Ten Minutes. My experience as a Naturopath in Fiji by Student Naturopath Jess

by Peninsula Herbal Dispensary

“Oh wow, we have the same birthday” I said gently, sitting cross legged on the floor opposite a woman of my exact age, her name was Kaliti. She smiled weakly. She had been pleased to see me but there was an unbelievable sadness to her that made me want to talk softly and slowly so as not to break her.

It was my third week in Fiji volunteering at the HART House, a housing commission for Fiji’s destitute. The property houses 124 flats that are rented out for $5 a week to anyone that has nowhere else to go. As a Naturopath, I had come to make house calls on all the residents and do some basic health checks.

Two other women sat with us. Outside you could hear the five children that also lived here playing and giggling. This was my seventh family I’d visited today so I was familiar with the setup of the houses- very little furniture, a small kitchen with nothing in it, a couple of mats on the floor which served as the sitting area/bed for this family of eight and an over powering smell that I can only describe as the smell of poverty.

Slowly this family began to warm to me and through broken English I learned of their story. Kaliti had just come from the hospital after an operation to remove an ovarian cyst. She had been living here helping her auntie who had recently become the sole carer of Kaliti’s 5 cousins. In January, the children’s mother had died from pneumonia, closely followed by their father from tuberculosis in June. Now they all lived here with their grandmother.

The grandmother was 61 years old. She looked tired and stressed. When I asked her about her own health, she began to cry. Through tears she told me that she had recently been diagnosed with diabetes, high blood pressure and fatty liver disease. She cried not because of her conditions but because of how scared she was that her grandchildren may have no one to care for them if something was to happen to her. On her death bed, her daughter had asked her to take care of the children and the grandmother had pleaded with her that she wasn’t strong enough to raise more children. But she had no choice.

The children are all in primary school. They have no shoes to wear to school. They out grew their sandals and now their thongs have worn out too. All five children have lice, ringworm and scabies.

This wasn’t the first grandmother I had met who was now the sole carer of her grandchildren. It was a common story line. Fijian people place high importance on loyalty to family. It’s inspiring. They will give so much of what they have to others even when they have hardly anything left to give.

For me this had been the hardest part of my house calls. Seeing how much help these people needed and yet they refuse to stop giving away the little they do have.

In the world where I grew up, a world that seems so far away from this one, we have so much. A life of poverty in Australia is often related to drug or alcohol abuse or wasted opportunity but in Fiji the people that live this way are here just because of where they were born. The most common scenarios I saw were women hiding with their children from domestic violence, or unemployment usually due to injury, disability, being a single parent, old age or just plain old bad luck. Every family was affected by illness, scarcity and depression. Every house call was another heartbreaking story.

The task I had come to do was not an easy one. The first three days were the hardest. Tears were shed on my hour-long bus ride home. I wrote updates to family and friends explaining the things I was seeing and would re-read before sending thinking “you’re exaggerated this for effect Jess, just write what happened” and then came the realisation that- no actually that is what happened. It was simply that bad. It was confronting and emotional and it was real. People do live like this.

One house call I found a man lying flat on his back in the middle of his lounge room. He was the skinniest person I have ever seen. The room was scattered with bowls of rotting food covered with flies, no furniture, he was wheezing badly and his clothes were soaked in sweat. I’ll be honest- no part of me wanted to venture in further. The smell was putrid. He coughed and sat up and told me to come and sit with him. I did and he told me about his life. He was 72, unemployed, his wife had died a few years ago and his two sons wanted nothing to do with him. He was suffering from asthma and talking was visibly exhausting for him. I found a Ventolin puffer on the floor and some cortisol tablets. He explained that he was taking half the recommended dose to make them last. Clearly this dose wasn’t enough. This man had no food and no money to buy food.

Two doors down from this man was another. Different story line but it had the same ending. This man was the same age as my dad. He was living here because 16 years before he had fallen and injured his spinal cord leaving him paralysed from the waist down. His disability meant he was unable to work. He was also obese and a diabetic with high blood pressure and a weak heart. The wheelchair he used was broken, some would say it was just a chair, but he loved it. It had changed his life when he received it 2 years ago. The 14 years before that he had had no wheelchair. His 5-year-old granddaughter cares for him. The two of them live together; they have no one else.

So how can I help? I’m just one person with only a very short amount of time with each family. I had ten minutes before I had to move on to the next one. To another ten minutes with another person who may be in even more dire need. I found it was very easy to slip into the mindset of “nothing I’m doing is helping.” I’m trained in nutrition and had come to do food education, but to these families, nutrition was a luxury.

On my first day, during a moment of “I don’t know where to begin” I decided to ask one very poor woman with diabetes to tell me everything she would normally eat in one day, something I would do with a patient at home. I’d hoped to find some small recommendations that could be made in her diet to improve things for her until I found out that she could only afford to eat rotti bread three times a day. These families couldn’t care less if added salt was making their blood pressure go up or what deficiencies they might have. Their life was deficient in everything.

So after a day or two I decided I had to change my thinking. What can I do with ten minutes. I decided to focus on the therapeutic relationship. The art of active listening. Being fully present, making eye contact, reserving judgement. At night, I read articles about how just asking someone how they are and listening to their story can improve their health. This helped me. (Links below)

I told myself that I would write everything down, go back to Australia and send more help. It wasn’t just ten minutes. It was just the first ten minutes.

At the end of my time at the HART community something really special happened. I came in that morning to the office to drop my bag off and say hello and standing there were 10 women from the community. They had been waiting for me. Each of them had spent the night before baking. On the table in front of me was a massive amount of food. They had organised a morning tea for my last day. They had used flowers from their gardens to make a beautiful neck wreath that they presented to me. They thanked me and they cried. They told me that no one had ever wanted to come into their community, into their houses to spend time with them one on one. That no one had ever just listened or sat with them and asked about their stories.

Yep- cue the tears. After weeks of feeling like nothing I was doing was working, I realised it was.

If I have learned anything from my time in Fiji, it is this- never underestimate how much you impact the people around you. Never underestimate the power of just making time for people. You don’t have to have a giant ticked off to-do list to prove you have made an impact.

Don’t underestimate the power of what you get back when you are generous to someone. And it’s not just about that warm fuzzy feeling (although that is great). We are so wired in the western world to think that by being generous we will have to give something away and that we will gain nothing, but this is so untrue. Generosity breaks down walls. It creates space for people to come together. Nobody loses when we are generous. Everybody gains.

What have I gained? So many people have approached me since I’ve been back from Fiji to ask about my trip and open up to me about their own experiences. They have offered to help me, offered to contribute, made donations and made suggestions for future volunteers. I was overwhelmed by the donations I received for this trip: people that I had never met before offering their support to me. Generosity creates more possibilities. They’ve wanted to get to know me and for me to get to know them. This trip to Fiji has created a network of support around me filled with like-minded people: people that I wouldn’t know anything about unless I hadn’t stepped out of my comfort zone and chosen to do this.

This experience has also given me some valuable skills that I can take back to my patients in Australia as well. Sometimes all we ever need from someone is space to tell our story, to be heard and to be acknowledged. It sounds so simple but providing this as a practitioner is almost the most important thing I can do for my patients. To be non-judgemental, to not try and rush in with solutions but to just be present with them in their situation. To get to know what it feels like to be them. I can now say I know this has a beneficial impact. I’ve see it.

As for the families I met in Fiji, I hope to go back to them soon. If I do, I’ll bring as much antibacterial soap as I can carry. I’ll bring bandaids and shoes. And I’ll bring people. My one wish is that I have inspired others to follow in my footsteps and to visit the beautiful people of the HART. If you think you can help and would like to, please get in touch with me.

To live in a country like Australia, to have running water, electricity, a first aid kit, shoes to wear to school, a roof over our heads and most importantly no anxiety that we may not always have this, we need to be giving back. I think everyone needs to know what real, rock bottom poverty looks like, especially those who will never come close to living this way.

I truly believe that we all have a calling in life to help society in a way that is unique to us. We all have an area of expertise, a skill set that could help someone or something bigger than ourselves. For you this might be animals, the environment, children, the elderly. You know what yours is, deep down, it’s there. Find that group that needs you. Help them. Do it for them but also for yourself.  The rewards are endless. Find your mission and be generous. Even if it’s just ten minutes.

Resources on the benefits of therapeutic relationship:

·         Ted Talk “The Doctors Touch” https://www.ted.com/talks/abraham_verghese_a_doctor_s_touch?language=en

·         The Role of Empathy in Medicine: A Medical Students Perspective- The Journal of Ethics  http://journalofethics.ama-assn.org/2007/06/medu1-0706.html

·         What is Clinical Empathy? – Journal of General Internal Medicine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1494899/#b3

·     How Empathy Can Help Empower Patients http://www.huffingtonpost.com/barbara-ficarra/why-empathy-empowers-pati_b_783138.html