The following article was published in the local paper. I believe that the crisis may have been solved (at least temporarily), and that Dr. Balachandra and the Medical Board have reached an agreement to provide supervision for the mid-levels on Tinian... but they are still waiting to hear the 'final' okay from the board.
Saipan Tribune, Wednesday, December 31, 2008
Long-term solution sought for Tinian clinic
By Nazario Rodriguez Jr.Reporter
The Department of Public Health must focus on the long-term solution of finding a doctor for the Tinian Health Center in light of the hospital now having no doctors or mid-level providers officially able to work at the clinic, the Public Health Secretary said yesterday.
“A long term solution is the most important,” Public Health Secretary Joseph Kevin Villagomez said yesterday.
The Tinian Health Center has been without a doctor since July, when Ronaldo Toledo resigned. Physician assistant Terri Clawson was prescribing drugs with the oversight of a Saipan doctor, but the Medical Licensing Board recently expressed concern about the number of narcotic drugs she has been prescribing. A Commonwealth Health Center doctor, Shirish Balachandra, was to act as Clawson's new remote supervisor, but the Licensing Board and Balachandra were unable to come to an agreement on supervision, forcing Clawson and medic Juan Pangelinan to use the Good Samaritan law in order to treat patients with life or death injuries.
Villagomez, who was on leave for a few days last week, said he was going to speak with deputy secretary Pete Untalan, who is now on leave, and see where the situation stands. It has been relatively quiet there lately, he said.
Villagomez said DPH must work to find a replacement doctor to solve the problem at the clinic. But in today's world, he said, it's hard to find doctors that are in general practice. Most doctors tend to specialize in a certain area to make more money. The ideal doctor to fill the role is someone at the end of his or her career, looking for a more relaxed way of living on an island such as Tinian or Rota, Villagomez added.
DPH works with the National Health Services Corp., an organization that helps underserved communities find health care professionals. Villagomez said during the next recruitment gathering, a representative from Tinian would be sent.
The situation at the Tinian Health Center will be a part of DPH's end-of-the-year report that Villagomez, like other Cabinet members, will turn in to the governor.
Wednesday, December 31, 2008
Life and death must be pondered
After the Korean tragedy, my walk this morning was full of thoughts of life and death... It seemed as though I saw signs of both more than usual...
The home next to the High School now has a roof; although it looks as though they may be putting another level on the building, as there are rebar coming out of the top of the concrete roof slab.
I had not noticed that, as part of the clinic 'sprucing up', they had placed lots of potted plants in the front of the building!
Here is the tree
and here is the flower
Here is the bush
and here is the flower
There seems to be lots of flowers coming out this time of year
It's hard to believe that this beautiful bird will soon have to fight to the death...
A fishing line in hung to dry in the morning sun
Fruit is found on almost every tree
Flowers on every bush
Even bushes that seem to be just large weeds...
Have a hidden beauty!
Everywhere one turns, life comes back...A Korean tragety
A young Korean couple came to Tinian for their honeymoon. They had waited until they were older (the husband was 29) so that they could save enough money to have the wedding and honeymoon they had always dreamed of: the perfect start to their life together; on a tropical island, where they could walk alone together on secluded beaches, party in a casino atmosphere, and go fishing at night with friends...
It was planned out in every detail. United in love, they would begin a life filled with fun and joy. They had taken the 'honeymoon' package at the Dynasty casino, had friends on the island to guide them around and celebrate with, and had plans to go fishing...
Cliff fishing is a very popular pastime in the CNMI. There are many sheer cliffs around the islands that drop straight into the water, making it easy to fish in the deep water without a boat: just drop your line down into the water. Many large fish can be caught from these areas. The danger is the cliff itself: the drop into the water can be anywhere from 20' to 150' (the east side of Tinian has cliffs that have to be 200' high). Care must be taken when walking or standing near the edge of the cliff...
Three or four couples had joined the newlyweds last night in their fishing adventure to the west side of Tinian. The cliff-line on this side is perfect for cliff fishing-- the cliffs are about 30'-50' high, and the water below is another 50' to 100' deep. Just right for catching large fish trolling the shoreline! While four of the men stood at the edge of the cliff fishing, the rest of the group sat and talked, ate and drank, and continued the party atmosphere that had begun on their wedding day.
I don't know what happened, but I can 'imagine' the wife looking with love and joy at her new husband talking and laughing with his fishing buddies, and then turning to share a moment of laughter with her own group... When she turned back there were only three men standing on the cliff line...
It took a moment for it to register in her mind; even the other fishermen standing nearby had not noticed... but then there was that sudden realization: her husband was gone!
The cliff was high, and the water was deep, and it was dark: there was nothing they could do! They called the Tinian emergency dept., who quickly put a boat into the water and raced to the site of the accident. Even then, it would take 30-45 minutes to arrive, and the same to return to the hospital by boat. Once there, it did not take long to find the husbands body, floating face-down in the water.
Terri got the call late last night, not long after we had gone to bed. It didn't sound good. Although the Tinian emergency dept. performed CPR all the way back to the hospital, there was really nothing they could do. Fate had already made its decision. All Terri could do was to try to console and treat the devastated wife.
It is hard to imagine: the couple's life together had begun only two days before... and had ended with the young wife on the floor of the emergency room, her hand clutching at her husbands lifeless form, her joy and future dreams spilling out on the floor through her tears...
Our thoughts and prayers go out to this young widow. There is still a lot of pain to endure. The body must be prepared, and then shipped home; the families must be told; the funeral planned and attended; and future plans and dreams washed away and new ones built... unimaginable!
It was planned out in every detail. United in love, they would begin a life filled with fun and joy. They had taken the 'honeymoon' package at the Dynasty casino, had friends on the island to guide them around and celebrate with, and had plans to go fishing...
Cliff fishing is a very popular pastime in the CNMI. There are many sheer cliffs around the islands that drop straight into the water, making it easy to fish in the deep water without a boat: just drop your line down into the water. Many large fish can be caught from these areas. The danger is the cliff itself: the drop into the water can be anywhere from 20' to 150' (the east side of Tinian has cliffs that have to be 200' high). Care must be taken when walking or standing near the edge of the cliff...
Three or four couples had joined the newlyweds last night in their fishing adventure to the west side of Tinian. The cliff-line on this side is perfect for cliff fishing-- the cliffs are about 30'-50' high, and the water below is another 50' to 100' deep. Just right for catching large fish trolling the shoreline! While four of the men stood at the edge of the cliff fishing, the rest of the group sat and talked, ate and drank, and continued the party atmosphere that had begun on their wedding day.
I don't know what happened, but I can 'imagine' the wife looking with love and joy at her new husband talking and laughing with his fishing buddies, and then turning to share a moment of laughter with her own group... When she turned back there were only three men standing on the cliff line...
It took a moment for it to register in her mind; even the other fishermen standing nearby had not noticed... but then there was that sudden realization: her husband was gone!
The cliff was high, and the water was deep, and it was dark: there was nothing they could do! They called the Tinian emergency dept., who quickly put a boat into the water and raced to the site of the accident. Even then, it would take 30-45 minutes to arrive, and the same to return to the hospital by boat. Once there, it did not take long to find the husbands body, floating face-down in the water.
Terri got the call late last night, not long after we had gone to bed. It didn't sound good. Although the Tinian emergency dept. performed CPR all the way back to the hospital, there was really nothing they could do. Fate had already made its decision. All Terri could do was to try to console and treat the devastated wife.
It is hard to imagine: the couple's life together had begun only two days before... and had ended with the young wife on the floor of the emergency room, her hand clutching at her husbands lifeless form, her joy and future dreams spilling out on the floor through her tears...
Our thoughts and prayers go out to this young widow. There is still a lot of pain to endure. The body must be prepared, and then shipped home; the families must be told; the funeral planned and attended; and future plans and dreams washed away and new ones built... unimaginable!
Tuesday, December 30, 2008
A walk through Marpo Valley
There are a lot of small dirt roads that criss-cross through Marpo Valley, in-between the paved roads that run east and west below the hills. Each road is lined with power lines, and occasionally one will find a home nestled in the foliage... but for the most part, the roads are empty, waiting for some family to build a home, or some farmer to plant a garden.
One of the sights that is becoming more and more common is to find 'lawn mowers' tied-up in front of homes. One poor filipino had carefully fed and cared for his 'law mower' for months, only to have it stolen by someone just before he was going to butcher it for a family feast... just another sign of the tough economic times we are in, I suppose.
I discovered another 'standing' garden along one of the roads. I think these are wonderful, and hope to build one myself one day!
You can always find a 'rooster ranch' along the way, as cock-fighting is a popular sport here in the CNMI.
Although most of the dirt roads are empty of development, there are beautiful homes that can be found here and there.
There is also an occasional piece of property that is fenced off and marked 'private property'. Many of these, though fenced, seem to be of little use. I expected to find cows, or goats, or gardens-- something to explain the expense of putting up a fence!? But most of the time, they just seem to be empty lots... but beautifully fenced!
Some of the locals have carefully designed their homesteads so that it will provide them with year-round food. They have coconut trees for milk and meat, banana trees, mango and papaya trees, cows, chickens, pigs, gardens, etc. Everything one might want or need to make a good life on a tropical island!
It is amazing how much fruit one can get off of small trees. These banana trees are full of fruit-- so much so, that the owner has to support the branches to prevent them from breaking.
Some of the lots have many trees, providing seclusion and shade.
One of the local products used a lot are coconuts. They are used for their milk, their meat (they are often fed to the local pigs also), and the husks are used to burn for fuel.
There are a LOT of chicken on the island. Some are kept by the locals and used for eggs and food. Others are wild, and can be found wandering all over the island. One of the sports on the island is to go chicken hunting.
One of the banes found on the island are the vines that grow and can eventually cover everything in its path!
They are a mixed blessing though, since most of the vines can produce beautiful flowers...
As always, one can find wonderful plants and flowers along the way!
One of the sights that is becoming more and more common is to find 'lawn mowers' tied-up in front of homes. One poor filipino had carefully fed and cared for his 'law mower' for months, only to have it stolen by someone just before he was going to butcher it for a family feast... just another sign of the tough economic times we are in, I suppose.
I discovered another 'standing' garden along one of the roads. I think these are wonderful, and hope to build one myself one day!
You can always find a 'rooster ranch' along the way, as cock-fighting is a popular sport here in the CNMI.
Although most of the dirt roads are empty of development, there are beautiful homes that can be found here and there.
There is also an occasional piece of property that is fenced off and marked 'private property'. Many of these, though fenced, seem to be of little use. I expected to find cows, or goats, or gardens-- something to explain the expense of putting up a fence!? But most of the time, they just seem to be empty lots... but beautifully fenced!
Some of the locals have carefully designed their homesteads so that it will provide them with year-round food. They have coconut trees for milk and meat, banana trees, mango and papaya trees, cows, chickens, pigs, gardens, etc. Everything one might want or need to make a good life on a tropical island!
It is amazing how much fruit one can get off of small trees. These banana trees are full of fruit-- so much so, that the owner has to support the branches to prevent them from breaking.
Some of the lots have many trees, providing seclusion and shade.
One of the local products used a lot are coconuts. They are used for their milk, their meat (they are often fed to the local pigs also), and the husks are used to burn for fuel.
There are a LOT of chicken on the island. Some are kept by the locals and used for eggs and food. Others are wild, and can be found wandering all over the island. One of the sports on the island is to go chicken hunting.
One of the banes found on the island are the vines that grow and can eventually cover everything in its path!
They are a mixed blessing though, since most of the vines can produce beautiful flowers...
As always, one can find wonderful plants and flowers along the way!This is a new one for me. I have seen the plant before, but havn't seen the flower it produces. It is very large and colorful.
Monday, December 29, 2008
A life-long marine comes home
Our oldest son, Michael, has been a marine since he was 17 yrs old. Now, after 15 years of service, he has decided to leave the military. He is currently stationed in Germany, with responsibility over the wounded warriors that are sent to Germany from Iraq and Afganistan.He is seen here with his wife Pri, and two of our five grandsons, Robbie and Gabriel. I'm not sure where they are (isn't it supposed to be winter in Germany?). They will be coming back to the states in February, then, moving to Brazil (Pri's family lives in Brazil). Pri hopes to begin medical school once settled in their home in Brazil.
We will be traveling to Utah to see them, and other members of our family, before they head off to Brazil. Our family is so scattered around the world, it is difficult to be able to see them!
Michael recently graduated with a degree in finance, and, after some time off, hopes to work with an international company in Brazil (with his knowledge of finance and economics, and being fluent in English and Portuguese, it shouldn't be difficult!).
Construction goes on and on
Even though we are all in 'holiday mode', the work continues on the island... we saw many who worked on Christmas day!
The duplex by the Grace Christian school is making progress. The roof is now poured and set, and once the forms are all removed the interior work can begin.
Many homes on Tinian have 'secret' gardens, hidden behind beautiful hedges.
The work on the amphitheater continues. It looks wonderful as it gets fully painted
The sidewalks around the building have been completed
And construction continues on what I can only assume will be seating for the theater
There is also a stand, or tower, being built behind the bleachers--perhaps for lighting or direction?
Some who visited the island for the holidays decided to stay at the beach... I'm not sure if this can be considered real camping-- just too many amenities!
Even with all the construction going on around it, the local Catholic church tries to keep in the Christmas spirit: beautiful flowers for the Savior...
And even their own Christmas tree in the yard...
The road construction is moving from east to west along the upper main street. It is now at the Catholic church, soon to start moving downhill towards the dock area.
The construction company has built two staging areas for their work. This small one holds excess dirt and drainage pipe.
This large one is surrounded by a fence built using old 55 gal drums. All of the construction equipment, material, etc., is held within this area.
One of the homes soon to be engulfed by the road construction has a beautiful 'standing' garden.
At the base of the road under construction, near the dock, is a sign welcoming you to Tinian's main village.
As you look up the road towards the village you can see some of the road construction equipment on their way to work. The roadwork is just about to start coming down this hill towards the dock.
There has been some work done by the hospital emergency entrance also. There used to be a large open ditch to the left that ran between the two buildings. It had a couple of beautiful trees and grass. Someone decided to fill-in the ditch and create a parking surface here... the grass and trees now gone... oh well.
The duplex by the Grace Christian school is making progress. The roof is now poured and set, and once the forms are all removed the interior work can begin.
Many homes on Tinian have 'secret' gardens, hidden behind beautiful hedges.
The work on the amphitheater continues. It looks wonderful as it gets fully painted
The sidewalks around the building have been completed
And construction continues on what I can only assume will be seating for the theater
There is also a stand, or tower, being built behind the bleachers--perhaps for lighting or direction?
Some who visited the island for the holidays decided to stay at the beach... I'm not sure if this can be considered real camping-- just too many amenities!
Even with all the construction going on around it, the local Catholic church tries to keep in the Christmas spirit: beautiful flowers for the Savior...
And even their own Christmas tree in the yard...
The road construction is moving from east to west along the upper main street. It is now at the Catholic church, soon to start moving downhill towards the dock area.
The construction company has built two staging areas for their work. This small one holds excess dirt and drainage pipe.
This large one is surrounded by a fence built using old 55 gal drums. All of the construction equipment, material, etc., is held within this area.
One of the homes soon to be engulfed by the road construction has a beautiful 'standing' garden. 
At the base of the road under construction, near the dock, is a sign welcoming you to Tinian's main village.
As you look up the road towards the village you can see some of the road construction equipment on their way to work. The roadwork is just about to start coming down this hill towards the dock.
There has been some work done by the hospital emergency entrance also. There used to be a large open ditch to the left that ran between the two buildings. It had a couple of beautiful trees and grass. Someone decided to fill-in the ditch and create a parking surface here... the grass and trees now gone... oh well.Thursday, December 25, 2008
Christmas at the Tinian clinic
There is a new angel at the clinic (no, it's not Terri!), hand made by one of the nurses!
Here are just some of the dedicated people who were at the clinic on Christmas day!
And this is the reason the Tinian clinic never closes, and why Terri was on call...
Terri and Freddie can be seen monitoring the transfer of a patient to Saipan via helicopter.
The helicopter is well designed: just open the two door and slide the patient in, strap them down, and away they go!I did find out something very odd... the helicopter does not land at the Saipan hospital! It lands somewhere distant, and then they have a 20 minute ride to the hospital by ambulance... The hospital on Saipan has a helipad... Just another strange thing about how things are done on the islands!
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