Volunteering in Nias
The next chapter of my trip took me to Nias, where I’d arranged to volunteer with the Surfing Doctors – affiliated outreach clinic, Friends of Nias, along with the goal of getting waves.
Nias is an island with a population of 900,000, located just north of the equator in the archipelago off the west coast of Sumatra. In the surfing world, Nias is synonymous with the famous right-hand barrelling reef break. Discovered by travelling Aussie surfers in the 1970s, one of whom died of malaria several months later (coincidentally while in G land), The Point, located at Sorake Beach in Lagundri Bay, is the island’s predominant tourist drawcard.
Jack and friends at the Friends Of Nias Clinic
Garuda Good etc
To get to Nias, I flew Denpasar-Jakarta-Medan with Garuda, which I recommend – they don’t charge extra for boards. Lion Air, on the other hand, the sole airline flying into Gunungsitoli (the main airport of Nias), holds a captive market. They charge an extortionate million rupees per board, not per board bag. From Gunungsitoli Airport, it’s a meandering taxi ride along the coast road to Lagundri Bay, which takes about 3 hours.
I was fortunate to stay free of charge in the clinic’s guest room, which is directly across from Raffiel’s losmen, one of the larger and best guesthouses in town. It’s about 400 metres to walk from here to the Point. Raffiel and his two sons (Alvin and Agus) deliver standout service and hospitality, helping with everything from meals and laundry to a last-minute 3 AM ride to the airport for a rescheduled flight.
I heard a few different iterations of the clinic’s inception story from locals and expats around the village. Founded by the late ophthalmologist Dr Raf Ghabriel with spare donations following his vision-saving surgery for a local woman, the clinic has been running since 2017. It provides valuable healthcare access to the community. A map on the wall shows volunteer medics from across the globe. I was the 54th volunteer since the clinic opened.
The Power Of Placebo
As laid out in the opening page of Dr Ghabriel’s guest book, “believe in the power of placebo, it’s that or Black magic, often it’s all they have”.
To put the medical resources on Nias into perspective, Gunungsitoli has the largest hospital, with general medicine and surgical services. This hospital has the only CT scanner on the island, to my knowledge. If the CT machine is down or there are subspecialty issues (like needing an angiogram), patients must be referred to Medan, Sumatra (expats prefer Singapore). This often involves a prohibitively expensive ferry or flight for locals.
Jack on an inside bomb at the corner
The Puskasmas
Smaller townships have a Puskesmas, a government-mandated community health clinic, which is found across Indonesia. They are overseen by the Indonesian Ministry of Health. They provide healthcare to the population at the sub-district level. This includes basic outpatient consultations, childhood vaccinations, maternal care, family planning, and the tuberculosis control program.
On the ground in Lagundri Bay, the vibe very much felt like “do what you can with what you have”, and locals were certainly appreciative for any access to healthcare, especially to be seen by a “Western doctor”.
The clinic employs six local nurses, most of whom have completed a bachelor’s degree in nursing in Medan. They also work at the private hospital in Teluk Dalam or the nearby Puskesmas. As is often the case, operationally, it’s the fantastic nursing staff that keep the clinic going. Few patients spoke English; most spoke Bahasa Indonesia, and some spoke only the local Nias dialect.
The nursing staff had good English, translated histories, and, most importantly, provided local knowledge, knowing exactly how to work within the system’s constraints. Each day in the clinic, we saw up to about a dozen patients. Most were known to the clinic and had basic medical records on paper to check previous issues.
Chronic Health Issues
Locals are treated free of charge, and many presented for routine checks of chronic health issues like diabetes, hypertension, arthritis and epigastric pain. There were also acute issues like viral URTIs, impetigo and road abrasions and injuries. I also saw a few tourists (all surfers) with issues like otitis externa, reef cuts and traveller’s diarrhoea in exchange for a donation.
As for investigations, we could monitor blood pressure (manual sphygmomanometer), pulse oximetry, blood glucose (preferably fasting), cholesterol (checked 6-monthly) and serum Helicobacter pylori RAT. There was a reasonably well-supplied inventory of medications and basic wound care equipment.
The local Puskesmas, a government-mandated community health clinic
The most memorable case came, as they often do, unexpectedly. As the clinic was wrapping up, I was alerted to a lady at the neighbouring pharmacy who had a “bad reaction to some milk”. I went to see her. She sat outside the pharmacy in a tripod position, distressed with itchy hives and angioedema. Her tongue was a swollen lump in her mouth. Her chest was wheezy, and her sats were in the low 90s – she looked sick. I rushed back to the clinic. My adrenals were squirting the stuff, but a frantic search around the clinic revealed none. “We need to call an ambulance. This is anaphylaxis. She urgently needs adrenaline!” I told the clinic nurse.
“relax, assess, react”
In these situations, I’m reminded that there’s no point worrying about the things you can’t change, or the things you can, and that, as Dr Chapman would teach, “relax, assess, react”. So, pointless to lament the lack of adrenaline. We managed with what we had. I copped an incredulous look from the nurse as I pried 10 tablets of prednisone from the packet. Along with another dose of antihistamine and a few bursts of Ventolin, the lady came good, fortunately. The ambulance never came.
My impression was that, for healthy Nias locals, who are the majority, there is good public health between the clinic and the national health services provided by the Puskesmas. Most basic complaints and issues are adequately addressed.
For anything more complex, it’s tougher. I heard from one expat a sad story of a young girl with some kind of congenital heart issue. She’d become known to a travelling Australian doctor who’d attempted to coordinate a medical retrieval to Australia for specialised care, but the stars failed to align for this in time, and she passed away.
Disparity Is Evident
Similarly, I heard stories of locals who’d died at young ages in the village of unknown medical issues that were never investigated. I saw a fifty-something-year-old man with residual hemiplegia from a “stroke” who’ll probably never access imaging – for cases like this, the disparity is apparent.
But it’s far from a disparaging place to work. The clinic had an amazing community feel. You can feel the impact that treatment, reassurance, and even referral have on locals who might otherwise not have their issues addressed.
“Really, though, we all came to surf.“
Everyone seemed deeply appreciative. Even after only a few days, I was recognised as the doctor in town. And there’s no better recognition than that from the local kids, “hey Doc,” they’ll call on the streets or even the surf.
Nias Village
One afternoon, I finally got around to taking a scooter up into the villages. Families dried rice, betelnut, and coconuts on blankets; kids played volleyball; dogs and chooks roamed free. Inquisitive stares quickly turned to smiling faces, with friendly waves or smiles; the villagers were absurdly welcoming.
One local offered to drop some bananas off at the clinic, which I couldn’t turn down. I forgot about it after a few days, until one afternoon he showed up with a comically large bunch – maybe a hundred bananas – far more than I could reasonably eat in the few days I had left. Every clinic thereafter, patients left with a fistful.
There was a strong sense of community amongst the expats and travellers as well. It felt like there were about 15 or so other travelling surfers in town, so faces quickly became familiar around town and in the line-up. Crew came from across the world, like France, Brazil, Israel and of course, Aussies. We’d eat at the same restaurants and play games of pool with local kids.
NRL Grand Final
A real highlight was Sunday, October 5th, bunked into a beachside losman with four other Aussies and a bunch of locals for the NRL Grand Final, a “scintillating” victory snatched by the mighty Broncos. We exhausted the losmen’s refrigerated Bintang supply, so we had to tuck into the warm ones, drinking them on ice. After, we gathered on the beach to share in a fresh-caught snapper, cooked on a fire of coconut husks and palm fronds.
Really, though, we all came to surf.
Barreled at Lagundri Bay, Nias
I arrived at a good time, catching a few days’ swell. Day one was four-foot, with sets shaping up to perfect almond barrels in classic Nias fashion. By the second day, it pulsed to six feet. Paddling out, I swear they were the most perfect right-hand barrels I’ve ever seen. Size tapered off the rest of my time in Nias. Still, I surfed each day, enjoying 2-3ft of swell most mornings and afternoons, with wave-pool consistency faces to practice turns.
ten-square-meter patch
Aside from the obvious (being a right), Nias is a remarkably different wave from G-Land. Where G-Land spreads crowds for kilometres along Plengkung Beach, in Nias, it’s as if the entirety of the island’s surf tourism concentrates into a ten-square-meter patch of line-up real estate. With such a tightly clustered pack, priority is a matter of who’s paying attention and who’s ready to turn and go when the sets come.
Despite its ferocity in a swell, Nias struck me as absurdly approachable. Jumping out through the keyhole to enter the line-up with dry hair from behind the impact zone. Unlike G land, which might be a half-hour, kilometre-long mission dodging reef and sets. The Nias reef also seemed deeper and less intimidating. Porous and softer underfoot, most people surfed barefoot and happily trod along the reef when washed in.
Crocodiles Sightings
Another wave called “Rockstars”, apparently just as good as the Point, was a 25km scooter ride away, on the other side of Teluk Dalam. A fast right-hand barrel over shallow reef. Each time I checked, it was never quite working. However, after hearing whispers of foul effluent and a crocodile sighting after heavy rain, I wasn’t too disappointed. It was still a beautiful ride. Through rice fields, coastal roads, and bustling streets, especially on Sundays when locals dressed up to attend church.
Friends Of Nias Clinic, all smiles
To close, I would like to extend a heartfelt thank you to all those who’ve made this opportunity possible, especially Dr Raf Ghabriel and the Friends of Nias team. To look beyond the perfect waves and consider how this remote Indonesian community might be helped, I am struck by the initiative and goodwill it’s taken to create this clinic and keep it running. How lucky I am to have been able to visit this special place.
Further reading: Jack Wilkinson – Reflections on the Surfing Doctors Conference and Friends of Nias, 2025. Part 1.