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Annual Review 2001

by Elisabeth and Hermann Oberli

Dear friends and relatives,

As expected, 2001 has proved to be a difficult year for the Solomon Islands. Though the civil unrest is theoretically over since the warring parties have signed the "Townsville Peace Agreement" in October 2000 which rules and regulates life amongst the different ethnic groups, many problems have not been solved and compromising proves to be very hard for some people here. The more than 500 high powered weapons still at large are not helpful in making the population feel safe. But worst of all is the ailing economy, which affects each and everyone living here. Let me give you a few examples:

The number of unemployed people is soaring, because many businesses had to lay off employees or even close altogether. The government is often unable to pay its employees' salaries on time or at all. Because people don't have any reserves - either in the form of a savings account or in the form of canned goods, rice or other foods - many families face real hardship. Several schools had to close because parents were not able to pay their children's school fees any more. This means that many teachers have lost their jobs because of this. However, the population growth is uncurbed; it is estimated that more than 20'000 children were born since the census of 1999.

At the moment, the Ministry of Finance is closed to the public, because the employees fear the large gatherings of people outside the building on pay-days. Very often Government paycheques bounce back at the banks, because the accounts are empty. If you want to cash a Government's cheque, make sure you are at the bank early, as your chances of getting cash are a little bit higher at 8.30 than at noon. As soon as the account is empty, people are turned down at the tellers.

We have regular and frequent interruptions of power and water. Solomon Electricity Authority can purchase fuel on a "cash for diesel" basis only. This means that they often run out of fuel for the generators if the kitty is empty. The Government ministries owe the company and also the Water Authority millions of dollars in unpaid bills, and private consumers often don't find the means to pay their invoices either, because they don't draw a salary. A true vicious circle! It can make the life of a housewife quite unpleasant at times, but of course this is trivial compared to the problems it causes to the shops and offices in town. It is quite risky to buy frozen food now, because you never know how many times an item has been thawed and re-frozen. I always check ice cream tubs by lifting the lid: if the contents are down to a few centimetres of a solidly frozen block of ice, don't bother! Buy it only if the ice cream adheres to the lid. Vegetables are judged by the size of the lumps in the packets: If they are like hazelnuts, that's ok, if they are the size of golf balls, buy only if you are desperate, if they are like tennis balls, forget the peas and corn kernels!

Last week Goodman Fielders, one of two industrial bakeries in town, closed down its operations. Early in the day the management was approached by a group of armed ex-workers demanding compensation payment for working during the uprising last year, so called "danger allowance". The management decided to give in to the demands in order not to jeopardize any lives. After the men left triumphantly, waving the cheques in front of the other workers, a tumult broke out in the premises and the white workers were threatened to get "kil finis". While the police restored some kind of order, the directors in Australia advised the local management to close down the whole enterprise. 200 people were made redundant on the spot, and the "waitmen" [white men] were out of the country that same afternoon. Maybe it was a bit hasty, but obviously there had been trouble before. So we are now stuck with the Hot Bread Kitchen products which don't taste very nice. Flour is already scarce in town, but I have been able to get a 5-kg bag, so I plan to bake our bread for the next month or so. I hope very much that I can keep the weevils under control and fend off the maggots by freezing the flour in batches overnight before use.

Solomon Airlines are not faring well in these difficult times. Air Vanuatu now operates all international flights, twice weekly to Brisbane and back and once to Nadi, Fiji, and back. Air Niugini offers two flights a week to Port Moresby with quite good connections to Far Eastern hubs and on to Europe. The domestic flights are totally chaotic. The airlines owns five little planes, two "Twin Otters" for 18 people and three "Islanders" for 9 people. Four of these planes are grounded because of mechanical problems. Both Twin Otters need new engines and two of the Islanders are up for major maintenance and overhaul. Of course there is no money to spend on this. One little 9-seater plane services the whole country, but because its reach is fairly limited, the outlying provinces Choiseul, Temotu and Rennell/Bellona have no flights to and from the capital any more. Like in the olden days, travel is by boat now. Some of the grassy runways in Malaita, Western Province and on Guadalcanal are so overgrown that the pilots refuse to land there. If you have to fly, it is a good idea to listen to the Service Messages on the radio every evening at 6.15 and 7.30. You will be told which flights are on the next day and at what time. Being in possession of a ticket with a confirmed seat means absolutely nothing. It took us a while to learn that and we showed up at the airport many a time with rucksack and laptop, only to be told: O sore, plein hem go wan aua eli tode (Oh sorry, the plane has left one hour early today) or: O sore docta, no eni plein disfala wiki (no plane this week).

Despite all this and more, we still like it here and tackle the daily challenges with gusto! Of course, eight years in the tropics may lead to some softening of the brain (and approaching retirement age might have to do something with that softening process as well!), but we still have a lot of fun socializing with our friends here and with visitors from overseas. Sailing on Sundays is always a good way of forgetting the quagmire of an ordinary Honiara week. Last weekend the National Optimist Championships were held, very successfully and with media coverage, and in early January we plan to hold Laser Championships. The junior sailors went to the Oceania Championships for Optimists in Tahiti. Next year we hope to send a team to the Championships in Samoa. Guess who plans to coach the sailors in strange waters there and be their chaperone on foreign soil? - Swimming in the sea has become a bit of a problem here, as all beaches in the vicinity of Honiara have become quite unsafe. Fortunately, many of our friends have wonderful pools in their gardens and we are always welcome to use them when we feel like. We know that the best pools are your friends' pools: all the fun and non of the hassle! The Dive Club has resurfaced after a lengthy period of hibernation. The committee is very active and I try to join in some of the fun there as well.

At the beginning of May we have moved from Naha Ridge where we spent nearly eight years to the East of Honiara. We live now in a house on the Seventh Day Adventist compound. What a change from crowded, noisy, dirty and dusty Naha to the tranquillity of the Mission compound with its wonderfully kept lawns, fruit trees, shrubs and flowers, its myriads of butterflies and birds. The nights are quiet; Saturday is the day of worship for the SDA, and the prohibition of alcohol, cigarettes and betel nuts on the premises for the church members helps a lot to keep the place peaceful and clean. Of course we are not restricted in any way, but try to respect our neighbours' way of life by not giving noisy parties on Friday night and not cart beer crates into the house on the Sabbath.

We did some travelling this year as well. One week was spent in Melbourne and one in Sydney, Hermann both times attending conferences and I having all the fun. I will never forget the climb of the Sydney Harbour Bridge in the afternoon of August 10th. What a spectacular, breathtaking view from there over the city, its beaches and waters, its sprawling suburbs and the Blue Mountains in the background, truly unforgettable. In the summer we spent a few weeks in Europe, bonding again with family and friends. Last month, Hermann flew to Cambodia for a week where he attended the AGM of the Cambodian Surgical Association in Phnom Penh. The friendly people and the beauty of the country impressed him, though the problems there are worse then here.

Last weekend the people in the Solomons have gone to the polls to vote in a new Government. Several political parties have been founded and 327 candidates, the highest number ever, contested the 50 seats in parliament. Even some women have plucked up the courage to stand for election. The results are not altogether to our liking. Promising paradise on earth and handing out of large sums of money, bribes in the form of canoes, outboard motors, free trips on chartered boats, 20 kg bags of rice, building materials etc. etc. during the campaigning has helped some unworthy candidates back into power. A lot will depend on the person of the new Prime Minister who will be elected next week. I think there is a chance for improvement despite all the problems, because people wake up now and realize in what dire straits the country is and that only an honest, incorruptible, hard working Government can pull the Solomon Islands through the present dangerous situation. We all hope and pray that the downwards spiralling of the economy can be halted, that the winding road into a liveable future takes a turn into the right direction, and that there is a light at the end of the tunnel for everybody to see.

For you and for us personally we wish that the year 2002 might be better, more peaceful and more hopeful than this one!

Elisabeth

It's Hermann's turn now:

What's new in the surgical department? My mission with ICRC, originally meant for three months, was prolonged twice to a total of eleven months. At the beginning of the year, I was busy visiting basic clinics at the outskirts of Honiara, to check on patients who could not come into the capital for security reasons. But I also worked at the National Referral Hospital as I had done the seven previous years. Again and again I saw patients with old war injuries who had to wait for treatment over a year. Other, non war-related patients came back to the hospital slowly. The disruption of services on Guadalcanal and Malaita meant often an unbearable amount of suffering and pain for the injured and sick people. The doctors at the hospital were faced with huge problems. Despite the fact that we are in email contact with many specialists all over the world for advice, we often had to find our own solution to medical and surgical problems, because nobody was able to help. In July, I somewhat reluctantly signed another two years' contract with the Government. I felt morally obliged to keep up the services in Orthopaedics and Traumatology at the hospital. Dr Tovosia was still in Lata, Temotu Province, working at the local hospital. He had been threatened by the Malaita Eagles and saw no other way but to abandon his work here and take his family and himself to the remote province for safety reasons.

In July, another Solomon Islander, Dr Patrick Houasia, started his five years' training in Orthopaedics/Traumatology with me. He will do four years here under my or Dr. Tovosia's supervision and spend one year working in an Australian hospital. He is enthusiastic about his work and studies hard in his free time. Mid-year, the local doctor in charge of General Surgery was granted six months leave without pay. The ministry in a curt letter informed me that, as of now, I had to look after General Surgery as well; they assured me of their full support and wished me good luck. So, once again, I am faced daily with the wide spectrum of surgery, ranging from new born babies with congenital deformities, neglected fractures in children (lots of fore arm fractures at present, because it's the mango season!), numerous fresh injuries from traffic accidents, bush knife fighting, gun shots, burns and many more. The treatment of Tuberculosis of joints and bones is an important part of my work and in addition to all that we see abdominal problems galore, including the daily occurrences of appendicitis. Because patients can only come to Honiara by boat, time is often a critical factor and the situation is dreadful for people in pain due to an infection or an injury. It is not unusual for patients nowadays to travel for a week from their home to Honiara, including days of waiting in the bush for transport.

Besides my clinical work, there are other projects in the making: Telepathology on the one hand and the building of a new Fracture Clinic on the other. Telepathology is a most fascinating aspect of modern medicine, especially valuable for remote areas. Thanks to information technology, the expertise of colleagues all over the world can be put into use for us. We have now a little laboratory at the hospital in Honiara and some of our staff was trained in the processing of tissue specimens for histological diagnosis. We put digital pictures of specimens on the Internet and wait for comments and suggestions from pathologists in Europe, USA and Australia. A striking example: A pathologist from Basle, on holiday in Crete, visited an Internet Café there, found our pictures and sent a diagnosis immediately. Building of the new fracture clinic will start in January. We are all looking forward to the solution of our problems regarding space, quiet working environment, comfort for the patients and cleanliness. Both projects are fully funded by the "Verein Medizin im Südpazifik" in Switzerland.

What keeps me here, in a country where it is hot and humid, where everything is covered in rust or mildew in a short time, where frustrations are daily and manifold, where basic necessities are often not available, where I sometimes feel I am the only one pulling the cart while others are holding it back? After more than eight years, I am still intrigued by the diversity of the surgical problems, by the often unconventional way to a solution, by the challenge to make do with our limited resources. And last but not least: after all this time I am still looking forward to go to work every single day. With my best wishes to you all and many thanks for the unwavering support we have experienced again during 2001

Hermann

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