Tuesday, January 22, 2013

Je suis l'externe à Nouméa

Salut à tous et à toutes!

It's currently my second week at the hospital here. I'm with the department of internal medicine here - pretty much means that in the 20 bed ward and in the consultation rooms we see a huge variety of cases that can come under this enormous umbrella (infectious diseases, rheumatology, dermatology, haematology, oncology..) It's a small hospital with branches of cardiology and internal medicine. The 2 main hospitals in Noumea and the private day/elective surgery clinics service all of New Caledonia and its islands, as well as surrounding pacific islands like Wallis. X-rays and ultrasounds are done here but they don't have the facilities for CTs or MRIs. These have to be done at another hospital and so patients are often shuffled around. There are no radiotherapy facilties on the island, so the drs here liase particularly with the haematologists and oncologists at RPA! lots of emails that use google translate, but in the end everyone understands everyone.

There is 1 head honcho, 2 specialists and 2 specialists-to-be (called interns but the system in France is very different ours. They have one year of premed - easy to get into but with a brutal exam at the end. something like a 10% pass rate. Then 6 years of 'undergraduate' med and at the end of the 7 years and depending on their marks/preferences they get into a speciality right out of med school. It takes 3 years to be a GP and then 4-5 years to be a specialist. As a med student, I'm an 'externe' who is doing her 'externat' and once you finish med school and are in your speciality training you're an 'interne' doing his/her 'internat'. I'm pretty much the only student here because all New Caledonian med students have to complete their studies in (European) France or more specifically 'en metropole' (since NC is actually a French island like Mauritius or Reunion Island).

Things were pretty damn challenging at first - everything was going so fast and I couldn't catch a thing!
There are a lot of words that are similar (thank goodness), words that are different (many many many) and words that are 'faux amis' - words with different meanings in different languages - the bane of all learners of any language! for example - a 'ganglion' in french is actually a lymph node (rather than part of the nervous system)! Rx stands for X-Ray instead of treatment. Things are getting better day by day and for the most part I can catch what is going on, even if I don't speak a lot. Taking histories is suddenly 100x more difficult, I lose all structure!

Half the cases during my first week were due to dengue fever (there's a seasonal outbreak atm), then lots of diabetes (patient compliance with meds and treatment is very poor here), classic scleroderma, spondylosis, haematological cancers, terminal neoplasia, lots of gout and polyarthritis due to rheumatic fever. Idiopathic thrombocytopenic purpura that was refractory to corticosteroids, rituximab (anti-CD20) and splenectomy! A Jehovas' witness who agreed to imunoglobulin therapy in the event of a significant bleed after a very very low platelet count (normally you can't transfuse any products into their blood but since the IVIg is completely synthetic..)

In total, has been very challenging but interesting and cool! I went horse riding with one of the doctors at the hospital this weekend, twas my first time and it was awesome!! so many firsts on this trip, woo!

gotta go,
take care folks!

Lifou, a trip of many firsts!



I feel like I winged this whole trip, ahah! On the day I arrived in Nouméa, I pretty much had no solid plans for how to get to Lifou (one of the 3 Loyalty Islands west of NC), who I was going to go with, how I was going to get around the large island, where and how I was going to sleep etc. Everything worked out splendidly, I am especially lucky to have avoided the cyclone that hit the islands the week before!

As I said in my last blog, I stayed at the hostel in Noumea in the hope that I'd meet people I could travel with. I met a lovely couple from Lyon there and they basically adopted me for the week! Quelle chance!

Managed to borrow a tent and snorkelling gear from one of my future housemates, and OOP-LA! I found myself at a camp site in the tribe of Xepenehe (TRÉ-PEN-NÉ-HÉ) in the north west of the island.


  
Lilo Rêve is a play on words - ilôt is a small island and when followed by rêve is a bit like "the little island of dreams" ie Lifou?
These 2 guys are stage lighting technicians from Lyon, 10 months into their year and a half long journey around the world. They've pretty much been camping, caravaning and couchsurfing their way through US, South America and the Pacific (so far). I'm so glad to have bumped into them because they were really welcoming, share everything and really looked out for me.
Lifou is a pretty difficult place to travel to if you're by yourself and if you aren't fluent in French. Everything is done over the phone (only the capital of Lifou has internet) and the only way to get around the island if you don't hire a car is to hitch hike. Pretty much every car or every second car will stop for you if you put your thumb out - a pretty amazing culture/way of life really! It's not recommended for single girls at night, because it's not uncommon for the locals to get drunk and violent after nightfall. On the whole, everybody says bonjour to you, and if you walk past someone's house and you didn't see them, they will call out to you just to wave.  

one of the cats at LiloRêve made me think of the Aristocats' line: "Everybody wants to be a cat, because the cat's the only cat, who knows where it's at!"

apart from showing me how to put up my first tent (or.. my first in about 8 years), my travel buddies showed me how to dehusk and then crack open a coconut with a knife and rock. Took me about half an hour of tearing, pulling and insistence that I do it by myself. coconut trees are everywhere, I think we had one every day as a pre-dinner apéritif haha. the brown ones (above) are sweeter than the green ones that you can cut more easily. 

20 days each month, a cruise ship brings hundreds (thousands) of mostly Australian tourists to Lifou and the island temporarily doubles in population. This also means that it's quite difficult to hitch hike because a lot of the locals take advantage of this and charge tourists to take them to the sites such as Les falaises de Jokin (the Jokin cliffs, pronounced Dokin). After about 1/2-1h of no luck, we decided to turn around when someone picked us up! woo! We had to ask permission from the local chief to go down to the cliffs and swim in the bay. 


the others agreed that the snorkelling at the falaises de Jokin wasn't as good as that at the baie de Jinek so we went there and joined the hundreds of Australian tourists who had come to visit. For some reason they seemed to be very overweight and very bogan. They bought overpriced twisties and coke off the locals (apparently my travel buddies met a girl on the Isle of Pines (another island) who makes 1500 euros per day off them!) 

This is what the Baie de Jinek looks like without heaps of tourists. 






an epic conch with a mollusc inside! 
A beginner's dive is called un baptème in french - a baptism. Neat!  


There are heaps of turtles around. I only managed to see two, but you can see (and touch!) loads of them in the morning or later afternoon if the sea is calm. 



2 well camouflaged clams

There are many of these traditional 'cases' on the island. many people sleep on rolled out mats. My current housemates showed me a picture of a case surrounded by many many marijuana plants - they were told that New Caledonia is second only to Jamaica in terms of weed consumption (or production? not sure). The domestic airport has no regulations/scanners of any sort. You could literally bring anything you want (explosives) on board. 

This is a pretty common site along the roads - colourful hedges. There are a lot of frangipanis and hibiscus here, as well as coconut trees and papaya trees. oh and there are heaps (hundreds) of butterflies - everywhere! it's a bit enchanted at times. 



 There's an empty catholic church about 5 min walk from our camp site in Xepenehe, and behind it is this little tropical secret garden style pathway that leads to this! a huge 20m whole in the ground turned open top jungle. vines everywhere, and a cave with water underneath.


Super impressed by the versatility of coconut trees!



The local town hall in the capital, Wé

Coconut crabs (crabes de cocotier) caught by the people who owned the second campsite that we went to (in Luengoni). To catch them you put a cracked coconut as bait on the ground near coconut trees - normally these crabs have super strong pincers and can crack open a coconut by themselves!  

 
This dog decided to join me in the front of my tent

C and J! lovely french couple who were awesome to me. J said that his moustache tattoo made a lot of kids in South America laugh. We had some interesting conversations with other campers - we had a barbeque with some other french people and some Kanaky people that they invited.

The kanaky culture (native people) is interesting. I only managed to learn a bit, but if you ever get invited into one of their tribes or homes (they often live in thatched huts on the islands), you have to do this thing called a coutume, where you present a gift of money and tobacco wrapped into tissue paper as a sign of respect before you enter the house. they're quite timid people, don't talk much to strangers except to say hello (they'll actually call out to you as you walk past their house), quite dark skinned, lots of kids, no shoes. on the islands, marriages are quite an extended social ritual - so much so that there are 3 months in the year when weddings aren't allowed to occur so that people can just take a break, haha. the month before the wedding is taken up by family members who come to eat and give their blessings. the wedding itself occurs on Mondays, and the following days are full of food as well. it's the groom's family that hosts the weddings/food/costs here. 
They drink this plant root called kava here, it's a bit like alcohol in that it can make you woozy. you're supposed to drink it straight (as a shot) and its effects are potentiated with or by alcohol. apparently it takes like dirt and you want to wash your mouth out afterwards.. so... there was really no incentive for me at all to try this famous drink.

The Champignon or the Mushroom - a rock/island in the middle one of the bays near Luengoni.


These rock formations were outside the Caves of Luengoni. It was all dark inside so photos didn't turn out so well but the caves were amazing! stalactites (organ pipe ones that are in layers) and stalagmites above and below water that was light blue and crystal clear. The pool must have been 6-7m deep and 15-25m long. amazing!

on the whole, Lifou was fantastic. I wasn't sure if I could manage on my own but I'm kinda pleased and proud of myself that I went anyway. a great week off before starting at the hospital! 


Monday, January 7, 2013

Mon français va s'améliorer..!



Dear forgotten travel blog,

Please accept my apologies as I slowly bring you back to life this month with what I’m up to and things I’ve found interesting.

It’s been more than a year since I was last in a non-English speaking country, and I’d forgotten how much there is to learn and absorb as well as how mentally tiring it can be.


This is my first time travelling solo in a place where I have to push myself to be very independent and organised – the convenience of public transport, regular business hours and information at my fingertips are definitely things I’ve taken for granted. I find myself in the position of not having a car (on the islands you have to be >25yo and have had your license for >3y), reliable public transport, a mobile (SIM cards + phone rates are through the roof, and most short term travellers find a telephone box every time they need to call someone) or internet (pre-paid sims don’t really come with internet plans like we have. You buy mobile internet by the hour or by the day. Gone are the days of quick wiki searches at the hospital!). Furthermore, it seems like every budget accommodation place (campsite, tribal lodgings etc) on the islands that I want to travel to don’t have websites. Instead, you have to call for more information, get prices and book. Really testing my French here.


Pushing my way through this new experience has been made so so much easier by my good friend S. She is seriously one of a kind. Having lived in NC for a year, she contacted many of her friends to ask them for favours for me eg to host me when I travel and when I start my placement at the hospital. I’m staying on a couch right near the hospital during my placement, and my new housemates are the best! Really so generous.
L drives me around and cooked me dinner last night, and he doesn't even know me!


I had dinner (these seem to be preceded with ‘un apéro’/aperitif/predinner drinks) with my future housemates (‘colocs’) on my first night. Lots of French as expected, much of which goes over my head because it’s so quick (a lesson for me in not speaking too much, haha). I’m realising more what a small world NC is – this guy I was trying to contact to become travel buddies ended up being at the house party that my friends took me to after dinner! Coincidence!

L, P et N. Engineer and engineers to be + fish they caught themselves!

Nouméa is an interesting place. A somewhat run-down capital - many buildings are from the ~60-70s and have graffiti, shops that sell clothes with an islander twist (in fabric or design) are common and the sidewalks are higgledy-piggledy. The large municipal fruit and vegie market (where there are surprisingly many Vietnamese venders) doesn’t really sell produce that seems very fresh, and the billboards and local announcements seem to be all done with WordArt. For some reason this place reminds me of a Pacific Cuba in that you get this sense of community - there are still new things to discover but that everything is a bit dated. Then again, I’ve never been to Cuba and am drawing from the olden day 1920s/30s/40s impression I have of it.  



The view from the hostel balcony



Interesting graffiti outside the hostel. L says that it doesn’t mean anything (let’s save the ….??) because the remaining word/s may have been scrubbed off. I took the photo mostly because of the angry santa and ‘SCUM POSER’. There’s also slutty xmas bikini girl on the far right (not in picture) which was funny.


One of the night clubs (I haven’t seen the others really, but this one looked a bit Thai to me!) note the kanak (local/native people) street pole in front.

La Place des Cocotiers (Coconut Tree Square)

RE community feel - everyone says bonjour to you on the streets and the transition from the formal ‘vous’ form of the language to the familiar ‘tu’ form occurs remarkably quickly and smoothly. It’s a place where you should ask for help just in case, because everyone is so willing to give it. Today I find myself with a borrowed tent and snorkelling gear to take on my trip to Lifou island, where I’ll be hitch-hiking around the island with a French couple I met at the youth hostel the day I arrived. Hitch-hiking here is apparently safe and very common, though I am only feeling ok with it because I’ll be in a group of three. More to come on that adventure.

Today (my second day), a small group of us (future housemates and couchsurfers) drove down ~1.5h to Yaté in the south of the ‘Grande Terre’ (main island). The scenery is quite different to what we have at home – mountains (of note is Mont Dore), valleys, rivers that flow into a very large dam (Barrage de Yaté) and winding dirt roads. The greenery is more of a may green (rather than the khaki of Australia) - tropical shrubs and trees (palm, fern-trees, mangrove-like ones), and the soil is mostly clay. The latter is quite a feature of the land here because it’s become exposed due to the nickel mines that are dug on the mountainside (as opposed to mines that are huge holes in or under the ground. Another addition to my quickly expanding French vocabulary: éolienne: a windmill, derived from Aeolus, the greek god of wind I’m told.




Mont Dore


20min of hiking led us to this!


Swam in aqua green water with some fish and jumped from those rocks on the right of the waterfall (despite having jumped into lakes/waterfalls a couple of times before, it still takes me FOREVER to build up the courage to jump off. Had to ask L to jump off the 5m ones with me, haha). It was really something. Relaxed, beautiful, some singing, lots of French that I didn’t understand again, but it was great. One of my future colocs, Q,  has a passion for collecting insects – he brought his insect net and spent at least a couple of hours searching for new species of cicadas (les cigales) whilst we were by the water. Unfortunately for him he only found two – he killed them with an insect poison and will pin them on boards and send them to the Museum of Natural History in Paris. Good for him.

So in summary, I have met some great people, seen some great sites, been pushed outside my comfort zone and am otherwise fine.

Have a great day et à bientôt!
x