Specialist GP Nikki Vadgama provides some tips to make your next paediatric eczema consult easier. She includes a review of new guidelines, resources, websites and medications for paediatric eczema management
Chatham splendour
Chatham splendour
![Mollymawk](/sites/default/files/2017-12/gull.jpg)
Martin London winds up a two-month locum on Chatham Island where he took his camera to document the spectacular landscape
Just look at the map of Chatham Island (there’s a fine old facsimile on the wall of the pub) and you’ll see it looks like a pelvic bone riddled with myeloma
No one seems to talk of “The Mainland” over here. It strikes quite forcibly on first arrival.
“I’m going out to New Zealand next week,” is what they say. The message is clear: Chatham Island is different. There’s a strong sense of history here, not all of it pretty, which engenders a clear sense of belonging. You hear the usual jibes of having to have your great grandparents born here to call yourself a Chatham Islander.
But in truth the people are warm and welcoming, interested in your own story and quick to say that it’s okay to walk over their land to witness the beauties of the Island.
And beauties there are in abundance but you have to go and find them. The land is mostly low lying and the charms are often in small Arcadian corners where tree and rock and stream resonate in perfect harmony against dramatic skies that would inspire a Victorian painter.
All that’s missing is the shepherd in dun clothing leaning on his crook and watching where sheep may safely graze. You’re more likely to see him in hi-viz fashion roaring by, probably too fast and helmetless, on his quad-bike. Or you’ll see a row of dusty utes belonging to the neighbours who are all working together in the docking yards.
It’s a hard-working community here, almost all involved to one degree or another in fishing or farming. Most people are strong and fit. Minor, and occasionally major, trauma features high on the menu of the health centre.
But it would seem that dietary modification has not kept up with some of the mechanisation of these industries and there are a few generous tums around. Working on that, and the smokes and booze, but I’ve been surprised at the number of particularly younger men who are determinedly cleaning up their acts.
Just look at the map of Chatham Island (there’s a fine old facsimile on the wall of the pub) and you’ll see it looks like a pelvic bone riddled with myeloma. Those lakes and lagoons are the result of tidal and ocean current deposits forming links between the more solid volcanic parts of the islands.
The scenery is expansive with great skies and subtle changes of light. But getting down to detail there are marvellous formations in a startling variety of rock forms – limestones, schists, basalts and breccia. Against these are the native trees, most particularly akeake, which form dynamic shapes in response to the maritime winds, and kopi, whose groves of straight trunks and dense canopy create cathedral-like enclosures.
Wildlife is mostly about the birds. Apart from the ubiquitous weka, there are the supercilious mollymawks, brightly coloured oyster catchers, the superb sleek terns, whizzing around like fighter jets and the rather sinister skuas.
Loads of harriers, occasional falcon and priestly herons (deliberate theft from Dylan Thomas!). Look up the legendary story of the Chatham Island Robin – a species recovered from a single remaining female.
Four legged creatures tend to be domesticated and a distinct hazard on the mainly shingle roads. As for the legless, both a 2m shark and a seal passed within a couple of metres of my feet as I fished off the rocks – stirring moments but they frightened off the cod!
Two months of locum here has been a wonderful experience – the slower pace of life, great hospitality, time to explore and some pretty interesting medicine. Here are some shots to whet the appetite of others who might be tempted to do a Chatham tour of duty. I’ve already booked my next gig, but it is not for another two years. There seems to be plenty of interest out there, and now I know why.
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