Wks 101-102: Tahiti to Fiji Part 2 (348nm)

Whilst we successfully reach Fiji in the end, the final days of our passage are by far the most stressful as my leg infection takes a serious turn and Laura is forced to take the lead in getting Serenity First over the finish line, after which we await support from the Fijian authorities.

We left off in our last post with the bulk of our miles in our passage to Fiji behind us but we were far from the home-stretch. I had developed an abscess on my leg that we were unsure how to treat and we still had around 350nm (or 2-3 days of sailing) to go to our final destination of Port Denerau on the West coast of the main island. Whilst we did provide a couple of updates on our tracker during this time, we weren’t sharing our full experience on Serenity as we didn’t want to cause any undue alarm. So we will use the space of this post to give a better account of the final few days of our passage and our first week upon arrival, and take turns recounting our individual experiences as they differed significantly.

What’s the plan? (Alec)

Up until this point, I had been frustrated with the infection on my leg, though not particularly worried, but my symptoms now began to escalate in a worrying fashion. The abscess started to grow quite rapidly in size and any movement or weight bearing on the infected leg was acutely painful. On top of this I was becoming increasingly feverish and struggling to maintain the levels of concentration needed to skipper the boat, or even hold down a watch. Infections at sea are one of the greatest concerns of all cruisers (see our previous experience in the Pacific), and the fact that this one didn’t seem to be responding to our initial choice of antibiotics heightened our fears. Serenity was currently fairly stable as we had reefed down the sails, and so we took the opportunity to assess our options.

We had two specific problems to solve: slowing / stabilising the infection and getting Serenity to Denerau and better medical facilities. If we couldn’t solve both of these together, then we would be forced to make requests for emergency assistance; however, we agreed that we weren’t at that stage yet and wanted to exhaust all our options first. We sent an update to our agent in Denerau in case we needed to request assistance later, and also to the boats we were sailing with. By this stage, we had spaced out such that they were all a minimum of 12 hours sailing away, but they all immediately offered to come and and standby / share medical supplies if it would be useful. Amari also provided the contact details for a couple of cruiser physicians they knew in Florida, who they said would be happy to take a call from us at any time.

Karl and Natalie (who own S/V Remedy that we had seen in passing in Tahiti) were the perfect advisory resource for us at that moment in time. We sent them photos and a summary of the treatment we had tried and they immediately jumped on a call with us to warn us that we needed to rapidly up our treatment game. We didn’t have the ideal antibiotics that they recommended, so they suggested we try pretty much all the other ones we had on board in the hope that it would at least slow things down. Their other recommendation was that we needed to drain the abscess to give my body a chance of recovering.

At this point, I was expecting a pretty strong performance from Laura, as she spends most of her TV watching hours glued to medical documentaries and I think by this stage has witnessed the performance of most common medical procedures. I revised my opinion though when she put forward the blunt vegetable paring knife as the surgical tool of choice, as I had struggled to cut a potato with it the day before. We agreed it would be better for me to make the incision, and Laura found a fresh box cutter / stanley knife that we sterilised for the job. I’ll avoid dwelling too long on the next ten minutes as it still makes me nauseous, but the short story is it was pretty disgusting how much goo was in there and I was very relieved to get it all out.

I had hoped that the draining would improve my pain and mobility situation, but unfortunately it had gotten so inflamed that it would be another 24 hours before I could start to move around again. So we were now onto solving the second problem of getting to Denerau and it was looking increasingly like it would be single woman effort. It is a testament to how much experience and confidence that Laura has gained over the last two-and-a-half years that she didn’t hesitate a moment to say that she could do it. That was all I needed to hear, and so after a brief summary of what I’d been planning to do with the sails and weather, I lay down and passed out for most of the next few days.

Becoming a single-hander (Laura)

Long passages can be isolating affairs at the best of times, but throw in a seriously unwell partner and it can be enough to make you want to give up. Except, well, you can’t give up. There’s no “stop” button. Not even a “pause” button. Heck, you even have to be careful about going to cry in a corner for an hour, because that is, typically, precisely when the weather will decide to change.

So, I was exceptionally grateful to have our little mini-rally of boats, especially when Alec’s leg got bad. Even though everyone was spread out by more than 50 nautical miles, it was comforting to know the other boats were out there, and to know we were all going through the same weather challenges. In short – we weren’t alone. Via an active email exchange, we laughed together, cried together and cheered each other on throughout. It helped me enormously to have that support system there when I suddenly found myself skippering Serenity.

I knew it was bad when, even after draining the abscess on Tuesday (18th August – passage day 12), Alec couldn’t put weight on that leg. In fact, he was in so much pain he couldn’t even sit up properly. I appreciate Alec’s kind comments above about my willingness to step up to the single-handed plate, but in my view, there wasn’t any choice in the matter. It was clear Alec was in real danger and we needed to get him to land and a hospital as quickly as possible. He was too unwell to sail, so I better figure it out!

This final three days of the journey is, honestly, a bit of a blur. That’s probably because of the fatigue combined with the extended high-adrenaline nature of sailing mostly single-handed. But it broadly consisted of: saying many four letter words to Neptune, adjusting sails and course, and extensive napping. Normally, we have a rule about someone always needing to be awake on board, but, yeah that sure wasn’t going to fly now. When I was completely exhausted, I would do a few hours’ worth of 20 minutes napping / 10 minutes on watch, which kept me going. And a few times Alec was able to sit in the cockpit and keep an eye on things for an hour or two to let me get a bit of unbroken sleep.

The weather stayed spicy (rapid, unforecast changes in wind strength, plus squally instability) until we were maybe 60nm away from Denerau, where it died completely. I was actually grateful for this, as switching to engine took away the stress on sailing; meaning, Alec could just pass out till we got there and I could continue my 20 down / 10 up regime indefinitely. We navigated through the Navula channel into the Nadi waters just before dawn on Thursday the 20th and I definitely shed a tear or two of relief when the anchor hit the mud in the quarantine zone off Denerau a couple of hours later!

It still feels a little surreal that I managed to quasi-solo the boat those few days, but I have to say I’m immensely proud! That is not to say that I’ll be signing up to do any long distance solo-sailing anytime soon, but its nice to know that, in a pinch, I can carry us :).

A true Fijian welcome (Alec)

Whilst a huge weight was lifted off both our shoulders once the anchor was down, the resumption of the increasing severity of my symptoms over the previous six hours, despite the aggressive course of antibiotics, meant that there was still quite a lot of stress and concern aboard Serenity First that morning. Our US doctor advisors were now flagging that the infection must be resistant to base level antibiotics, which in a worse case scenario could mean MRSA (a ‘superbug’ that I was only familiar with through news stories of hospital closures amid outbreaks). This was coupled with the fact that I had metalwork in my infected knee from a previous surgery, and knew that this could lead to even more complications if the infection progressed unchecked. I had no idea of what the Fijian healthcare system would be like, but was struggling to manage my fears as to whether they had access to the drugs and expertise that I might need.

We had been warned that the bureaucracy and delays upon arrival in Fiji were perhaps unsurpassed in the South Pacific, and on top of this there was now the challenge of COVID in the mix. It was therefore a far more than pleasant surprise when a small motor launch came alongside Serenity within thirty minutes of anchoring, and we were relieved that we would get our COVID tests straight into the system. But again we had misread the situation – our agent had done a fantastic job explaining the potential severity of our situation and so they were here to immediately take me to hospital. It was a welcome that so exceeded our timeline expectations that I ended up leaving Serenity with no spare clothes or toothbrush. We have since learned that Fijian’s pride themselves on the friendliness of their “Bula” welcome, and whilst this can be delayed due to the concept of “Fiji time” they know how to move fast when needed. By the time another thirty minutes had passed, I had been transferred by ambulance to the COVID isolation ward of the local hospital (otherwise empty due to Fiji’s success in controlling the virus) and was being assessed by a doctor. I don’t think the NHS would have been able to move any faster.

The doctor explained that they had a treatment protocol in place for antibiotic resistant infections and that meant they would need to try some alternative drugs before they would be willing to prescribe those that the US physicians were advising. It seemed only fair that my treatment would need to be in line with what locals could expect, and the ‘good’ news was the new antibiotics were administered by IV and were fairly uncomfortable going in thus confirming that all good medicine needs to hurt a bit to be properly effective. I was told I would be receiving these new drugs every six hours for the next three days alongside regular cleanings of the abscess. Outside of treatment, I would be left entirely alone because I hadn’t been cleared yet for COVID. My errors in packing so light now became apparent as I only had my phone for company, and hadn’t even got a charger.

Thankfully one of the nurses leant me her charger and I was then able to speak with Laura and bring her up to date. The nurses were so incredibly friendly in all my interactions with them and I felt so lucky in the circumstances in which I now found myself. Laura was able to visit once during my stay to provide some other essentials, and gradually the swelling on my knee began to recede once more and my fever subsided. By the time the third day arrived, I was feeling almost entirely myself again. I was rested, ready to return to Laura and the boat, whereas she was still recovering as she’d had a lot more to deal with in the interim.

Mutiny by default (Laura)

I could not be more grateful to our agent and the health ministry of Fiji for taking Alec’s condition so seriously and getting him to hospital incredibly quickly after our arrival in Denerau. However, shortly after he was carted off I realised that, having disposed of my captain, I was unexpectedly about to experience first-hand the outcome of mutiny. I found myself in charge of the ship and not 100% sure what to do next. Well, I wasn’t allowed to move the boat or go on shore until a new COVID test came back negative, so I did what any good sailor stuck by themselves at anchor would do – broke out the rum. Just kidding. Well, mostly. Actually I took an egregiously long shower and slept for 12 hours. I’m pretty sure I watched a few Disney movies too. Life ain’t so bad!

Then, the reality set in. Once the COVID test comes back, the boat has to go into the marina to complete the customs, immigration and biosecurity formalities. And, um, it seems to be just me aboard. I haven’t helmed a park in the last two years (I pride myself on my linework, but the rudder and I haven’t always seen eye to eye), nor parked solo EVER. Maybe that pesky captain would have been nice to have around after all…

Since I am a strong, self-sufficient woman, I immediately put on my most pitiful-looking face and asked the Fijian Navy if perhaps they could lend me an officer or two. They could not have been nicer and eagerly agreed. In fact I think they were delighted I’d asked! So, come Saturday morning when my test result finally came back and the Health Department cleared me to leave quarantine, officers Gus and Buli jumped aboard ready for action. Both were seasoned Navy divers used to defusing old mines in the deep offshore, so helping me park was more like a fun vacation than work in their eyes. They had a great time exploring the boat taking selfies while I pulled up the anchor, and then got very excited when I agreed to let them helm down the channel!

Then it was time to get serious and actually park. Mercifully, the wind was less than five knots and there was no current to speak of. Further aiding my situation, the marina was finger pontoons and I got the dockmaster to give me a spot where I could go bows-to (i.e. drive in forward rather than reversing in) with the pontoon on my starboard side (the side our stern kicks to in reverse). Not to mention, half the marina came down to catch lines for us, since our story had spread by now and sailors are a very supportive community. So, really any novice could have done this park, but still!

I had pre-prepared all the lines and fenders, and gave Buli and Gus detailed instructions on which lines to throw, in which order, and what to do if we were coming in too close to the dock. Being military guys, they executed with precision and we were safely in the slip in probably 2 minutes. What was I even worried about? Half an hour later, all the paperwork was done (the kind biosecurity people even let me keep all my cheese) and I was FINALLY able to go see Alec. Joking aside, once we were tied up and checked in it was a huge weight off my shoulders. I mean, it was kinda fun to munity (by default) for a couple of days, but I was pretty darn happy to have my captain back when they let him out of prison hospital a few days later :).

COVID and infection free (Alec)

In addition to my infection subsiding, I also received a negative COVID test result by my third day, which meant that all the pieces were in place for me to be discharged. We had worked out that our insurance coverage was not as extensive as we’d thought for the specifics of this situation and I nervously awaited the size of the bill that awaited us. However, I was assured that there was nothing to pay (“healthcare is paid by the government”) and so the spring in my newly restored step was further increased. It felt so nice after the isolation to be back on the boat with Laura, and by this time all the other boats from our group were also checked into the marina. I was still working my way through a load of oral antibiotics, which put the breaks on the celebratory beers but that felt like a small sacrifice for all this company and a chance to sleep in my own bed.

We still had outstanding questions regarding my knee surgery and whether there would need to be any additional treatment to address these complications. The hospital X-Ray had no film, so we had been told to go to the local private clinic and then bring the images back to the hospital for a final assessment. Our friends on Influencer recommended a taxi driver contact of Opeti, who happened to be a popular member of the local rugby community. When we discovered that I had witnessed his brother winning a major rugby tournament in Dubai, he immediately became our best friend and ally in navigating our remaining appointments. I hope we didn’t jump too many queues in the process, but we were back at the marina within two hours with x-ray and assessment completed. It was positive news, but I had some reservations at the speed with which I had been dismissed by the doctor at the local hospital. Opeti suggested he take me to the larger specialist hospital the next day, and once again he repeated his tricks of accompanying me around the confusing layout and ensuring I wasn’t forgotten about. The doctors continued to agree that based on the x-ray and my condition there was nothing further to be done, but they relented and prescribed me some extra ABs to replenish our boat stocks in case disaster struck again whilst we were at sea.

Our comfort with the diagnosis grew when my sister got a confirmation from an NHS colleague that the x-ray showed no signs of bone infection (thanks Liv!). It took us a while to realise why we had been so reluctant to accept this good news, which was the misalignment with what our amazing US doctor contacts had been warning us about. It eventually dawned on us that the US healthcare system is such a different culture due to the relative wealth / costs and associated legal risks for doctors working there. Of course their opinions would be the most conservative possible that we would get, and that conservatism had got us into Fiji in the best possible state. Now that we were under the coverage of what had proved to be a competent and effective healthcare regime, we could afford to relax our standards again and the NHS standards are yet to let either Laura or I down.

In summary, this was without doubt the biggest challenge we have faced in our journey and we are so glad that it happened towards the end when we had been able to build up our skills to a point where we could just about cope. A long passage, tricky weather, short-handed sailing, antibiotic resistant infection and entry into a foreign country with stringent COVID requirements really was close to being the perfect storm. We wouldn’t have been able to manage without the support from our sailing friends (Will, Dottie, Grace, Nick, Thez, David, Anne, Kristen, Matt, Sydney, Aaron and Nat), their medical contacts (Karl and Natalie), our agent (Jo), our family and the Fijian authorities and medical staff. It has also completely opened my eyes to the risks of infection and superbugs in a very visceral way, and makes it far more obvious why doctors are so concerned that antibiotics are being overprescribed. Finally, I’m so grateful that I was able to lean on such a super spouse throughout this entire ordeal – it’s no exaggeration to say that I might not have made it without her and I can only hope that I never put her through anything that tough again.