dollars you can get a BLT Twister Combo ( chips and pepsi Max)  and 1000 more kilojoules : 37% of your daily requirement. The Large Combo ( just more chips and more Pepsi ) for two more dollars is 4453kj, just over HALF your daily energy needs! I noticed they also have an enormous amount of salt.

Who would  have guessed these numbers were so high?

Animals are wonderful

As you can see Angora rabbits are very cute fluffy little animals that apparently make good pets :

"People keep angora rabbits for breeding, showing and for their wool. Either way, they are quite docile creatures, very intelligent and make good pets as long as you are prepared to spend some time grooming them. As a result of all this grooming, angoras are used to human contact and react well to being around us."

Ive just followed a link from the NZ Herald website to a video that shows how their long fluffy wool is removed , so it can be made into beautiful soft garments that most of us can't afford.  I probably should have  included the link to the video because it is something many of us probably need to see :  horrifying and distressing cruelty, a naked demonstration of the bastardry and viciousness of human beings towards innocent and defenceless animals.  I couldn't watch all of it.  It is sickening and revolting and utterly appalling : the animal is tied to a board, and the wool ripped off in handfuls, like you would pluck a dead chook, revealing the angry red soft skin underneath, while the rabbit shrieks and cries out pitifully, struggling . And this is repeated every few months. The wool can be cut off but it is worth twice as much if "plucked" because the fibre is longer. 

Apalling cruelty - an image from the video 

And for the sake of what? Personal gain for the grower, luxury and pampering and prestige for the buyer. Is there no limit to the extent we are prepared to go in our need for comfort and status and glamour? How could anyone argue this is not abhorrent?

This video was made in China where 90% of Angora wool comes from. The article reported that several stores in the UK have now refused to sell Angora products, and one has even offered a full refund for any that are returned. I hope more shops follow their lead, but such is the nature of human greed that I doubt this monstrous practice will disappear until its outlawed. 

A Fact for you

Each year human activity currently adds over 30 BILLION TONS of CO2 to the atmosphere.

Thats a staggering amount of anything to be loading into the skies - 30 billion tons!  And as the graph suggests the amount is increasing rapidly. I cannot understand how anyone could assert that 30 billion tons of CO2 couldn't possibly  affect anything, let alone the climate.

What we are struggling to realise in the west is that the Planet is not so vast, or human activity so insignificant that we couldnt destroy it.

Just something to think about.

Things to Look At

Sculpture by the Sea in Sydney

I am not sure if I should be apologizing for the lack of Posts over recent weeks. If I thought that what I was doing would be interesting for others to read about then I would write something, but mostly what I am doing is not, so I don’t. 

But I know what its like to have a few favourite web sites that you click on for updates every so often, and to be disappointed when nothings changed. I don’t like to disappoint visitors to this Blog too often so Ive decided to accept my responsibility as a Blogger to the loyal readers and post something a little more often – maybe once a week?

At present I am in Burnie, a small  city on the northern coast of Tasmania, and I will be here for a couple of months. The hospital is up a steep hill from the coast road and many of the rooms have a sea view, out across the notorious Bass Strait that separates this Island state from the Mainland, 125 miles to the north. Today theres a strong Northwesterly, probably 20 to 25 knots by the look of the whitecaps and the big seas out there.

Later in the week, further east, a fleet of maxis will be racing across the strait in the famous annual Sydney to Hobart yacht race. They leave Sydney Harbor on Boxing day and if the wind stays like this they could do it in record time.

I am doing my usual thing, Obstetrics and Gynaecology , in a modern fully equipped up to date hospital with every modern convenience and no expense spared. It gets boring at times because my role here is to supervise and advise the trainees who are desperate to do just about everything, so I get relegated to being the assistant. One consolation is that late at night, once the tricky part of emergency surgery has been done I can go home and leave them to finish off, and I don’t have to bother with any of the paperwork. 

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Before coming here, I was in my favourite place once again, Darwin. It’s a four and a half hour flight from Sydney, and a 2 hour time difference. One thing I look forward to, on the journey there or back is having a window seat and looking down at the extraordinary patterns and colours of the vast Australian outback. At first glance it looks bleak and orange and empty but if you look much more carefully at it, you see wonderfully intricate patterns and subtle color changes and almost everywhere, remarkably, but far far apart, thin mostly straight lines of tracks roads and fences, a very occasional outstation with an airstrip, and the odd  dam with radiating spidery cattle tracks. Its hypnotizing beauty.

Back in

Sailing in the sand

Sapphire finally went back in the water on Friday afternoon. She had a nice new coat of paint and earlier in the day her name had been stuck on, and she looked very smart. The Radios all worked, the SailMail prescription was renewed and SailMail tested with a GRIB file download of the weather, the new wind instruments I ordered from Australia had arrived and been reattached to the masthead and were working, I had freed up the almost frozen throttle/gear change cable, replaced the batteries, replaced the wrecked sheet winch, had the sail repaired, the dodger cover completely restitched, reattached the Hydrovane with larger bolts and backing plates – the third time !– and all I had left to do was see if the motor would start. And it did – straight away!

I felt the boat sway a little in the water as the travel Lift slings were lowered away and she settled - I felt so relieved at being back on the water. In a few days we would be heading out of the marina at long last, more than a year since arriving…wonderful!

Just before engaging the engine, as always I peered over the stern to look for the exhaust discharging all the rusty water that had been in the motor all that time – and craned over even more when I saw nothing other than a little smoke… “odd” I thought and waited a little longer for something to appear  ….still nothing!

I turned off the motor and went to check the through-hull water intake valve hadn’t been turned off – it hadn’t. But water definitely wasn’t getting through - maybe a bird or wasps or something had made a nest in the intake and blocked it? I shouted up to “Mo” the crane driver  - I would need a tow to my appointed jetty, and then I would sort out the water problem.

So my first journey for the sailing season was a tow by a guy in a tinnie to the other side of the circular marina where I was squeezed in between “Captain Georges” a 45 foot owner-built aluminium monohull from France and “Moonshadow” a beautiful shiny blue 56 footer from London. After tying up with two lines fore and aft I went below to sort out the water problem.

What I soon discovered was that the bearing in the water pump was seized, so I took the  whole pump off the front of the engine and eventually got it turning again. The bearing felt rough and stiff and I guessed would have to be replaced sooner than later, but after  a while I had it turning quite freely, I reassembled the pump and turned the motor on again. And this time? Still no water!

I pulled it all apart again: no it was all ok – but then I looked into the hole that the impellor shaft slots into on the front of the engine – the “slot” looking back at me was broken – there was nothing for the pump shaft to engage into – it had tried to turn against the seized pump and broken itself when the pump refused to budge. And it looked to me that to get at that broken bit you would have to pull half the motor apart! That was Friday afternoon, late, and I had the whole weekend to imagine various ways in which even though it looked impossible to fix simply, there would be a way : maybe a sleeve could be fitted over the broken bit, or maybe a stud could be drilled into it and a new piece fitted over the top like a crown on a broken tooth. There would probably be a special tool that can fit in and pull it out without dismantling the whole engine; even if they did have to dismantle the engine it wouldn’t take long; there would be a simple alternative pump you could use instead; I tidied up the front of the motor to make it easier for them on Monday.

And this morning was Monday. The mechanic came and within 5 seconds he was shaking his head. The motor has to come out! Apparently the bit we are looking in at is the end of a cam shaft that operates all sorts of other timing things  back there inside the motor – if you could pull it out, all these other bits would drop out of position and it would be impossible to put it back….there was no other solution. And the parts might be hard to find….

So I closed the boat up and went for a drive and a coffee. My sailing season was over before it had even started. Bugger!

The Third Installation of the Hydrovane, and new sign writing

Rugby? Yes, but I wont be mentioning the Yachting.

"Grog" = Kava; Very important in Fiji - but I prefer the Icecream

Working at the Hospital in Lautoka was fascinating, challenging and rewarding. In Fiji everyone is incredibly friendly and there is an openness and warmth thats inclusive, and welcoming. When you experince it at the airport or in your holiday resort you might be tempted to think they are making a special effort for Tourists, but no, everyone really is like that, everywhere you go. So I was working in a  very warm and supportive environment with hardworking and fun loving people. The clinical cases were interesting, and I was given the specific task of beginning to develop, support and strengthen the relationship between the Base hospital and the five peripheral subdivisional hospitals. This meant I got to travel about and visit them all, meet the staff, inspect the facilities, conduct training and teaching sessions there, and then provide feedback and make suggestions about where improvements could be made. I also assisted the Regsitrars prepare for their exams by going to their teaching sessions and helping with Mock Exams. This was all quite different to the clinical work I was used to doing, but I did plenty of that as well.

One evening at 8pm when I was on call we received an urgent call from the subdivisional hospital at Sigatoka. A woman had been brought in from a distant barely accessible inland village in shock. It was thought she had a ruptured ectopic pregnancy, a complication of early pregnancy feared for this very reason, that women can suddenly collapse with massive internal bleeding, and die.  She needed urgent surgery, but was too unstable to transfer to Base, and  unfortunately there was no surgeon in Sigatoka. Years ago these little hospitals were staffed by clever old fashioned General Practitioners who could  do that sort of emergency surgery as well as  appendixes and caesareans,  and a few other basic surgical things. Unfortunately however, after a couple of Military Coups there was a massive depletion of trained medical personnel, many of whom were Indo-Fijians  fearing the worst left for Australia and New Zealand. Health services everywhere but especially in the districts took a massive backward step as a result, and they are still trying to recover from it. But the little operating theatres in each hospital are still there, though hardly ever used. The local solution to this awful dilemma is to activate "The Flying Squad". We didn't actually Fly to Sigatoka, we drove, so I suppose it should be called The Driving Squad but that doesn't sound anywhere near as glamorous or exciting.

The Flying Squad  consists of a couple of Theatre nurses, an anaesthetist and a surgeon - in this case, me - who are rapidly assembled and speed off in an Ambulance with lights flashing and siren blaring, taking with them a full set of sterilised theater instruments to the hospital where the patient is. We were supposed to also take blood but I hadnt known then that the subdivisional hospitals have only two or three units and expect us to bring more. Fortunately someone asked me about it as we headed south, but instead of going back we radioed ahead to Nadi Hospital, called in there on the way through and picked up the extra units. It was quite a scary ride, because the road is poorly lit and narrow, cattle and horses are often seen wandering across it, not to mention people and dogs and goats, but we made good time, and maybe ten minutes after arrival we began the surgery, and gave her the extra blood. The ectopic was the worst kind - cornual - but wasnt hard to deal with. We brought her back to Lautoka, arriving at about 2am, and a couple of days later she went home. There have been three deaths from Ectopic pregnancy in this district in the  last year, and about 7000 births - by comparison, in Australia over the three years 2003-2005 there were nearly 750,000 births but only one death from ectopic pregnancy.

The Course Participants at Sigatoka Traing Sessions

Clearly Ectopic pregnancy seems to be a particular problem in Fiji, with a mortality over three hundred times what it is in Australia. Its related to tubal damage from sexually transmitted infections, which occur at very high rates here, but this is not the cause of the excess mortality. The cause relates to what the WHO calls "The Four Delays" - delays in recognising theres a problem, delays in deciding to do something, delays in reaching a healthcare facility, and delays in receiving the correct care.The Four Delays apply to all causes of maternal death. In Australia every woman of reproductive age - say 12 to 50 - who comes to an Emergency Room, gets a Pregnancy test, no matter what the reason for her being there is, and there are usually prominent notices reminding nurses and doctors to do them. The nett result is pregnancies get picked up earlier, ectopic pregnancies are recognised before they have ruptured, and simple laparoscopic surgery usually means they can be cured and go home the next day.

The problem for Fiji is firstly the lack of education about the danger signs - this leads to delays in recognition and in deciding to seek help. The remoteness of many fijian villages contributes to delays in reaching help, and sadly the medical profession here is not as vigilant as it ought to be, so there are additional delays in receiving the correct care. Pregnancy tests are often not done, and thats often because they are not available. The Health budget, indeed the economy generally is not robust enough to supply the thousands of pregnancy test kits that would be needed - so overseas charities have often provided them, but on an inconsistent basis. I suggested to the subdivisional hospitals that they buy a few from the local chemist and recover the cost of each one directly from the patient , but they told me that would contradict the policy of care being free - but will do it anyway! The retail cost is $3.95 but they could get them for a lot less if they bought in bulk from a supplier.

This scenario is repeated at every level throughout the health service in Fiji, and made me realise anew what a massively expensive undertaking it is to develop and maintain a modern health system. There are liquid soap dispensers above many sinks - but they are empty, and so are the paper towel dispensers. Many lab tests become unavailable once the budgeted supply of reagents has been used up,  the recommended tests for diabetes cant be done because the special glucose drinks have all been used up, CTG monitoring paper is in short supply so the midwives run it for ten minutes at a time instead of at least 20, many of the hospital buildings are in need of basic maintenance and in the operating theatre disposable caps and masks are in short supply. We did three laparoscopic cases and then they ran out of the special cleaning fluid for the instruments so couldnt do any more. There isnt the money to run a proper cervical cancer screening program, so I have seen more cervical cancer in six weeks here than I ever saw in all my working life in New Zealand and Australia.  If these women need radiotherapy, its not available in Fiji. No doubt similar budgetary constraints apply in paediatrics and general surgery and medicine.

Anyone coming here from a developed country would probably be shocked - but having worked in Ethiopia and South Sudan I see the glass here as half full, not half empty ( or too big as an engineer once said)  In South Sudan and Ethiopia  most of these tests are NEVER available,  you can't diagnose cervical cancer let alone treat it because there are hardly any doctors, there is NO pathology service, and most of these women would never get to hospital because there are so few roads and so few hospitals.

There is therefore much to admire in what has already been achieved in Fiji. The Doctors and med students and nurses are really hard working, eager to learn and on the lookout for any extra bit of help they can get, but there is still much to be done.

Watching Rugby - very popular here.