Notes from Fiji hospital, Oceana Hospital system and Denareau private hospital

January 13, 2026
Two kayaks on a calm lake, with mountains and cloudy sky in the background.

Medical emergencies all have a similar feeling. Intensity, urgency, a changed perception of time; only events and human encounters progress, time seems warped, unimportant.


After several sleepless nights because Jeff was having difficulty peeing and he was beginning to have pain, he went to the onboard clinic to get catheterized. There were three attempts with successively larger catheters. This was painful and distressing for him, though he kept joking

about it, “this is not good sex!” The attempts were unsuccessful. He was given pain killers and an ambulance met us at the dock for a 10 minute ambulance ride to the hospital. Jeff is an 80 year old man with an enlarged prostate so he normally has trouble peeing. But this time it

stopped altogether and there was blood.


We are waiting at the hospital for the urologist. Nurses and a general practitioner have spoken to us in English. Very kind, polite, casual and patient. The urologist arrives and talks with Jeff. He is going to get the operating room ready and put Jeff out. Then he can do the operation.

We wait in our curtained off cubicle Jeff is lying on a bed. A woman who came with her husband, who has high blood pressure, is behind the curtain to the left of us. He had collapsed. She is reciting the Lord's Prayer and Hail Marys over and over in an emotional whisper. She is crying. A young man is in the cubicle to our right. He seems to have broken his arm. It is all wrapped up in white gauze. Earlier a man had been stung by something and ointment was applied. A pregnant woman has come in.


This is a modest hospital, very basic, two floors. They have what they need. A few flies buzz lazily around, but most are killed by the electric device on the wall. A very slight smell of urine is in the air. We arrived here about 8:30. It is now 2:00. Jeff has had an ultrasound, blood pressure checks and an EKG. Now he is in a wheelchair waiting for the nurse to take him to an operating room.


The waiting room has about 10 people waiting. About 50 chairs in all. Not terribly busy for a Saturday. Light and darker coffee colored skin, attractive, rounded features and large expressive eyes set apart the native population. They are only a little curious about us. There is no rushing here.

Two people paddle a wooden boat on a body of water.

Jeff is not the first passenger from a cruise ship to have this kind of difficulty, we are told by a nurse. It happens now and then.


They can't locate the doctor. Jeff is waiting in the wheelchair and his anxiety level is going up. He wants to be able to get back onboard before 6:00, when the ship is leaving. Finally he is wheeled to the elevator and taken to an operating venue. The anesthesiologist arrives with a pink hair cover, and black scrubs. A nurse in a pink hair cover also arrives.


“I will put the drops in and the urologist should be able to steer through.” He explains what the options are and says the urologist will too. Jeff is giving the anesthesiologist the Parallel Currency summary. He has lived in Fiji all his life. He appears interested. I give him a card. He

gave me some Fiji dollars to buy hot tea. Jeff and I haven't eaten all day. The public health sector in Fiji is collapsing. “There is money, but I don't know where it goes.” says the anesthesiologist.


The urologist has not turned up yet. Very, very, slow, slow, here in Fiji. “You won't feel pain, you will be out.” the anesthesiologist reassures Jeff.


The doctor has arrived, it is 3:00. He will take a look in and get the urine out of the bladder. Jeff has started peeing spontaneously. “Not enough”, the doctor says. According to what he sees with his scope, he will do what he can today. We may have to stay an extra day. The next port,

Lautoka, Fiji, is about 3 hours away by car.


I am not allowed into the operating room so I wander around, buy a cup of tea and sit outside to warm up. When I returned the nurse gave me a thumbs up. The surgeon found a blockage in the urethra, it is the enlarged prostate pressing against the urethra, we find out later. The urine

has been drained by a catheter that he left inserted, and the bladder was flushed. He told Jeff that a few more hours he would have gone septic and died. Kind of a strange thing to say. We had been there waiting for him since 8:00 in the morning. No rushing here.


Health emergencies are to be expected on a long trip like this. And outcomes are not always good, sometimes tragic. A young woman onboard died of a stroke not too long ago. Pneumonia, flu, COVID, dysentery, jelly fish stings, spider bites, falls that sprain muscles or break bones,

cuts from coral that need stitches, chronic conditions that force passengers to leave the ship and go home. Recently, two passengers died who had been on an 11 day cruise on a ship that anchored near us. They were snorkeling with full face masks and died of carbon dioxide poisoning. This can happen if the mask does not vent sufficiently. The doctor and nurses on board have a lot to do. But there are things they are not equipped for. And that is when you hope you are near a hospital. In the end, we were lucky. We return to the ship in the evening. Our doctor onboard is saying that Jeff should get a permanent fix for the urine situation. He would like Jeff to go to another hospital while we are in Fiji since we will be here for at least 10

more days. We arrived at the next dock and took an ambulance to the private hospital in Denareau. It is on a separate island, about an hour drive, that is accessed with a small bridge. The very wealthy live here. Reminds me of Boca Raton, Florida. Shops, restaurants, fancy homes, resorts. People vacation here from New Zealand and Australia.


The petite Indian GP is able to understand what is wanted, a subpubic catheterization. She got instruction from the ship doctor and the urologist from Suba hospital and none of it was making sense to her. Doctors don't communicate well with each other it seems. So we try to straighten this out. We are waiting now to see what they will do with us. The contrast between this resort area with its private hospital and the previous places and hospital we experienced is extreme. They have all the modern equipment, and even a helicopter at their disposal. The bright young Indian/Fijisava GP is arranging things, she is efficient and charming. We killed some time by sharing a breakfast at one of the restaurants, an interesting interpretation of eggs Benedict. Neither of us had the energy or curiosity to browse the expensive gift shops. Jeff buys a fruit pop that we share, then we go back to the hospital and Jeff lies down.

Children playing near a boat, next to a wooden building. One child jumps, others sit or stand.

Eventually we are informed the operation cannot be performed till tomorrow so we have to stay overnight and be taken back to the Suvu hospital in the morning. A three hour trip by ambulance. There is only one urologist in Fiji. And we have already met him. We are taken to stay at a fancy modern house owned by the private hospital, located in the suburbs among others like it. Each with a dock on connecting canals that go out to the ocean.

Small tastefully landscaped yards separate the homes by about 20 feet. The backyards are dominated by swimming pools. A couple and their two year old are living there, but are leaving just as we arrive. The wife injured her hand getting off a sailboat ladder. A doctor recommended surgery. But they want to have it done in New Zealand and will fly there. The private hospital that is better equipped than any other in Fiji is not good enough. They are friends of one of the fancy hospital's investors and are guests of his in the house. This must be the reason it feels sterile and not like a home. It is rather new, very modern with three bedrooms and baths, a high ceilinged living room/ dining room, granite kitchen counters and a breakfast island. It feels empty even though the family had been here quite awhile and the husband runs a waterfront restaurant nearby. No cooking has been going on, only reheating in the microwave. There are several boxes of granola bars in the cabinet and canned spaghetti, nothing worthwhile in the

refrigerator. Even the child's toys scattered about seem sad. The closets are empty, it feels like no one lives here or they have been gone for a long time. We will be picked up at 4:00 am to drive 3 hours to Suva hospital where Jeff was catheterized three days ago.


Now on our way, it is dark. Our driver, “Captain Reggie” says, “The night is getting smaller.” His ambulance interior is decorated with fake flowers, ivy and other unexplainable textures and objects. He is an Indian National. He narrates as he drives. He explains to us that milk comes from New Zealand, juice and beef from Australia, almost everything, 80 percent of what the island needs, is imported. Very expensive for the population. Even though Fiji has the best fruit it has no factories to make juice. Jeff gives the Captain the Parallel Currency summary. “I will do it! I am part of the Parliament here. I can get to the prime minister.” The ride was very interesting and not only because of the entertaining driver but also because we passed through beautiful countryside. It reminded me of central Florida, the trees and plants were familiar, except there are mountains. The mountains are strange shapes and make recognizable forms like you can see in clouds. One they call the sleeping giant. You see his head, his body and toes, a recumbent silhouette in black volcanic rock. All the mountains are dark, sharp and craggy, with deep valleys, covered with green vegetation. They grow sugar cane here and brew their own beer. Homes vary a lot. There are poor areas, but not as extreme as other places we have

been, and they transition to suburbs around the local general hospital and shopping areas then to extreme wealth in the resort areas. The country people who live on small farms and in little villages also work in the hotels and resorts in the wealthy areas. We see them, mostly women, waiting for the bus, which they pay for, on the side of the road in the dawn light. It is around 5:00.


“ If you need something you will see it, if you don't need something you will not see it.” our driver opines. The day is opening. Islanders are Fijian, Indian, Filipino and some Chinese. There is interesting history attached to all these groups, the order and reasons for their immigration. We are waiting for the doctor, it is 7:00 am. Jeff is finally being operated on, it is 12:00 pm. There was no need to get here at 7:00. But we have learned by now that time doesn't exist in Fiji. In the operating waiting room the TV is showing medical soap operas. Nurses and doctors flirting and emergencies happening. Men in charge. Everyone is white. After Jeff's operation we stayed overnight. The doctor wanted to see the drainage run clear or pink.

We left in the morning around 7:00 with a taxi we found outside the hospital. A nice guy, Indian, not talkative. Three and one half hours to where our ship was anchored. We pass again through beautiful countryside, mountains, valleys, and people riding horses. We make it back to the

tender and then to the ship. We are both exhausted. The ship will travel overnight to Savusavu.

July 14, 2026
The rain falls straight down and hisses as it craters the surface of the water. From the ship this island presents as lush, dark green and mostly mountainous with a strip of village on the coast. The rest of the coast is mostly narrow beaches interrupted by other smaller settlements and resorts. It is raining heavily. The mountains turn shades of grey and blue, become distant, then disappear behind a dark scrim as the storm intensifies. We are told that flying foxes live on the island. Fairy tales and magical thinking surface at the thought of their evening flights, voracious appetites for the local fruits, their massive leather wings and communal, upside down palavering. Maybe in ancient times locals translated this into a supernatural background for their stories. Tioman is one of the most uncomfortably hot places we have visited, among the mostly hot locations we have gone to so far, this is saying a lot. The average temperatures have been around 85° and up. But here 90° feels like 100° or more because of the humidity. On land the heat is most intense. Even by late afternoon it had not cooled. The locals are immobile, sleeping in hammocks slung between the trees.
July 6, 2026
On this island the local boats generally have blue hulls with a red stripe and a green cutty with a small solar panel on top. There is not as much activity on the water as we saw in Coron. Just a few boats venture out in the morning and throughout the day. We happened to arrive on the 19th anniversary of the incorporation of the village and they were having a celebration. Jeff was able to talk to several members of the local government who were out and about and introduce them to our Parallel Currency concept. According to one official, a person can rent an apartment and have meals delivered and light cleaning done for less than 1,000 USD a month while living on their island. They asked Jeff how to solve their problem of no doctors in their new hospital. He suggested the Cuban model. Start a University. Hire teachers that can train doctors and nurses and whatever skills the island needs. Offer this education for free to the local population. Offer the educators housing and hospitality while they are teaching and a good deal for their retirement. They were intrigued and wanted to keep in touch. It would be very interesting to hear what happens. Maybe we can visit again in the future.  When we explore the village, using Jeff's new wheelchair for the first time, the going is a little rough. There are avenues between the open shopping booths but they are for walking and motor scooters.
June 29, 2026
The reason our ship is returning to Singapore so frequently, while traveling in South Asia, is because they have the most dependable supply of marine diesel fuel. Since the war started it has become the foremost consideration of our voyage. Several new fuel saving activities have been recently introduced. Traveling at slower speeds between ports, drifting with engines off, staying at ports longer (four days instead of two) anchoring out near island villages for several days, and a 1,500 dollar fuel surcharge monthly per cabin was recently attempted as a mandatory requirement. When it was resisted, it was made voluntarily. Many passengers cannot sustain this increase in their monthly fee and some passengers have contracts guaranteeing no monthly fees if 300,000 was paid upfront for lifetime ownership of the cabin. This was very uncomfortable for many residents for several reasons. The prospect of the cruise possibly going bankrupt was raised in many minds. And the lack of foresight on the part of the owners has created anxiety. Ever since the war started it has been clear that fuel was going to be a problem. Their answer was that availability was going to be the problem, not price. This proved to be wrong. The price of marine diesel fuel has more than doubled. On a residential cruise ship there is a unique dynamic which is not available on land. Getting the passengers to pay for the company's money emergency can not work because if a passenger cannot pay they just leave the ship, then the company loses monthly fees and the surcharge. The owners and wealthy passengers can't pass the expense on down, it comes back to them and they have to consider paying more themselves. On land the prices increase to compensate elite business owners, they can avoid tax hikes with ‘clever’ accounting and they get tax breaks from the government, while the rest of the population has to pay the higher prices plus higher taxes. This cruise situation is more representative of what people can afford to pay or not pay. An interesting real life example of a successful challenge to unequal economic pressure. Of course this has caused resentment and misunderstandings because everyone, even the wealthy, have to think about how important this cruise is to them and how much more money they can spare to keep this business venture afloat at the expense of their own future wellbeing and interests.
June 22, 2026
The dragon boats are out. It is Sunday morning when we arrive in Manila and dragon boat crews are practicing in the harbor. On the bow of some of the narrow boats a thin man stands with a paddle demonstrating the movement and rhythm of the stroke; another man stands in the stern controlling the rudder. Races are held regularly. There are similarities between this ancient sport and the racing crews of Britain and the US. But these small boat racing techniques developed separately and for different reasons, according to what I have read. In general, big cities are much the same. They are expensive to travel around, a taxi or Grab (Uber) are necessary, and there is little relief from the heat and humidity except in the malls and museums. The intensity of shopping and making a living is at a fever pitch.
June 15, 2026
Returning to Caron, Philippines. Several miles off shore, while passing the Island of Borneo, we observed a surreal sight. Stationary skeletal structures on the horizon, some of them with flames shooting from a long up tilted pipe, like a dragon breathing fire. These were oil derricks 30 or more miles from the coast of Brunei burning off natural gas, a volatile by-product of oil drilling. They come into view, are left behind, and new ones appear, as we progress. At least 30 derricks paralleled our course. Normally there is nothing to see except an occasional container ship. So this is exciting. I read that there are at least 200 of them in this vicinity. Also, some have been decommissioned and made into marine habitats, (dismantled and sunk), by the Brunei government who deploys and maintains these derricks. They are a major exporter of oil and share the Island of Borneo with Malaysia and the Philippines. This experience of observing oil drilling activities during an oil crisis feels a bit surreal.
June 8, 2026
The approach to Coron, Philippines. Mountains all around, some narrow cream colored strips of beach. Single person open boats drift here and there, some are paddled. The larger colorful outrigger boats glide by like water spiders, leaving no wake. Clouds have bunched and swelled above the land taking up a lot of the sky blue sky. This is the rainy season. Our ship is drifting slowly. We are not expected at port for a while. The opening of the harbor is in sight and a green entrance marker is visible.
June 8, 2026
In its present form, Capitalism cannot easily fix the ongoing problems of its own making. It has become an economic formula for much of World commerce. Its empowerment of the often unrestrained pursuit of profit, guided by the optional moral consciences of some individuals, businesses and nations has allowed for broad interpretation resulting in vast destructive behavior. We have been able to personally visit about forty countries during more than a year of continuous travel. Our goal is to complete one circumnavigation within another two years. This trip has developed into a unique opportunity to research World economies. Which was our hope at the onset. We are now in Southeast Asia and it is possible to make a few observations. The opening of ‘free markets’ with Capitalism worldwide has become a modern form of Colonialism. Countries that are thriving go into developing nations with the huge advantage of currency value and technological superiority. They essentially locate in each country resources that can be monetized and profit made, hire employees for less than they can in their home countries, then take the majority of the profit out of the host country. This dramatically changes the existing natural balance in most of these developing countries and thrusts them into the financially unbalanced world of free market capitalism for which they are not prepared and have no immunity. Where we have traveled so far, many developing countries are turned into tourist attractions and the young people are mostly encouraged to aspire to ‘hospitality’ work, keeping their expectations low. The following is a short summary of how Capitalism has evolved in recent history. People have benefited for many hundreds of years from the innovation and competition inherent in the practice of Capitalism. But now the symptoms of its flaws are obvious and too damaging to ignore. When Capitalism fails from its own weaknesses it can, in its final form, become fascism; dictatorial power, militarism, an autocracy that crushes opposition. It makes a few people very rich and creates a dictator to protect their wealth and influence resulting in an ultra nationalist state. When a country is completely invested in Capitalism, like the US, it must constantly monitor its military and financial power in the World. Looking back; the US petro dollar was established during the 1973 energy crisis by Nixon/Kissinger, in order to keep the US dollar strong next to other currencies. Controlling the high value of a nation's currency is essential for Capitalism to thrive and it was clear that oil was the blood of World economies. Arab oil traded for dollars in exchange for US military protection was the deal with the Saudi government. Because oil energy is a major labor saving device and creates exponential productivity and wealth, trading dollars for oil made the US Dollar the “preferred currency” and kept its value high. In 2024 the agreement with Saudi Arabia expired because the US could no longer protect Arab nations militarily. Also the rise of renewable energies challenged oil supremacy. One of Capitalism’s characteristics is to concentrate wealth in the hands of a few and encourage profit making over stabilization of a good quality of life for the rest of humanity. Over emphasis on profit making has suppressed education, healthcare and general dignified survival wherever it dominates. Wealth is not a barometer of intelligence or happiness. It is an advantage in Capitalist societies that opens opportunities in education and business. All it takes is a few powerful people to keep Capitalism going, apparently the richest 10% of the World population. That Capitalism has lasted so long is in part a testimony to its ability to keep adapting and improving on its least attractive strengths: control over the means of production, control over the value of currencies, amorality, exploitation, and a powerful military. Capitalism is presently a pervasive economic belief system and acts as a powerful temptation and World influence. Its social impact is on par with Communism, Democracy, Religiosity, Socialism, Liberalism, Conservativism, etc. This has again been made clear by the present oil/food crisis, created by the US/Israel attack on Iran that resulted in Iran closing the Strait of Hormuz. (Was this war a move on the part of the US to control oil and keep the USD strong?) This situation may already be worse than the energy crisis in the 70’s that created the US petro dollar. The World population is larger and more interconnected economically than ever before, making this oil shock even more damaging than the one in the 70’s. Oil is a valuable fair trade commodity. Its locations and price are controlled by a handful of companies and nations. (A common characteristic of Capitalism.) This essential energy source is centralized and vulnerable. The World economic system is in shock and being held hostage to the flow and price of oil. But this time there is a competitor for preferred currency, China's Yuan. Humans have become, over approximately 500 years, adapted to Capitalism. It feels inevitable, no matter what it destroys. It has captured the popular imagination like a religion. But unlike religions it encourages people to cast aside concerns of morality and the fate of humanity. Its symptoms and failures are explained away as the evils inherent in humanity or individual failures. But religions have shown they can evolve. Economics can evolve also. Like the worm of Protestantism that entered the apple of Catholicism, maybe there is a pest that can invade the Capitalist feeding frenzy. This pest could be in the form of a Parallel Currency, that would create, in time, a hybrid World economy dedicated to the dignified survival of all humanity. Any nation or state could introduce a Parallel Currency to be used next to existing currency. A currency printed to provide a base for humanity; the essential needs of life; food, shelter, education and healthcare. Not freedom, not security, but what comes before humanity can have either of these things, survival. Life long access to food, shelter, healthcare and education. There is enough. Basic needs are the least expensive and most abundant things a nation can provide its citizens. The Parallel Currency is a way to pay for it. A few countries are already trying to do this with their tax structures and laws, but a Parallel Currency would do it without taxation or inflation. With a stroke of a pen it can be initiated. It is a separate currency that can only be used for basic needs; their creation and distribution and is destroyed when it reaches a bank so it won't create inflation. It also will not inhibit the positive capabilities of existing currencies. They will function normally. The Parallel Currency would be a closed loop created for dignified human survival. A form of this is already used by the major developed nations to supply and sustain their large militaries. You are provided food, shelter, education and healthcare as long as you are employed by the military. China has built, in its isolation, a successful hybrid of Capitalism and Socialism controlled by its Communist government. In approximately 40 years they have brought their massive population out of poverty and become one of the most technologically advanced nations on the planet. Freedom of speech, freedom of religion are not enough. A government by the people, for the people, must also guarantee freedom from starvation, homelessness, and freedom from ignorance and curable illness. All things for which we have, as a human species, developed remedies. This is the overarching injustice of Capitalism. That these remedies exist and have been largely made possible by Capitalism but are not shared with all humanity. People have evolved beyond the war response to disagreements, but governments have not. By eliminating the tensions created by economic inequality with a Parallel Currency dedicated to providing survival needs Worldwide it is possible to see a new way. It is our responsibility to help economics and governments evolve with us. Susan Caumont Renew the Earth, renewthe-earth.org
May 18, 2026
They have only recently become independent; 2002. The struggle and tragedy of this objective still vibrates in the air and has left scars. Poverty, deteriorating roads and sidewalks, buildings and ambitions. In the intense heat of the day, most shops can't afford to have or to turn on air-conditioning. A large tree shaded park where an unchained warrior statue shouts to the sky, is heavily used by all ages.
May 8, 2026
Our arrival on the island of Waingapo is welcomed with a red carpet. The carpet leads expectantly to where several men wait, holding 11” by 14” laminated photo narratives of tours they can take you on and tell you about with three word comments in English. Past them chairs, also covered in red, have been set up under an awning for our “dignitaries.” Beside these are a few tables with souvenirs. Several young boys wait on either side of the red carpet to perform for the passengers as they disembark. Many local people are also waiting in the growing heat for the Exodus of the passengers. Ours may be the first cruise ship that has stopped at their island. One passenger finally emerges and avoids the carpet and the boys. They are shocked. Eventually a group does come out together and allow themselves to be greeted and entertained. They have selfies taken with the boys. Then return to walking and looking into the screens of their phones, bowed over them like they are praying After exiting the port area there is a long walk through parked cars, trucks and taxi drivers out to the crumbling asphalt of the main road. It is lined with vendors, a gauntlet of drinks and snacks. A ferry is unloading, people and motorcycles are streaming out. These are the customers the vendors are waiting for. A large number of motorcycles are parked on either side of the road waiting for their owners. We make our way between the crowds of people and vehicles to the hot uphill slope of the road that goes somewhere, which is hidden from sight by bunches of dark green trees. Shortly we are defeated by the heat and start back. Access to other parts of the island that are considered appropriate for tourists require a taxi, negotiations for price and where it will go. Generally we try to avoid this and are most interested in what we can observe and who we can meet by walking. We talk to a motorcyclist on our way back who says he has access to local Royalty. Jeff describes the Parallel Currency concept to him and gives him our website card. I am also able to pick up some interesting scraps of paper from the garbage that lines the road. I use their patterns and color to create abstract images on postcards I make to send to friends and family. In the end this has turned out to be a very satisfactory walk. There are very few palm trees here, which is remarkable. A different ecosystem than Bali. The mountains are low, flat topped and shelved. They define the spine of the island. Bunches of dark green trees patchwork the slopes getting denser as they approach the water. The water is blue/green and clear, fishing boats are high prowed and the smaller boats have outriggers made of bent PVC tubing. It is now early evening and the sun is low. I am walking around the outside deck of our ship taking in the 360 degree view and the sounds. On the starboard side a band is playing on shore and a singer starts up a contemporary tune. As I round the bow a chant drifts through the dusk, the Muslim evening prayer. This dominates the port side then at the stern blends with the music on shore, which dominates on the starboard side. Round and round as I walk they alternately blend and retreat, blend and retreat. I notice as I look out over the port side that the tide has gone out and long flats of seaweed, rocks and soil are exposed. People have walked out onto these surfaces to harvest edible sea life, gathering them into plastic buckets and bags. I feel like I am watching history.
May 4, 2026
We dock at the port of Bali. It is too hot and far to walk anywhere, so we hired a taxi driver for the day and invited our friend Wido to come with us. He is Indonesian, his home is in Jakarta and this is his first visit to Bali. Indonesia is a country of 17,508 islands. There is a governor on each one who communicates with the central government. Few Indonesians have visited every island. What strikes me immediately as our driver, Budi, finds his way through the dense traffic, is the careful weeding of the center island between opposing lanes. This is exceptional because of the extreme heat. No one could be doing this during the day. People must come out at night, when it is cooler, and meticulously pull the weeds. It becomes clear as the day passes and more and more of Bali is revealed, that attention to detail and extreme patience is a characteristic of the Balinese. The traffic is a dense mix of motorcycles, cars and trucks.
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