Ignoring the Covid Rules
The neglect of Josephstaal

Why are most aid posts non-operational

| My Land, My Country

AUCKLAND - Scott Waide’s article on Josephstaal got me thinking about access to medicines to aid posts, the primary level health facility throughout rural Papua New Guinea.

As a kid, during holidays at home, you knew you’d get help at the aid post if you fell ill with malaria or got scratches on your legs that became infected.

But by the time I reached university, it the same story on both sides of my family – aid posts closed for some reason or another.

Fast forward 20 years and aid posts in my villages are permanently closed.

The PNG 2019 Health Sector Performance Annual Review showed that, except for one province, the rest did not meet the national target of 85% open.

If you take time to see the previous years’ reports, this is the trend.

The 2019 report gives the following reasons for closures: weakness in systems including support and recruitment of personnel, having a supportive management and stability in the community. Here’s a quote from the report:

“Aid posts provide the primary level of health care for most of the population. A functioning aid post brings accessibility of the health care services to local villages, and hence provides an opportunity to improve health and well-being.

“Aid posts have been described as the backbone of the health system in PNG. Over the past decade, there has been a decline in the operation of aid posts, compromising access to health care for many.”

How can we break this vicious cycle? The obvious answer is by addressing the factors mentioned above.

So how come year in, year out the reports tell us nothing has changed? Like the saying goes, if we do the same things all the time, we should not expect different results.

I totally understand that there are multifaceted issues present but, as a pharmacist, here’s one area I envisage could be addressed to improve the training of pharmacy assistants to manage aid post and health centre medical supplies.

The University of PNG pharmacy school had a pilot program training pharmacy assistants sponsored by provincial health authorities. I don’t know what the latest status is, but I’m sure funding would make a whole world of difference.

In the meantime, can our respective government representatives in the provinces identify what the issues are regarding the closure of aid posts?

Is it because the aid post orderly retired? Is it because the building is not fit to be used? Is it because no medical supplies order has been put to the provincial medical stores? If this is so, why? Is there anything the community can do to help?

I had the privilege of working as a provincial pharmacist for two years in one of the provinces and the routine rural health visits proved an eye opener for me.

The main thing I found was that the personnel appointed to look after medical supplies were given a mammoth task without giving them the tools to carry out the job.

Short trainings in basic inventory keeping, ordering the right medicines based on the usage and time taken to receive next order, and proper ways to store medicines went a long way.

Most importantly, the networks created and being able to work together to ensure continuous medical supplies was a very fulfilling experience.

I hope the powers-to-be read this humble blog post and approach this important issue with the urgency it needs.

We cannot afford to keep being content with reporting majority of provinces performing under par.

Barbara Angoro is a Papua New Guinean pharmacist and a PhD student at the University of Auckland. Some of her other work can be found on her personal blog https://duresisodyssey.wordpress.com


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Philip Fitzpatrick

I got round to quite a few more remote villages where aid posts had been abandoned in my years doing social mapping.

The usual story was that the aid post orderly or health care worker had been there for a while but was driven away by the lack of regular salary payments, the shortage of medicines and the difficulty getting them and the general lack of amenities in the village or area like tradstores, schools etc.

The latter also included maintained airstrips or road access.

Some of these people were quite dedicated and stayed on without being paid and using any medicines they could scrounge. I often convinced the companies for whom I worked to buy medicines to take into such areas.

As for those who left, you could hardly blame them.

Aid posts can't exist in a vacuum and need all sorts of other support surrounding them that makes staffing them attractive to the health workers. Something like the way they were set up in the old kiap days.

Training more workers is fine but you have to make sure they are supported on the job too.

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