FIJI — Curly Carswell, the father of deep sea diving in the country is a happy man these days. But it wasn't long ago when he was stretched to the wire trying to rid the country of a stigma attached to diving decompression illness or the bends. By September 2004, the government had revealed plans to review the Fisheries Regulation 1997, to deal with the rising problem of decompression illness. Cabinet based its decision on a submission by the then Minister for Health Solomone Naivalu who pointed out the illness was an emerging health problem, particularly in the Northern Division. Decompression illness, he said, was an occupational disease which cost the government a lot of money to treat. But it was a preventable health issue. The cost of treating cases of decompression was quite significant, he said, and was on the rise. He urged a concerted effort to bring about change. He said a policy and legislative environment supporting health protection of divers could help reverse the annual incidence and complication of the illness. A review was to ensure employers of divers were held accountable for their safety. Mr Naivalu said most divers in the beech-de-mer industry were untrained and ill equipped to undertake deep sea diving. Because of the urgency of treatment, he said, almost all cases required evacuation by a chartered airplane or helicopter, resulting in a substantial cost to relatives and the government. While most, he said, made a complete recovery, others ended up with permanent complications, including permanent disability, or died either on their way to the local hospital or while seeking late treatment. Mr Carswell, the national co-ordinator of the TRNi Recompression Chamber, harbours frightening memories. "You go back eight years ago, there were multiple deaths almost on a weekly basis," he remembers. Deaths used to be in the hundreds. Now it's way down. It would be good if it stayed down." Apakuki Puisue, the operations manager at the TRNi Recompression Chamber agrees with him. "Over the last six months, there've only been four cases. There were six cases last year," he reveals. "There was one year, some time in 1987 or 88 when there were about 47 cases." Sadly though, he says, it's not easy trying to stop divers. "We can't stop them because it's their livelihood," he says. "A lot of these divers do not have qualifications, but then again, the bends can affect any diver, even experienced ones. There are many factors that can contribute to causing the bends." Alcohol, fizzy drinks and even coffee thickens the blood, he says, and can affect divers once they head back to the surface from a deep dive. Mr Carswell and Mr Puisue believe awareness campaigns by the commercial dive industry, the Ministry of Fisheries, Labour and Occupational Health and Safety have contributed to the decrease in the number of divers suffering the bends. "One of the good things that happened was when laws governing divers were strengthened in 2006," Mr Puisue says. Decompression illness For the average person, the air we breath is mostly a mixture of two gases, nitrogen (78 per cent) and oxygen (21 per cent). Unlike oxygen, nitrogen cannot be converted into other substances by the body. Most of the nitrogen that is inhaled is expelled when a person exhales, but some is dissolved into the blood and other tissues. During a dive, however, the lungs take in more nitrogen than usual because the surrounding water pressure is greater than the air pressure at sea level. As the water pressure increases, so does the pressure of the nitrogen in the compressed air inhaled by the diver. Because increased pressure causes an increase in gas density, the diver takes in more nitrogen with each breath than he or she would at sea level. Instead of being exhaled, however, the nitrogen dissolves into the tissues where it remains until the diver begins to return to the surface. On the way up, decompression occurs and with the change in pressure, the extra nitrogen gradually diffuses out of the tissues and is delivered by the bloodstream to the lungs which expel it from the body. If the diver surfaces too quickly, potentially dangerous nitrogen bubbles can form in the tissues and cause decompression sickness. These bubbles can compress nerves, obstruct arteries, veins and lymphatic vessels, and trigger harmful chemical reactions in the blood. Symptoms can appear minutes after the diver surfaces or within eight hours. Jona Lequ Jona Lequ manages a smile and reaches out his right hand for a handshake. He strikes a forlorn figure on a bed at the rehabilitation Ward in Tamavua. Bare-chest, a blanket covers his lower body. He lies on one side, facing curtains that have been drawn over a row of windows. He's stared at that row of windows for almost three months, with orderlies like Jiuta turning him over in a two hourly ritual which offers a change of scenery to face the door to the room he shares with other patients. A television provides a thankful break to the monotony that has been part of his daily life since May 23 when he was transferred from the Colonial War Memorial Hospital in Suva where he'd spent about three weeks. | | Hyperbaric chambers are used to treat divers suffering from decompression sickness. Unable to sit up, stand, or walk, Jona remains optimistic of one day being able to do all the things he could do before fate delivered a cruel blow in late April. He's a casualty of the dreaded decompression illness. "Doctor Tukana's told me at the rate I'm going, I should be able to walk around Christmas," Jona smiles. I'd met Jona in March. He'd hopped onto the boat I was on heading to the island of Vorovoro off the coast of Macuata. Jona was on his way home to Mali Island. He'd carved a reputation diving the seas of Macuata, with the bainivualiku, the third longest reef in the world, being his playground. Jona accepted that the sea was fraught with danger. He'd had his first brush with death in 1999 as a 16-year-old. It was Christmas eve and he was among men from Yaro Village on the island of Kia diving along the bainivualiku. His mother Seini Caucau was at Labasa, oblivious to the danger her son was in at the time. "We'd gone diving for fish to sell at the Labasa Market for some money for Christmas," Jona says. "I boarded the second boat with a friend. "At about 2pm, he'd come up to the surface and jumped into the first boat that came around to collect divers. "So by the time the second boat arrived, everyone assumed I'd jumped on the first boat as well. By the time I hit the surface, I could still hear the sound of the engine moving away from me. It drowned my calls for them to come back." For once in his life, he'd felt so lonely, lost and forgotten. He was still a teenager with a lot of years ahead of him. He was reported as a missing person to Labasa police. Jona was rescued that evening just as searchers like Josaia Wasasala headed back to land in the fading light. He'd swum along the reef hoping to see some other fishing boat. "I guess I was fortunate then because I still had my speargun with me. My rescuers told me they saw the reflection of my gun in the setting sun," Jona says. In April this year he'd gone out diving for a company based at Vunivau in Labasa. He needed cash for a birthday at home. "We dived near a place called Yalewanikalou, an uninhabited island in the Yasawas," he says. "We were diving for sucuwalu which fetch a good price these days. On the fifth day, we were ready to go back home. One of the divers was also sick. "But then the owner of the company asked me if I could go down one more time. I went down about 3pm for a 20 minute dive. "When I got back to the surface, I felt weak. I was given another tank and went down again." The effort to stabilize his nitrogen levels would fail. "I hit the surface and felt better. I changed and lay down. "We left about 4.30pm and reached Raviravi about 8am. By then my whole body was painful, especially my joints. I was rushed to the Labasa Hospital and arrived there about 10am. From there I was flown across to the CWM Hospital and into the decompression chamber." "By then I could not move any part of my body." Jona can now speak again, and after rehabilitation can move his arms and twitch his toes. "The staff here at Tamavua have been very helpful and very encouraging. I'm slowly learning to walk again. I know it's going to be tough, but my doctor tells me never to give up. I'm hoping to be back at Mali by christmas," he says. "I guess the only thing I can say about this whole episode is that I hope companies that hire divers have a heart and consider the welfare of divers in the long run." He harbours hope of another chance to try and tame the vast Pacific Ocean. by FRED WESLEY |
