Mercy Mission: moments from disaster

Published in Latitudes and Attitudes' magazine, USA, and in 'die Yacht' Germany

It is frightening how one moment we can be in paradise and the next in hell. On our recent cruise to the Louisiades we experienced both. Just when you think everything is going well, Murphy's law steps in. We had a medical emergency on board which tested our resourcefulness and showed us our vulnerability. Next time we travel in remote areas we will be medically better prepared. This is our story. 

Cathy and Eric of Erica were way to the east in the Cavaldos chain, waiting for a weather window to sail to Cairns. Gina and Christian of Caesura and Cate and Rob of Indecision were at the west end also waiting to make the passage back to Australia. The race was on! Each yacht considered they had the ultimate departure location for the best point of sail. We had had great fun crossing from Townsville mostly in sight of each other with humorous radio scheds making the time pass quickly and we were looking forward to the return journey. However, fate stepped in. 

On our regular evening sched just prior to our departure date Gina, concerned about Christain, spoke to Cathy who is a registered nurse. Christian had come back on board after dining on Indecision feeling icy cold with waves of shivers. No, nothing to do with Cate's lovely cooking!

He had an alarmingly high temperature of 39 degrees C with no apparent cause. Anxiety set in as the possibility of contracting Malaria was ever present in our minds because it can be fatal.

As Dr. Deb says in her book, Travelling Well, "untreated malarial fever can cause death within 60 hours, although the average is four days." 

Giving medical advice over the radio saved Christian’s life

Giving medical advice over the radio saved Christian’s life

After a very tense 24 hours with his temperature escalating to the 40s, the cause of the temperature became apparent. A tiny coral cut on his shin showed signs or infection so it was suggested that he start what oral antibiotics were on board, knowing these were not the recommended choice. 

Within 12 hours Christian had swollen and painful lymph glands in his groin, a red streak from the wound and continued high temperature. This showed how even the smallest coral cut should not be left untreated in this environment We now fully realized the magnitude of the seriousness of the situation. Here we were. stuck in a remote place. with no suitable antibiotics, a day's sail from the hospital in Misima and unable to contact them because their communication systems are limited. Possible problems bombarded our minds. With no medical insurance how would we cope with the costs of hospitalisation, an airlift to the mainland or Australia, leaving Caesura in Bwagaoia Harbour, Misima Island, or getting crew to sail her back? All these questions and more added to the anxiety. The consequences that isolation and remoteness can bring hit home hard and showed us clearly how much we took for granted the medical services in our own country. 

On board Erica anxieties were also high. Cathy had a real dilemma giving medical advice by radio without eyeballing the situation. This, together with the bonds of friendship, were the basis of the decision to tum around and make the mercy dash 90 nm back to the Deboyne group. 

As you may imagine, the reunion upon arrival was highly charged with emotion. It was quickly evident that Christian was very unwell and possibly with a disastrous outcome if not treated immediately with the correct antibiotics. The diagnosis was a wound infection, caused by a small coral cut, with cellulitis (infection of the skin tissues) and suspected septicaemia, (bacteria in the blood). 

Cathy realized that intravenous antibiotics were required and the decision to administer them on board in a remote location, with possible side effects, was not taken lightly. Rather than endure an uncomfonable trip to Misima for Christian and delay treatment, it was agreed to administer the drugs immediately. After a series of injections over 24 hours there was noticeable improvement. but we were faced with yet another challenge... he needed more drugs. Our stores bad been depleted. How to get them was our next urgent priority. 

Cathy administering IV antibiotics. Streaks of red are seen from the infected cut.

Cathy administering IV antibiotics. Streaks of red are seen from the infected cut.

After an emotional farewell to Cate and Rob on Indecision, who had to arrive in Hobart by a certain date. We made our second mercy dash, this time taking both Caesura and Erica to Bwagaoia Harbour on Misima Island. Cathy and Gina visited the hospital and spoke to Naomi, a very competent remote nurse practitioner (there is no doctor in the Louisiade Archipelago) and consulted by phone with a doctor on mainland PNG. Our hearts sank as Naomi told us their stores of suitable intravenous antibiotics were compromised, however after further consultation with the doctor on the mainland it was agreed we could purchase their remaining stocks. 

What a relief! But this still was not enough. Oral antibiotics were needed to follow this treatment and the hospital had no supplies of these! Another challenge. 

Be prepared for the worst - especially when sailing in the tropics where infections are more likely to develop.

Be prepared for the worst - especially when sailing in the tropics where infections are more likely to develop.

We arranged with Naomi at the hospital for her brother to bring further supplies with him on the Friday morning flight from Alotau. Just in case this did not eventuate, the next morning on 'Sheila Net' Eric radioed other yachts nearby and was able to source appropriate antibiotics from the yacht Swaggie, 20 nm away at Kamatal Island. This meant a third 'mercy dash' to Kamatal and back before nightfall. 

The drugs arrived on the plane only six hours late, but they meant that Christian was well enough to make the crossing to Cairns only one week later than anticipated; a happy ending to a story fraught with challenges and anxieties. This was a learning time for us. Next year we will not part with our antibiotics to the locals, which depleted our own stocks this year. We will ensure we have the appropriate antibiotics for the most common illnesses and consider the benefits of insurance. We will be prepared for the worst, hoping the best happens.