"We live in a wonderful world that is full of beauty, charm and adventure. There is no end to the adventures we can have if only we seek them with our eyes open." ~ Jawaharal Nehru

Sunday, April 28, 2013

Out of the ashes... We will rise!

More about the fire that necessitated a CODE RED in K.K. Song.

Rumah Kilau at Nanga Lijau was totally razed to the ground in a fire that started about 1am.

2 people perished in the fire. A father and his adult daughter. From what I heard, the father ran into the burning house when he heard his daughter calling out to him. In the end, he succumbed to his 97% burns in Sibu Hospital. More about the fire in the Borneo Post at the link below.

K.K. Song decided to send a mobile team to the site a day later to provide medical support. 

Rumah Kilau... or what's left of it!

Rumah Kilau is a half an hour boat ride upriver from Song. To reach the long house one has to climb a steep & rickety plank walk.

1 step at a time!

Apparently no one made an attempt to put out the fire when it started cause it wasn't feasible to haul water up the 20 feet embankment. Instead, they just ran deeper into the jungle while watching their longhouse go up in flames. For your information, the is no 'bomba' facilities in Song. The nearest fire station is 1 hour away upriver in Kapit or downriver in Kanowit. Hard to imagine right? No firefighting services in this day and age in a town that has 2 petrol stations, 2 secondary schools, 6 primary schools, a clinic cum hospital, a police station and a bank! Even if we had firemen, I wonder if they were able to aim their hoses up this steep embankment from their fire fighter boats. Hmmm... 

What greated me at the top of the steep plank walk was total DESTRUCTION!

Everything was razed to the ground. Only the 'belian' or ironwood pillars was left standing. Even the tops of the coconut trees were not spared. They were all charred. Gives a new meaning to those 'burnt coconut' drinks you get in Thailand. Even after 24 hours, the site was still smoldering away. I could feel the heat emanating from the ground.

I could only imagine how hot the heat must have been during the height of the fire. Even the dinnerware in the picture below has melted into a blob of glass with little resemblance of what it might originally have been. I cringe to think of the final moments of horror as the 2nd victim faced death in the inferno. Such a horrible way to go. I can only hope that it was quick.

They had erected a little hut at the hill over looking the longhouse, or whats left of it. This was where we set up the mobile clinic. Most of the patients I saw were those with hypertension, diabetes or some chronic disorder that had lost all their medications in the fire. Rest assured, many had BPs that were sky high due to the exhaustion, lack of sleep, anxiety & heat. My MA took care of the acute problems such as headaches, gastritis, diarrhoea & skin lesions. It was hot, hot, hot under that zinc roof and I was sweating buckets.

The victims of the fire basically ran out of the burning longhouse with nothing but the clothes on their backs. They have now taken refuge in a hut which was used to press rubber sheets. You see only ladies and children here as the men are busy sourcing for materials to build a new longhouse or down in Song buying supplies.

Despite the tragedy, life goes on. Cooking is done communally in the open and everybody chips in whenever or however they can.

A spot of colour in otherwise sombre surroundings

Some of them have even moved deeper into the jungle and have created makeshift homes for their family. 

Zinc house put together
Work in progress

What really surprised me was the speed these people have rebounded after the tragedy. Like a phoenix rising from the ashes, work on a new longhouse has already begun. With help from generous contributors, the supporting pillars for a new longhouse is already in place. 

Help is still pouring in from various quarters. However, I hope this tragedy also highlights the need for proper  firefighting services in the Song district, including a firefighter boat to ply the Rejang. Please, please, please resurface the plans for a equipped, functioning fire station here in Song.

Saturday, April 27, 2013


It was a Tues morning. I'd just gone to bed. I was glad I wasn't on call. Despite not having to run a clinic that day, I was knackered. Just came back that afternoon from Kuching, after attending a course. I think age must be catching up. Felt so tired from all that waiting to catch my flight, taxi & boat back to Song. I'd left my hotel in Kuching at 8.30am and had only arrived back in Song at 3.00pm. 

Next thing I know, my handphone wakes me up from my slumber. One of the student MAs is on the line. "Doktor tolong datang, ada patient burn dan Doktor X tak dapat set line" 

0200 - That's when the nightmare began.

I arrived at the A&E and a golliwogg greats me. The victim is totally charred, from head to toe. His hair is singed curly. He has no more eyebrows or eyelashes. One of his eyes is semi opaque from a flame burn. The skin is a colour of cooked sweet potatoes, with areas peeling revealing raw, pink dermis underneath. What really striked me was whats left of his shorts/ underwear. It had melted into an underwear shaped plastic gunk. I think his shorts were blue...Thank God he was wearing cotton briefs underneath or else his nylon shorts would have just melded with his genitals. I can only imagine the agony he would have to go through to remove the pieces of melted plastic.

The air in the A&E smelled of cooked meat, soot & smoke. My MO looked up at me semi-defeated. "I can't get a line. I can't even see or feel a vein". The victim reminded me of a boiled sausage. Oedema or leaking of the intracellular fluids had set it and his whole body swelled uncontrollably. It looked as though he would burst out of his skin any minute now. I must admit, I'm not very good with neck lines, what more with the oedema around the neck area. In my head warning bells rang - Secure a line & the airway! Unfortunately, our clinic wasn't equipped to deal with emergencies like these. There were no femoral or angiocatheters. The only thing I could do was set in a gray branulla into both his femoral veins to run fluids. Unfortunately, this process had to be repeated a couple of times as he kept struggling and dislodging the branullas before the  sedation could kick in. My MO picks up quickly and does an excellent job of replacing dislodged branullas and keeping the victim hydrated. With fluids in, I can finally access the severity of the burn - 97% partial thickness. To reduce fluid loss and prevent hypothermia, we covered the victim with garbage bags. In proper A&Es you have burn or space blankets. Here, we make do with whatever we have, be it cling wrap, foil or garbage bags!

The person who brought in the victim told me a whole longhouse with 32 pintus or doors had gone up in flames. He wasn't sure how many victims there were but did think there were 100+ inhabitants in that longhouse. Did a mental calculation - even if only 30% of the inhabitants had injuries, we would be expecting 30+ people in KK Song. This was gonna be a disaster zone. Time to activate CODE RED! 

Unfortunately, no panic buttons like this

All staff staying in the premises were contacted. Many did not even bother to answer their phone as they were not on call. Next was to turn on the ambulance siren and let it blare for a good half hour. Even then, only a handful came. A big thank you to those who did. Upon post-mortem a couple of days later, many of the staff admitted they heard the siren but didn't bother to come down as no one had ever called a code red before and they didn't know what they were supposed to do! 

Anyway, back to the scene. By then, we had converted the waiting area into a triage zone with all the gurneys lined out. Hospitals upriver & downriver were alerted and put on stand-by mode. The district office and police were also alerted as we would depend on their boats to transport the victims. Hospital Kapit even sent down an EMS team at the first sign of daylight.

0430 - By this time, the patient started desaturating despite high flow oxygen. His airways were closing up due to oedema & swelling. Tried intubating the patient. Basically, a tube is shoved down into the trachea so we can do the breathing for him. Despite being able to see the epiglottis and vocal cords, it was tough. First, had to clear up the soot in his airway. Then started intubating him with a size 7 ETT and went down all the way to a pediatric size 3 but still failed. Even tried to nebulise him with adrenaline to reduce the oedema but without much luck either. In the end I had to make the call to to a chricothyrotomy.


I have never done this before. I had previously watched an elective tracheostomy being done during my ENT rotation. This was done in a controlled OT setting with proper equipment & the aneasthetic team on stand-by. Basically, you make an incision midneck all the down to the trachea and pass a tube though. So here I was with my "Handbook of Bedside Surgical Procedures" and a T&S set to do the cricothyrotomy. Read thru the procedure twice, gathered all my equipment, said a quiet prayer asking for Divine help to guide my hands and proceeded with the horizontal incision. Thank God I managed to get a size 3.5 ETT in. Secured it and started bagging. His saturation when up to 92-97%. However, his BP started going downhill and we had no choice but to start a dopamine infusion.

0630 - By this time the calvary had arrived. The EMS team from Hospital Kapit took over. The anaes MO managed to insert a size 6 ETT and get a proper fermoral catcheter in. Despite dopamine, his BP continued to plummel so in the end he was on triple inotropes. They did everything they could to stabilise the patient. We could throw away the garbage bags that was covering the patient and replace them with proper burn blankets. The police also came in to tell us there was only 1 other person unaccounted for and they were still looking for the body. The other longhouse villagers escaped unhurt or with only minor burns.

0915 - Finally the victim was stable enough to be transferred  He was sent by the hospital speeboat to Kanowit where he would continue the journey to the Sibu Hospital Burn Unit by land. Unfortunately, he took a turn for the worst during the journey and had to be stabilised in Kanowit Hospital before further transport. I think he only reached Sibu at noon. The CODE RED was called off around 0930 when none of the purported burn victims turned up in Song.

1130 - The remains of the 2nd victim was brought in. She was so badly burned beyond recognition that all that was left was her skull, torso, upper arms & thighs. Basically, she was a huge lump of coal with bone fragments (femur & humerus) sticking out. Her remaining bones were collected in a Milo tin. Despite 2 weeks in the HKL Forensic Unit, this was the worst remains/ corpse I have ever seen. Probably CSI and Criminal Minds conditioned me for what I saw, or else I would have puked on the spot. No BBQs for me for a while!  

Unfortunately, the patient succumbed 48 hours later in the ICU. According to his surgeon, he needed a reserve of 140% to survive, something he never had to start with.

Before I end, I need to give a big THANK YOU to all who responded when called, especially the EMS team from Hospital Kapit.

It is times like this when I'm forced to think out of the box and make do with whatever little we have here in Song. I thank Him for His Wisdom, His Guidance & His Strength to see me through, and the unceasing prayer support of my loved ones that buffer me in trying and difficult times.

Sunday, April 14, 2013

End of an old day, dawn of a new...

Last post about BSB.

Post boat tour, found a seat by the waterfront and was rewarded by this:

A rainbow at dusk

The waterfront area in BSB has some really expensive restaurants - one was Italian, the other  Japanese. As I was feeling a bit peckish, decided to stop for some coffee and watch the world go by.

Fancy restaurant complex overlooking Kampung Ayer

My not so 'atas' cafe

Walked about for a bit after that, till I got hungry again. Note that not many Bruneians come out to the city after dark. Maybe they go to the suburbs like Jerudong or Gadong. Contemplated going there, as recommended by the Lonely Planet but public transport stops at 6pm and taxis are almost non-existent and expensive (come to think of it, never saw a single taxi my 24 hours there!). Most Malaysians who come here, drive in or rent a car.

Monument to commemorate the Sultan's 60th
Had some mesmerising fibre optic lighting

Finally ended up at Kompleks Bangunan Yayasan Sultan Haji Hassanal Bolkiah, Brunei's largest shopping mall. No retail therapy for me there as everything was expensive, thanks to the exchange rate. Decided to do dinner at the food court as none of the eateries around the area looked enticing enough.

Their version of 'kolok mee'
More liao!

Next day, I was to take the bus back to Miri. Got up pretty early and had breakfast in the hotel. Was surprised they had milk fish and garlic rice, a Pinoy staple. Brunei depends largely on a migrant labour force. Most of the workers in the hotel as well as F&B industry are from the Phillipines whereas the construction line depends on Indonesian, Bangladeshi and Chinese (semi-pro) labour.

My Pinoy breakfast

Since I had only a couple of hours to spare, decided to seek out BSB's green lung and was not disappointed. About 2kms from the city is the Tasek Lama Recreational Park. This well kept park has some pleasant trails around the waterfall or the reservoir. As I was pressed for time, decided to do the shorter waterfall trail.

Trail routes

Tasek Lama waterfall

View from top of the trail

Must say its quite a nice place to bring the family for a stroll. The trails are well marked and all around the park are jogging tracks. Even the kids will have a ball at the various playgrounds.

No getting lost here

It was time to leave Brunei so made my way to the bus station. Discovered that the bus was only leaving 1 hour later as it was Friday prayer time. So I decided to wile my time away at Brunei's largest market - Tamu Kiaggeh. Unfortunately for me, this was closed as well.

No business done at this hour

All businesses shut down on Friday afternoons regardless of who the proprietor might be. You stand a fine if you fail to comply.

All shut down

As I had nothing left to do, just waited around the bus station till the bus arrived.

Waterways in the city

I have plans to be back as I heard the diving here is pretty good. Fodder for my next post perhaps?

Thursday, April 11, 2013

Venice of the East

Kampung Ayer BSB is also known as Venice of the East. This is a large village on stilts situated just by Brunei Bay. It is home to almost 10% of the Brunei population and up to date there's close to 40,000 villagers here. According to geography professor Abdul Aziz of the Universiti Brunei Darussalam, this is the largest and most famous water settlement of Southeast Asia. "It was historically the very core of Brunei and one of the most important centres of trade in Borneo."

The best way to appreciate Kampung Ayer BSB is a boat tour. I was milling about the steps at the waterfront when a boatman approached me. For B$20, you get a 1 hour boat tour of the sights. Very interesting perspective into their lives... everything is done above water. From homes, schools, mosques, shop, etc...

Boardwalks connecting between homes

Despite being simple wooden houses, 
most homes have 1 or more AC units

A religious school - closed when I was there 

A secondary school

There's even a busy Shell station. Unlike the ones on the Batang Rejang, theirs doesn't float. The petrol hoses are pretty long and it stretches all the way down into the boat. You fill up the tank and deposit your money into the little bucket which is then hauled up to the attendant. Petrol is much cheaper here than compared with Malaysia cause it's produced and refined locally.

After the tour of Kampug Ayer, the boatman brought me for a mangrove safari. He told me if I was lucky, I would be able to see Proboscis monkeys or Monyet Belanda.

Into the unknown?

On the way, passed the fame Istana Nurul Iman, the Sultan's official residence. Apparently this palace has 1,788 rooms, 257 bathrooms and a banquet hall that can accommodate up to 5,000 guests. Unfortunately, the palace is only accessible for 3 days a year when the Sultan throws open his doors for Hari Raya. My boatman has gone in not once but twice! He says he has never seen anything grander in his life. The Bruneians revere their Sultan as how the Thais revere King Bumiphol. Alas from the river all I could see was the rooftops and can imagine how humongous the grounds must be.

Istana Nurul Iman
supposedly more magnificent than Buckingham Palace

Also came across a peculiar rock formation.

Doesn't it look like the sunken Titanic?

The boatman then guided the boat into the swamps and killed the engine at a little alcove. He then told me to look up into the trees.

Quit looking at me!

This was the closest I've ever been to proboscis monkeys in the wild. They are really funny looking creatures with their extra appendage of a nose. I remember waiting patiently for them in Bako but only managed a fleeting glance. This time I spotted so many of them, and so easily I lost count after a while. I especially love the picture below, a silhouette of a solitary monkey in the fading light.

By the time we headed back to the waterfront, dusk had already descended. I looked back and lo & behold... 

Thursday, April 4, 2013

24 hours BSB


BSB is in one of the top ten richest countries in the world after Qatar, Luxembourg and Singapore. I had the opportunity to spend roughly 24 hours there & sadly it was not all gold and glitz, although this entry will be about it.

Boarded the early bus at 7am from Miri at Pujut Corner. I think it cost me RM40 for the 4 hour trip. Handed my passport to the conductor as the bus pulled out and he kindly filled up the immigration form for me as the bus journeyed on. 

Brunei is DRY!!!

As Brunei is an Islamic nation, they have very strict rules about alcohol. It's even stated on the bus ticket. I have read Thorn tree & TripAdvisor posts about how tourist try to bring in a tipple by transferring them into mineral bottles and thermoses. Hello... respect the culture of the country. When in Rome, do as the Romans do!

Anyway, after 1 1/2 hours or so in the bus, I got off at the Malaysian checkpoint, and next to the Brunei checkpoint. Painless 10 minutes procedure to get my passport stamp (Yay! Another ASEAN country to complete the list!). Half way thru, stopped at Kuala Belait, an oil town to pick up more passengers. Small beachside town with all the amenities and  an array of international eateries to choose from, thanks to the O&G industry. Quite a pleasant town for an expat. Saw lots of pretty Shell employee bungalows on the way.

This is their only mode of public transport - Public Bus

Arrived in BSB around 11am so started looking for a place to stay. Most of their hotels are rather pricey, thanks to a strong exchange rate (B$1 = RM2.50). Decided against staying at the YHA dorms (Upgraded myself from backpacker to flashpacker). Walked around and finally found an old hotel for B$65 at the far end of the town. Although it had a mini swimming pool, the bed was lumpy & the lift was dodgy. Thank God it was only for a night. I happened to only carry RM and Sing dollars at that time so paid them the equivalent in Sing Dollars, which was equal dollar for dollar.

This is how retro my hotel was.
Even had an old style juke box by the bar.

Set out to explore and get some lunch, as well as some Brunei dollars.

The Sultan is ever present

Was surprised at how empty the streets were, even at lunch time. If it was KL, freaking traffic jam, man! And this is in a country where almost everyone has cars cause fuel is so freaking cheap!

Hello! Anyone around?

First thing first... A visit to the Royal Regalia Museum. Heard there was an insane ammout of gold on display there and wasn't disappointed. Plus it was also a place of refuge in the searing midday heat!

Shoes had to be removed upon entering.
Bedroom slippers provided!

This place had the Royal Chariot, Royal Ceremonial Regalia and all the gifts given to the Sultan by Heads of State on display. There's even a interesting looking solid gold arm for the Sultan to rest his chin on during the crowning ceremony. Unfortunately, cameras were not allowed at the exhibit halls, only in the rotunda. All in all, a pretty interesting place to spend an hour or more regaling in Brunei's past and ogling the opulence.

Ceremonial shield
(Notice I was wearing a cardi cause it was freaking cold in there?)

Ceremonial payungs

Royal Chariot
The Sultan gets paraded around the streets on this 

Most of the sights in Brunei are accessible by foot as the city is rather compact. Decided to walk about a bit when it wasn't so hot (but still pretty hot by my standards as I got a sunburn, despite a cap!).

Royal Regalia Museum

Royal Ceremonies Hall

Brunei National Library
They had a fantastic mosaic mural! 

Walked all they way to the river edge and was rewarded with the imposing Sultan Omar Ali Saifuddin (SOAS) Mosque. Really, this place is pretty majestic and with clear blue skies as the backdrop, a photographer's dream.

The grounds are immaculate and such a pleasure to wander in. Pretty water features ie: fountains and ponds around, well tended lawns and well manicured shrubs. There's even a Royal Barge albeit a static, concrete one on display. So peaceful...

The Royal Barge

Most impressive for me was the area for cleansing/ 'wudud'. It had beautiful Roman columns with Islamic geometric patterns. The worshipers who were preparing to go into the mosque must be wondering why I was so awed with their 'wudud' area! Hahaha! Really hoped I could go in to see the amazing stained glass of the dome & run my hand thru the opulent Persian carpets (I know cause I sneaked a look). Even came appropriately dressed, jeans and a long sleeve cardigan covering my tank. Alas, it was not to be so as it was a Thursday and it was prayer day for them. So all I could do was camwhore a bit outside the grounds!

More next post on my trip to the Venice of the East!