Nursing at the SIL Ukarumpa Clinic

Nursing in Ukarumpa

Tour of the SIL Clinic




Getting settled in here in Ukarumpa of course means a trip & tour of the medical clinic with Aunt Donna, where she is a nurse. I also believe she does more than just the role of nurse, it looks like social work, physiotherapy, radiography, pharmacy, nurse practitioner all rolled into one. She showed me the medical rooms, dr.’s offices, treatment room, overnight room, casting room, xray room & developing room, lab room complete with microscopes, very well stocked & organized drug rooms, and dental area. I also realized that the SIL members & families use the one side more often and the Ukarumpa village (native PNGs) use the other side. She introduced me and had me assist a wonderful PNG woman to complete a series of lumbar xrays. This particular woman was in a great deal of discomfort & we were trying to determine the source. But throughout it all she was using her English to speak to me (which is truly gracious of her and a sign of respect rather than Tok Pidgin) and asking me questions.

Not surprising, like most medical facilities, this unit is a busy area but due to its well organized layout and clearly excellent, more than competent experienced team members things were running smoothly & efficiently. No surprise there! One aspect that I had not really put together is how when aviation shuts down over the holidays for a greatly deserved and required holiday break, that means no mail in or out. No mail in or out means no labs sent in or out. So really the clinic, the finance, the store, the schools & aviation end up with the holiday break 

I wish I had learned pidgin prior to visiting but I am picking parts of it up, & can understand some of it or at least what the topic of discussion might be 



Aunt Donna has been on call for a great deal of the holidays as we took a 4 day trip to Madang and 2 of her fellow colleagues are away from Ukarumpa (1 to New Zealand for a month, the other taking 6 month furlo to go home to the U.S. for the birth of her first granddaughter). Needless to say that can make things a bit hectic when you are 2 persons short. So over the holidays I tagged along when Aunt Donna’s on-call radio would have a concern that would require going into the clinic. Ukarumpa and the Aiyura valley experienced a bout of bacterial dysentery making its way through the community. Most were coping with it but count on the little ones to get dehydrated and therefore required 3 days worth of daily IM Ceftriazone injections. What troopers! So often was the case that while we were there for our planned injection visits that another call would come in before we headed home. One of the most interesting calls for me was assessing, diagnosing and treatment a young teenager with malaria. Now this was not unfamiliar territory for this gentleman, with a previous history of malaria he nonchalantly admitted to not taking his anti-malarial meds while down in the lowlands (where more susceptible to bites vs the highlands). So after vitals and a head to toe assessment, Aunt Donna taught be how malaria slides are down in the lab room with the electron microscope. From blood draw, slide drying and staining to analyzing the red bloods cells under the microscope and how malaria is confirmed by the number of malaria ‘filled’ red blood cells within the micron field. Very cool!! Indeed this gentleman had malaria so we found what we need for treatment (doxycycline – increased doses and strict regimen that he should have been following anyways). All in a day’s work for Aunt Donna!



Yet another day, I tagged along and helped stain slides this time for a white blood cell count and differential. Now coming from a world of leukemia I do know my white blood cells but somehow it is just cool to analyze red blood cells, white blood cells and platelets under a microscope. Analyzing the granulocytes, neutrophils, eosinophils, basophils, lymphocytes and monophils (haha feel like I am forgetting something perhaps it will come to me) and how the purple stain shades their nuclei and components well it is just neat. The other side of things also helps when you are able to physically count them up on the slide in a 100 count to determine the number and percentage. Needless to say this cute little 8 month old PNG boy we had finger poked for the blood smear slide had high lymphocytes……………….. this nurse says a little infection is brewing. Fun experience to do with your aunt too!!

So Aunt Donna has been on-call a fair amount in the weeks that I have been visiting as different nurses have had vacation and furlow but other than during the day early evening hours to late morning times, there have been few adventuresome calls. Well that changed last night, when Aunt Donna’s on-call radio rang out at a little after midnight. One of the guards in the Guard Dog Security company that provide excellent service to protect and secure the SIL Ukarumpa centre had been hurt, apparently ‘shot’. Now me and my western ways assumed that to be a gunshot of some kind and feared the worst. So Aunt Donna quickly arranged the driver (the on-call nurse is supported with an on-call volunteer driver with a medical truck who picks them up and returns them home as to avoid walking alone in the middle of the night to the clinic, smart if you ask me!!), notified the on-call doctor, Carl, and the fellow training nurse, Hannah, that there was an emergency and to get to the clinic. Now I am not sure if Aunt Donna knew the nature of the call at the time but she quickly found out that the guard had not only been beaten up but ‘shot’ with a wooden spear at close range into his back. Skillfully carrying out her assessment I am sure as Dr. Carl took photos (before and after photos are standard I am told for a lot of things here, especially this type of incident!), Aunt Donna was thankful for many reasons but the placement of the object was in the thick of the man’s meaty flesh of his lower back and only penetrating in about an inch and a half. ‘Shot’ could have been a great deal worst. He had the wooden spear removed and stitched closed, and ordered under rest for several days. All in a night’s work here in Ukarumpa!! Have I mentioned how cool a place this is. Praise be to god for the skill of those responding and caring and prayer for a quick and speedy recovery for this young man.