I haven’t really felt well since Fiji, and yesterday I finally went to the doctor to try to get some answers. I’d had several symptoms, but the biggest was malaise and fatigue. Just something as simple as walking a couple of miles, which used to be fun, could be enough to leave me exhausted and give me a good fever until I ate and slept. Lately I’d started getting strange and unpleasant feelings in my stomach as well, and a 10-14 day passage to Australia was no time to have some sort of stomach emergency, so up the hill I went in a local taxi to the Luganville hospital.

The hospital wasn’t quite as desperate and dirty as the one in Tonga, although it was simple. It was a single story with no air conditioning, so the windows were open and the buildings were relatively small with open-air passages and space between them to allow the air to flow through. At reception I just had to provide my name and the $30 US expat consultation fee (about 3.5 times the rate for locals) then take a number and sit on one of the wooden benches in the covered, open-air waiting area. I was second in line, so I got to get up and see the Chinese doctor relatively quickly. I explained things and she had me lay on the table and then pushed down in various places around my abdomen. Apparently it’s only in the US that doctors learn to say things like "Hmmm", "Uh-huuh", and "Okaaay" as they examine you. It always makes me think they’re actually figuring something out as they go, but apparently in Chinese medical school, they don’t learn to ask you to tell them if it hurts, they just start pushing and trust that you’ll let them know if they found anything.

She found a spot to the right of my belly button that hurt and then it was back to the desk and she started filling out a couple papers. She thought malaria was a possibility, so one paper was for a malaria test. I asked her what all the pushing and probing meant and she said that appendicitis was out but that the spot where I was sensitive usually meant worms and than the second piece of paper was for an ultrasound to see what was going on in there. I asked how much the ultrasound would cost, and she laughed. It was covered in the $30 she said and I’d get my money’s worth.

I walked off to the Laboratory door, which was around the corner from the Blood Donor Bleeding room where a gray-haired local in flip-flops, camo shorts, T-shirt, and a white lab coat pricked my finger put the blood on a slide, and told me to come back in 15 minutes for the result of my malaria test. The ultrasound room was in the radiation section, but the ultrasound technician was on leave for a week, so the hospital in the second largest city in Vanuatu was without ultrasound until next week. I stopped by to see the doctor and let her know thinking there must be a work-around, but when I told her, she just had a look on her face like "Uh-oh, what should I do now?" followed by a look of resignation and told me to just get the results of the malaria test.

I waited outside the Laboratory door until the guy stuck his head out and handed me a piece of paper. The result was negative, so it was back to the doctor. She looked a little uncomfortable at having to make a decision without enough information, but as we were leaving the next day, she decided to give me medication to kill parasitic worms. We talked over symptoms again and she decided there were several different parasites it could be. She wrote down a couple of the names and started laughing a nervous, "I’m grossed out" kind of laugh when she told me about the one they called the black devil. "Ugh, black and ugly, eyes, little devil" she said as she drew a little face on the paper on her desk and  then added horns and eyes as though it was a clinical depiction. Wow, I thought, that does seem like a plausible explanation for the way my stomach has been feeling the last few days. Since it takes a stool test to identify some of them (neither of us seemed to keen on that), she gave me one prescription for pills to kill the black devil, one for pills to kill various and sundry parasitic worms, and one for severe abdominal pain killers — "Very strong," she said, which worried me more than finding out I was likely host for the black devil worm.

Check out the Bislamic instructions

All the medication was included in the cost of the consultation. The black devil pills were 2 a day 3 times a day for 7 days, so I started them after dinner that night. All night long my stomach gurgled and bubbled and in the morning the painful spot had moved from the right side of my stomach to the left, so I was optimistic that I might be on the way to recovery. My energy does seem to be coming back, and the condition of my stomach improving daily, so it seems like her guess was right. I hope so.