Today a woman died: glimpses of life at a rural mission hospital
26 July 2016
KEVIN PONDIKOU
A CRITICALLY ill mother of eight children was flown in to Rumginae from Yehebi on Tuesday.
She was flown here by our Missionary Aviation Fellowship (MAF) pilots based in Rumginae in what was a last ditch effort to save her life.
This courageous woman was suffering from what turned out to be disseminated tuberculosis with cor pulmonale, heart failure secondary to lung disease.
A long term missionary at Yehebi, Dale, and his wife had sponsored her and her husband’s tickets to fly to Rumginae.
It was another glimpse into the awe-inspiring work that missionaries continue to do for rural Papua New Guinea in 2016.
........
In the out patients’ department I was seeing a woman with acute appendicitis.
"Dr Kevin, if we can bring the woman to the airstrip by 2.30 the plane will be here to bring her back" the Yehebi missionary's wife had told me.
Sem spid na nau iet, I dropped everything and organised the community health work (CHW) students to stretcher the patient to the airstrip.
These CHW students remind me of when I was a freshman medical officer, when things like kindness, respect and patience were natural inclinations for me.
These days, having been assaulted time and again by harrowing experience, I'm more pragmatic. And practical. I wonder if that's an improvement or a sign that I'm battle scarred and losing my human touch.
The way CHW student Kelton removed the IV drip and cleaned the site, and how the other CHW student walked back to the hospital to get plaster, gauze and scissors to tape the site, reminded me that these small things are something I've lost somewhere along the line.
........
At the patient’s bed, I told the husband, "Balus bai kam now, em bai gobek".
The husband was crying by the bedside but I was thinking practically about transporting his wife back to Yehebi, and wasn't paralysed by emotion.
"Na mi?" he said.
Ten minutes before the plane landed, she died outside the MAF shed.
Her husband was understandably grief stricken and crying, wanting to return to Yehebi with her body as soon as possible.
Whilst holding to two infants, he said, "Mi nogat lain lo here bai mi hat lo stai lo hia wantem tupla pikinini".
We brought the body back to the ward to be put in the morgue.
........
It was just yesterday I was trying to talk to this woman. She was eating a plate of plain rice so I waited for her to finish.
She was painfully thin, and when eating she would alternately give a spoon to the child.
It was a reminder that in Papua New Guinea, women still put their husbands and family before themselves.
I couldn't believe what I was seeing. At death’s door, and still showing love and care for her toddler.
.........
I must have seen too many deaths because someone dying is part of the job. If I was in this husband’s situation, this is the part where my whole world would crumble.
Seeking medical care in rural Papua New Guinea is a path lined with obstacles.
I'll have to work on my grief counselling skills and need to figure out a better way to handle such deaths.
It's not okay to allow someone to die a tragic death and sweep it under the carpet because they have little or no significance to your life.
If you allow such a travesty to occur to the rural majority of Papua New Guineans, it won't be long until your own life will be affected by the continued neglect of rural health care.
So now I have an image vividly emblazoned in my mind of a young man crying whilst watching his wife pass away whilst his toddler son was crying on the adjacent bed.
The baby did not understand what was happening in his life. The husband knew what was happening. I knew what was happening.
He was strong enough to cry.
I was two levels above being messed up.
.........
There should be a limit to the number of times a man can be put into a situation to watch tragic death.
Collapsing on my trusty couch this afternoon, the thought crossed my mind that I should retire and rid myself of such emotional turmoil.
It's not normal to witness a death and not be affected by it.
Throughout today I was under immense stress and pressure to bring this woman home to Yehebi.
I had to take a full 30 minutes off to lie down and refocus. It was that traumatic. Lately I find I need 10-15 minutes to just lie down and figure out what is going on.
Of course, I know what's happening, I just need those minutes to remind myself that it's okay to make tough decisions.
Last week I was on a high after the caesarian section. I thought to myself, "Yes yah! Now I can handle anything".
But fast forward a few days and I'm wondering if I can continue dealing with these horrifying scenarios.
.......
Sometimes, when I have a lot I want to say to someone about what I am thinking, I find it easier to type. "No comment blood."
In case I should ever forget this woman and her husband and this tragic day, I'm writing this as a reminder to my future self to treasure life and protect the lives of others as best I can.
Taim u lukim onela man krai lo meri blo em dai and hear his wails at the Rumginae airstrip while you stand with some CHW students next to his wife's lifeless body.... em displa taim bai u save what life is and what pain it can bring.
The body will be flown back on Monday.
Was reading The National for 19 September and saw an article about sexual touching it took me back.
We were living in Baimuru, Gulf Province, PNG, when my wife complained about unusual sort of pains in her abdomen.
One afternoon I came from home and found a few tiny pieces of copper piping on the kitchen table.
“Where did these come from?” I asked her.
“Oh they were in my stomach!” Lynette giggled.
She went on to tell me that a girlfriend from the area had recommended D…….. a local sorcerer as somebody who could make the stomach aches end. So that afternoon he came round to visit her and help her.
She told how he had her lie down on a couch and then shutting his eyes he mumbled some local language phrases while moving his hands over her body. He then clutched his own body through his shirt and suddenly shouted as he opened his hands to show her these bits of pipe he had removed from her intestines.
He was paid about K20 and went off home or perhaps to the store I ran to spend it!
I found out that the magic-man was a worker in the local Gulf Fisheries factory just beyond the western end of the airstrip. Among their equipment was small copper piping.
My wife never really got well and ran away later from treatment at Kapuna Hospital after some strange behaviour there too.
In 1981 and still experiencing these pains I took her to the General Hospital in Port Moresby. I was amazed to see quite a lot of women also bent over with abdominal pains. All of them had been receiving the contraceptive injection Depo-Provera which I later found out had been banned at that time for use in the USA and continued to be so until 1992.
One of the adverse effects of the drug I now know is cardiac problems – my wife died from heart disease in 1991.
Was Papua New Guinea a guinea pig for this effective but dangerous drug?
Posted by: Arthur Williams | 20 September 2016 at 11:26 PM
I second that Dr Aisi. Without the rural health workers I wouldn't be alive today.
Lavongai Island has never had its own doctor during my over forty years connection with the place. The best we had were HEO's who were generally as good as a doctor and certainly had to be able to deal with all sort of medical emergencies..
Here in Wales if I ring for an appointment to see a doctor they ask which one I'd like to see. After the PNG years of my life I always say anyone will do, and inwardly give thanks. Similarly with dentists.
I can recall some lowly aid post orderlies living far from any town who gave their services 24 hours a day if necessary.
Also many nurses who did lifesaving work which elsewhere in the world would be done by doctors and sadly with very few facilities or even right drugs or equipment to work with.
God bless them all who even as I type are facing unimaginable traumatised patients, perhaps by torchlight.
Mind I knew a few who made me cower when it came to 'kisim sut'. I can still feel small nodes in the buttocks where one lady at Taskul gave me many jabs over the years.
Babies immediately shrieked when she came near them. Thankfully she was one of a few such poor 'dart' nurses. In his time 'Masta Bia' was perhaps second only to Lapun Darius.
I was once asked to cash a government cheque for Vevien. It was his overtime payment for a month of ferrying, in an open dinghy, seriously ill patients from Taskul to Kavieng; often in the dead of night with a monsoon blowing with its torrential rain.
A wantok would hold a waterproof torch, that the Vevien had bought himself and stocked with batteries he also bought. Holding a drip would be a young nurse or even nursing aide.
Sometimes they failed to reach the beach at Kavieng Hospital before the patient died; but often he or she would recover thanks to the dedicated rural health team that had braved the elements.
Vevien's overtime cheque it was for 75 toea. I never banked it but keep it as a memorial to a good man who served his country for a pittance while the spivs were busy ripping off the nation and lining their pockets and when venerable MPs even PMs are lauded for what they did during their time in parliament.
My hero died too young driving his outboard in the middle of the night when he apparently, not verified, was in collision with another boat possibly with a drunken driver.
Posted by: Arthur Williams | 27 July 2016 at 08:23 PM
Dear Kevin - Well done in the circumstances.
I know the majority of our population lives in the rural who are neglected or missing out on very vital services and health is one of them when it is supposed to be delivered.
With the current National Health Service Standard (NHSS) hopefully these gaps can be narrowed but how long I do not know.It takes the politicians with good vision for their districts to achieve this.
I take my hat of for your passion for our people out in the rural majority and the missionaries who fill a lot of these gaps where the government can not reach.
Keep the good work up. I would like to know more about your health facility when we roll out the NHSS to Western Province.
Posted by: Dr Desmond Aisi | 27 July 2016 at 07:57 AM
Wow, thanks for representing the forgotten citizens of our nation through the telling of this story. You won't see this on any newspaper headline. Hats off to MAF and medical professionals like yourself providing a service where our government has failed.
Posted by: Mason Daimoi | 26 July 2016 at 11:11 PM
I remember Barbara Ellis Arthur. She showed me her bottled collection of bizarre growths that she had cut out of various people - quite mind boggling. In those days the hospital was a long limbom affair with a thatched roof.
I also knew Kath Donovan at Balimo. She died a couple of years ago. I took a troubling medical condition to her and she advised me I had piles and to stop sitting on wet logs and cold rocks, advice I've faithfully followed to this day.
Posted by: Philip Fitzpatrick | 26 July 2016 at 09:53 PM
Phil - I have the APCM magazine 'Light & Life' for May 1969. It tells how Field Director George Sexton opened the new hospital on January 24 1969. Built by Ray Goodlett with Doug Beckett, Max Brooking, Dan Ippel and several Papuan carpenters.
It reflects on the two years work of Dr Barbara Ellis, especially with many TB sufferers, aided by Sisters Margaret Thompson and Jean Stewart.
Also notes the work of Dr Kath Donovan with the same mission at Balimo hospital
I was with APCM's commercial arm Pasuwe Ltd working from Kawito in late 70s. Supplied some of the missos at Rumginae and their other 20 plus stations with their basic groceries etc, 90% by MAF, though occasionally Douglas or Talair charters.
Posted by: Arthur Williams | 26 July 2016 at 08:24 PM
Meanwhile, Governor Ati Wobiro, Provincial Administrator Dr Modowa Gumoi and chief of Fly Care Foundation Inc, Norman Carl May, were all found guilty to have conspired in establishing the Fly Care Foundation between 1 January and 30 December 2013 using K7.6 million of funding from the provincial government.
Posted by: Michael Dom | 26 July 2016 at 05:09 PM
When I was a kiap at Kiunga in 1969 I visited Rumginae frequently.
The road connecting the two was a nightmare of windy bush material bridges through swamp and bright orange mud.
My fellow kiap at Kiunga, Joe Nombri, spent a lot of time keeping the road open. There was no gravel or river stone to be had in the area and that made it doubly difficult.
At one stage I trekked from Rumginae to Ningerum surveying a road to join them up. That later all went by the board when the road from Kiunga to Ok Tedi was built.
The ADC at Kiunga, Barry Creedy, married Joy, a nurse from Rumginae. Barry has passed on to the great patrol post in the sky but Joy still lives in Queensland.
The hospital has a proud record of serving the people of the Upper Fly.
Posted by: Philip Fitzpatrick | 26 July 2016 at 11:18 AM
Kevin is a champion and I am very, very proud to know him. He gives me faith that the next generation can do a better job than the current one.
Kevin works at the delivery end of a 30% health budget cut and is also supported by the MAF which receives zero government funding to provide this critical service.
Meanwhile air services such as South West Air and Hevi-lift PNG celebrate their latest business successes thanks to resource developments.
We celebrate macro-economic success and ignore the distress of rural community health services.
Elsewhere the Evangelical Lutheran Church struggles to establish a university seeking counterpart funding from government but this inevitably reduces capability for servicing rural health from church and government.
People pray to God, but their are their priorities lie elsewhere.
This years Repentance Day will be another farce.
PNG Stop praying. #JustDoRight
Posted by: Michael Dom | 26 July 2016 at 10:48 AM
You painted the picture of rural Papua New Guinea well..one of the many crushing stories of one husband, 7 children's uncertain future and a community's devastating loss.
Keep writing from where you're planted, Kevin.
That's a progress in your effort to assist the people there and tell the rest of humanity of some of our challenges.
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Rumginae Hospital and Community Health Worker Training School are operated by Evangelical Church of Papua New Guinea Health Services - North Fly
http://www.rumginae.info/
Posted by: Corney Korokan Alone | 26 July 2016 at 08:58 AM
Thank you Kevin.
Posted by: Tanya Zeriga-Alone | 26 July 2016 at 07:10 AM