Holiday over, it was time to get to work. The road trip from Nadi to Suva took around three and a half hours, and provided great window-gazing opportunities to see the sugar cane fields and to get a feel for the volcanic landscape. We also passed through some traditional villages, one of which was heavily policed as the President was making a visit. Most of the police activity seemed to be focused on the roadside stalls selling fresh cooked sweetcorn. In the car we speculated that foodstuffs were being impounded bodily as a security precaution.
So to Nadi. The main purpose of my Fiji trip was to deliver a peer to peer training programme for Fijians with spinal cord injury on behalf of Motivation Australia.
First, a little luxury. My co-trainer Lisa Chaffey and I were booked into the Grand Pacific Hotel where we were to hunker down and plan the job. The hotel provided us with rooms at a discounted rate, and we provided feedback on wheelchair access in return. I can report that the room was generously proportioned and easy to get around The bathroom was also spacious and included a wide, folding shower seat and was laid out in a way that made transfers easy.
However, I must report that the indoor zen garden was not very wheelchair friendly, as it consisted largely of soft sand. In future, they may wish to tarmac it.
Instead we realised early on that flexibility was going to be key, and that we couldn't assume that those we were working with had been exposed to even the most rudimentary knowledge about spinal cord injury. Another telling experience came whenever we travelled to downtown Suva to grab a bite or do some shopping, perhaps best summed up when Lisa asked,
"Why is that man staring at me?"
She immediately remembered that she wasn't in Melbourne, and we realised that our presence as wheelchair users on the streets of Suva was causing something of a stir. The general reaction of unashamed staring drew from me my usual response, which is to stare unashamedly back. This was inevitably met with a smile and shout of "Bula!", accompanied with a thumbs up or a proffered handshake.
Preparation over, it was time to leave the colonial luxury of the Grand Pacific (where the staff had, for some reason, decided that Lisa and I were husband and wife), and we made our way to the training venue, a theological college on the outskirts of town that was perfect for our needs.
On Sunday evening we met the participants. In the first hour I learned that one of our number was unable to transfer from wheelchair to bed without an overhead handle. In ten minutes, I taught him how to make this transfer without assistance or a monkey bar. This was the first time he had done so. In twelve years.
This example sums up the nature of our task. I have always felt passionate about my role as a peer to peer trainer, as I was fortunate enough to be given such guidance when I was going through rehab and it had a profound effect on me (it's all in 'the book', you know).
In Fiji, I was expecting a lack of resources; Fiji is not a wealthy country. But what struck me most was the lack of knowledge. During the week we spent working with ten disabled Fijians, their family members and carers, and staff from Spinal Injury Association of Fiji, we covered topics that I was briefed on as part of the patient education programme at Stoke Mandeville, including bladder and bowel management, and avoiding pressure sores.
To put this knowledge in context, these issues don't just affect quality of life, they can have a profound effect on life-expectancy. When Professor Ludwig Guttmann founded the first spinal unit in 1944, most people with spinal cord injury died within 2 years from infections caused by pressure sores or renal failure caused by poor bladder management.
The week in Fiji was exhilarating and exhausting. We developed a great atmosphere, with everyone throwing themselves into the training with enthusiasm. As well as the sessions on health issues, we ran extensive wheelchair skills training and some sport sessions. Again, we had some significant wins, including finding a way for one of the participants to self-propel in her wheelchair for the first time since she was given the chair seven years ago.
The aim is for this group of participants to stay in touch and meet regularly to come up with some peer led activities that they can organise for themselves with a view to attracting other people with disabilities to get involved.
We intend to stay in touch with our participants and over ongoing encouragement so that the course has a significant legacy. And in future? Who knows... maybe other Pacific islands could make use of our services...
On a final note, I would like to thank Lofric for providing me with intermittent catheters during the trip. It was great to have the confidence that comes with single use catheters while travelling.