FDS

Generally in Sarawak, FDS stands for the FLYING DOCTOR SERVICE. The Flying Doctor Service was introduced in 1973 to provide basic health services to people living in remote areas. The service operates 3 helicopters that are rented under a contract with a private company. The helicopters are based in Kuching, Sibu and Miri and together, they cover 141 locations in the remote rural parts of the State with a attends of about 70,000 outpatients, children and antenatal mothers every year. The Flying Doctor team comprises a medical officer, a medical assistant and two community nurses who visit the locations once a month or once in two months. The Flying Doctor Service also provides medical emergency evacuation (MEDEVAC) of seriously ill patients from the locality to the nearest appropriate hospital, from rural health clinics to hospital and from hospital to hospital. It also served as cargo run to rural health clinics in delivering medical items and drugs. During disease outbreak in the state, the Flying Doctor Service helicopters are also used for quick transportation of field investigation and control medical and health teams. (Taken from the Sarawak Health Department's website)

However, here along the Batang Rejang the FDS takes on a new form - the FLOATING DOCTOR SERVICE. Good serviceable roads end near Kanowit. From then on, the only way to reach the towns of Song & Kapit is by boat. The Batang Rejang is a lifeline to the various settlements and longhouses along its banks. Not only do people rely on it for transport, water for household chores, it also provides a livelihood in the form of exotic wildlife - think buaya, empurau, labi-labi!

No traffic jams, only boat jams!

Here in Song, other than the main Klinik Kesihatan Song, there are 4 other rural community clinics along the Batang Katibas, the main tributary of the Batang Rejang. They are:

1. Klinik Kesihatan Nanga Tekalit

2. Klinik Kesihatan Nanga Bangkit

3. Klinik Keishatan Engkuah

4. Klinik Kesihatan Chemanong

Follow the river
From Pasar Song down to KK Chemanong!

The first clinic, KK Nanga Tekalit is located 45 mins from Song. It is the only clinic accessible by road. The other clinics are located 1 hour away from each other, all only accessible by boat.

Here is where the FDS comes in.

The clinic's sampan

Usually the FDS team, compromising a doctor, a sister, a nurse +/- the dietitian as well as the boatman and navigator makes the 1 week trip upriver. The only way is by sampan. I have inquired why fibreglass hulls are not use, since they are much lighter. Apparently, they are too fragile and will not withstand all the knocks by flotsam and other floating whatnot. Rubber dinghies are also out of the question as they won't be able to hold all our cargo!

Loading up
Notice the extra fuel we carry in jerry cans
Plus, you have to do a balancing act on the log to get to the sampan! 

We carry everything from medication, instruments, rations for the 1 week trip and bedding. There are no shops along the way, so we need to load up on everything in Song. Sometimes if we are lucky, we get local villagers selling deer, fish or local jungle produce. Usually we stay in the clinics serviced but sometimes we  op for the longhouses, especially if invited by the tuai rumah.

It's a beautiful journey upriver. Lots of overhanging trees that provide shade but it still gets hot and a tan is inevitable! Along the way, the banks of the Katibas is dotted with long houses and schools. I have yet to see a crocodile but herons, eagles and hornbills are regularly spotted.

People pay tons to do boat journeys like this.
For me, its part of work!

The first day is usually spent seeing patients in KK Nanga Tekalit. Then we push on to spend the night in Nanga Bangkit. The journey to Nanga Bangkit is particularly exciting as we have to transverse a series of rapids. Usually, it means nothing more than getting a big splash to me but most of the female staff gets jittery when we near this place. I'm definitely not taking chances with these rapids, despite being able to swim and a life jacket. I have called off a return journey as it was raining cat & dogs with the rapids turning to a Grade II-III. Its fine in a whitewater rubber raft, but not in a rigid sampan!

Bangkit rapids

A welcoming sight after the Bangkit rapids.

Klinik Kesihatan Nanga Bangkit

After Bangkit, its another 1 hours journey to KK Engkuah where we usually spend a night. Engkuah's also the place where I get to mandi sungai. Despite my healthy paranoia of croc infested rivers, I still jump at the chance to mandi sungai. Thank God the river is clear here... at least I get to spot the croc before it spots me!

KK Engkuah - won an award for best rural clinic

Finally, the last clinic KK Chemanong is slightly more than 1 hour away from Engkuah so we sometimes stop for a breather midway. When I mean breather, its usually a ciggie & pee stop for the guys! Hahaha!

With the boys!
L-R: Navigator, health inspector, medical assistant, captain, doc

As these rural clinics are only manned by a MA or dresser, the local folks take the opportunity to get checked by a doctor during the FDS clinics every 3 monthly. I see anywhere between 25-50 patients per clinic session. Its tiring and draining, living conditions aren't the poshest, I get bitten by mossies, feas and other thingamajigs but compared to what the folks of the Katibas go through daily, I have no right to complain. In fact, I look forward to the next trip upriver.

By Friday, we pack up and head back to Song. The trip downriver is faster. It only takes 3 1/2 hours. Then its back home to do my 1 weeks worth of laundry and take some well deserved Zzzzz.