Observations of a Visitor.

Jennifer Galvao volunteering at Crisis Care clinic Date: 4th of June of 2013

As I walked into the patient room, I noticed the frail elderly man lying on the medical table. By his side was Mama Gloria, holding onto his hand as the nurses began to cut off a piece of plastic food wrap from a roll and applied triple antibiotic ointment onto the top layer. After having made sure that the wound had been properly cleaned and sterilized, two of the nurses, slowly placed the wrap around the man’s arm, all while remaining attentive to the sensitivity of the wound.

The elderly man who had been treated at the Crisis Care Centre that day had actually been Made, the uncle of Gede, a driver for the clinic. His uncle had been involved in a motorcycle accident six months earlier. Left with small pieces of glass in his arm and later on a metal rod, which doctors had failed to inform him had still been in his arm and delayed his recuperation process, doctors soon lost hope and figured that amputation of his limb would be the only option for the elderly man. However, for Gloria, there was still hope.

After researching online, Gloria came across information regarding a cutting-edge technique which Australian medical professionals had been using for a while and which had proven to be somewhat effective. This method called for the use of plastic food (saran) wrap as an alternative to the traditionally used gauze dressings, which were previously being used to heal the wound. Unlike the gauze dressings, this method seemed more sensible considering that since the wound was still in its early stages of healing, it would not penetrate and cling to the wound. The transition to use the saran wrap also proved to be less expensive. This was an important factor considering that the supply of dressings had begun to run low and the clinics’ financial capabilities were scarce. As time progressed, Mama Gloria and her nurses began to notice that, although slow, the wound had begun to make progress in healing. The patient continues to travel to the clinic every two days to receive treatment and the progress is visible, in that, areas of the wound where there were originally severe inflammation in the early stages of treatment, there is now barely visible scarring.

The patients’ improvement was also a result of a second innovative method, which Mama Gloria learned about during her online research. This method entailed wrapping a bag-like matter around the patients’ arm and placing a tube within, which would help to administer oxygen directly to the region where the wound was situated. A similar procedure was used during a study conducted by the Global Healing Center. During the study, surgical scientists used topical oxygen therapy to treat thirty patients with a total of fifty-six wounds. The treatment duration ranged from twenty- four days to eight months. The results showed that two-thirds of the wounds had healed with oxygen treatment alone.

The application of oxygen helped in the healing process, in that, oxygen has proven to be essential in helping to maintain cellular integrity, function, and repair when tissues are injured. Oxygen not only plays an important role in energy metabolism but also is very important in polymorph nuclear cell function, neovascularization, fibroblast proliferation, and collagen deposition.

Mama Gloria’s investigational tendencies have proven to be life saving. Her fearlessness and open-mindedness towards new and revolutionary medical techniques is what makes her a professional at what she does and an influential figure within the small rural village where the Crisis Care Center is located. She is very much aware that often, conventional methods may not be applicable to every situation. At times it becomes necessary to venture away and to acknowledge that in circumstances where resources are inadequate, all options have to be taken into consideration. Because of innovative thinkers such as Gloria, patients such as Made will not have to endure life as an amputee but will be able to live as testimony that with courage and the willingness to think outside of the box, anything is possible. 



Caring For The Poor Of Bali The Crisis Care Foundation of Lovina.

Excerpts from an article in the Bali Advertiser by Skye Laphroaig

The Crisis Care Foundation (CCF) operates a small clinic in the village of Enjngsangyang Kaliasem, (near Lovina) in North Bali. The area consists of five primary villages, amounting to 1000 people without adequate water. Rivers are dry and there is no water for cooking or washing for most of the year. The Crisis Care clinic provides urgently needed free medical services to some of the poorest families in the community, with an Emergency Room to stabilise patients before transferring them to nearby hospitals. Crisis Care’s specialty is providing round the clock ICU treatment for burns victims, literally saving peoples lives.

The lady who runs the clinic is affectionately known as ‘Mama Gloria’. She has supported the local community for over sixteen years with her knowledge and nursing experience. When Gloria Goodwin came to Lovina seventeen years ago, she discovered a side of Bali unknown to many tourists. In the remote mountain areas, she saw poverty, sickness, and a severe lack of healthcare and education. Appalled by what she witnessed, Gloria created the Crisis Care Foundation where she provides essential healthcare to many people in need and accepts clothing from visiting tourists who would otherwise throw them away.

When I first approached Gloria for an interview, she had recently attended to a young Indonesian man with severe burns. Erwin accidentally tipped over a Bakso cart while selling boiling soup to customers on the street. During my visit, I was surprised to witness an area of Bali so impoverished, and yet so resilient. Some would say, ‘the real Bali’. Mama Gloria greeted me with a hug and shared some amazing sights, unknown to most tourists who visit this island.

The Foundation has a highly trained and well-respected resident doctor, supported by 10 staff, including two ICU nurses, and two midwives. As part of the ‘Outreach Services Program’ Crisis Care supports a local SMP school. Punggang School is situated half way up a windy, unstable mountain road and has 80 students. A sponsor has donated funds for a catchment tank to be built in order to capture rainwater for emergency use. Town water is very expensive here and jobs are scarce, so many people suffer from a lack of water for cooking, washing their hands, general hygiene, and toilets. Water is ferried up the mountain by Crisis Care staff, using jerry cans; the water is from a deep bore near the clinic. Some women walk 5 kilometres each day to collect the basic life requirement which, in contrast, is flowing out of taps and showers in every hotel room across the island. There are no motorbikes here; people must walk.

Lovina is known for its peaceful, friendly people. Activities include dolphin watching, scuba diving, snorkelling, visiting hot springs, serene ocean and ancient temples. When Gloria first arrived in Lovina as a tourist during 1995, she was attempting to heal after the death of her son, hoping to “turn the pain around and find something useful from it.” She felt a calling to remain in Bali and serve the people in need and could not ignore the plight of the Balinese community.
During my visit, Gloria gathered some donated clothes for Erwin, a Javanese orphan who was taken in by a Balinese family just five days prior to his accident. We take off in the old Crisis Care van, which doubles up as an ambulance to inspect the wounds of a young man who is very lucky to be alive.

A smiling and grateful Erwin meets Mama Gloria knowing she and her dedicated team saved his life. Without her round the clock treatment, Erwin would have probably died from shock and infection. The Bakso soup cart, which toppled over, left Erwin with both combustion burns and scalding burns to over 60% of his body. Now his torso and legs are healing and in three months he will fully recover.

“After the accident Erwin was taken to a Singaraja hospital, but they had no beds and no room, so a doctor made the decision to transfer him to the clinic”, Gloria recalls. “I first discovered a dressing called Burn Aid during the Bali bomb and we now have a sponsor who is an executive for the Australian pharmaceutical company,
Rye Pharmaceuticals, that makes the product. It is impregnated with tea tree gel, and regularly used for burns overseas. The company sends us Burn Aid free of charge.”

Founding Director, Gloria Goodwin believes it is her mission to help provide stress relief for the poor and sick of Bali, so they may enjoy their piece of paradise as well as the many tourists. At the age of 66, Gloria would ‘rather be here making a difference than playing lawn bowls and bingo back home’. I decided to interview Mama Gloria and find out more about life in Enjungsangyang.

Crisis Care has a highly trained resident doctor and two Balinese Midwives and two ICU nurses to assist. They cope with births as well as offering pre and postnatal care to hundreds of local women. The ICU nurses are highly trained to cope with emergencies. Trauma and counselling support is available from a local welfare worker working with the clinic. Outreach services include home visits to those who are unable to go to the clinic, school support programs, HIV/AIDS counselling, emergency aid for disasters, landslides, fires, flooding and road traffic accidents, counselling for social needs, homelessness, family support, child abuse.

Patients are very poor and do not have a safe environment in which to live. Often, they only have a ‘cow shed’ type dwelling with a dirt floor. CCF treats infected wounds, tuberculosis, dengue fever, typhus, intestinal worms, malnutrition, deals with childbirth, and many other things in between.

CCF also deals with a veriety of accidents for example the Balinese use an old-fashioned scythe to cut grass on the sides of roads. This implement is very sharp and serious lacerations occur often. They also suffer burns while cooking on open fires and carrying pots of boiling rice around on unstable ground. And of course, we see injuries resulting from motorbike accidents.

People wanting to donate to Crisis Care Foundation can transfer money via Western Union or deposit into our bank accounts in Indonesia and Australia. If you are coming to Bali on holiday, you are welcome to hand over the donation in person by visiting the clinic in Lovina and get a better understanding how your money is allocated. If you are planning a visit to the clinic in Lovina please let Gloria know well in advance either by phone, or by email.

CCF also requires help in are several areas including manual labour. A couple of men with ‘carpentry’ experience can help renovate a building and replace the roof with a corrugated one. CCF will raise the money required for materials, and provide accommodation. We also need stretch gauze bandages, (not crepe) and medical supplies from overseas. Also any second hand bedding would be greatly appreciated because the mountains get very cold during June, July and August. Please contact Crisis Care if you can help.

One of the great challenges faced by Crisis Care is raising the funds needed for paying staff and other basic monthly overheads. The clinic is open from 8am until 7pm every day except Sunday.