Mami, where your baby hat?

I have finally found 5 minutes to write something - although you can bet that having been asleep now for 4 hours, he is due to wake up any minute now.....



So, the longer version of having a baby in the Turks and Caicos Islands.



I was in the Myrtle Rigby Health Complex, built by the British Government in 1994. The maternity ward was built for 5 beds (going by the positioning of the curtain tracks), yet there were 7 of us in there at one point. The Maternity ward consisted of one room, plus the delivery room (which doubled as the incubator room too), a bathroom (1 bath, 2 steel toilets, 2 tiny steel basins - one of them out of commission on account of a cleaners trolley being in the way) and the nurses station which was right by the door and squeezed in between the beds. So it was a cosy, intimate place to be! My bed was stuck between a wall and the curtain of the adjoining bed, so every time the doctors/nurses came past to examine me they had to struggle with the curtain and fashion some sort of screen at the end of the bed - although when you've given birth any sense of personal space and decorum go out the window!



There were windows right around the ward, but the hurricane shutters were closed so there was precious little natural light in there - but also no curious on-lookers either (the hospital is all at ground level).



I turned up on the ward at 2.30am on the Monday morning - we had to wait for someone to come open the door (it had a security key pad on it) and then I was whisked from 21st Century Provo to a parallel universe operating much on the same level as "Carry on Matron", or what I imagine a nursing home of the 1950s would be like. Sister (Guyana) briskly ushered Osh and Nicky out the door (strictly no-one in the delivery room and no children on the ward at any time) and instructed them to go get my bag. She was tickled pink to discover I was Elizabeth Mary and referred to me as that for the rest of my stay (don't forget that the West Indians are very God Fearing). Of course Isaac was being in a hurry and whilst the bag was mostly prepared I'd not told Nicky where it was - but between him and Osh they sorted it out and returned it, just in time to say hello to Dr Roberts (Dominica) who had arrived to do the C-Section. Looking immaculate as always at 4am! I was a little nervous about telling the nurse that I was supposed to be having a section - you can imagine that on the NHS deciding to have a section on account of previous 'traumatic' labour (the Dr's word not mine) and then still demanding that c-section having gone into labour spontaneously would have been met with short shrift. Not here though. I said I was hoping for a C-section and the on-call Dr. was promptly called....now that's what I call service!



The operating theatre (just the one) was just across the corridor and I was wheeled in, with the contractions happening frequently now (don't worry, no gory details here!), and I was, I confess, terrified! I was on my own - save for the medical staff (mostly Filipino), shivering uncontrollably (fear and the AC) and very very miserable. As they gave me the spinal anaesthetic I really really wanted to be anywhere but there. What happened next is a bit of a blur.....I think I remember someone showing me a baby....and the next thing I remember I was back on the ward, unable to move (frozen legs) and very very drowsy. Turns out Isaac was fast asleep in his little fish tank by the bed - and there he remained for much of the day because I discovered soon enough that moving was bad enough - sitting up and lifting a baby was a whole other matter.

That night not much sleep was had - you can imagine that on a small ward next to the nurses' station the lights were on all night, and there was a constant stream of women giving birth so the noise was rather primitive all night (for the anthropologists out there, the Haitians are prone to sing hymns in creole, the Turks Islanders are more quiet!) That first night (Monday), 2 women gave birth, Tuesday during the day a woman due for a section the following day was turned away and told to come back later as they had no beds (that could have been me too.....), a woman turned up in stage 2 labour and looked like she was going to give birth there and then at the end of my bed, that night another 2 women produced babies and a woman vomiting blood was admitted. In fact Tuesday night was utter bedlam. The poor woman vomiting blood was admitted at about 1am - at this point the ward was full, so her bed went along the bottom of my bed (which was unfortunate as the one bodily function I can't stand is vomiting.....). How the staff on duty coped is beyond me: not only were they dealing with this woman (7 months pregnant) but they were delivering babies at the same time! Wednesday during the day a set of twins was delivered, Wednesday night was quiet (thank heavens). In total, I think I counted 9 babies born over the course of 4 days: 1 white baby (that was me!), and slightly more Haitian babies than Turks Island babies (probably in the region of 65% Haitian, the balance Turks Islanders).

One of the benefits of being all of 10' from the nurses' station was that life was never dull: many of the nursing staff are Guyanese, there was a Nigerian nurse, a Keralan nurse, probably a couple of Jamaicans (although I'm not good at distinguishing one accent from another yet) and all the SEN staff were Turks Islanders. The banter between them was very entertaining, especially for someone interested in linguistics. I was endlessly amused at the Guyanese habit of saying we instead of our and she instead of her - so a nurse would be asked to 'go take she temperature' or one of them would say 'they came to we house'. Also, being so close to the nurses' station, my medical knowledge increased 4 fold. Turns out the woman admitted vomiting blood was suspected to have pre-eclampsia, this was then ruled out and they thought it might gastritis. The doctors, however were puzzled by the 'coffee grounds' she was vomiting which was apparently digested blood which indicated something serious going on inside. They attempted to insert a gastric tube which she refused (all this was going on feet from my bed - nothing like on ER when those tubes just slide down!), they then told the husband (both Haitian, he spoke good English, she was able to yell "stop", and a variety of obscenities in English but little else) that either she consent to a tube being put down anaesthetic, or they would have to discharge her (there being nothing they could do for her if they didn't know the cause of the problem, plus it being a health and safety nightmare what with digested blood all over the place). She agreed and off she went to theatre - 1 hour later she was back with the tube, but at 5am she pulled it out. The nursing staff were seriously cross with her at this point and boy did they let her know it. Not because it was more work for them, but because they genuinely cared about her and couldn't get her to understand that a modicum of discomfort might just help them help her. They weren't helped that she was sure that the tube into her stomach would harm the baby.....a low level of education wasn't helping anyone at this point.

Another consequence of the nurses station being on the ward was that visiting hour sometimes never happened - whilst the rest of us were privy to everyone's medical history, the members of the public were not allowed on the ward whilst the doctors were there (Dr Roberts plus Dr Naira (Nigeria) and Dr Guzman (Cuba)). This rather explains the security key pad on the door and the very hefty security guard there to eject cheeky visitors and to calm the rabble outside on the couple of occasions that visiting hour never happened. Sister (a different one each shift) ran a very tight ship and wasn't going to stand for any nonsense from anyone - mothers included! What I also discovered was that these were no ordinary nursing staff: one day they might be on maternity delivering babies, the next day they could be in A&E dealing with RTA, the next day on the general ward dealing with all manner of problems. Their level of skill was astonishing, but because there was a comparatively small number of staff, over the course of 4 days I got to know them all - and every time they came back on shift they knew who each of us was, and remembered a little bit about all of us. This was certainly not my experience from British hospitals were you are simply another nameless patient. Even the 3 cleaners (who religiously swabbed the decks at 6am, noon and 6pm) were friendly and remembered who all the mothers were. The staff work in incredibly difficult circumstances (at one point there was 1 digital thermometer in the hospital that was working....and it was on the maternity ward!) yet are always polite and cheeful and kind. In short, the attention I received in there was second to none. I would not have wanted to give birth in there for the first time, and its not the place to be if you are after 'natural' child birth (sister was a great believer in strapping you to a table and attaching the monitors - mostly because there simply wasn't room to wander around) and not the place to be if a major emergency comes about.

I was discharged Thursday - but my repeated suggestion that Isaac was jaundiced finally paid off and blood was taken from him Thursday morning. The blood testing machine in Provo isn't working, so the samples were sent to Grand Turk - they got there at 2.30pm and at 6.30 the result finally came back showing that he had very high levels of biliruben (dying red blood cells that make you yellow). Dr Ventura (Filipino) wanted him to stay under the lamp - although she conceded that it wasn't the most efficient lamp available and if a very sick baby was born they'd have to take him off the lamp to make way for the sick baby - Nicky suggested I discharge the both of us and make use of the natural sunlight. Which is what I did - although discharging Isaac against medical advice was a little scary.

That night, I slept in the dark, in my bed, after a lovely lovely wash and slept probably the best night's sleep I have ever experienced. I was back in the clinic on Wednesday for Isaac to have his BCG against TB (rife over here) and he had another blood test, which showed his levels were still elevated, but declining. It was ironic that Dr Zoe had expressed surprise that I'd taken Isaac to visit friends 2 days after coming out of hospital (I declined to tell her we'd also been to the beach and the supermarket) and yet said that the only place to get the BCG was the government clinic - a four hour wait surrounded by the sick was presumably safer than taking him to IGA to buy milk! The clinic was interesting, as always, and the number of women coming up to me and decrying the fact that Isaac didn't have a hat on was amazing. To me, it was 28 degrees, pleasantly warm, to them, I was a feckless white woman who clearly didn't see that he ought to be in a hat, booties, gloves and swaddled in a large fleece blanket to ward off the cold weather! Poor Isaac was the white baby on the ward dressed in Osh's cast-offs where as all the other babies had brand spanking new baby sets to wear....conspicuous consumption I think they call it.

So here we are nearly 3 weeks later: Isaac is very much less yellow thanks to frequent exposure to the sun (trying hard not to fry him to a crisp too!), feeding well and sleeping a lot. He is putting on weight and is noticeably longer than last week. I've lost count of the number of people that have expressed surprise that I gave birth at the clinic - commenting that I must be brave or mad. Secretly, I'm very proud that I had the courage to do it, and I've certainly earned a huge number of brownie points from the Turks Islanders - as a rule those that can, pay to leave the country for their babies.

The arrival of baby Isaac - the short version

Grandpa, Mim, Isaac and Osh, moments after arriving home

Celebrating his arrival with champagne

The boy

Isaac on 1 December in hospital.

To satisfy the need for pictures, here are some and the brief details. All the gossip of what it is like to give birth in a small cottage hospital in the West Indies, a hospital run along the lines of a 1950s nursing home are to follow...

Isaac Hogarth Turner, born 5 am 1 December 2008 by C-Section. He was supposed to be delivered by planned c-section on the 3rd, by at 2.30 Monday morning he decided he wanted out! He was born on the night when Venus and Jupiter were two very bright stars visible to the naked eye just above the moon....an auspicious baby!

He is a little jaundiced but I brought him home on Thursday (against medical advice, gulp) to give us both some sleep and him lots of natural light therapy. Off to Dr Zoe tomorrow to see if his biliruben levels are within the comfort zone yet. Fingers crossed.

He is eating and sleeping very well. I am very well - a little sore still but now able to walk upright!

BYO blood

I was back in the clinic on Monday for yet another visit. But older and wiser this time: I nabbed a seat close to the doctor's door so that when he came out and whispered my name I had a better chance of not missing it and I clung to that seat for 4 hours...a huge improvement on the previous week's 7! I managed to knit the best part of a jacket for Baby Turnip whilst sat in that seat, Stanley once again entertained us (walking round and round the room ranting about British passports, I concentrated on my knitting remembering that you never, ever make eye contact with the nutter in the room), although SPICE were elsewhere.

I finally got in to see the doctor (Dr Naira from Nigeria) who was kind and as interested as a doctor can be with so many patients to see. He confirmed that I was booked in for the 3rd of December, reminded me that I needed to identify a blood donor and order yet another thyroid test for me. And after yet another ultrasound (what a treat, compared to the 1 you get on the NHS in Portsmouth) which confirmed that Baby Turnip was probably nearer 7lb rather than the 6lb of the previous estimate, I walked home.

The weather has changed dramatically: the evening air is cool (think the evening air of an English summer after a crackingly hot day), the days are sunny and the sun still hot, but the cooler air keeps it all under 30 which is fabulous.

The following morning I went for the blood test and Nicky came to to see if he could be a donor. Not, is the answer. Osh is A, Nicky is A, Nicky's dad who is currently staying with us is O but at 86 I'm not sure how long he'd recover from having nearly an armful taken out of him. All the other people I've contacted are either A, too skinny or currently anaemic.

So why, you might be asking yourself, do I have to get a donor? Although there is a blood bank here, it is very very small. The hospital carries a list of donor which are contacted in the case of an accident (all the more frequent), so they try and get those coming in for elective surgery to organise their own donor which a) takes the pressure of the blood bank and b) means they can get in more blood for the bank (assuming the happy event that the donated blood is not used). So I'm still on the look out for a donor - I thought O was the most common group, but apparently not. And I thought I could give a pint of my own blood, but turns out it is too close to surgery.

All attempts to get an infant car seat have proved fruitless - although we do have a rather fine infant hammock sleep thing which is rather fun. The only infant seats on the island are $240 (sell for $50 in Florida), so in the end I've ordered one from Miami and am having it delivered to our Miami postbox - enormously expensive but still $100 cheaper than buying the same thing here.

So here I am on the look-out for a donor, the bag for hospital is packed and I'm trying to tidy up loose ends so that Nicky doesn't have too much to do whilst I'm away. I'll be admitted on the Tuesday, surgery on Wednesday (no idea what time, although I might find out when I got to the clinic yet again on Monday...yawn). I'll probably be in hospital until the weekend, but will endeavour to post an update as soon as I am out.

The National Health "Service", I use the word Service with caution

The nagging worked, and here I am updating the blog. Excuses for not doing so earlier: very slow internet connection (now resolved); busy with other stuff; not much of any note to report etc etc.

Yesterday was an education. I've been seeing a doctor privately throughout my pregnancy - and whilst to British ears that sounds wildly extravagant, when you get to the end of reading this, you'll realise why it is the option of choice out here. At $85 a visit you certainly can't afford to be a hypochondriac here, but for a regular once a month check up, it is money well spent....and how many NHS doctors in the UK provide you with their personal cell phone number and an invitation to call whenever you need to?

However, whilst money can certainly buy you access to a doctor out here, when it comes to delivering a baby on the islands the playing field suddenly gets very level indeed. My doctor is going to perform the C-section, but the only place to do so is at the government clinic (immediately opposite our house). The notion of me being booked in by a separate route on account of being a 'private' patient doesn't exist, so in order to have the baby there, I had to register as a patient at the government clinic. The clinic is somewhat like a cottage hospital: it doubles as both the government provided GP service and a hospital all in one building (although emergencies are thankfully not wheeled bleeding and dying through the GP waiting room!). So, forewarned that I needed to be prepared for a long wait at the clinic, I went yesterday at 8.30 (the smart women start queuing at the door at 7am....there are no appointments, but the place works on a first come, first served basis). The short version of this story is that I left at 3.40pm, having had my blood pressure taken and spent 10 minutes with a doctor who read through the notes from my own doctor. That's right....7 hours in the same room for nothing to happen.

The long version - and trust me, the more colourful version follows.

The waiting room has 6 banks of hard plastic chairs in a square room (probably no more than about 90' square), treatment rooms are off this room. The receptionists sit behind reinforced glass on one side of the room where someone has cut parsimonious holes in the glass in all the wrong places.....so you have to shout through the hole to be heard and then quickly jam your ear against the hole to hear the reply. And then repeat the process 2 or 3 times to make sure you heard right.

I had paid the $250 to register as a patient (the fee for 'belongers' is far less than this) for the antenatal clinic the previous week. The room was filled, standing room only by the time I got there at 8.30. Needless to say, I was the only white woman in the room - which is a little unnerving at first, but by the end of 7 hours, I realised that had another white person come in the room they would have looked very out of place! For the most part, the people in there were very pregnant and there for the ante-natal clinic, or mother's with children for their shots. Nearly all were either Haitian or Dominicans (judging by the languages being spoken), I was the only Brit and spent an enjoyable day with a lovely woman from Kisumu (Kenya) who's husband works for the Government Investment bank. The woman from Kenya couldn't get over the level of inefficiency in the place....which says something either about Kenya's level of medical provision or the Turks Island ability to process patients....one or the other!

I was armed with a book (History of the World in 10 1/2 chapters by Julian Barnes) and a breakfast bar. At 11 Tim dropped in with a couple of bottles of water and more biscuits, at 11.30 a nurse called me in and took my blood pressure (which was by now up to 125/75....a long way up from my normal which is around 90/60). In the meantime Stanley paid us a visit: Stanley is one of the local nutters. He is probably around 65, wanders around Downtown, sometimes in his blue Santa hat, always armed with a file of important looking papers (most of them religious tracts) and wearing an official looking ID badge on a chain around his neck. Rather than preaching to us or singing to us (his other talents), he walked around and round the waiting room yelling at everyone to leave him alone, holding gibberish conversations with the (un)lucky few he chose at random and then left (presumably because the best way to be 'left alone' was to leave himself!). After Stanley, SPICE showed up which sent a ripple through the place. The Special Police for Immigration, Customs and Excise regularly do sweeps across the islands picking up the undocumented, but also the unfortunates without their documentation (ie legal). One of them guarded the door then the rest did a sweep of the room demanding to see work permits. The place was very crowded and very noisy and so I decided to sit tight and see what happened. I have no work permit because I don't work - so on that basis felt no need to go justify my existence to them. But, I was also without any documents because they were all in the Immigration office being regularised.

As I suspected - and I am shameful of this - they didn't even ask me for any proof because there were plenty of Haitians and Dominicans in the place they could bully and terrorise. The poor woman from Kenya was given grief because her documents were also in immigration and they wouldn't accept copies of her NI payments proof (you can't pay NI without a work permit) or her TI drivers licence (you can't get a TI drivers licence without proof of residency). I'm not sure they removed anyone from the building - maybe it was just a scare-mongering exercise - but one does wonder whether they went around the wards next, enquiring of people's status (dragging the sick from their beds etc!).

The presence of illegal aliens in the country is a huge issue at the moment. The bulk of the illegals come in from Haiti and the bulk of these are semi-literate and unskilled. They put a huge strain on tight resources (in terms of policing, but also socially in terms of bringing with them TB, HIV and petty criminals) and on such a small island it is vital that a check is kept on immigration. What makes an utter mockery of the situation, is that Immigration officials accept bribes to stamp Haitians in through the airport - our 2 illegal Haitian workers regularly fly back and forwards to Haiti and have acknowledged that they get in and out by bribing immigration officers. So the right hand is letting them in and the left hand is trying to get them out.....or maybe the right hand is just doing their best to ensure that the left hand has something to do all day to justify their salary!

Suffice to say that once SPICE had gone the room had noticeably thinned out - which was good news for those of us left. Or so we thought. At 1pm Nicky popped in to bring me some sandwiches, I spent a couple of hours playing with 2 Haitian toddlers (who thought it hilarious that I couldn't understand a word they were saying and were fascinated by my freckles), the cleaners arrived to swab the place down before the start of the afternoon session and the place was a room full of Creole banter and laughter as the cleaners (Haitian) exchanged shouts and jokes across the room with the patients.....for all the language and mannerisms and chaos around me I might as well have been in Port au Prince for about 10 minutes. By 2.30 the morning clinic was done with and the place filled up for the afternoon. There were just 4 of us hugely pregnant women left.....ominously the doctor appeared to be about to leave when Nicky arrived with a cup of tea for me. Nicky, he of the short temper and plenty of experience with Turks Island medical provision tried to find out when I might be called in. Only to discover that the nurse in charge of the pregnant women had knocked off for the day, the reception staff had no idea and the doctor was indeed about to leave until the next day. By this point there was me and a woman from Haiti who had been there since 7am.....Nicky charged into the administration office and demanded that someone do something about the utter lack of service. And lo, a woman he knew emerged and managed to get my file onto the desk of a very sweet Filipino doctor and I was finally seen at 3pm. Or rather she read through my doctor's notes, asked me all the usual questions (what was the date of your last period and then proceeded to work out how many weeks I was by hand; how much thyroid was I taking ..... all this information of course was already on file!) and confirmed that everything was fine and she would 'put in a request' for me to have the C-Section on 3 December. Note the 'put in a request'. I have to go back Monday to see the regular doctor on Monday for yet more pointless questions and to (hopefully) find out if 3 December is a definite or not. Armed with a flask of coffee, sandwiches, a book and cushion - those seats are not comfy for someone with little padding!

No-one knows why it took so long to see me, or indeed why the doctor was leaving before some of us had been dealt with....but the level of noise in the room and the quietly spoken doctors (Filipinos and Indians just cannot do 'noise' like West Indians) probably didn't help in their bid to call patients to their rooms. What was remarkable was that in the course of 7 hours there was never any fighting about who had jumped the queue and who should be seen more urgently. I've seen plenty of arguments break out in the Immigration office when mouthy large women (and that is the usual culprit) come barging in demanding to see someone in authority much to the annoyance of the hundreds that have been waiting patiently for hours.

So, there we have it. I am probably going in on the 3rd to have this baby, I'm hoping that I don't have to wait a full 7 hours on Monday just to have my blood pressure checked and have the date confirmed. But I did get to read a chunk of my book, I did meet some interesting people and I did learn that whilst my credit card can't help me avoid the Government clinic for this procedure, for all other medical problems I can buy my way into a quiet, calm, efficient doctors waiting room....unlike many of the woman in the Government Clinic who have to forego a day's wages each month for the sake of 10 minutes with a health care professional.

Baby news

My sincere apologies to all of you that have been checking back regularly to find out what happened to the baby....and for all your lovely emails of support. I should have written days ago and kept forgetting. And the intermittent email access hasn't helped much.

So here's the news: baby is absolutely fine. Has a full head of hair, apparently (no idea what colour it is!), is bang on target in terms of dates etc. My fluid levels were great too - they had increased from 5 to 12.79 in a week and the conclusions reached was that I had lost fluid due to dehydration and stress. Hurricanes can clearly take a toll on the unborn as well as the rest of us! So, now on a regime to down plenty of fluid - and Baby Turnip (as he is known) is still kickboxing ALL DAY, so he's clearly not bothered much by the fact that the level of his swimming pool went down for a while.

I have to endure the trauma of the Mrytle Rigby Clinic in a couple of weeks - this is the government hospital over the road which doubles as the state GP provision and hospital in the same building. They are currently building a HUGE brand new hospital, but it won't be finished until way after the baby is born. Although I'm having the baby privately over the road (I'm not entitled to any national health service provision) this does not spare me the chaos, disorganisation and bedlam of sitting over the road to have a check up and book me in for the C-section which is scheduled for 1 December (although I met a woman yesterday who is due on 31 October and they were trying to book her in for a C-section on 5 November.....go figure!). I'm sure it's no worse than a British inner-city hospital on a Friday night - only more Haitian perhaps! More on this when it happens.

As for the utter madness that is the so called 'disaster relief' effort in this country, I'll fill you in on all this tomorrow.

headless chickens and the like

The week after returning from Grand Turk has been frantic. Monday's round of phone calls revealed, finally, that they did want 30 toilets sent over to be used for the tent city (turns out this is just a feeding station rather than for people to sleep at too), so that day was very busy loading up the toilets and getting them to the dock for shipping. The crucial deal here was that we would not have to pay for shipping them if we got them there for 6pm. There were the inevitable cock ups with us being told to go to point A when we needed to be at point B, getting to point B only to discover that some of the unloaders didn't have ID on them and couldn't enter the port (leaving Nicky to do all the work), no container had been organised (making shifting 30 toilets that much harder). We also shipped over the white poop truck (an Isuzu flat bed with a tail lift and a small pump on board) which we knew needed a new starter motor. Everything got to the dock on time, and arrived in Grand Turk the following lunchtime.

Nicky went over on Thursday with the new starter motor to fit to the truck and get these toilets into position and set up. Except the truck refused to start. He spent a very frustrating day driving around trying to find somewhere that could fix the truck...but no-one could. He commented that the island was now in a more backward and under-developed state than it had been 20 years ago when he lived there. So right now we have 30 toilets at the dock in Grand Turk, a truck that won't start and the bad news that PPC (the local power company) that were 'sponsoring' the free shipping has withdrawn their deal. So whilst the obvious solution is to bring the truck back to Provo where it would be fixed in a heartbeat, no-one knows when the next barge is leaving Grand Turk and we'd have to pay for it. What looked like the potential for us to expand the business in Grand Turk (currently without a portable toilet provider) is beginning to look like the proverbial white elephant - and an expensive one at that. The government mechanic took a look at the truck today and he couldn't figure out what was wrong with it either. Nicky is now booked to go back on Monday with Cholo to see if they (Cholo took out the old starter motor) fix it. The real worry, of course, is that in the meantime someone manages to find a means of pumping the toilets and steals the contract out from underneath us. Although with our toilets currently languishing at the dock it is all rather academic.

Does it appear to be very unsavoury to be talking about making money at a time like this? Well I guess to some extent it does. But bottom line is that we make money renting out toilets and cannot afford to let 30 of them go for free. We are certainly not looking to make a killing out of this, but whilst there are funds to set up the toilets (Rotary are paying for them) then we didn't feel bad at making them an offer. It's not as though we've not given heaps of labour and money to the relief effort as it is in terms of food, tools and a generator to folk on the island. Grand Turk is only 60 miles away and yet at times like this it may as well be the other side of the world for all the difficulty of getting there. A friend today suggested we try getting Nicky a seat on the DC3 which Missionary Flights International are running at the moment, or on the US Coast Guard helicopters, but no contacts have revealed themselves as yet.

The other devastating news this week was that Colin (he who was taken ill the night the hurricane struck) died on Tuesday night in Miami. He had pancreatic cancer which took him very quickly (barely a week from diagnosis to death) and he very sadly never made it back to the islands. Having to cope with the destruction of homes is one thing, but doing all that AND coping with the loss of the head of the family is a whole other order of magnitude. Of course, with no phone lines and no power, there are no fax machines on the islands so we had to act as the intermediary for the hospital in Miami to fax down the release papers to Provo, which Nicky took on a plane to GT, for his widow to sign, for Nicky to bring back and then fax back to Miami the following day. You tend to forget all the simple things in life that can't be done when there is no power.

Whilst Nicky was on Provo on Thursday he also fell into conversation ("why does he always fall into compersation" says Osh!) with the insurance assessors over there. Turns out that the rumour that the miserable assessors wouldn't go on account of there being no cold beer and no TV was just a vicious rumour. The reality was that there was such a huge demand for them and so few of them that people were (and still are) waiting days to see them. Anyway, these men said that the number of uninsured and dramatically under-insured on the island was staggering. Nicky's depressing assessment of the situation was that the entire place was being managed by a group of headless chickens that had no idea what to do (not dissimilar to the US after Katrina in that respect), no-one wanted to delegate (thus losing what little bit of influence and kudos they'd attained as a result of the disaster) and ultimately, the island may never recover. The notion that nothing was being done - that is, folk sitting back and waiting for Government to step in and mend their roof etc - that there was an un-urgent atmostphere about doing anything was confirmed by others that have been over there since. A Jamaican friend sagely noted that, following Hurricane Gilbert 20 years ago, some communities are still struggling to get back to where they were, and today someone noted that Grand Bahama, devastated by a hurricane some years back never recovered economically. In fact, the influx of Bahamians here was largely due to them moving south in search of employment and opportunities in the Turks.

The first cruise ship returns on 8 October. If the terminal is reasonably functioning (at the moment the artificial beach is no longer there, the pool is full of filthy water etc) the boats will come and the employment for many will return and things might just start again. But if the major cruise lines opt to avoid Grand Turk (on account of there being no 'facilities' there - and by that I mean bars, shops and a pool....these cruising types are not remotely interested in the historic sites away from the terminal) then all the other cruise lines (including the smaller 'quality' ones) will drop out too and that will be the end of Grand Turk's rise to prosperity as we know it. Sobering thoughts.

Another sobering thought is that my doctor has raised a tiny concern about Baby Turnip's development and is booking me an appointment to see a peri-natologist in Miami next week. Whilst all other indicators are bang on target, she is concerned that I am not as big as I ought to be (I had also noted that this bump didn't feel anywhere near as uncomfortable as Osh did at the same stage). There are no peri-natologists on island, and no facilities at all for premature babies. So I'm off to Miami at some point for the day - fingers crossed that this is just my doctor being (thankfully) over-cautious. Worst case scenario is that there is something wrong with the baby and I'll have to go back to the UK to have it taken out early. I'm currently 28 weeks so viability is good (if not brilliant) but the cost of doing all that in the US would be eye-watering. And of course on top of all the other worries and difficulties we have at the moment it is the sort of hiccup we don't need. But we'll soldier on as we always have! Pip Pip.

The aftermath of Ike

Osh sluicing himself down with fresh water out the tank after a cooly dip in the sea.

When we finally got word from Grand Turk it was from Daniel's Aunt on her cell phone up in Miami. The night Ike struck her father - Colin (to all intents and purposes Nicky's ex-step father-in-law...the relationships are complex here!) a lovely man, had been taken ill and was admitted to hospital with jaundice. He was discharged later that night as the roof of the hospital started to detach from the walls (not conducive to good medical care, as a rule) and they moved the 'walking wounded' out. Monday morning first thing he and Donna (his daughter) were air-lifted out to Miami. We learned that Colin was under going tests and that Grand Turk had indeed been devastated by Ike - we knew at this point that Daniel's mum had lost the roof to her house, Donna had lost the roof to her house, Daniel's grandmother (thank goodness) had retained the roof to her house and had a generator so all the family were now decamped to her place. Jay, Daniel's Mum's husband had lost his fishing boat (which he'd made a point of taking out of the water and moving to the leeward side of his house) which is his primary source of income. The cruise terminal had been destroyed - Donna makes her living selling jewellery at the cruise terminal. All in all things looked bleak: not only were there immediate problems in terms of comfort and housing, but potentially long term problems with income too. You can imagine that with no power on the islands and the upper stories of Scotia Bank gone (ie banks not in operation at this point) that cash was in very very short supply. The prospect of income not being there altogether can't have helped moral either.

For the rest of that week we spent hours on the phone trying to get hold of Martin, our friend who owns the Saltraker (a lovely old building on Grand Turk) to see if there was anything we could do. Martin (in Somerset) had little information and getting hold of Erika (the manager) was hard. All day we could hear DC10s taking off with relief supplies for Grand Turk (and South Caicos and Salt Cay which had been equally badly hit) and we had US Coast Guard helicopters flying over us delivering supplies. The airport was closed to everything but emergency aid traffic and Provo had gone into overdrive. We were inundated with texts giving us information on where to donate money and food, the supermarkets were collecting unwanted hurricane supplies, the biggest 'department store' on the island (for want of a better way to describe it!) was collected used plywood, CBMS the concrete provider were organising free shipment of packages to Grand Turk, there was not a generator to be had across Provo as people rushed to buy up what was left to ship to friends and relatives on the stricken islands. Commercial flights resumed on the Thursday and, having organised a generator (thank you Belinda!) he and Daniel left on the first flight to see what they could do to help family and friends at the Saltraker.

Life for us had returned to more or less normal on Provo: school started up finally on the Thursday (much to the relief of many parents!); the power was finally back on in Five Cays and Leeward (the poorest and richest neighbourhoods respectively) and everything was working as normal. Oisin and I flew to Grand Turk on Friday after school armed with food, lamps, water, money, crow bars, hammers and heavy duty work gloves. The scene of devastation on Grand Turk was breathtaking.

The original airport building - an old steel structure abandoned about 5 years ago - had completely collapsed in on itself; there was a small light aircraft with it's nose buried in the turf where the wind had tossed it like a toy; there were two cars on top of each other in the airport car park. Clearly, things had been far, far more violent here than in Provo. The drive into town revealed barely any telegraph poles standing - those that were strewn all over the roads were snapped in half. Some houses had lost just shingles, but many had no roof, their insides fully exposed to the world: possessions and the traces of homes on full public view (often, the roof goes then a wall collapses). There was not a single leaf left on any tree standing. Only the coconuts had managed to hang onto a few fronds but these looked very battered. The whole place looked like a deserted town, derelict after years of neglect. Tellingly, the old buildings had all survived with a bit of roof damage. It was the modern, new buildings that had suffered the worse. Unfortunately, Woodville, an old, old building that Colin was restoring (it had been in Daniel's family for a number of generations) did not fare well: the roof has mostly gone and many of the wooden walls have now lost their siding, leaving the building more exposed to the weather than it had been before.

We went to set up beds at Island House - all done by lamp light as dark by now then went to get fish and chips and a cold beer at the Turks Head (the only place on the island serving food and anything approaching a cold drink - courtesy of a generator). The following morning saw us breakfasting on the food I'd brought from Provo (the supermarket was closed on account of it having lost it's roof, a couple of small, small Haitian and Dominican shops were open, but with nothing really to sell) and then we set out to the Saltraker. The building had survived: it is around 200 years old, made of wood and has lived through a number of big hurricanes. Erika described how they were huddled in the upstairs corridor, breaking up furniture in the middle of the hurricane to fix windows as shutters were ripped off the outside and the glass gave way under the pressure. She said it was the most frightening experience she has ever been through and she described the whoomf, whoomf sound as the building LITERALLY flexed in and out as the pressure from the hurricane threatened to crush the place into match wood. Again and again, people have said it is a miracle that no-one died that night. The mess out the back of the Saltraker was astounding. Where there used to be a tin-roofed covered eating area, surrounded by huge mature trees and bougainvilleas was a dramatic tangle of dead branches, leaves, buckled tin sheets and tar. The roof had come off the kitchen (a building separate to the hotel itself), that roof was lodged in the one tree that remained standing and providing a background noise to the scene was the periodic clattering of a lone sheet of zinc bent over a branch way up in another tree in the other yard as it waved in the wind. Again, the place looked like it had been abandoned for years....

A big problem that people have had in Grand Turk is that they can't clear up until the insurance assessors have been to visit. There is clearly a huge demand for them at the moment and the rumours that they (mostly white folk from the US) didn't like flying backwards and forwards on small aircraft and weren't prepared to overnight with no ac, no ice, no tv, no internet connection didn't help morale any. Erika had been unable to do anything to the hotel itself, but we could set to work on the garden. The first job was to clear out the debris. Nicky had spent all day Thursday and Friday doing this, and we made another huge dent in it on Saturday. That afternoon Micky and Annie turned up (they'd been made homeless - when asked how her house had fared Annie replied " it no longer exists" - gulp!) to help along with Terry and Donna. Many hands make light work and by sundown we were all exhausted but had cleared much of the back yard. Osh was terrific, helping drag branches to the pile for the following day's bonfire and generally charming all the women with his winning ways. He'll be known for years to come as the little boy that came to help (the number of white folk coming from Provo to help was pitiful). His reward for being so good was lots of fun in the sea with Daniel's cousins (about his age) that evening. The disturbing news Saturday morning was that the Turks Head had been ordered to cease selling food and cold drinks. The man who has the lease is not the best-liked person on the island and proceeded to NOT cover himself in glory as the day went on. Apparently he'd decided that he didn't like the accounting in the bar by his bar manager (someone he's never got along with) so he shut the place down. On an island with very few generators, that one source of electric light, ice and a chance to wind down was a much needed haven and there were a lot of demoralised people around Saturday night.

Nicky lived on Grand Turk for a number of years and knows all the old haunts so we set out to find some food for us that night (more corned beef and tinned potato salad that we ate for lunch didn't appeal much). We chanced upon the Legal Begal, a Dominican bar serving hot food and cold beer - I went through the farcical situation of having to yell at the girl behind the bar about what we wanted because they had the music at full volume on account of a) the generator outside (very noisy) and b) they are Dominicans and don't know how to do anything quietly. Had there been others in the bar, I'd've understood her reluctance to turn the volume down, but there was no-one in there. So what could have taken 2 minutes took 5 on account of the deafening noise [note to self: maybe I should write the order down rather than try and shout?]. Waiting for the food outside we chatted to Frances, an elderly Haitian woman living in a garden shed (although I've seen better garden sheds, to be honest) behind the restaurant. Most of her belongings were outside drying, one wall of the shed was, erm, not there and she was still paying $150 a month for the privilege of living there...Dinner that night, eaten watching the sun go down from the trashed terrace of Island House was wolfed down and we collapsed exhausted in bed at 8.30 (what else do you do with no light?!?).

Sunday was more of the same: a bonfire to burn the rubbish (the dump was closed and reportedly the gates piled high with garbage as folk tried to keep the rats away from their houses with the mounting piles of steaming food scraps) and taking apart the kitchen roof so it could be burned. Every 20 minutes or so Nicky took a refreshing dip in the sea followed by a sluice down with fresh water from the tank. Access to water, per se, is not an issue there. Access to clean water is a whole other matter. Most of the water tanks are contaminated with plant debris - fine for bathing in but you'd not want to drink or cook with the stuff (which under normal circumstances is what people do because normally the tanks are clean). Osh and I spent most of the day building lego things in the shade (it was very very hot), dreaming of ice and fans and sluicing ourselves with water from the tank (which was refreshingly cool).

The Red Cross were doing the rounds on Sunday dishing out mosquito nets and water purification tablets and we took the opportunity to check out 'tent city' which is being set up for the est. 500 homeless. It is a grim affair (mind you, I suppose refugee camps are never anything but grim...and this is effectively what it is) with a large clear walled tent set up in a barren plot of land. Blue Loos has been asked to provide toilets for the sites on Grand Turk (two, reportedly one for TIs and the other for 'foreigners'), South Caicos and Salt Cay.

A telling note about all this: when we got home on Sunday night I took Osh into the bathroom to clean his teeth and he said "isn't electricity great Mim, you can turn on a light and flush the loo and have ice too"...