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The quest to find what’s happening to PNG’s children

PNG childELIZABETH FINKEL | Cosmos | Extract

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ADELAIDE - Popular images of the people of Papua New Guinea tend to concentrate on colourful costumes, decorations and ceremonies – such as this picture showing locals at the city of Mt Hagen – but away from tourist spots the situation is very different.

Amidst yapping dogs and swaying palms, the nervous young mother sits at the sturdy table set up in the dusty yard of her village.

Local health workers Pele Melepia and Priscah Hezericlad stretch out her one-year-old baby girl and measure her length with a contraption that resembles those used to measure foot size. The baby is also weighed carefully on a set of digital plastic scales.

Next it is the mother’s turn. Cleared of the clunky devices, the table is quickly transformed into a state-of-the-art pathology lab. Atop a sterile blue paper cloth appears a small blue box, two white strips of filter paper and a small graduated glass rod.

A large drop of blood ebbing from the mother’s pricked finger will reveal whether she is anaemic or carries malaria parasites. A vaginal swab, which she has discretely provided, will take stock of any genital tract infections.

The entire exercise has taken the four-member team – also comprising Primrose Homiehombo, who interviewed the mother, and Dukduk Kabiu, the community liaison officer – half a day.

The potholed three-kilometre dirt track that leads to the village situated within the Tokua plantation is one reason. Waiting for the mother to return from an excursion is another.

It’s not unusual. For the last two years the dedicated Papua New Guinean staff of the Melbourne-based Burnet Institute have repeated this exercise thousands of times to track down mothers and babies in remote villages across the province of East New Britain).

Populated by some 400,000 people, the island is a microcosm of the mainland, nestled to the south-west. Villages are isolated by rugged terrain and accessing them is often a one-to-two-day journey down potholed dirt tracks and across footbridges, carrying equipment and ice buckets to keep tissue samples cold.

Their dedication stems from a conviction that the measurements and tissue samples they are gathering will help solve one of PNG’s most pressing health problems: the poor growth and development of its children, commonly known as ‘stunting’.

“We need this data to advise our politicians”, Essie Koniel tells me. A handsome, middle-aged woman from a tiny fishing village in the north-west of the island, she’s the Burnet Country Operations Manager for the 40-strong team at the Institute’s headquarters in Kokopo, which has been the ENB capital since volcanic eruptions destroyed Rabaul in 1994.

“This data is like gold”, agrees Brendan Crabb, the Burnet Institute’s Director. “We’ll never have to repeat this study and it won’t just help the people of PNG; it will help poor communities all over the world,” he tells the people at the village in Tokua plantation via liaison officer Dukduk Kabiu.

Crabb is making one of his regular visits to Kokopo, accompanied by his partner – paediatrician Michelle Scoullar – deputy director and public health physician James Beeson, midwifery professor Caroline Homer, paediatrician Chris Morgan and me – a journalist and donor to the program.

Globally, children in poor countries experience stunting rates of about 22%, but PNG stands out with around 45% of its children falling well below the normal range for height by the age of two. It doesn’t just mean these children will be short; they are more likely to be sickly throughout life, and less likely to reach their full intellectual potential.

It’s not a statistic that sits nicely with prime minister Peter O’Neill’s modernisation narrative.

There’s no doubt the country’s public health system is struggling. The polio outbreak last June put PNG on the global radar but any number of indicators bear testament: chronic malaria, drug resistant TB and the fact that PNG women are 35 times more likely to die in childbirth than their sisters across the Torres Strait.

Nevertheless, stunting stands out as a problem of special urgency. The World Bank President, Jim Yong Kim, has highlighted stunting as “a humanitarian disaster”. The World Health Organisation ranks it as a number one priority for development – and with good reason.

The prospect that a fifth – or in the case of PNG, half – of the population is starting life behind the eight ball is a dismal basis for nation-building. “People will be left behind,” says Crabb.

While it’s clear that modernisation and rising affluence largely eradicate the problem of stunting, in PNG that’s a slow process hindered by rugged terrain, earthquakes, tsunamis and erupting volcanos. For Crabb, the question is “What can you do while waiting for the country to modernise?”

That’s why three years ago, the Burnet in collaboration with the PNG Institute for Medical Research, the University of PNG and government partners, embarked on the landmark ‘Healthy Mothers, Healthy Babies’ study to winkle out some answers.

Now, as the final data comes rolling in, the combined teams are starting to find answers and, ever so carefully, consult with community partners to plan the first intervention trials.

So, what exactly is stunting?

Link to the full article here


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