Crossing the flooded rivers to reach Panaras
12 January 2013
LEAH BOONTHANOM | Australian Doctors International
AFTER MESSI WE HEAD FOR Panaras Health Centre, several bumpy hours and rising rivers away. Where necessary, we jump out of the 4WDs and wade across rivers by foot, so the vehicles can better negotiate the rushing waters.
During the rainy season this sole thoroughfare is completely cut off. The locals can be isolated for weeks, save for taking to the ocean in canoes.
It’s no wonder they refer to their birthplace as the ‘Last Page’, a slice of New Ireland that feels all but forgotten. Except for today.
Our arrival in Panaras coincides with preparations for the National Mask Festival in neighbouring New Britain Province. For the first time ever a dance group from the West Coast has been selected to represent New Ireland – and that group just happens to be from Panaras.
We join the excited villagers for a final dress rehearsal, settling on the sandy beach beneath knotted pandanus palms. Musicians beat kundu drums and a garamut that reverberates a beautiful wooden timbre.
The male dancers wear turmeric yellow grass skirts and headdresses embellished with drongo feathers and sing in the old language. The first act is a ceremonial warrior dance, showcasing strength and ferocity as the men stomp on the earth and agitate coconut shell rattles.
The second depicts four mischievous forest dwarves comically darting about in masks with oversized ears and exaggerated expressions.
The finale re-enacts the cremation of a dead man in traditional Kuot tribal custom and, instead of being a sad affair, the mourners’ theatrical wails of anguish are met with hilarity from the crowd.
“It’s so wonderful to see our young men keeping alive the West Coast’s traditional culture,” an elderly onlooker says proudly, pointing out a muscular mute performer who hasn’t missed a beat. “We have to preserve our culture – it’s different, it’s unique and it’s our identity.”
The following night I am awoken by water buckets clanging and minutes later, a newborn crying. Four babies arrive by the light of a kerosene lamp during our three-day stay, all delivered safely by the health centre staff, with no need for the patrol team to intervene.
This isn’t always the case. PNG’s infant mortality rate is 47 deaths per 1,000 live births, comparable to Bangladesh.
Its maternal mortality rate is 733 per 100,000 live births, the highest in the Pacific. Key factors include peri-natal infections, post-partum haemorrhage and a lack of skilled birth attendants.
“The most difficult thing is delivering babies at night without proper lighting,” says Anasine, who is the only female amongst three community health workers stationed here.
The staff relish every word – in isolated areas like this they are the front and final line of any emergency. Merrilee also distributes medical equipment donated by ADI sponsors, including scales, stethoscopes and surgical instruments, and teaches staff how to use it.
The women’s health nurse Jennifer stays up past midnight helping staff update clinical records.
“These community health workers receive only two years formal training, lack basic essential equipment and yet are more-or-less doing the job of doctors,” says Merrilee in amazement. “But as our integrated health patrols prove, it doesn’t take much to improve the situation.”
The community is already seeing the benefits of Merrilee’s training on malaria prevention and diagnosis and the new MALA-1 treatment, given during a visit five months earlier.
Malaria cases here have dropped from 16 in one day to 16 over an entire month. Merrilee insists that staff weigh every patient as part of routine examinations – TB is highly prevalent in the region and weight loss is a good indicator of infection. She also trains staff to test patients for diabetes using glucometers donated by Roche Australia.
“We learn a lot from the ADI doctor and everyone else on the team,” says Anasine. “Patients are no longer returning again and again with the same problem because now for the first time we can treat them properly.”
In the midst of an afternoon downpour, the HIV/AIDS educator Audrey, TB coordinator Wilson, and water and sanitation inspector Eremiah visit a local school to give health talks to the students.
Wilson and Eremiah teach how to contain TB and maintain personal hygiene in the absence of running water and toilets. Audrey delivers a no-nonsense session on safe sex and drugs. It’s an essential initiative, considering that PNG accounts for 99% of the Pacific region’s reported new HIV infections.
Back at the health centre, a village elder comes to Audrey for HIV testing. “I want to have the experience so I can see for myself what it feels like. Then I can tell the younger people and encourage them to get tested too,” he says.
Tomorrow: Part 3 – New Irelanders smile in face of adversity
Thanks for this, it is a great piece.
The most interesting point for me was the comment made by Anasine about the difficulty of delivering babies at night because of the lack of light. Which just goes to show the importance of 'parallel infrastructure'.
So the next step in integrated support interventions may be to take along an engineer to install solar lighting systems?
Posted by: Tess Newton Cain | 12 January 2013 at 05:40 AM