Tinian Health Center (THC) is a hop, skip and jump away from the main hospital where I work — but unlike Kagman which is also very close, it involves a plane ride to get there. As you can imagine, this means that the patients there do not rely on the hospital for anything except emergency care. In fact, speaking with the director at THC (as much as they would prefer not to do this), without the support of outside providers, they very much act as an urgent care or emergency center. This is changing now that more providers are consistently coming out, and I hope that this new initiative to have the pediatricians at the hospital come over to THC ends up being a sustainable, consistent one.
I am here now for a scheduled four day visit to help see complicated pediatrics patients (as well as hematology/oncology patients) so wanted to share what Tinian is like. I have come here once before for a short visit with a friend, but haven’t stayed for more than a day. I will scatter these posts with my experiences at the clinic — while it may seem that all I did was play, I was working!
First step to get to Tinian: the commute.
I drove to the airport the morning of my commute with a few more bags than usual (I packed some foods to bring with me so I wouldn’t have to eat out every day) but just a few minutes earlier than what I would have done to get to the clinic in Saipan. At the airport, the check-in process is easy (notably, I was not asked for my ID in any form.. hmm. maybe that was an oversight). Anyway, you check in at the counter and stand on the scale. No, you don’t put your luggage on the scale — it looks just like the one you use at the airport, but you stand on it while holding whatever you are going to bring on the plane. I weighed in at around 150 pounds with all my stuff! It felt like a lot of stuff! ;)
After that, they give you a plastic colored card with numbers on it (numbered 1 to 5) because you are about to get on a six-seater plane. The coloring helps identify which flight is up next. Here they are fueling up the plane.
The airline balances the plane depending on where you weighed in at so they tell number “1” to sit somewhere and maybe number “3” to sit next to them — the numbers just make sure they don’t pass out too many seats on one plane. When there is a large group of tourists going, I understand they just fly plane after plane to get them over in little groups of 6.
Suffice it to say, a 6-seater plane is not very big so you are basically in the cockpit!
The views from these little low-flying planes are gorgeous though if you go during the daytime. Here you can see the northern portion of Tinian. See those grown-over runways? Those were the most used runways in the Pacific during World War II — and happen to be where the Enola Gay took off with the atomic bomb that eventually fell on Hiroshima.
After the arrival at the airport, I got picked up by the clinic staff and brought to the ‘hospital’ or clinic — it’s kind of halfway in between.
Here’s a tour of the facilities!
Here’s the view from the road — big sign for hospital and in the distance, a sign for the emergency entrance in red.
Here’s the view of the front sign — this facility was built 30 years ago.
Tinian has a population of about 3500 people at least count (compared to Rota where there are approximately 1700). I think of Tinian as approximately the size of my whole undergraduate class at the university I went to!
Yes, we raise awareness here about Ebola too. You never know who travels where nowadays although I’d venture to say it’s pretty unlikely considering we are probably exactly on the opposite side of the world as West Africa — but always good to be aware and prepared.
My clinic room. Honestly, everything I need. I had my laptop, a landline connection, my paper notebook, stethoscope and medical equipment. (That computer in the corner is … a place holder — no screen. Eventually the hope is to equip here with the electronic health record that we have at the main hospital. — which happens to be the same EHR as the one used by the Indian Health Service)
Here’s the phlebotomy (blood draw) area and the lab. It has very limited availabilities here — some chemistry tests but no ability to do any blood smears or blood counts (which limits me!). All the other samples are sent to the lab in Saipan which processes them to be done there or off island. This is probably more cost effective but the results of any of those tests basically take a day to come back which limits what you can use those tests for.
The lab area..
And the radiology department consists of a digital x-ray machine and a room for ultrasound.
This comprises the outpatient clinic side. There is an area for urgent visits that is staffed by nurses in the evening since there is only one physician on island here normally. This doctor happens to be trained in anesthesiology AND family practice which is a pretty good combination for an island with only one doctor.
Here’s one of the two holding areas where they can keep patients overnight while waiting for transport to Saipan or if they need some extended treatments. Any surgeries are obviously done in Saipan and they have the ability to change the six-seater planes that service this island into a one bay stretcher plane to get them over. It honestly is a 10 minute flight maximum from door to door so it’s not far — but does require a plane!
Here are the bags of saline. It was kind of reminiscent of other places I have been abroad. Honestly, these are the bare bones of what you need, which is is why things all look similar.
Here is a wall of emergency medical supplies for those types of situations. Basically, they need to be able to stabilize their patients for the transport which means certain medications are required, fluids, and supplies.
More to come from Tinian. A sneak peak.. Taga Beach!