Impressions of Borneo: Part 2

Photos by Kari Malen
Photos by Kari Malen

Nick 2Dr. Nick Aloisio, a physician at the University of Rochester Medical Center the Seneca Park Zoo Chapter of the American Association of Zoo Keepers sent to Borneo to the Health in Harmony Clinic, has sent new news regarding his travels. Enjoy!

“Klinik ASRI is a place like no place else. A haven where the most caring providers and staff come to work, it provides access to quality medical care to an under-served and impoverished population hidden in this remote corner of the world. The ASRI staff faces daily challenges including lack of medical supplies, limited medications, and at times, even prolonged periods of loss of power. Providers here are challenged, unlike anywhere in America, and are made to prove themselves as true clinicians, using their physical exam skills to reach a diagnosis and select appropriate treatment plans using their eyes, ears and hands. They are experts at the physical exam, an art which seems to have been lost back home, where conclusions are rarely made by clinicians without confirming lab studies, X-rays, or CT scans.

ASRI functions without many of these advanced studies, and yet, their patients appear to get better. Their diagnostic modalities (aside from their skilled exam) are limited to the most basic of bedside blood and urine tests or other studies that can be done by looking through a microscope and counting cells, or describing their appearance. You want a chest X-ray of a patient you think may have pneumonia or tuberculosis? Or you want to the know the electrolyte levels of a patient with kidney failure? You’ll have to ask the patient to drive themselves two or more hours by motorcycle to the nearest facility, pay full-price out-of-pocket for these tests, and then come back. This is after, of course, the patient has already traveled incredible distances, sometimes as far off as six or seven hours on the back of a motorcycle, trekking over unpaved roads, to be seen by a provider with medical training.

And as if that wasn’t enough, they always arrive with a smile. The endless smiles here may be the most remarkable feature of the people I’ve met. Whether they are welcoming you to have lunch with them, introducing you to their family, or instead describing how severe their pain is, or that they cannot afford treatment for their father with terminal colon cancer – they persistently portray a smile. It seems they find contentedness and gratitude in a place where others might feel anger or despair; but not here. And ASRI’s physicians reflect this positive quality as well. Following their medical school education, mostly received in Java, the most metropolitan of the islands in the Indonesian archipelago, these physicians have chosen to serve in this community of need prior to continuing on with their residency training. Years of service in the Klinik ASRI appears to have fostered a very capable set of young physicians. They are thoughtful, thorough, patient, and inquisitive. Though their mastery of the English language varies, this does not obscure their clear mastery of the medical sciences and their clinical skills. I continue to wonder if my input regarding patient work-up and management is helpful or educational, if it isn’t me who is learning the most from our case discussions. Beyond their strong medical knowledge, these special providers also demonstrate exceptional empathy; a caring, patient-focused approach which permeates through this place. It is clear to me that this environment cannot be created by reeducating a facility’s staff, or by simply declaring a set of institutional values. Instead, perhaps this focus and philosophy exists within the people who make a place what it is, or it doesn’t. I am loving my time here in the clinic and am excitedly anticipating next week’s schedule of patients. I don’t doubt that my experience here will continue to alter the lens through which I view the world back home.”

– Nick

First impressions of Borneo

The following are the first impressions of Dr. Nick Aloisio, a physician at the University of Rochester Medical Center the Seneca Park Zoo Chapter of the American Association of Zoo Keepers sent to Borneo to the Health in Harmony Clinic. We hope you enjoy hearing about his travels…

Photo by Kari Malen
Photo by Kari Malen

“After five flights, three taxis, a train and a boat, and over 60 hours of traveling, I’m finally here…

And my first impression is: it was worth it.

I feel like I’ve stumbled onto the pages of one of Michael Crichton’s novels, or maybe this place really is…real. But I guess we’ll see if this mystified feeling wears off after I defeat this jet lag. Truly though, I’m loving this place so far. There are sounds of the forest everywhere; birds, rustling wind, the nearby river and crickets who sound like they’re probably the size of a horse! The vegetation around here is thick, as is the air. Just sitting here, I’m still sweating as bad as when I was hauling 65 pounds of luggage through the Jakarta airport! On the bright side, when I finish with this email, I’ve got a nice cool bucket-bath waiting for me.

I’ve had a brief tour of the clinic, which is inspiring and amazing all by itself. I can’t wait to see it tomorrow when it’s full of patients. And apparently there’s no rest for the weary here – they’re putting me to work bright and early tomorrow! It looks like I’ll be seeing patients side by side with one the Indonesian providers and I believe I’ll be helping to manage their emergency area, if the need arises. I’ll send you guys another update with more impressions about the clinic itself, once I see it all in full action, and pictures too, when I can.

Alright gang. Thank you all for your support in getting me here! I’m so glad I’ve finally made it. Everyone has been super welcoming and friendly so far, and they’re making me confident that I’m going to have a great time; and that the long journey to get here, will be well worth it.

Talk to you again soon.”

– Nick