Wadalei is a remote Aid Post on the northern side of Ferguson Island, Milne Bay Province. Ferguson island is very rugged with two steep sided mountainous formations reaching to 5000 feet to the West and East. They are separated by a narrow flat-bottomed valley containing a fresh water lake. It’s inhabited by different warring tribes, many of whom have seen little of the outside world. The aid post near the lake was abandoned due to tribal fighting. The number of mothers who lose their lives in this region of Ferguson is not known, but it is many. Because of this and due to the rugged terrain, distance and tribal fights women are forced to deliver in their village.
We love supporting Wadalei, not only because it’s run by two conscientious community health workers but because the aid post can be the only refuge apart from Kalokalo for women coming from the interior to have their babies. We had been there on several occasions to upskill staff, build a waiting house, renovate the labour room and drop off our Mother and Baby Gifts. The two female community health workers, Priscilla and Lindy, who run the small aid post, do lots of deliveries. We had recommended a hospital delivery for two mothers after conducting an antenatal clinic there in October 2020.
During our ANC we examined 2 women who were ‘high risk’ mothers. One mother, Aileen was pregnant with her eleventh baby and the amount of amniotic fluid surrounding the baby appeared to be excessive (polyhydramnios). This was confirmed with our portable ultrasound. She also had a poor obstetric history having a retained placenta with her 6th delivery followed by four more normal deliveries in the village. Although Alotau is only an 18 hours journey by boat neither she nor her husband had been there before.
After the clinic Kila and I walked to her village a short distance away to discuss the possibility of her having this baby in Alotau. This was to be a casual meeting because I thought it would be hard to convince the couple to travel to Alotau for
delivery and consider family completion anyway. Mothers use their last delivery as a sort of litmus test and Aileen delivered her last four babies without a problem in the village so what was so different with this pregnancy.
They were a happy couple The husband, Lota said he had travelled to Esa’ala (3 hours by dingy) once or twice in his lifetime but he had never been to Alotau. ‘There was no need.’ he said.
It transpired during the course of the discussion they had fears of going to Alotau. Firstly, the family could not afford the boat fare ($15) and secondly, not knowing anyone in town caused them to worry about survival and security.
“We have everything here, I am scared to go to Alotau, I don’t know what the people look like’’, Aileen admitted when we first spoke to her.
We discussed the need to have a supervised delivery in Alotau because of the risks to Aileen associated with polyhydramnios. Kila, Priscilla and Lindy suggested at the same time they may consider family completion after delivery if they wanted it. Aileen was happy with this decision and a casual glance to the husband confirmed his approval not that legally she needed it .
As Kila and I were concerned for Aileen’s safety and the thought that she would get ‘caught’ in the village when close to delivery, we offered to come back at the appropriate time in the Beaver and fly them to Alotau.
This would be an incentive for them to accept the offer I thought. Murphy’s Law often plays a hand in preventing mothers reaching help when they most need it. We have seen enough mothers deliver in their village or AP after being advised to deliver in Alotau and sadly they experience a problem during delivery and die. They are either trapped due to bad weather preventing sea travel, no communication or an abusive husband.
I thought Lota was a capable and good husband and provider although many medical people would criticize him for allowing his wife to go through ten pregnancies. Feeding and educating 10 children in the village is no mean feat. The reality is few men understand the risks associated with pregnancy and delivery and see women giving birth in the village as a normal event. Sadly, woman suffering a complication during pregnancy and losing their life as a result is also considered a sad but normal outcome.
Aileen and Lota both agreed it would be best to have their last baby in Alotau as they thought eleven children was enough. Their elder children would look after the younger ones while they were away. Aileen was now 30 weeks gestation and we thought it safe to depart Wadalei for Alotau at 36 weeks.
The other mother of concern was a short girl of 15 years with a baby at 24 weeks gestation. She would definitely need to deliver in Alotau where a caesarean section could be performed if required.
So we all agreed Kila and I would return in the Beaver and pick up both mothers in 6 weeks’ time. We would keep in regular contact with Lindy, the CHW at Wadalei Aid Post until then. This was possible as although the AP didn’t have a functioning HF radio, the mobile network had recently been installed in the area.
Time was passing on and we were wondering what had happened to the mothers of concern at Wadalei Aid Post. We hadn’t heard anything and sometimes this can mean the mothers have made their way in by boat or they have gone cold on the idea. Worse still the husband may decide it’s too far, too costly and too inconvenient. Worse still, the solar panels powering the batteries near the transmission tower have been stolen and the network is down. Our attempts to phone Lindy at Wadalei had resulted in the usual automatic voice message “This number you have dialled is currently unreachable”
We were at the hangar when finally, a phone call came from Lindy in late December…. “Hi Doc, the young 15- year-old mother has made her way to Alotau with her mother by boat but Aileen is still waiting in the village. Are you going to come?”
This was the ‘signal’ we needed to move.
“Ok tell Aileen and her husband to get ready. We will be there early morning”.
I looked at Kila who was listening to the call on loud speaker. “We have to get this mother otherwise she will die in the village giving birth.”
THOR’s whole mission in life is to reduce the number of women dying in childbirth in PNG. After investigating 31 maternal deaths in Milne Bay you get a ‘sixth sense’ about all this and you see the same scenarios play out time and time again. Your first decision to usually right. In this case ‘deliver in Alotau not Wadalei’ and you just have to make it happen. If you have made a commitment then stick to it.
Wadalei is a 50-minute flight from our Gurney base in good weather. It’s a water landing with the aid post a short walk inland from the water’s edge. That part of coastline is fringed by a shallow ribbon reef which runs parallel and about 30 meters out from a flat sandy beach. There are the occasional small gaps allowing access into the beach and the one most suitable for us I previously noted was marked with a fallen rain tree. You can only see the gap when fairly close to it and there is no room for error in a sea plane as you have no brakes in the water and you can’t reverse if your off line. So the tree marker was sort of reassuring to us that we could get to the beach safely. It would make loading our passengers easier.
This was to be our first time into Wadalei and our plan was to land into the wind and taxi through the gap in the reef marked with the tree. Of course, if this was not possible due to conditions, then the sea anchor would be deployed to hold the Beaver in position and hope our passengers, assessing the situation would quickly mobilise. The weather was forecast to be low cloud with rain showers and a 5-10 knot NNW wind. Not ideal but the wind would ‘sort of’ favour us given the location of the AP on the remote northern side of Ferguson Island.
Kila and I were up at 4am. We had prepared the Beaver the afternoon before and planned an early departure for when the sea conditions and weather are usually at its best although this is not always true.
We gave a quick call to Lindy at Wadalei before departure…
“We are coming now and please be ready. What’s the weather like” Lindy replied ‘Oh rain and low cloud Doctor,’
“Heavy rain or light rain?”
“Light rain, light rain and small wind Doctor” Lindy replied.
“OK we will try”
We departed Gurney at 7am heading east along the coast for East Cape at 500’. climbing over the Owen Stanley Ranges which lie between us and the islands
to the north. Sometimes referred to as the backbone of PNG they run the full length of the country only dropping to 1000’ towards the most easterly point which is East Cape. Once at East Cape we climbed to 1000 feet and cut across,
Low cloud prevented us
now heading north, scud running to avoid showers and black heavy clouds
banks. Forty minutes later we approached Ferguson Island or the bottom half
of it at least as the rugged mountains and high terrain were covered in cloud
and driving rain. We descended to 500 then 300’ to get under the weather
and maintain visual with the ocean and coastline. Cutting across East Cape heading north
As we flew low along the west coast of Ferguson along the straight separating Ferguson and Goodenough Island we glanced to our starboard side to see if our ‘short cut’ was open. This track takes us between two 5000’ mountains and over the inland lake and low lands and brings us out over Wadalei coast on the north side. It takes 10 minutes of our flying time and saves fuel. But it was blocked with low mist and rain and too risky.
Kila co-pilot took one look… “We are NOT going up there”.
The thought came to mind to abort the mission due to the deteriorating conditions but knowing people were waiting for us and Aileen was close to delivery we decided to push a little further or until it became too dangerous to do so.
We passed Kalokalo HC and rounding the north west point tracking coastal along the north coast into moderate rain showers and underneath lumpy dark clouds.
We were 2 minutes out from Wadalei where the coast line runs into a
large sweeping bay and if you follow the bay it runs straight past the aid post.
Our efforts were rewarded as they often are when you push the envelope a little, in order to help a mother in need. We were almost out of our comfort zone, and indeed my co-pilot expressed several times “let’s turn back” when the cloud lifted by a hundred feet or so and it stopped raining. At least we could see the coast fairly clearly and the rising jungle terrain behind.
Moments later we made visual the small community of Wadalei and a crowd of people gathered on shore. Some fisherman in their canoes were out fishing but would soon move in close to the action once the Beaver arrives. Actually, they heard us coming for a good 2 minutes before sighting us the husband would later tell us.
We made a low pass and headed out cross wind over the sea to come back around and prepare for a landing into the wind. From observing the coconut trees and the direction of the swell it was apparent that the wind was blowing parallel to the beach.
The landing was soft and short due to wind and choppy swell. We taxied in close to the reef and the tree marking the passage into the waiting crowd but I could see the swell was pounding onto the shore and I thought it best to anchor out.
Arriving over Wadalei the clouds lifted
We dropped anchor in 15 feet of water onto a sandy bottom. She held with the Beaver swinging around into the wind and swell. We were OK …. for the moment at least.
This is always a bit nerve racking when you are totally exposed to the whim of wind, tide and swell. The sea can change for the worst so quickly and put the Beaver at risk of dragging anchor, the consequences of which are not worth contemplating. And besides there was a rocky outcrop close by where we had finally settled.
“Quickly where’s the mother?” we shouted to the people on the shore. Not sure they could hear us as they would have been 80 meters away and with the wind picking up sound travels… away.
It seemed to take forever but finally we noticed some movement on shore. I expected to see Aileen and Lota paddling out to meet us but instead there was a single canoe paddled by one person making its way to the Beaver. After we hailed frantically to the crowd to get the mother
we were to be greeted by a messenger bearing good tidings I had hoped. He asked “Are you here to pick up the mother? !!”. I’m not sure if this was normal polite protocol for visitors arriving by sea plane or simple a fill in till the other canoes arrived. But it wasn’t so funny at the time and I had my doubts as to whether we had come all this way for nothing.
In any case we were glad he relayed the message back to the people on shore because soon after three canoes made their way out to the Beaver. Aileen arrived first paddling herself with a
modest amount of cargo and looking a bit hesitant. The Beaver looked a bit intimidating and not having been out of Wadalei all her life, not to mention boarding a float plane for a ride to Alotau
it must have seemed frightening. Poor Aileen looked frightened and at one stage I thought she would turn back. But then the husband urged her on from shore to keep going. He soon
followed with their second eldest daughter in another canoe being propelled along by a man swimming behind pushing the canoe forward. It looked a little strange if not comical but I
realised he had no room to paddle and to do so would have resulted in him going around in circles. Finally, the rest of the cargo came following behind.
Now after we heard our young 14-year-old mother had already reached Alotau by boat we removed the extra seats in the Beaver to save weight which left only two seats for Aileen and Lota. The daughter would have to sit on the floor and just hang on.
I recall the following events happened simultaneously as time was critical. Kila helped everyone get buckled up and make sure doors were closed and seat belts were fastened. At the same instance I pulled up the anchor, stowed it into the front hatch on the port side and jumped into the left-hand seat and buckled up. We were now adrift. With the on-shore wind now driving the Beaver towards the reef, any delay in the Beaver starting up would spell disaster. Conscious of this possibility I quickly primed the cylinders with fuel and turnedtheignition. TheBeaverstartedinstantlywhich is always a relief in these sorts of conditions and we taxied away from that rocky outcrop and turned downwind to the end of the bay. Having reached what I thought was a suitable distance to take off before reaching open sea swell, we pointed into the wind which by now was 15 knots out of the north. Kila turned to our passengers and reassured them all was OK.
Lota with eldest daughter and swimmer arrive
With no time to waste we powered up with full throttle, retracted the rudders and started our run into a stiff northerly breeze and choppy swell. We lifted off quickly in front of a waving crowd Kila recalls not that I was conscious of anything else while scanning the instruments and listening to the sound of the Pratt and Whitney as take offs and landings on water are challenging and require one’s full concentration.
It’s always a relief to get air born again knowing you have your passengers safely on board and you’re on your way home. Forgotten were the images of foreboding weather and thoughts of aborting the mission. The mere thought of turning back and leaving Aileen to deliver in this remote location would weigh heavily on one’s conscience for every more. It sounds like a Biggles story but it is anything but.
Back to Base.
We followed the coast eastly at 500’ as it seemed the best way out of the confused conditions. We certainly were not going back the way we came and we were to eventually circumnavigate the island. Shortly after rounding the eastly end of ‘Ferggi’ we broke into clear skies and sun shining on green jungle and blue ocean. Aileen looked more comfortable now and started talking for the first time since boarding. We passed over the extinct volcano and rising clouds of mist coming from the sulphur vents of Budoya.
Once back at our base we drove Eileen and her husband and daughter to the hospital to settle in and await delivery. It was obvious from the cargo they came with they didn’t have much in the way of possessions, so on arrival at the hangar Kila gave them a sleeping mattress, plates and cutlery, K100 spending money plus a food hamper and a mother and baby gift.
Shortly after lunch we arrived back at the hangar after dropping of Aileen at the hospital. We were half way through washing the Beaver down as we do after a day of water landings, when Kila answers an urgent call from the Alotau hospital.
“We have a mother at Misima hospital in obstructed labour. The Doctor there is away. Can you assist?” Kila “Yes we can.”
Thank you all for your continued support of The Hands of Rescue. If you would like to help reduce maternal mortality, please Donate Now, or get in contact to see how you can help out.