Taking Care of Business

A brief business update from Palau – I finally got out to Peleliu and was able to give my presentation. Because of the short amount of time I've got left, I'm not going to be able to do the longitudinal follow-up part of my project very well – frustrating, but there's not much I can do about it. The Governor wanted me to find an interpreter before he'd arrange a group meeting, but there's no way I can find an interpreter from the hospital and his office doesn't seem to know anyone on Peleliu who could do the job. However, an extremely busy day in the clinic (probably precipitated by the fact that we didn't make it out the week before) netted me 7 patients for my presentation – I had hoped to get 15 over 4 weeks, so if I can get 10 over 2 weeks, I'll be pretty pleased. When you consider that Peleliu has a population of 500, and maybe 150-200 of those are adults, and that less than half of those have diabetes or hypertension (though more than half are obese), and that I've only personally seen maybe 20-25 unique patients with hypertension/diabetes actually at the clinic, that's not a bad percentage of the patient population. I'm going to give a copy of my materials to the Governor's office if they want to present them and reinforce them at a community meeting (as they had asked permission to do), so there is some chance that the information will eventually reach a greater proportion of the population, but it will have to happen after I leave.

However, I also lined up a second presentation. After the storm last Thursday, I wound up at the hospital mulling my options for getting a working project. Kristen, though she claimed not to have any ideas, as usual wound up pointing me in the right direction – she suggested I talk to Tino, saying he had a youth group I might be able to talk to. So, I went over to Tino's office and sat down. What followed may be the most hectic 30 minutes of my life:

"Tino, I've got a problem."

"Jesse, what's your problem?"

"Tino, I haven't been able to get out to Peleliu for two weeks and I'm running out of time to do my project there."

"Jesse, how can I help?"

"Tino, I need an audience."

"Jesse, I can get you an audience."

"Tino, I need a venue."

"Jesse, I can get you a venue."

He went on to explain about his youth group, which apparently is some diet/exercise educational dealie, and a state-wide program which has a section dedicated to non-communicable diseases, so he figured he could just bill me as the diabetes/HTN part of it. He could spread the word to his youth group, but he also wanted to get some of the older patients in to hear my presentation, so he wanted to talk to the Governor of his state, Ngardmau (Nard-mow, ow as in cow) and get her involved in it. He called the office to see if the Governor was in – she was, but she was leaving in 30 minutes. It was about 3:30 at this time. After a brief moment of indecision, he got up from his seat.

"Umm… where're you going?"

"To get a car. Come on."

We ran over to the public health office, where he borrowed the keys to someone's state car, but failed to ask the license plate or parking lot – instead, he just knew it was a black state car, and we ran around the parking lot trying to open every black state car in the hospital's three parking lots until we just found the right one (which felt pretty shady). Given that we were in a hurry, it would've been more time-efficient just to go back and ask the license plate number and location, but , eh. By 3:40pm, we found the car and were off. He was supposed to have the car back by 4pm – apparently, it's illegal to drive state cars after 4pm without 'a reason.' I thought we had 'a reason.' He didn't. I don't claim to understand the law here. The Governor's office was only a 5 minute drive away, and we hopped out and hurried in. The understanding was that Tino would do the talking, since he's the one who knows 'what's up,' as they say. He greeted the Governor, then started to explain who I was, before just turning and asking me to introduce myself.

"Hello," I began, in a speech I've rehearsed and performed innumerable times, "I'm Jesse, I'm a visiting medical student from the University of Washington, and I'm doing a project on diabetes and high blood pressure for ---"

"That's enough, I'll talk," Tino interrupted, and, somewhat stunned, I meekly shut the hell up and took a seat.

They began to rattle off in Palauan – I'm not sure what was said, but it seemed to work, because the Governor expected me to do my presentation the following week (that would be last week, now) on very little preparation. Tino arranged for it to happen this Tuesday, a week before my departure, giving us some time to get our act together.

While I was sitting and listening to them talk without any ounce of comprehension, one of the girls working at the office glanced over at me,

"You're a U-Dub student?"

I blinked, but, excited that someone knew the good old UofW, I responded enthusiastically, "Yeah!"

"You're from Seattle, then?"

"Yeah, you've been there?"

"I lived there for two years!"

"Best city in the country," I stated objectively.

"I hated it," She replied with a grin.

"…What? Why?" This was the first time I'd met a Palauan who didn't like Seattle or Portland (the two most Palauan-heavy places, apparently), though I'd met many who have said they wouldn't want to live there.

"It rains too much!"

Aghast, I pointed silently at the window, where a veritable typhoon buffeted the glass.

"Well, yeah, but it's different!"

Mark this: Palauans and Floridians both will whine about Seattle's rain, but refuse to acknowledge their own.

A quick drive back to the hospital got the car back at 4:03pm and completed a whirlwind of activity that wound up arranging for a second presentation for me – a back-up in case Peleliu wound up a bust. Tino had a variety of changes he wanted to make to my presentation (which was fine, I had a week or so to work on it), and we're getting a couple of BP cuffs/stethoscopes to do blood pressure screenings, as well as a measuring tape and a scale to do BMI screenings, and I dropped some cash on him to help put together water and healthy snacks for the attendees. If there's one thing I've learned in this life, it's that if you want people to show up, you offer free food.

I'm not sure which project I'll wind up doing my poster/abstract on – all of the build-up has been to Peleliu, but if the Ngardmau presentation works out much more cleanly, I may be forced to use it instead, since there's no real way to force both of them onto a single poster. We'll see.