Warrior Training (18 page)

I took the end of the wick with a set of tweezers and slowly removed it from the wound. Like a multicoloured scarf being pulled from a magician's pocket, the pus-filled wick kept on coming. I cleaned the injury and picked up a fresh wick with a pair of forceps. Holding the wound open, I carefully pushed the forceps into the man's leg, my eyes flicking up to his face as I tried to ascertain how deep the sore penetrated. It wasn't until the forceps were at least three inches inside the man's thigh that he offered a wince.

‘Keep going, mate, you can go a bit deeper,' said the Doc.

If I go any deeper I'll be through the other side
, I thought.

I pushed until the man flinched again. I then began the tedious process of threading the wick into the wound. When it was done I removed my gloves and took a deep breath. ‘That was pretty full-on … you're a tough guy,' I said, nodding my head. I didn't bother to ask the
translator to spell it out; the man could see I was impressed.

Inserting a sterile wick into a man's leg.

That day I treated about a dozen patients, from prescribing half an Asprin to thin the blood of a woman with high blood pressure, to treating otitis externa (pus-filled ears), a fungal infection, food allergies and mastitis. The most difficult patient to diagnose suffered from an array of problems: difficulty breathing, swollen feet and clubbing of fingers (thickening of flesh underneath the fingernails). He also had an enlarged liver and spleen.

‘It's highly likely this guy has HIV that may have progressed into AIDS, but without a blood test there's no way to be sure,' said the Doc. ‘All we can do is treat the symptoms and try to make him feel more comfortable.'

The true extent of HIV on the island was unknown, but according to reports in Dar es Salaam, 60 per cent of all donated blood in the capital was infected with the virus. Because there was no way of determining whether or not someone on Chole Island was HIV positive, it was likely the virus was spreading at an alarming rate. The key was education.

There was one young man who came into the clinic with fluid-filled lungs, a large abdominal tumour and a severe rash over his stomach and lower chest. The lymph glands in his neck, under his arms and in his groin had become so enlarged that two of them had ulcerated the skin and burst.

‘Fenno, what's your diagnosis for this guy?'

‘By the size of his lymph glands, it looks like he has a major infection,' I said, frantically flicking through my
Patrol Med Aide Memoir
.

‘What about the rash?'

I consulted my handbook. ‘I don't know … it fits the description for herpes.'

‘Yeah, it's called herpes zosta. It's a painful rash that can be triggered by a low immune system – a strong indicator that he has AIDS.'

‘Can we tell him we think he has AIDS?' I asked.

‘No, not without confirmation. I would say he has less than three months to live.'

As I looked at the man, my chest felt heavy. I asked him if I could take his picture, and he smiled and nodded his head. He stood still, his hands by his sides, his head tilted slightly to the right. I have since analysed this photo many times and wondered when it was that he died. My eyes are drawn to the burst lymph node on the left side of his neck. I then look at his eyes, which have the stare of someone who has just died. This man knows something pretty bad is going on inside him.

This man knew something pretty bad was going on inside him.

He would have passed away nearly 10 years ago. To most, he is just another statistic, another African nobody who has succumbed to the virus. But during his
examination, I saw a cheeky side to his persona that I liked. For me, this man was real, as real as death. Sometimes when I think I'm having a shit day I recall this sort of experience, which enables me to put things in their right perspective. A shit day, in reality, is usually still a pretty good day.

That evening, Col and I went for a walk around the island. We climbed through the remains of what appeared to be an old German garrison. Just a few walls remained, swallowed by the forest and covered with vines.

The next morning a man came to the clinic with two puncture wounds on his left ankle. He was in the water when he was bitten by a snake. I immediately applied a pressure immobilisation bandage and informed the Doc.

‘Does he feel nauseated or have any stomach cramps?'

‘Not that I'm aware of. He looks fine.'

‘Then it's probably not poisonous. If it was then there's not a lot we could do. He'd be dead before we got him to the mainland.'

‘What, there's no antivenom, not even on Mafia Island?' I asked, almost horrified.

‘Nah, mate, depending on the type of snake and the amount of venom, it will either kill him or it won't. Was the wound bleeding?'

‘No, it was dry.'

‘That's a good sign,' said the Doc. ‘Just keep an eye on him and see how he goes.'

I asked the man to wait outside but when I returned he was gone.

Many children on the island were anaemic and had swollen stomachs. We treated them for worms and prescribed Mebendazole. Malaria was also prevalent. We took a blood sample which we analysed under the microscope. Although the Doc explained it several times, I was flat out focusing the thing, let alone making an accurate
diagnosis. Children were treated with chloroquinne and liquid paracetamol.

One woman regularly came in complaining of seeing smoke in her eyes. It was bizarre but I think she liked me. Her eyes were fine but she did have high blood pressure. We gave her some tablets to lower her blood pressure.
I'm sure I'll see you in a couple of days
, I thought. She was back the next day.

‘I think she likes me.' A woman who complained of smoke-filled eyes.

When I arrived at the centre on 16 January, I saw an elderly man seated in the waiting area. His feet were swollen to an enormous size.
What the freak is going on there?
I thought. The Doc told me the man had elephantiasis. It is caused by a parasite that blocks up the lymphatic system, preventing it from draining.

‘If you catch it early, it's reversible,' said the Doc.

‘What about this guy?'

‘Unfortunately, for him it's too late.'

Running a children's clinic, Chole Island.

It must have been a day for feet, because my next two patients both had deep gashes on their insteps. The first man had been struck by a machete, while the second had had an outboard motor dropped onto his foot. There didn't appear to be any broken bones so we cleaned the wounds and applied steri-strips.

On our second last day the Doc asked if I would like to run a children's clinic.

‘Sure,' I said. ‘It'll be a good way to finish off.'

Mothers and their babies were lined up all over the place. For them it was a special day, and they'd dressed their babies in their brightest, most flamboyant outfits. They looked gorgeous, but after I'd examined 85 of them I shot Col a look that said:
Is 25 too young to get a vasectomy?

My initial motivation for wanting to go to Chole Island was two-fold. I hoped to increase my medical knowledge in order to become a better soldier, and I was after adventure. A deep desire to help others really hadn't entered my
mind. But after spending a couple of weeks with the Doc and Jackie, their sense of humility and service had a big effect on me.

I'm a believer in the saying ‘Hang around what you wish to become'. If you want to be a happy person, stick with people who make you laugh. If you aspire to be a back-stabbing arsehole who never has a good word to say about anyone or anything, then I'm sure there are plenty of people out there who can show you how to get there. The Doc and Jackie were two amazing people who were having an enormous impact on the lives of many. Everyone has goals and dreams for their future, but I don't know too many people who are more driven to help others instead of themselves.

On 23 January Col and I left the island and began our journey north to Arusha. Trying to find the right bus was tough – there were at least 50 jammed in a depot, all parked at different angles with hundreds of people running around yelling. A large African man offered me a challenge.