Obviously, by the pained expression on my face, I earned my place in the more serious injury waiting room and was seen fairly quickly by a doctor. In fact, the place was crawling with doctors and nurses, to the point they were almost tripping over each other. I was popped onto a gurney and sent from one room to another, eventually ending up in an urgent care room with some pretty unwell looking people. I thought I would lie on my back and think of England. The mould that was growing on the ceiling tiles did little to ease my woes. I seemed to hang there for ages, with only the melee of urgent care to entertain me. Karen was allowed in briefly, but was told to wear a mask as the patient in the bed next to me was a suspected case of active tuberculosis. Ugh!

They took my blood for analysis (they did this a few times whilst I was there) and the nurse did not wear gloves whilst doing this! They got blood on them and then went off to the next patient. Karen saw this and was horrified!

After a while I remember being wheeled to one side of the room and curtain pulled across. This is where they did the ultrasounds. I was joined in this space by a couple of doctors and what seemed like 10 student doctors. Lab rat! I think this space doubled up as the janitors closet as there were buckets, mops and large plastic containers of bleach.

The ultrasound was inconclusive so next up was an x-ray. So, I was wheeled away to an x-ray room where the technicians greeted me dressed in soccer (aka “football” for the Brits) shirts as scrubs. They manhandled the x-rays plates underneath me on the gurney, which was really, really painful.

When my x-rays were read the bad news was I had 5 broken ribs, a couple in two places. The good news was I did not have a pneumothorax ( a punctured or collapsed lung ) so I could fly. If my lung had been promised I would have been stuck in Sandakan for several weeks.

After spending quite some time in a “holding” area I was finally wheeled to the ward, where I was to spend the next 2 or 3 days under observation (being poked by several doctors under the observation of armies of student doctors).

I don’t want the following to come across as a bashing of the public healthcare systems of developing countries. These are just observations. The staff at the hospital were friendly and competent within the limited resources available to them. That said I think basic sanitation is within reach of these institutions; a lot of it comes down to education.

In some ways, I was lucky to be in the ward I was, which was half empty. Apparently the main surgical ward was full, noisy and very hot. There was, of course, no air conditioning, a necessary comfort factor for a westerner, softy like myself, apart from opening a window (letting the hot air in) and some ceiling fans, one of which squealed like a stuck pig (apologies to my fellow vegans for that metaphor). The open windows did let in the lizards, who did a super job keeping down the insects and were to be my only source of entertainment outside of visiting hours.

I was next to the bathroom. Which was good in the sense of not having far to stagger but bad in that there was a constant stream of folks coming past. The bathroom had a single toilet stall, whose wooden stanchions were rotting from the base up, due to the humidity and the sluicing of water when they are being cleaned. The door frame to the toilet stall was about 5 foot 10 inches high, and I am 6 foot 5 inches, so I had to keep ducking which was not easy with broken ribs. The shower was basic with no grab rails or disabled seat. And yes, there was no toilet paper or soap in the bathroom!

The ward itself was open plan, which I didn’t have a big issue with. My biggest initial concern was with the bed, which was about 5 foot long, so even sitting up my feet were wedged against the end. Malaysians are generally short so I guess they make the beds to fit. Much to my relief, on my 2nd day at the Duchess of Kent, one of the nurses saw my plight and removed the end to the bed. Oh my goodness the wonder of being able to stretch out. As well as getting no toilets roll, they did not provide food or water. Luckily I had Karen and Sheng, from Kinabatangan Wetlands Resort (she did an amazing job looking after us – including washing my clothes), to feed and water me. If I had been traveling alone goodness knows what would have happened.

Everyday I was asked to get up by the nurses so they could make my bed. They also gave me some clean scrubs to wear. The blankets on my bed had large brown stains on them. I thought this might be coffee. But when they took the pillowcases off and there were two hand sized blood stains on the pillow I realized that this was probably not “coffee”.

The ward furniture was also a little worst for wear. The beds and side cabinets were made of metal and had started to show the effects of years of exposure to the humid atmosphere of Borneo.