As part of his final year elective placement for medical school, Lachie Roach and his friend Jamie went to G-land with ‘Surfing Doctors’ and Nias with ‘Friends of Nias’.

What was it like getting to Lagundri Bay?
The trip to Nias and back was challenging. We travelled on Lion Air, which we found to be quite a difficult airline.
On the way to Nias, we flew from Denpasar to Jakarta, which was delayed, meaning once we arrived, we only had 10 minutes until the departure of our flight to Medan. We had to run from one terminal to another, arriving just before they were shutting the doors. We had a short wait in Medan, then boarded a small twin-propeller plane to Gunung Sitoli. Once we arrived, we had a driver pick us up and drive us for 2 hours to the clinic where we stayed in Sorake.

Was it your first time there? How long did you stay?
This was our first time in Nias. We stayed and volunteered at the clinic for two weeks.

 

What were your first thoughts on the clinic and the place you stayed?
Before arriving, we were warned about “culture shock.”
We arrived at the clinic at around 7pm. We met Raffiel, whose home/surf house accommodation and restaurant are directly across the road from the clinic. He gave us the keys and a tour of the clinic.
There is one main room that is divided with a curtain. This acts as a waiting room and consult area with medicine cabinet when the clinic is open.

How busy was the clinic?
Raf set up the clinic to allow for maximum surfing, which is excellent. The clinic opened from 1pm until 4pm — this meant you could surf in the morning, have lunch, then work at the clinic, and there was still time for a surf afterwards.
A nurse attended the clinic, acted as a translator, and took notes throughout consults.
Saturdays were the busiest as they are a religious day, and patients fast in the morning. Patients are encouraged to come in after this so their fasting blood sugars can be tested, as diabetes is rampant in the community.

 

Were there any dramas/emergencies while you were there?
The most significant difficulties associated with working out of the clinic were limited resources, proximity to help, and language barriers.
The resources at the clinic are limited to basic investigations (capillary glucose, lipid and urate sticks, and urine dipsticks) and whatever is in the medication cupboard.The closest hospital is in Gunung Sitoli, which is 2 hours away. From what we could gather from nurses and locals, there was capacity to do some basic pathology and X-rays. It sounded like there was a gen med and a gen surg team in the hospital, but for anything more serious, people needed to be transferred to Medan or Jakarta.


The language barrier provided obvious difficulty in history taking, conducting examinations and explaining management plans, but with persistence and patience, all was very achievable. The area I found most difficult was emphasizing the urgency of presentations and the urgent need for action by the patient.

Most patients presented needing ongoing management of preexisting chronic conditions. These included reflux, hypertension, dyslipidaemia, gout, and osteoarthritis.
However, in our two weeks, we had some critical presentations. These included a patient with urinary retention, a patient with pleural effusion, a patient with hemiplegic gait and loss of sensation in the lower limb, and a patient with a clinical picture consistent with hyperthyroid and bilateral hemianopia. Each of these obviously required investigation and management beyond the scope of this clinic, so we encouraged them to go to the hospital, wrote notes describing what we found and called the hospital — however, equal parts baffling and understandable, most patients were not financially equipped to get transport or taking time off work to go the hospital.

 

What was the most rewarding element of your trip?
Seeing the impact that the very limited work we could do was having on the individual and the community. The people there are so kind and grateful.

What did you think of Lagundri?
I’m a goofy footer, and Jamie is natural. Both loved the wave. Paddle out is through a keyhole up the point. It’s a single take-off spot, so it can get a bit competitive with the crowd. Waves come in pulses with long lulls between. It is unreal if you can catch it during a pulse with not too many people out. The best waves are the double-ups.

Did you surf any other waves in the area, or were you too busy at the clinic?
We hired scooters for a couple of days but never surfed anywhere else. We went up to Kings Village, which is worth the trip. Supposedly, there are a couple of other good waves. The locals are more than happy to point you in the right direction.

 

Who of the people you met at Sorake, either in the clinic or in the surf, were the most memorable?
Raffiel and his family across the road look after the clinic. We struck up a deal for meals there, and it’s where we spent the majority of our time when we weren’t surfing or at the clinic. His daughter-in-law Wita is one of the nurses at the clinic, and her 3-year-old daughter Jess was hilarious; she would run around the surf camp playing with everyone.
Hash runs a surf camp with his family about 5 minutes from the clinic near the keyhole. Initially, we met Hash as a patient; he and his family were very friendly. We sat and had beers with him every afternoon while we watched the surf. His daughter Elvira is a pharmacist and is responsible for restocking the clinic, so if there were any stock issues, we spoke with her.

What boards did you take with you, and were they the right choices?
I rode a …Lost Rad Ripper (6’0” x 20” x 2’ 1/2”) and a …Lost Driver 2.0 (6’1”x 19’ 3/8” x 2’ 1/3”). Jamie rode a Sharp Eye Stormz model and a Tokoro.
Both of us were super happy with our choices. We felt like they were adequate. We would’ve been under-gunned if the swell had gotten any bigger.