I've been reluctant to share too many details about the children I'm caring for. Not for lack of interest because we definitely see some perplexing, complicated and even amusing cases. It's mostly to protect their families' privacy. This case from last month will be an exception:
"Dina" (not real name) needed to be medically evacuated for specialty care that we can't offer in Saipan- we have no neurosurgeons, no MRI machine nor a pediatric neurologist. In fact, we have no pediatric specialists- which actually makes my work that much more enriching and exciting: I get to dig deep in my knowledge base and peruse the literature myself in a range of fields that in the mainland I'd refer out- immunology, cardiology, kidney diseases and by far the most prevalent: infectious disease.
This 8yr old was having a progressive illness leading her to go from an adorable, active chatterbox to paralyzed from the neck down over a couple months. We needed to get her to the closest major referral center. As of now, that is Manila, Philippines. To get there is a 45min flight to Guam, then a little under 4h flight to the capital of Philippines. Given the complications, a doctor, nurse and respiratory therapist were to travel with her. As my first air transport that involved moving this young girl between SIX places- I thought it worthwhile to document:
#1: ambulance from the Commonwealth Health Corp. Center, the main hospital of the Commonwealth of the Northern Mariana Islands to the helipad in the south of the island:
#2: Onto the helicopter, continuously "bagging" (manually inflating the breathing bag) as we fly the 1hour, four islands south to Guam.
First island is Tinian, 2nd most populated in CNMI. This is where the South Pacific WWII campaign had its strategic location. At one point, North Field was THE largest and busiest landing strip in the world with war planes taking off or landing every minute. It is also where the plane that had the first atomic bomb launched from.
Second island is "Goat Island" an uninhabited island- except for goats.
Third island is Rota, the smallest of the populated CNMI, known as the 'friendly island' where the reaches of WWII did not touch and so much of the original tropical beauty remains. Nadeah and I will get to see for ourselves next week when we visit for the first time. That small isthmus connects the large part of the island and that 2-tier outcropping known as "wedding cake"
Fourth island is Guam, by far the most visited and commercial of the islands in this chain. The north half of the island is essentially the U.S. military, with its own shops, restaurants and economy- not benefiting the locals who survive off tourism. The massive hotels seen here on the edge of the gorgeous lagoon are the hub of that tourism.
#3: Ambulance from helicopter to the United airplane to Manila (not pictured)
#4: Make shift ICU in the economy section of the plane. The outer 2 seats in 3 rows were folded forward and the stretcher was hoisted over them. We sat in the aisle seat of those 3 rows, working through a curtain. It was half to protect the girl for gawkers eyes and half to protect passengers from the disheartening image of a girl with a breathing tube.
#5: Going through customs, immigration in Manila and getting her on the ambulance to the hospital
#6: Arriving at the hospital around 11pm and giving report to the doctors who will take over her care in the ICU. Also not pictured.
The one update we've gotten from the hospital in Manila is that her condition does not seem reversible at this point, a sad outcome. Unclear if there was anything more we could've done, will have to read the medical reports when she returns to Saipan..
Hope you learned a little more about what my work entails and the neighboring islands now and historically.
