Sunday, August 22, 2010
A Saturday Afternoon Bike Ride
It is August 21st today, and we finally had a birth yesterday. I was on second call, so the “baby midwife” as the second midwife is called here. The woman was an young primip, who had developed slightly elevated blood pressure about five weeks ago. She also had proteinurea (for you non-medical types protein in her urine) at 28weeks. Nobody had thought it was significant. A student was taking care of her, which is the norm here, and a senior midwife did each visit with them. The senior midwives are largely southern,and do not speak Inutittut, which is the language that is used for maternity appointments.
Two weeks ago I was asked to help with a visit, which I did, but seeing the blood pressures, insisted on a consult. Blood tests were ordered before the consult, and the student figured out which tubes were needed, and took the blood. (Yes we do our own blood taking here.) So we began checking blood pressure twice a week. This last week however, the blood pressure was high enough to need another consult. We started a more normal, for me course of care...twice weekly blood pressure, once weekly blood tests, and twice weekly NST’s (non stress tests).
There is no fetal monitor here. Non Stress tests are done by using a Doppler and two people, one to count and one to write. The fetal heart is taken for six seconds and then announced, then there is a four second rest. This is repeated for twenty minutes. The writer takes down all the numbers and plots them. When the twenty minutes is up they are joined, and you can get a line that shows if there are accelerations or not.
We did this Thursday, but as her pressures were very labile, we consulted again. The docs said to take her blood pressure again at the end of the day, and if it was high to let them know. It was, so consultation again. The MD’s decided that she should be induced with cervadil that night, and hopefully would go into labour. She was to remain in hospital, but under the care of the nurses, not the midwives, although she was staying in maternity.
This always causes a bit of stress for the nurses. They are not OB nurses, and the hospital is largely chronic care. There are twenty beds, and really is largely extended care. The building provides care for the whole community, but where in some communities there are group homes for seniors, there is not here. The seniors that need help are in the hospital, and so are the handicapped, who cannot be cared for at home. There are also a few beds for the babies and children with lung problems, and others who need to be observed. There is usually no surgery, and when there is, as there was last week, it is very specific. Last week a dentist was here taking out children’s teeth. Apparently they do orthodontics under an anaesthetic as well. (I do not know this for sure but was told that by the Inuit Midwives.)
Anyway, the woman went into labour, and had an extremely precipitous PIH birth. Mainly she went from three centimetres to birth in less than two and a half hours. Of course there were decels, a shoulder dystocia and a PPH. Typical PIH birth and only a little fast for an Inuit primip. But all this was done with no heart monitor, or additional monitoring. (It worries me slightly because I am the senior midwife here in September, and it is not something that I will do. So, there may be some battles with the director or the physicians. Am hoping there is just no more PIH. This is the second case since I have been here, although the other lady was from another community).
When the client was not having so many contractions, first thing in the morning, the student who was working with her said...”maybe we need a little synto” to get her going. Quite cavalier really. Luckily she delivered without oxytocin.
After delivery and overnight a postpartum worker took care of her. Post partum workers are women who take care of the women and baby dyad. They work eight hour shifts, so probably three postpartum workers and one or two trainees took care of this couple.. And there are always numerous family and friends at the maternity as well.
At two this afternoon I went to the maternity to discharge the baby. The first call midwife was already there, having dealt with a miscarriage, and had said she would do the baby as well. She had a different student with her, who really did need more experience, so I decided to leave. Told the other midwife I was going out on the road to the Hudson’s Bay so she gave me the walkie talkie. Apparently the phones do not work out there. Mind you, no cell phones work here. There is talk of getting a company to get them working for the Bay and Ungava coast, but who knows if the rumors are true or not.
She also suggested that I take the bike and go out. What bike?? Turns out there is a bike in the apartment building (six apartments only) that does not belong to anyone, and everyone uses. It seemed like a good idea.
">
Went to the co-op, and got an avocado then back to the apartment. Forgot my camera, but did pick up water and took the walkie talkie, which is large, and headed out. The bike is purple. It matched my hair. The sky was overcast, but it was warm, and thank goodness I only wore my bug shirt. It also saved my arms and back.
As I rode off the realization quickly came as to why this bike was “free”. The gears did not work. Instead of ten or twenty, there are perhaps two gears. Not great for going up and down hills on gravel roads, but better than nothing, and it could take me further than my feet.
I rode through town and out the other side, following the road to the Bay. Before the houses ended, the gravel started, and it is heavy gravel, so the going was a little rough. There were a few bugs, but on the bike they were not noticeable.
I went over the first hill, and then I started to see things. There were mushrooms everywhere. Now fresh picked mushrooms are lovely, usually, but there are some poisonous ones here, and they are red. So, finally I got off the bike, took my water out of the bag I was carrying and started to collect mushrooms. Like all wild mushrooms it is advisable not to take the really big ones, because they have worms and maggots in them. Worms is what are in them here, and in the south you can often find the maggots after the worms.
So I was carefully checking out the mushrooms, and suddenly noticed that the blueberries and blackberries were ripe, so also picked some of them. Now the blueberries and blackberries are the size of small huckleberries, but they grow very close to the ground. I got enough for some youghert, so was happy with that, and about five mushrooms, and four puffballs.
Back on the bike, and riding along, and I suddenly saw little orange aupicks. These are Arctic raspberries, and they are orange in colour when they are ripe. They grow one on a stalk, so at first I thought they were flowers. Each little one is about two inches high and the berry sticks up from the stalk. They are delicious.
Of course while I was picking the berries, the bugs picked me. I realized I was being bitten on the face, but afterwards realized I was bitten inside my ear. It is quite odd to feel yourself being bitten inside your ear canal, and scratching with your finger to find a fly under your nail. Then you know that you are in trouble. Hearing becomes different, and you get a little vertigo as your ear canal closes from swelling.
As I had been riding a number of quads had passed me. They rode down the road and then off on little trails, and the riders were also collecting berries. You could see the quad drive off, slow down and the riders looking for what looked liked good areas. Picking berries here requires only a small container. The size means you are unlikely to get anything close to a bucket, and a small jar of jam can take a whole afternoon of picking. Of course if it is the aupicks, a number go into your mouth as well.
I felt very lucky and turned around to go home. I had not made it as far as the Bay, but had mushrooms, puff balls, aupicks, blueberries and black berries. Then I also noticed the little red mushrooms that were everywhere. I am going to go back and take my camera. There were so many little things to make the camera useful.
Rode home, having a good ride, although not that far really, maybe two or three miles, and got the filthy bike into the building.
Got upstairs and opened my bag. One of the puffballs was past its best and the ride had opened it, and its slimy contents. It went in the garbage. The other two will be my breakfast, with a mushroom as well, sautéed, put on toast with a little cheese grilled on them. And if nobody takes the bike tomorrow, the walkie talkie and camera and I will be repeating this little trip. If the bike is busy, then will have to decide if we are busy enough for me not to go out, as I am still on call. Either way it will be a fun day.
Two weeks ago I was asked to help with a visit, which I did, but seeing the blood pressures, insisted on a consult. Blood tests were ordered before the consult, and the student figured out which tubes were needed, and took the blood. (Yes we do our own blood taking here.) So we began checking blood pressure twice a week. This last week however, the blood pressure was high enough to need another consult. We started a more normal, for me course of care...twice weekly blood pressure, once weekly blood tests, and twice weekly NST’s (non stress tests).
There is no fetal monitor here. Non Stress tests are done by using a Doppler and two people, one to count and one to write. The fetal heart is taken for six seconds and then announced, then there is a four second rest. This is repeated for twenty minutes. The writer takes down all the numbers and plots them. When the twenty minutes is up they are joined, and you can get a line that shows if there are accelerations or not.
We did this Thursday, but as her pressures were very labile, we consulted again. The docs said to take her blood pressure again at the end of the day, and if it was high to let them know. It was, so consultation again. The MD’s decided that she should be induced with cervadil that night, and hopefully would go into labour. She was to remain in hospital, but under the care of the nurses, not the midwives, although she was staying in maternity.
This always causes a bit of stress for the nurses. They are not OB nurses, and the hospital is largely chronic care. There are twenty beds, and really is largely extended care. The building provides care for the whole community, but where in some communities there are group homes for seniors, there is not here. The seniors that need help are in the hospital, and so are the handicapped, who cannot be cared for at home. There are also a few beds for the babies and children with lung problems, and others who need to be observed. There is usually no surgery, and when there is, as there was last week, it is very specific. Last week a dentist was here taking out children’s teeth. Apparently they do orthodontics under an anaesthetic as well. (I do not know this for sure but was told that by the Inuit Midwives.)
Anyway, the woman went into labour, and had an extremely precipitous PIH birth. Mainly she went from three centimetres to birth in less than two and a half hours. Of course there were decels, a shoulder dystocia and a PPH. Typical PIH birth and only a little fast for an Inuit primip. But all this was done with no heart monitor, or additional monitoring. (It worries me slightly because I am the senior midwife here in September, and it is not something that I will do. So, there may be some battles with the director or the physicians. Am hoping there is just no more PIH. This is the second case since I have been here, although the other lady was from another community).
When the client was not having so many contractions, first thing in the morning, the student who was working with her said...”maybe we need a little synto” to get her going. Quite cavalier really. Luckily she delivered without oxytocin.
After delivery and overnight a postpartum worker took care of her. Post partum workers are women who take care of the women and baby dyad. They work eight hour shifts, so probably three postpartum workers and one or two trainees took care of this couple.. And there are always numerous family and friends at the maternity as well.
At two this afternoon I went to the maternity to discharge the baby. The first call midwife was already there, having dealt with a miscarriage, and had said she would do the baby as well. She had a different student with her, who really did need more experience, so I decided to leave. Told the other midwife I was going out on the road to the Hudson’s Bay so she gave me the walkie talkie. Apparently the phones do not work out there. Mind you, no cell phones work here. There is talk of getting a company to get them working for the Bay and Ungava coast, but who knows if the rumors are true or not.
She also suggested that I take the bike and go out. What bike?? Turns out there is a bike in the apartment building (six apartments only) that does not belong to anyone, and everyone uses. It seemed like a good idea.
">
Went to the co-op, and got an avocado then back to the apartment. Forgot my camera, but did pick up water and took the walkie talkie, which is large, and headed out. The bike is purple. It matched my hair. The sky was overcast, but it was warm, and thank goodness I only wore my bug shirt. It also saved my arms and back.
As I rode off the realization quickly came as to why this bike was “free”. The gears did not work. Instead of ten or twenty, there are perhaps two gears. Not great for going up and down hills on gravel roads, but better than nothing, and it could take me further than my feet.
I rode through town and out the other side, following the road to the Bay. Before the houses ended, the gravel started, and it is heavy gravel, so the going was a little rough. There were a few bugs, but on the bike they were not noticeable.
I went over the first hill, and then I started to see things. There were mushrooms everywhere. Now fresh picked mushrooms are lovely, usually, but there are some poisonous ones here, and they are red. So, finally I got off the bike, took my water out of the bag I was carrying and started to collect mushrooms. Like all wild mushrooms it is advisable not to take the really big ones, because they have worms and maggots in them. Worms is what are in them here, and in the south you can often find the maggots after the worms.
So I was carefully checking out the mushrooms, and suddenly noticed that the blueberries and blackberries were ripe, so also picked some of them. Now the blueberries and blackberries are the size of small huckleberries, but they grow very close to the ground. I got enough for some youghert, so was happy with that, and about five mushrooms, and four puffballs.
Back on the bike, and riding along, and I suddenly saw little orange aupicks. These are Arctic raspberries, and they are orange in colour when they are ripe. They grow one on a stalk, so at first I thought they were flowers. Each little one is about two inches high and the berry sticks up from the stalk. They are delicious.
Of course while I was picking the berries, the bugs picked me. I realized I was being bitten on the face, but afterwards realized I was bitten inside my ear. It is quite odd to feel yourself being bitten inside your ear canal, and scratching with your finger to find a fly under your nail. Then you know that you are in trouble. Hearing becomes different, and you get a little vertigo as your ear canal closes from swelling.
As I had been riding a number of quads had passed me. They rode down the road and then off on little trails, and the riders were also collecting berries. You could see the quad drive off, slow down and the riders looking for what looked liked good areas. Picking berries here requires only a small container. The size means you are unlikely to get anything close to a bucket, and a small jar of jam can take a whole afternoon of picking. Of course if it is the aupicks, a number go into your mouth as well.
I felt very lucky and turned around to go home. I had not made it as far as the Bay, but had mushrooms, puff balls, aupicks, blueberries and black berries. Then I also noticed the little red mushrooms that were everywhere. I am going to go back and take my camera. There were so many little things to make the camera useful.
Rode home, having a good ride, although not that far really, maybe two or three miles, and got the filthy bike into the building.
Got upstairs and opened my bag. One of the puffballs was past its best and the ride had opened it, and its slimy contents. It went in the garbage. The other two will be my breakfast, with a mushroom as well, sautéed, put on toast with a little cheese grilled on them. And if nobody takes the bike tomorrow, the walkie talkie and camera and I will be repeating this little trip. If the bike is busy, then will have to decide if we are busy enough for me not to go out, as I am still on call. Either way it will be a fun day.
Monday, August 9, 2010
Welcome to Puvirnituq
<<
Welcome to Puvirnituq
Well maybe, or maybe not. As I sit here, nursing my hot, itchy sore ear and cheek, covered in bug bites, am not sure about the welcome. Have been here a little over a week, and have been here been on call the whole time. Likely we will have a birth tonight or tomorrow, and since I am first on call, it will mean more busy times. At least here we do not have to be at work from 9 to 5 if we have been up all night.
Arriving here was lovely. My camera battery died just prior to getting near to PUV, as Puvirnituq is affectionately called, or POV short for something similar that used to be the town’s name. The amazing thing is all the water, as it seems to be all over the north. In PUV though, you add colour. The water has amazing colours, and as there are drop off s a few metres off all the Islands there are an amazing array of colours in the water.
I did a medevac to Umiujaq, one village below Inukjuak and about an hour, by plane, south of here, and was surprised to see trees. Well, honestly they are not trees as you and I know them, but they were four to six feet tall, and grew in little clusters here and there. Our driver said they had one really big one...about seven to eight feet tall. They were really proud of that tree. It was also very verdant and green in the village. Unfortunately it was also heaving rain, and we were in a rush, so could not take photos. A woman had given birth there, which is not supposed to happen, and I had to check out everything and make sure the 36 week baby was okay.
She was fine and dandy, and had already breastfed by the time we got there.
As we arrived though, we got a call saying we would be heading to Salluit, for another patient, not maternity. So, it was, can you do this as fast as possible please, but at the same time teach the nurses because they will be doing follow up on this Mum and baby, and they have not done it previously. Not surprising as Umiujaq is only 400 people. Their pregnant ladies usually leave at 36 weeks and go to PUV, or somewhere else, to deliver. Some go to Inukjuak as it is closer, and many have relatives living there. (I thought about suggesting we check out their Northern store to see if there was any bread, but since we were in a rush, decided it was not a good idea. Also the Northern was the size of a normal house, so thought their stock might not be so large.)
a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVxzpp51G1S5MEZJJ5A_YsqCuxsyGbEBdlQeGoSNmmML_6XJYpmvVha54UX6hSbObaLWhBjlhRz9PMpGPOvEoSAEUy3vlg5UHLbYlHM5TT0jOMlGtMCLNBGKZlyX2Gpl0OXspMAvoButQ/s1600/medevac+1+9+Umiujaq+terminal.JPG">
We drove back to the airport and were then told that we were taking two more patients from there, as the sched (scheduled flight) had not been able to land there due to weather. Prior to leaving PUV we had also been told we might not be able to land due to weather, but if we did not make it we would go to Kuujjuarapik and get more fuel, then try again on the way back. Luckily we did not do that.
Just before we took off, with the two extra patients with us, the pilot told the nurse that we had to stop off at Inukjuak, for an emergency. Oh well, what is one more person. The weather there was great. Now remember that these villages are about 35 minutes flight time from one another, and PUV is another 35 minutes north of Inukjuak. The weather systems are all different. So, we got into the clouds, and it was amazing to me that instruments can tell you where you are, because the whole flight seemed the same...in the middle of fog. But we successfully took off and landed several times that day. Inukjuak was quite nice, once we were under the clouds, and we landed without incident, picked up a patient on a stretcher and their escort and were off to PUV. The nurse was also told that there was no way they could land at Salluit, due to weather.
Well, as I started to say, it is amazing the differences a few miles make to the plant life in this region. Inukjuak is a beautiful green colour. There are masses of berries and grasses, and everything is very green. They also have the beautiful colours of the waters there, and the village itself is between the Inukjuak river and the Hudson’s Bay. It is a town of approximately 1600, with the highest number of people per capita on welfare, in the whole Quebec, according to the Midwives there. And judging from the number of food coupons we gave out there compared to PUV, it is a statement I believe. (There is a food coupon program for pregnant women and nursing mothers up here. I am not sure if it is Quebec wide, but suspect now.)
This time landing in PUV, my camera was at the ready. I snapped pictures and got some beautiful shots of the islands and the water. Lots of reds in the rocks and water colour, but the land is not green as it is further south. Everything here is much browner, despite the rain that has been prevalent since I arrived. I was also told by one of the midwives that the bugs were not bad here because the caribou had been through already. She said that when the caribou herd goes through the area, the bugs follow it. Not my personal opinion, as I am wearing my bug shirt, even if everyone thinks it is “cute”.
My previous medevac had been to Salluit. It was in the middle of the night, so did not take my camera, which was quite silly. It is light here by five am, so there were lots of photos that could have been taken and Salluit is truly beautiful. It is on a fjord in between two hills, well, hills if you live in BC, but the people here have said mountains. It is all in your perspective. The sun was rising as we left and it really was beautiful. Only problem with Salluit is the weather, which is very iffy most of the time. Even in summer you can get stuck there for three or four days because of fog, clouds, or the plane just not being able to land.
PUV has two stores, the Northern and the Co-op. Anyone who has been reading my blogs or facebook notes will know that this is the norm here. The Northern is a chain which used to, and may still, belong to the Hudson’s Bay Company. The Co-op’s are stores belonging to the Inuit of each village. In some places they say the Northern is for the southerners and the Co-Op is for the Inuit. I have not found this to be particularly true. Everyone seems to shop in both, depending on what they want. And if you want snack food or pop they both have an amazing variety!
The hospital here is divided into three areas. It has Nursing, the Department, and the Maternity. Nursing is where you go for an appointment, or if you need to see a doctor, although you see a nurse really, and if you are seriously ill, or have some problem that you will need to go south for, you see a doctor. This seems to be similar to Rankin. The doctors are considered the specialists of the south and the nurses are considered the GP’s of the south. There is a lab, a pharmacy, X-rays and usually ultrasound department, and everyone from the whole Hudson’s Bay coast of Quebec comes to this hospital for these services. The Department is the in patient services. I believe they have 20 beds but many are chronic care, and they also have an emergency department. Maternity has three birthing rooms, each with a double bed and chest of drawers. A tray is brought in for a birth that has most of the necessary equipment on it. There is also a clinic room, bathroom, office, storage room and emergency room. There is no baby stuff set up in the birth rooms. If there is a problem you take the baby to the emergency room. They have no EFM’s.
Other villages have health centres that consist of two or more nurses, and doctors either full time or sometimes depending on the size of the community. They seem to handle emergencies, and general health very well. If there is an emergency a plane is sent from PUV to the community, to pick up the patient. They are then screened here, and if necessary, sent by jet to Montreal. There seem to be jets to Montreal every day, but I have been told this seems to be the case right now, but is not in reality true.
I was told by Midwives in Inukjuak that years ago Inukjuak was to have the Hudson’s Bay hospital, but some old men in town thought it was a bad idea. They said they were quite mad at those men because there were now no jobs in that town, and PUV had jobs. PUV is the same size as Inukjuak, but it seems to have more problems as well. Both towns are friendly, but there are more jobs and money here, and it seems, more alcohol, drugs and violence. It may be my perception, and certainly it is nothing like a large town in the south, but the demeanor here is different than in the other villages. Having said that, I am liking it here just as much as in Inukjuak. It has its own flavour and character, as do all the northern villages.
To finish the medevac story, the woman we picked up in Umiujaq was with us til about six thirty that evening, when a Challenger jet came to take her and another patient to Montreal. I got home about seven and was called again at one thirty in the morning to go back to Inukjuak for another patient. The flying isn’t exhausting, but everything around it is. Getting ready, getting equipment, knowing the general information about the patient you are going to get, but not really knowing what you will be doing, and generally flying by the seat of your pants (pun). It does make the work a little more exciting. I am sure that if we have any normal births, (no births so far) it will be even more fun to be here.
So, I am enjoying the wind and rain and sun, the plants and ocean, knowing that by a month from now the temperature will have dropped and we will be experiencing very different weather. The berries will be picked and mushrooms harvested, and everyone will be getting ready for winter. Until then I will just observe all the wonderful changes of the north.
Welcome to Puvirnituq
Well maybe, or maybe not. As I sit here, nursing my hot, itchy sore ear and cheek, covered in bug bites, am not sure about the welcome. Have been here a little over a week, and have been here been on call the whole time. Likely we will have a birth tonight or tomorrow, and since I am first on call, it will mean more busy times. At least here we do not have to be at work from 9 to 5 if we have been up all night.
Arriving here was lovely. My camera battery died just prior to getting near to PUV, as Puvirnituq is affectionately called, or POV short for something similar that used to be the town’s name. The amazing thing is all the water, as it seems to be all over the north. In PUV though, you add colour. The water has amazing colours, and as there are drop off s a few metres off all the Islands there are an amazing array of colours in the water.
I did a medevac to Umiujaq, one village below Inukjuak and about an hour, by plane, south of here, and was surprised to see trees. Well, honestly they are not trees as you and I know them, but they were four to six feet tall, and grew in little clusters here and there. Our driver said they had one really big one...about seven to eight feet tall. They were really proud of that tree. It was also very verdant and green in the village. Unfortunately it was also heaving rain, and we were in a rush, so could not take photos. A woman had given birth there, which is not supposed to happen, and I had to check out everything and make sure the 36 week baby was okay.
She was fine and dandy, and had already breastfed by the time we got there.
As we arrived though, we got a call saying we would be heading to Salluit, for another patient, not maternity. So, it was, can you do this as fast as possible please, but at the same time teach the nurses because they will be doing follow up on this Mum and baby, and they have not done it previously. Not surprising as Umiujaq is only 400 people. Their pregnant ladies usually leave at 36 weeks and go to PUV, or somewhere else, to deliver. Some go to Inukjuak as it is closer, and many have relatives living there. (I thought about suggesting we check out their Northern store to see if there was any bread, but since we were in a rush, decided it was not a good idea. Also the Northern was the size of a normal house, so thought their stock might not be so large.)
a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVxzpp51G1S5MEZJJ5A_YsqCuxsyGbEBdlQeGoSNmmML_6XJYpmvVha54UX6hSbObaLWhBjlhRz9PMpGPOvEoSAEUy3vlg5UHLbYlHM5TT0jOMlGtMCLNBGKZlyX2Gpl0OXspMAvoButQ/s1600/medevac+1+9+Umiujaq+terminal.JPG">
We drove back to the airport and were then told that we were taking two more patients from there, as the sched (scheduled flight) had not been able to land there due to weather. Prior to leaving PUV we had also been told we might not be able to land due to weather, but if we did not make it we would go to Kuujjuarapik and get more fuel, then try again on the way back. Luckily we did not do that.
Just before we took off, with the two extra patients with us, the pilot told the nurse that we had to stop off at Inukjuak, for an emergency. Oh well, what is one more person. The weather there was great. Now remember that these villages are about 35 minutes flight time from one another, and PUV is another 35 minutes north of Inukjuak. The weather systems are all different. So, we got into the clouds, and it was amazing to me that instruments can tell you where you are, because the whole flight seemed the same...in the middle of fog. But we successfully took off and landed several times that day. Inukjuak was quite nice, once we were under the clouds, and we landed without incident, picked up a patient on a stretcher and their escort and were off to PUV. The nurse was also told that there was no way they could land at Salluit, due to weather.
Well, as I started to say, it is amazing the differences a few miles make to the plant life in this region. Inukjuak is a beautiful green colour. There are masses of berries and grasses, and everything is very green. They also have the beautiful colours of the waters there, and the village itself is between the Inukjuak river and the Hudson’s Bay. It is a town of approximately 1600, with the highest number of people per capita on welfare, in the whole Quebec, according to the Midwives there. And judging from the number of food coupons we gave out there compared to PUV, it is a statement I believe. (There is a food coupon program for pregnant women and nursing mothers up here. I am not sure if it is Quebec wide, but suspect now.)
This time landing in PUV, my camera was at the ready. I snapped pictures and got some beautiful shots of the islands and the water. Lots of reds in the rocks and water colour, but the land is not green as it is further south. Everything here is much browner, despite the rain that has been prevalent since I arrived. I was also told by one of the midwives that the bugs were not bad here because the caribou had been through already. She said that when the caribou herd goes through the area, the bugs follow it. Not my personal opinion, as I am wearing my bug shirt, even if everyone thinks it is “cute”.
My previous medevac had been to Salluit. It was in the middle of the night, so did not take my camera, which was quite silly. It is light here by five am, so there were lots of photos that could have been taken and Salluit is truly beautiful. It is on a fjord in between two hills, well, hills if you live in BC, but the people here have said mountains. It is all in your perspective. The sun was rising as we left and it really was beautiful. Only problem with Salluit is the weather, which is very iffy most of the time. Even in summer you can get stuck there for three or four days because of fog, clouds, or the plane just not being able to land.
PUV has two stores, the Northern and the Co-op. Anyone who has been reading my blogs or facebook notes will know that this is the norm here. The Northern is a chain which used to, and may still, belong to the Hudson’s Bay Company. The Co-op’s are stores belonging to the Inuit of each village. In some places they say the Northern is for the southerners and the Co-Op is for the Inuit. I have not found this to be particularly true. Everyone seems to shop in both, depending on what they want. And if you want snack food or pop they both have an amazing variety!
The hospital here is divided into three areas. It has Nursing, the Department, and the Maternity. Nursing is where you go for an appointment, or if you need to see a doctor, although you see a nurse really, and if you are seriously ill, or have some problem that you will need to go south for, you see a doctor. This seems to be similar to Rankin. The doctors are considered the specialists of the south and the nurses are considered the GP’s of the south. There is a lab, a pharmacy, X-rays and usually ultrasound department, and everyone from the whole Hudson’s Bay coast of Quebec comes to this hospital for these services. The Department is the in patient services. I believe they have 20 beds but many are chronic care, and they also have an emergency department. Maternity has three birthing rooms, each with a double bed and chest of drawers. A tray is brought in for a birth that has most of the necessary equipment on it. There is also a clinic room, bathroom, office, storage room and emergency room. There is no baby stuff set up in the birth rooms. If there is a problem you take the baby to the emergency room. They have no EFM’s.
Other villages have health centres that consist of two or more nurses, and doctors either full time or sometimes depending on the size of the community. They seem to handle emergencies, and general health very well. If there is an emergency a plane is sent from PUV to the community, to pick up the patient. They are then screened here, and if necessary, sent by jet to Montreal. There seem to be jets to Montreal every day, but I have been told this seems to be the case right now, but is not in reality true.
I was told by Midwives in Inukjuak that years ago Inukjuak was to have the Hudson’s Bay hospital, but some old men in town thought it was a bad idea. They said they were quite mad at those men because there were now no jobs in that town, and PUV had jobs. PUV is the same size as Inukjuak, but it seems to have more problems as well. Both towns are friendly, but there are more jobs and money here, and it seems, more alcohol, drugs and violence. It may be my perception, and certainly it is nothing like a large town in the south, but the demeanor here is different than in the other villages. Having said that, I am liking it here just as much as in Inukjuak. It has its own flavour and character, as do all the northern villages.
To finish the medevac story, the woman we picked up in Umiujaq was with us til about six thirty that evening, when a Challenger jet came to take her and another patient to Montreal. I got home about seven and was called again at one thirty in the morning to go back to Inukjuak for another patient. The flying isn’t exhausting, but everything around it is. Getting ready, getting equipment, knowing the general information about the patient you are going to get, but not really knowing what you will be doing, and generally flying by the seat of your pants (pun). It does make the work a little more exciting. I am sure that if we have any normal births, (no births so far) it will be even more fun to be here.
So, I am enjoying the wind and rain and sun, the plants and ocean, knowing that by a month from now the temperature will have dropped and we will be experiencing very different weather. The berries will be picked and mushrooms harvested, and everyone will be getting ready for winter. Until then I will just observe all the wonderful changes of the north.
Subscribe to:
Posts (Atom)
