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Nurse & patient - Port Moresby Hospital
Nurse tends a seriously ill patient at Port Moresby General Hospital


ADELAIDE - About 20 years ago I was the Chief Executive of a large regional hospital at Mount Gambier in South Australia.

At that time, two of my colleagues left SA Health and took up appointments as advisers to the Lae and Mount Hagen hospitals respectively.

They soon realised that the health system in Papua New Guinea was in a parlous state. They contacted me and asked me to twin my hospital with Mendi hospital and provide it with help and support.

To this end, I persuaded my board of directors to allow me to visit Mendi hospital in early 1999.

I was greeted at Mendi by the hospital's manager, who took me on a tour of the facility. It was in a terrible state, being desperately short of equipment, drugs and all the essential materials required to provide a decent service to the local people.

The staff, notably the nurses, were working miracles with almost nothing. I was amazed at their ability to do this. They were incredibly committed and had good skills but utterly unsupported.

All but one piece of biomedical equipment in the hospital was unserviceable, mostly because no spares were available for the competent bio-medical technician to repair or maintain the equipment. Appeals to Port Moresby for help had fallen on deaf ears.

Hospital rulesUpon my return to Mount Gambier I asked my senior bio-medical technician, a man with exceptional skills as an instrument maker and miniature engineer, if he would go to Mendi to help repair the bio-medical equipment. He agreed.

I asked him to call in every favour ever owed to us by the manufacturers and retailers of bio-medical equipment used by the hospital.

Also, I asked him to contact every colleague in South Australia to source whatever obsolete, redundant or spare piece of equipment he could lay his hands on.

He subsequently spent six weeks in Mendi during which time, with access to two huge crates of equipment sent from Mount Gambier, he and the local technician repaired every piece of equipment in the hospital. This was very well received.

I also organised a staff exchange for two senior nurses from Mendi to come to Mount Gambier for six weeks to learn as much as they could about how we did things, especially in relation of accident and emergency services.

We organised local accommodation and meals for them, while Mendi paid their airfares.

Unhappily, I was unable to maintain the relationship because my board baulked at the costs involved. We were under tremendous budget pressure then and they felt we could not (politically) justify spending many thousands of dollars on a remote hospital in PNG.

More happily, my senior bio-medical technician's efforts had not gone unnoticed by AusAID, which paid for him to spend about three months each year travelling around the Pacific fixing stuff. I cannot recall how long he did this for, but it was several years at least.

Now, 20 years later, nothing seems to have changed. A former colleague is in Mount Hagen and believes that most hospital staff are doing their best with little or no support from a government which is either unwilling or unable to support them.

The PNG government is a disgrace to its nation. It routinely betrays its people through incompetence or corruption or indifference.

It is beyond belief that the desperately under-resourced colonial administration was more able to deliver basic health, education and transport services than the PNG government has shown itself able to do over past decades.

The same can be said for the maintenance of law and order. A mere handful of patrol officers and police carried out this task, mostly without resort to heavy handed tactics or violence.

It wasn't perfect, but it did work, mainly because the people accepted that they received fair treatment most of the time, even if they didn't like the outcomes that much.

Surely there is someone, somewhere, whether in the government or in the ranks of the PNG public service who can do something about this deplorable state of affairs?

It is not hard to foresee a very grim future for PNG if the current situation is allowed to persist.

This is painful to contemplate for those of us lapuns who once believed that Papua New Guinea could and should have a shining future.


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David Vorst

I suspect I am one of the advisers to whom Chris refers and I am still in PNG but no longer as an adviser but working in a province in the health system.

The health system is in disarray, there is widespread corruption particularly in the procurement and distribution of drugs, budgets have been cut although, through smoke and mirrors, it appears that they have increased.

And, while per capita funding is reasonable for a developing economy, the way the funds are spent particularly by the National Department of Health means that not much actually flows to where it is needed.

Chris is right in saying it is a disgrace and there is little prospect of change. The corruption is far too endemic.

In fact, many people working here say that there are two countries - Port Moresby, as flash as any major capital city, and PNG, where preventable disease is close to being out of control.

Funding cuts by both the PNG government and donors have seen a dramatic rise in the number of cases of HIV/AIDS and tuberculosis, including multiple drug resistant TB, and hospitals do whatever they can to support their clinicians, who often have to work without the basic drugs and consumables they need.

I wish I had the answers to how the health system can be fixed, but the best I can do is assist in making sure care is available to those who need it.

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