Big, fat raindrops. Honestly, it has rained every single day since I've been here. I can hear the smiles spreading across the faces of my good friends back in the UK, but fear not, even though it is raining here, it is still rather hot. The type of hot that requires constant air conditioning. No, but in all seriousness, this is some heavy duty rain that is going on. It's actually quite scary when it is beating on the windows, or when the windscreen wipers of the car are desperately swinging from side to side. The good thing about wearing military uniform is that it makes little difference if it is raining or not; the outfit is camouflaged and the heavy boots, which are oh so flattering, do a grand job of protecting feet from seeping rainfall. Military uniform, combats in particularly, means there is no fear of ruining little suede pumps, or getting splashes on dry-clean only trousers. I'm even beginning to feel quite comfortable in my combats, despite the fact they are ridiculously big, and I feel like I just borrowed a giant's uniform whilst mine are having to be specially made.
On the plus side, the weather is set to get better here in the next two weeks, unlike in Great Britain, which is set to receive a lovely icy blast sent with love, from Russia!
Apart from the rainfall, little else to report. Jet lag is gradually becoming a thing of the past, and I'd like to think that I have acclimatised after a run on the beach, which didn't feel too dissimilar to running in an over-sized sauna. My fear of potential snakes hiding in shallow puddles is subsiding too, as I ran straight into a puddle in the grounds, turning up my music loudly so that I could drown out the fear.
Now might be a good time to write about the country actually.
Apparently, Brunei is the size of Dorset, run by a dictatorial monarchy who has asked for British Military presence to deter any internal coups that might evolve.
The good Sultan Hassanal Bolkiah also pays for the British Army to be here, though the sum was not disclosed to me.
The most obvious thing about being in Brunei is the incredible presence of Shell. They own alot of the land here, and almost everywhere we go, there are these 'nodding donkeys', which are pumpjacks that provide an up/down motion necessary for powering a submersible pump in a borehole. These nodding donkeys are EVERYWHERE. You could be driving along, admiring the lovely, manicured lawn of the (Shell) Golf club, only to see this nodding donkey right bang in the middle. Or, on a tour of the garrison, and looking out to see the helipad, and a safe distance away will be, yep, a nodding donkey.
Brunei is rich in oil and gas, and it is this commodity, which allows the sultanate to provide the population with good living standards that includes free health care, schooling, scholarships abroad, subsidised living and very cheap fuel. In fact, 1 litre of fuel in Brunei is half the price of 1 litre of water.
It's also a sober country in more ways than one. Respectful of their religion, there is no alcohol in the country apart from in the military and Shell compounds. No clubs, bars, discotheques or beauty contests in the country exist either and if there are more than 10 people meeting in one place, a special permission is required for this, although this may in part be an effort to prevent collusions that might result in a coup.
There is however one Bruneian that marked himself out; Prince Jeffri, brother of the Sultan, is now exiled, after allegedly spending £3billion on luxuries such as yachts, (strangely named after women's breasts), gold toothbrushes, hotels, etc. Described as a playboy, the Prince, who was once the finance minster, was said to have struggled on an annual allowance of £500,000 when living in London! Alright for some huh?
To be fair to him though, I think he had in excess of 30 children and 10 wives to support.
There is quite a bit more to write about Brunei, but not done that much research, so shall save it for another time.
My first week is coming to a close, and to be honest, it's all gone so quickly. It's been quite the whirlwind and the surrealism of being amidst the army in a foreign garrison has not quite set in. I've been with a range of GPs, some civilian and one military. Their practice is so varied that sometimes it's a little confusing to work out what is idiosyncratic and what is not.
One thing that I am struggling with is the plethora of abbreviations and acronyms. Whilst I feel like I'm just beginning to understand the language that is medicine, along comes a new language that is altogether impossible to decipher. It's not just the language that is a challenge, it's knowing signs and insignias, and understanding ranks, and companies, and uniform, etc. I suspect it's a matter of time and experience (something that has been said to me time and time again in medicine) but the truth of the matter is, this does not appear to have much logic, nor is their a key text that I can use for reference. Or is there, and have I just not found out about it yet?
Well, the weekend starts early here, to be precise at exactly 1200 hours. I suppose I ought to go away and start thinking about my ssc objectives, perhaps sit on the veranda back at the mess and occasionally look out to the sea.......
Thursday, 29 January 2009
Wednesday, 28 January 2009
Thwarted plans
Well, when I found out that I was going to be spending three weeks in Brunei with the Army, I had images of me training hard with the officers and Gurkas, early morning physical training (PT) sessions in the seriously hot climate and maybe, just maybe, an afternoon workout after a labourious clinic with one of the regimental/senior medical officers.
No, it hasn't happened. I'm not allowed to do PT sessions till the THIRD week because that is how long it takes to acclimatise. Yes, acclimatise. I initially wanted to 'pah' this guy away when he told me this, then I remembered where I was and who I was talking to and decided against it (though I have a sneaky suspicion that my face may have betrayed my emotions). My pleading to the senior medical officer (who also happens to be my assessor) went unheard. Apparently, it's physiology! Pah!!!!!
In all honesty, I think it might be a good idea, even though I feel seriously left out. I want to do PT, and yes, I want to wake up at 6am to do a birkin march for 4 miles carrying 15kg wearing combats.
Alas, just as the jetlag is leaving, the acclimatisation (or lack of) is setting in. Today was my first full, proper day. I was beyond the confines of the medical centre and taking part in a health fair. This had me nervous because it involved travelling beyond a safe environment where I'm doing clinical work, and in the midst of this enormous event, open not just to the entire garrison, but also, a Director General who was visiting. This meant wearing my uniform without fault, including my beret, and saluting when being saluted to. Bear in my mind that I've had no formal training in any matters military, and the big fuss about the Director General's visit to the Brunei garrison has created (I was banished to my room on Monday night because there was a dinner for him in the Officer's mess) had me literally shaking in my boots. Talking of which, these boots are INCREDIBLY heavy. My legs today feel like I've been carrying 5kg load on each, so perhaps that can be compensation for the lack of PT.....
In case any body was wondering, I was saluted to, and I saluted back. It was done as quickly as possible in the hope that any mistakes were too quick to be visualised by the human eye - I think I fooled them!
So the health fair - I was apparently in charge of the sun protection and alcohol stall, which involved me informing anyone that came by about the 'importance of suitable sun protection' (only the Gurka wives were interested - the Gurkas and other officers/soldiers seemingly too hard to take an interest) whilst the alcohol stall involved me quizzing everyone that walked past eyeing up the plethora of bottles that were used as props, about their drinking habits....apparently the 21 units/week is a new concept to 90% of all the soldiers. Rest assured, I was happy to impart the necessary information relating to 'excessive' alcohol consumption. I was particularly pleased to hear the words 'yes ma'am' when I told them to 'keep within the 21 units'. Joy!!!
Talking of alcohol, they like it here, ALOT. Whether it is the weekend or the weekday, there's alcohol of any type. You name it, they have it. My response of 'I'm not a big drinker, especially on a school night (yes, I actually said on a school night) was met by momentary, collective deadly silence, that left me slightly uneasy and darting my eyes from officer to officer in the vain hope that I would come across a pair of understanding eyes. There were none that I could see....
OK, so on to some important stuff. Today was the first day when I got a real taste of Brunei. The weather was inescapably hot. Usually working in air conditioned environment, today's fair was ridiculously humid and stifling and no amount of water helped. It was also the first time that I saw so many Gurkas and their families and it was insightful to see how little of the public health message that we are saturated with in the UK is available to them here.
Another interesting thing about healthcare here is the style of the consultations. When my tutor initially suggested that I look at the different consultations styles employed in the medical centre here for my SSC, I scoffed at the idea, writing back with a declaration that as a student of the Hull York Medical School, I felt quite well versed in the various consultation styles and would rather do some 'real' clinical work. Hmmm. I hate to say this, but I feel like a little humble pie is in order. It is really interesting to see the different ways the GPs here approach consultations. Yesterday, I saw a consultation with a Gurka, a wife of a British soldier, and a British officer. The difference was incredibly overt. The consultation with the Gurka was something akin to that between a school nurse and a notoriously delinquent 14yr old boy, whilst that with the wife was more similar to what we're (usually) accustomed to at HYMS/UK and with the officer, well, it was like me taking a consultation with a friend, very jovial and laid back. When I asked the doctor about it (don't worry, he was a civilian doctor), he said he was completely unaware of it all but subsequently changed his approach to the next Gurka that came in....and turned to ask me if that was better.....Huh? Well, I suppose so.
Another new aspect to the consultations here is the language barrier. The Gurkas are fairly fluent in English (though this wasn't always the case. Up until about 10 years ago, the selection for Gurkas was purely reliant on physical and medical criteria, now, they have to sit a GCSE maths paper and on passing that, a GCSE English paper. If they pass both, they are selected for the physical followed by the medical.) Often, if not exclusively, the Gurkas are selected from rural Nepal, and their wives almost invariably come from the same region where they are not very fluent in English. This makes consultations tricky. The medical centre has two translators, but they are not always available, so the consultations go in one of several ways. The patient uses painfully broken English and the doctor tries to decipher what's wrong...it's not always clear that they have it right until the examination. Or the patient brings her husband, which is not terribly comfortable, because the doctor is usually male and when asking questions directs them to the husband as opposed to the wife. Often the husband answers without asking the wife (and the doctor feels this is acceptable). Rarely, the patient is a child who comes in with their mother and it is the child who translates. Incredibly (and luckily) the children have an excellent command of English, are very good historians and feedback to the mothers about the plan that the doctor has just devised in an impressively mature way. As you can guess, there is no agreement on the management plan; the doctor decides,the patient accepts, whilst I'm sat in the corner shaking my head ever so slightly.
Today was an excellent day, apart from the heat and exhaustion and the piercing headache that resulted from 3 hours sleep and lack of caffeine (stupid mistake on my part) at breakfast. I was so excited about coming back to the Mess to freshen up and what not, when the doctor who was driving me back thought it would be an excellent idea to drive me around 'town'. Please bear in mind that 'town' is the garrison. A very homogenous area of barracks, some new, some old, but nonetheless homogenous. There is also the Shell compound, which looks very similar to the military garrison. This 'tour guide' was not a quick whizz, this was a protracted 45 minute drive, over bumps and potholes, which did nothing but exarcerbate my headache, not only because of the physical commotion, but also because of the intense effort it took to be polite and responsive to the obligatory narrative as we drove around.
On the flip side, I got back before sunset, which meant that I could finish the day off by walking along the beach, with the water lapping my feet as the sun set over the South China sea. Impressive, very impressive. As always, there's a bit of mishap with me. I underestimated the rapidity at which the sun sets in this part of the world. Before I could make it back to the mess, it was almost pitch black, and the mesmirising waves that were initially enticing me, were now very threatening and everytime the waves hit my feet, a little part of me screamed inside. Even worse, as I got back to the grounds and tried to navigate my way through the pitch black, my feet squelched in little puddles that I was told could potentially contain snakes. I did not feel worthy of wearing an army uniform; the scream that was once inside was now an audible whimper. Oh the shame.What would Her Majesty say!
No, it hasn't happened. I'm not allowed to do PT sessions till the THIRD week because that is how long it takes to acclimatise. Yes, acclimatise. I initially wanted to 'pah' this guy away when he told me this, then I remembered where I was and who I was talking to and decided against it (though I have a sneaky suspicion that my face may have betrayed my emotions). My pleading to the senior medical officer (who also happens to be my assessor) went unheard. Apparently, it's physiology! Pah!!!!!
In all honesty, I think it might be a good idea, even though I feel seriously left out. I want to do PT, and yes, I want to wake up at 6am to do a birkin march for 4 miles carrying 15kg wearing combats.
Alas, just as the jetlag is leaving, the acclimatisation (or lack of) is setting in. Today was my first full, proper day. I was beyond the confines of the medical centre and taking part in a health fair. This had me nervous because it involved travelling beyond a safe environment where I'm doing clinical work, and in the midst of this enormous event, open not just to the entire garrison, but also, a Director General who was visiting. This meant wearing my uniform without fault, including my beret, and saluting when being saluted to. Bear in my mind that I've had no formal training in any matters military, and the big fuss about the Director General's visit to the Brunei garrison has created (I was banished to my room on Monday night because there was a dinner for him in the Officer's mess) had me literally shaking in my boots. Talking of which, these boots are INCREDIBLY heavy. My legs today feel like I've been carrying 5kg load on each, so perhaps that can be compensation for the lack of PT.....
In case any body was wondering, I was saluted to, and I saluted back. It was done as quickly as possible in the hope that any mistakes were too quick to be visualised by the human eye - I think I fooled them!
So the health fair - I was apparently in charge of the sun protection and alcohol stall, which involved me informing anyone that came by about the 'importance of suitable sun protection' (only the Gurka wives were interested - the Gurkas and other officers/soldiers seemingly too hard to take an interest) whilst the alcohol stall involved me quizzing everyone that walked past eyeing up the plethora of bottles that were used as props, about their drinking habits....apparently the 21 units/week is a new concept to 90% of all the soldiers. Rest assured, I was happy to impart the necessary information relating to 'excessive' alcohol consumption. I was particularly pleased to hear the words 'yes ma'am' when I told them to 'keep within the 21 units'. Joy!!!
Talking of alcohol, they like it here, ALOT. Whether it is the weekend or the weekday, there's alcohol of any type. You name it, they have it. My response of 'I'm not a big drinker, especially on a school night (yes, I actually said on a school night) was met by momentary, collective deadly silence, that left me slightly uneasy and darting my eyes from officer to officer in the vain hope that I would come across a pair of understanding eyes. There were none that I could see....
OK, so on to some important stuff. Today was the first day when I got a real taste of Brunei. The weather was inescapably hot. Usually working in air conditioned environment, today's fair was ridiculously humid and stifling and no amount of water helped. It was also the first time that I saw so many Gurkas and their families and it was insightful to see how little of the public health message that we are saturated with in the UK is available to them here.
Another interesting thing about healthcare here is the style of the consultations. When my tutor initially suggested that I look at the different consultations styles employed in the medical centre here for my SSC, I scoffed at the idea, writing back with a declaration that as a student of the Hull York Medical School, I felt quite well versed in the various consultation styles and would rather do some 'real' clinical work. Hmmm. I hate to say this, but I feel like a little humble pie is in order. It is really interesting to see the different ways the GPs here approach consultations. Yesterday, I saw a consultation with a Gurka, a wife of a British soldier, and a British officer. The difference was incredibly overt. The consultation with the Gurka was something akin to that between a school nurse and a notoriously delinquent 14yr old boy, whilst that with the wife was more similar to what we're (usually) accustomed to at HYMS/UK and with the officer, well, it was like me taking a consultation with a friend, very jovial and laid back. When I asked the doctor about it (don't worry, he was a civilian doctor), he said he was completely unaware of it all but subsequently changed his approach to the next Gurka that came in....and turned to ask me if that was better.....Huh? Well, I suppose so.
Another new aspect to the consultations here is the language barrier. The Gurkas are fairly fluent in English (though this wasn't always the case. Up until about 10 years ago, the selection for Gurkas was purely reliant on physical and medical criteria, now, they have to sit a GCSE maths paper and on passing that, a GCSE English paper. If they pass both, they are selected for the physical followed by the medical.) Often, if not exclusively, the Gurkas are selected from rural Nepal, and their wives almost invariably come from the same region where they are not very fluent in English. This makes consultations tricky. The medical centre has two translators, but they are not always available, so the consultations go in one of several ways. The patient uses painfully broken English and the doctor tries to decipher what's wrong...it's not always clear that they have it right until the examination. Or the patient brings her husband, which is not terribly comfortable, because the doctor is usually male and when asking questions directs them to the husband as opposed to the wife. Often the husband answers without asking the wife (and the doctor feels this is acceptable). Rarely, the patient is a child who comes in with their mother and it is the child who translates. Incredibly (and luckily) the children have an excellent command of English, are very good historians and feedback to the mothers about the plan that the doctor has just devised in an impressively mature way. As you can guess, there is no agreement on the management plan; the doctor decides,the patient accepts, whilst I'm sat in the corner shaking my head ever so slightly.
Today was an excellent day, apart from the heat and exhaustion and the piercing headache that resulted from 3 hours sleep and lack of caffeine (stupid mistake on my part) at breakfast. I was so excited about coming back to the Mess to freshen up and what not, when the doctor who was driving me back thought it would be an excellent idea to drive me around 'town'. Please bear in mind that 'town' is the garrison. A very homogenous area of barracks, some new, some old, but nonetheless homogenous. There is also the Shell compound, which looks very similar to the military garrison. This 'tour guide' was not a quick whizz, this was a protracted 45 minute drive, over bumps and potholes, which did nothing but exarcerbate my headache, not only because of the physical commotion, but also because of the intense effort it took to be polite and responsive to the obligatory narrative as we drove around.
On the flip side, I got back before sunset, which meant that I could finish the day off by walking along the beach, with the water lapping my feet as the sun set over the South China sea. Impressive, very impressive. As always, there's a bit of mishap with me. I underestimated the rapidity at which the sun sets in this part of the world. Before I could make it back to the mess, it was almost pitch black, and the mesmirising waves that were initially enticing me, were now very threatening and everytime the waves hit my feet, a little part of me screamed inside. Even worse, as I got back to the grounds and tried to navigate my way through the pitch black, my feet squelched in little puddles that I was told could potentially contain snakes. I did not feel worthy of wearing an army uniform; the scream that was once inside was now an audible whimper. Oh the shame.What would Her Majesty say!
Monday, 26 January 2009
Brunei Darussalam
That is the official name of the country and I'm safely in the confines of the officer's mess now as I battle jet lag and a general sense of feeling overwhelmed.
All is well; flight was long though all in all not bad at all especially since I managed to sleep a few hours.
This is not going to be the most interesting blog I'm afraid because despite napping for two hours earlier this afternoon, I'm suddenly feeling sleepy again. What's that all about? There is also the slight fear that I will sleep through my alarm and miss the ride to the medical centre. Not good if it happens, not good at all.
Despite this nonsensical rambling, I have one interesting thing to report. On the way to the officer's mess this afternoon, as I sat minding my own business and generally taking in the new environment, I saw a little monkey by the grassy verge. I saw it a few yards away, and as the coach got closer, I realised that my eyes weren't fooling me, it really was a little monkey (am not sure what type of monkey it was, but it was a little monkey for sure). So what, you might say. Well, about 10 yards away, was a small crocodile, or something akin to a crocodile (I'm not good with animal nomenclature as you might have guessed and hence why I'm not studying veterinary medicine) but it was definitely a scaly thing, similarly shaped to a crocodile, complete with tail. OK, now how is this going to work! I suspect that walking at night is a big no no because goodness knows what variety of animals one might come across. I suspect I'll be sleeping with one eye open from tomorow onwards for fear that these creatures might be in the room. Tonight, I'll be sleeping like a very tired and jet lagged little person who spent an inordinate amount of time curled up on an aeroplane seat.
Talking of sleep, the land of nod beckons.
Am sorry for the rambling. More exciting things to report tomorrow no doubt.
All is well; flight was long though all in all not bad at all especially since I managed to sleep a few hours.
This is not going to be the most interesting blog I'm afraid because despite napping for two hours earlier this afternoon, I'm suddenly feeling sleepy again. What's that all about? There is also the slight fear that I will sleep through my alarm and miss the ride to the medical centre. Not good if it happens, not good at all.
Despite this nonsensical rambling, I have one interesting thing to report. On the way to the officer's mess this afternoon, as I sat minding my own business and generally taking in the new environment, I saw a little monkey by the grassy verge. I saw it a few yards away, and as the coach got closer, I realised that my eyes weren't fooling me, it really was a little monkey (am not sure what type of monkey it was, but it was a little monkey for sure). So what, you might say. Well, about 10 yards away, was a small crocodile, or something akin to a crocodile (I'm not good with animal nomenclature as you might have guessed and hence why I'm not studying veterinary medicine) but it was definitely a scaly thing, similarly shaped to a crocodile, complete with tail. OK, now how is this going to work! I suspect that walking at night is a big no no because goodness knows what variety of animals one might come across. I suspect I'll be sleeping with one eye open from tomorow onwards for fear that these creatures might be in the room. Tonight, I'll be sleeping like a very tired and jet lagged little person who spent an inordinate amount of time curled up on an aeroplane seat.
Talking of sleep, the land of nod beckons.
Am sorry for the rambling. More exciting things to report tomorrow no doubt.
Sunday, 25 January 2009
No turning back now...
Well, the day has finally arrived and at 5.45 this morning, when the shrill of the phone alarm rudely went off, this day had come a little too soon for my liking.
Alas, am now sat at a surprisingly busy Terminal 3 at London Heathrow. Imbibing much needed coffee, I'm following suit with the many hi-tech travellers who have their laptops precariously placed on their lap (the name lap-top just became clear to me now), and taking full advantage of the wi-fi.
Not much to report at this stage apart from to say that I'm not feeling terribly nervous (yet) though I am a little apprehensive as to what to expect.
There is the small issue of the 17 hour journey, which ordinarily would have pleased me but I have a sneaky suspicion this isn't going to be the biggest carrier, and short as I am, there is only a certain amount of time that I can sit cross legged without getting impatient or developing serious cramp.
Oh, there is also the fact that when I left the house this morning, it was a blizzard of cold, windy rain and the last thing my tutor emailed me was; 'it is very hot here, hat and sunglasses are required'. I have, unfortunately left the big, floppy and generally unflattering hat my mother put out for me to pack, but am pleased to say that sunglasses are deeply ensconsed in my ridiculously heavy hand-luggage.
This is all rather very strange. This is actually my SSC. The majority of the cohort are in Yorkshire, and rightly doing a spot of revision as an adjunct to their SSC, whilst little miss adventure is sat at the airport on her way to Brunei.....hmm. Perhaps I should have thought this through a little more.......
For those who are reading this and are dubious about the veracity of this SSC, rest assured that my tutor is strict, has high expectations and my luggage is packed with books as well as insect repellant and army boots (yes, I will be in uniform and yes, it is somewhat oversized).
Well, I'm going to make another trip around the duty free shops and resist from making any impulsive purchases that will weigh down my over-burdened shoulders.
Over and out.
Alas, am now sat at a surprisingly busy Terminal 3 at London Heathrow. Imbibing much needed coffee, I'm following suit with the many hi-tech travellers who have their laptops precariously placed on their lap (the name lap-top just became clear to me now), and taking full advantage of the wi-fi.
Not much to report at this stage apart from to say that I'm not feeling terribly nervous (yet) though I am a little apprehensive as to what to expect.
There is the small issue of the 17 hour journey, which ordinarily would have pleased me but I have a sneaky suspicion this isn't going to be the biggest carrier, and short as I am, there is only a certain amount of time that I can sit cross legged without getting impatient or developing serious cramp.
Oh, there is also the fact that when I left the house this morning, it was a blizzard of cold, windy rain and the last thing my tutor emailed me was; 'it is very hot here, hat and sunglasses are required'. I have, unfortunately left the big, floppy and generally unflattering hat my mother put out for me to pack, but am pleased to say that sunglasses are deeply ensconsed in my ridiculously heavy hand-luggage.
This is all rather very strange. This is actually my SSC. The majority of the cohort are in Yorkshire, and rightly doing a spot of revision as an adjunct to their SSC, whilst little miss adventure is sat at the airport on her way to Brunei.....hmm. Perhaps I should have thought this through a little more.......
For those who are reading this and are dubious about the veracity of this SSC, rest assured that my tutor is strict, has high expectations and my luggage is packed with books as well as insect repellant and army boots (yes, I will be in uniform and yes, it is somewhat oversized).
Well, I'm going to make another trip around the duty free shops and resist from making any impulsive purchases that will weigh down my over-burdened shoulders.
Over and out.
Tuesday, 20 January 2009
Preparing for take-off
Well not really, but my long list of to-dos before the impending trip to Brunei is growing decisively shorter, which is just as well because time is running out and panic and excitement beginning to set in.
So the scene is set; uniform ready, proposal form almost done, flight details received, now I just have to do the mental preparation.
Thankfully, it's been a busy couple of weeks, so stress hasn't been an option that I can entertain. There is no time to stress, too much to do and little time as the old adage goes.
Well this was just a test-run. Tune in for more soon, hopefully I'll have more exciting things to report on.
So the scene is set; uniform ready, proposal form almost done, flight details received, now I just have to do the mental preparation.
Thankfully, it's been a busy couple of weeks, so stress hasn't been an option that I can entertain. There is no time to stress, too much to do and little time as the old adage goes.
Well this was just a test-run. Tune in for more soon, hopefully I'll have more exciting things to report on.
Subscribe to:
Posts (Atom)