Did a bit of rechecking and my tambu actually had an acute liver failure and not renal/kidney failure. It's uncommon and some causes are unexplainable.

According to one clinic "Acute liver failure, also known as fulminant hepatic failure, can cause serious complications, including excessive bleeding and increasing pressure in the brain. It's a medical emergency that requires hospitalization."

'Acute' means sudden onset and does not necessarily mean severe.

'Fulminant' means occurring suddenly, rapidly, and with great severity or intensity. In other words you could die.

My tambu's situation was acute and severe - he could have died.

The same clinic website also states that "Acute liver failure can develop quickly in an otherwise healthy person, and it is life-threatening. If you or someone you know suddenly develops a yellowing of the eyes or skin; tenderness in the upper abdomen; or any unusual changes in mental state, personality or behavior, seek medical attention right away."

So how do we triage that?

The NSW Health Department regulations stipulates triage in five categories here http://www0.health.nsw.gov.au/hospitals/going_to_hospital/triage.asp, prescribing how life threatening the condition is.

"Patients are triaged on the basis of the speed with which they need medical attention. The Triage Nurse allocates a triage category to a patient based on the statement:

"This patient should wait for medical assessment and treatment no longer than..."

1. Needing treatment within 2 minutes - immediately life threatening
2. Needing treatment within 10 minutes - imminently life threatening
3. Needing treatment within 30 minutes - potentially life threatening
4. Needing treatment within 1 hour - potentially serious condition
5. Needing treatment within 2 hours - less urgent condition

So according to the above description from NSW Health my tambu was at level 3 and should have received medical attention in less than 30 minutes.

I assume the statement is written down on their medical card or board or what have you, and that the concerned friends or family are duly informed.

We received no such clarification at POMGH Emergency ward.

We remained ignorant and helpless - apparently as the the emergency medical professionals at POMGH, and our health department would have us remain.

My in-law was later diagnosed as having non-infectious meningitis, i.e. swelling of the brain. Hence, the stiffness and altered consciousness.

We had waited for 36 hours while my tambu's saline IV ran out.

We had brought him over from POM Private Hospital, where his condition had been stabilized and observed, and with the saline drip attached.

Saline solution is a sterile solution of sodium chloride salt at 0.9% concentration - the level in tears, blood and other body fluids (courtesy of wikihow.com).

It probably costs too much money to replace sterile saline solutions so I recommend that the POMGH Emergency ward start buying coconuts because running out of saline IV is no good excuse.

In fact, everyone should bring their own coconuts whenever they or their family and friends are likely to need saline IV at hospital.

Fortunately my tambu is a young man and was able to respond to treatment. He survived.

Vikki's words seem to point toward doctors doing triage. For those waiting, the problem was that, of any category of person in attendance, there was no triage.

Can the point by Philip G Kaupa be drawn to the attention of a legal person, to help in understanding on 'non-medical negligence of an employee'?

It is likely the Minister for Health will have had that advice, but what of bureaucratic intermediaries and at each shift, the duty nurse?

Whilst I dont want to promote Digicel I am compelled to.
Digicel runs this marvelous insurance program where you pay 58 toea or less each day to be insurance covered for death and another 58 toea for medical bill after the first day of up of K 96 per day on their BIMA program.

This is available to all digicel users who can be registered to the program, everyone, working person or unemployed person, so long as you have a digicel phone.

What is one kina twenty toea per day when we spend more than 5 kina per day on flex cards. Not only that most PNGn's spend more than 2 kina per day on beetle nut and smoke.

Under the Bima insurance and a digicel owner can hook up easily dialing *164# this can give a sick person or parent the assurance to seek a private doctor. We all know how dreadful it is at the public hospitals and health centers and clinics but when we are given this opportunity with the likes of Digicel, we complain it is too expensive that they keep on deducting and we forget that we splurge more that K 2 every day on unnecessary up keeps on the likes of buai nuts and smoke.

At least with Digicel's Bima, there is a prospect of a benefit when it is crucial. You wont get that with splurging on buai and smoke.

I do not want to belittle the tragedy at the Gerehu Clinic, nor do I want to enrich the Digicel's coffers however the knowledge that I could for up to 58 toea per day, have the opportunity not to sit waiting for long in a dreadful place like a public clinic can be the best remedy.

We feel for the little girl....she could have been saved if she as attended to earlier. Such a tale is not uncommon in many parts of the country.

If you are in the health profession, such a story might help you to see that just reaching out and attending to one child, or person is very important.

Yet there are many committed health workers in the country chipping away at the hours and saving lives...

Just like many other sectors, the health sector really need big improvements and support.

"I am the one in ten / A number on a list / I am the one in ten / Even though I don't exist / Nobody knows me / But I'm always there / A statistic, a reminder / Of a world that doesn't care"

- UB-40, Present Arms 1981

It's sad but true...this happened at the Gerehu St John's hospital. I've been going there for some time now and it's always the same....no nurses or if they turn up they are angry because there's a long line of people to serve...just makes you wonder why he/she even decided to take up the profession.

Thanks Vikki for the contact details..I'll get in touch with the health authorities, something needs to be done.

I waited for 36 hours at POMGH Emergency for my tambu to get a replacement IV saline and treatment for complete renal failure.

We arrived at around 7PM.

My tambu was initially treated at POM Private Hospital across the road for 24 hours. He had been unconscious, then semi-comatose for most of that time.

Although my tambu was seated in a wheel chair I had to stand holding him upright for hours on end. There was no space for him to lie down.

There was one nurse at Emergency all night, but we saw him only two or three times actually in the room taking care of people.

When we finally got into Emergency ward there were at least five 'young doctors' in the enclosed office space.

What were they doing in all that time?

Thanks Vikki.

I will try the email address and forward this article link.

In PNG, if you die by being killed either during tribal fighting, by accident or by murder then there is a compensation payment either prescribed by court order or by out-of court settlement.

If you die from assumed sanguma practice then the community tortures and murders the alleged sanguma and gets the family to pay your compensation. The court has nothing to do with any of this.

If you are raped then compensation payments are settled out-of-court.

If you are clearly ill from human frailty and the medical system is unable to provide services to you, and as a result you die, then that is just too bad.

In order to benefit from the current system citizens are advised to be killed by fighting or by accident, pick someone to accuse of sorcery when feeling ill, not be concerned about rape because they will be paid, but never get seriously ill because there is no profit in it.

A sad commentary, Paeope.