Covid in PNG: I hope Canberra understands
My Spear and My Bilum

Mola: Soon people could die in parking lots

St John’s Ambulance member sanitises hands at Covid testing at Taurama Aquatic Centre (Kalolaine Fainu - The Guardian)
St John’s Ambulance member sanitises hands at Covid testing at Taurama Aquatic Centre (Kalolaine Fainu - The Guardian)

GLEN MOLA
| Guardian Australia

PORT MORESBY - At Port Moresby General Hospital, about 20% of women presenting in labour have symptoms of Covid-19. Of these, about one-third (four to five women a day) test positive.

We get the test results back about two to three hours after we take the swabs, so often by the time the woman is delivering her baby it is too late to transfer her to the Covid isolation ward for the birth.

Staff attending to her could have been exposed to the virus without being able to don the appropriate level of personal protective equipment and practice other precautionary measures to protect themselves.

Since mid-February, the rise in Covid cases in PNG has been exponential.

Even with our low rates of testing our total numbers have gone from 1,000 to 2,300 in the past month and deaths from 10 to 25 in the same period.

We now see about 10 of our nursing and medical staff becoming Covid positive every week, and the number is rising along with the community numbers.

Positive staff are put off work until they test negative some weeks later. To date we have lost 30% of our maternity department workforce.

Our midwifery protocols stipulate that one midwife should not have more than four women in labour to care for; however now we find that we sometimes only have two midwives on duty for our labor ward of 30 beds – all of which are typically full at any one time.

Doctors are now filling in to provide a significant part of the midwifery care, especially on the night shift, but three of our 20 doctors have also tested positive this month.

My concern is that we will reach a point in the near future where we will have insufficient staff to keep the doors open.

If we get to this point, what will happen to the more than 50 women who present for pregnancy care every day?

Some may make it home again with their severe pre-eclampsia or life-threatening bleeding or to give birth, while others may end up dying in the hospital car park.

The Port Moresby General Hospital is the only hospital in the capital that offers maternity care for public patients.

The service is basically free, and most of the time we are able to provide basic care for the 20,000 women who are admitted to our service each year without any additional cost to them.

Over the past 50 years, in the 92-93% of women who are booked for pregnancy care in our city’s antenatal clinics, we have managed to achieve the lowest level of babies deaths of any public maternity in the low-to-middle-income world (18-19 deaths per 1,000) while having possibly the lowest caesarean section rate of any large public maternity in the world (5-6%).

In the rest of PNG only about 50% of the country’s (mainly rural) pregnant women are able to access pregnancy and birthing care.

This results in PNG having some of the highest national maternal and perinatal death statistics in the world.

Port Moresby General Hospital has a track record to be proud of, but it is all possibly about to end – because the Covid-19 epidemic has finally reached PNG.

The same scenario is playing out in the general part of Port Moresby General Hospital.

The Covid isolation ward has been full for the past week; now we have taken over one of the medical wards to be an additional Covid ward.

In addition, each part of the hospital has a small isolation area for Covid positive cases that are admitted with other problems and then found to be positive in the course of their admission.

All of these are mostly full as well.

When the general hospital staff reach levels where the emergency department is unable to maintain the service, then its doors will close as well.

Then we will have people who have car accidents, knife wounds, TB, typhoid etc dying in the main car park, or being sent home to their fate.

We need a vaccine urgently, but by the time it reaches us it could be too late to save the health service of Port Moresby.

Professor Glen Mola is the head of Obstetrics and Gynaecology at the School of Medicine and Health Sciences and Port Moresby General Hospital

Comments

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Stacey Wagumisi

I can vaguely remember one of the daily papers' report last year when the first wave of C-19 hit our shores.

In that report, Dr Mola was urging Papua New Guineans to not plan on having babies in these uncertain times: "Please try not to procreate because trying to deliver babies when the pandemic hits our nation is going to be a DISASTER!"

Nobody took heed of his advice. We still went about our lives, making more babies. This is the end result of not heeding to experts advice.

Face the dire consequences and try not to blame the government of the day. They are doing everything they can. Yumi no save lo harem tok!

Paul Oates

The widening credibility gap between Canberra and PNG is not just about how aid is or has been previously spent. We have been banging on about this problem for years and getting nowhere. Years of writing to successive Foreign Ministers and their Department have been firstly politely rebuffed and then dismissed with the predictable ‘snow job’ from the public service staff who write what they are told to write by those who really have no idea what it is like at the kunai roots.

Australia has been able to take and mostly keep control over this pandemic. That objective has been possible due to a number of significant factors. As an island continent, border control can be effectively regulated.

State and Federal governments that have the power to issue and enforce the movement or lack thereof, of potentially infected people and the ability, we hope, to eventually inoculate enough people to reduce or mostly eradicate the disease.

Added to that, Australia was fortunate to have a health system that has just, and only just, managed to cope with the results of those who have caught the disease from those who brought it back home.

There are however other factors that mitigate Australia’s response to helping PNG. The Australian situation differs from that of PNG in a number of ways. In addition to the limited resources needed to fight the pandemic, PNG has a culture that promotes close contact between people in communities. Home quarantining is nether possible nor practical.

Food and water must be gathered from gardens and not delivered to the front door in packages by a no contact delivery person.

Education about how a virus spreads is not well known, even in Australia. Effective hand washing and sterilizing is hard enough to get Australians to do. How will this be possible on a large scale in rural PNG?

A virus can spread by not only coughing and sneezing and the dispersal of droplets in the air. It can be spread by close contact with those who are infected and who have touched a surface that someone else can touch and subsequently pick up the virus from that surface and then touching their eyes or mouth etc. Handshakes are effectively outdated. The sheer scale of how the usual coughs and colds have disappeared in the general Australian community is proof that hand sanitation works in addition to mask wearing. However, the mere fact that a person is wearing a mask is not enough to stop the virus from spreading.

The ‘germ factories’ of pre school and kindergartens etc. are alive and well as parents must work to pay off their mortgages etc. Then those who caught the virus on board close contact cruise ships reportedly can’t wait to go on another cruise. Go figure!

PNG is going to suffer in the same way as other less fortunate countries and there will be the inevitable fake news being spread about what this disease is and how it is being spread, not to mention how to cope with the symptoms. Even the recent US President was not above spreading fake news so who can blame others if they are not fully aware of the situation or try to use it for their own gain.

If nothing else, the effects of this pandemic will show just how much lack of awareness and appropriate knowledge there is in Canberra and the true situation of the people in rural areas of PNG.

If the spread and lack of control over drug resistant TB in the Western Provence can't be managed, what happens if mass migration then starts up in the Torres Strait?

Salim planti marasin na ol samting bilo haus sik igo lo PNG em gutpla. Tasol marisin bilo het klia imas girap wantiam long Kenbera, laga?

Philip Fitzpatrick

I think you're right Arthur.

It's now time to forget political correctness and recognise the horrible mess PNG's politicians have created.

Aided and abetted by Australia no less.

arthur williams

Groaning and gnashing of teeth!
The legacy of the huge amounts of Australian largesse since 1975 has come home to roost. All problems cannot be solved just by economic gifts. For years Oz politicians were quite happy to give many billions to the incumbents in Waigani Haus Tambaran with little attempts to supervise the mountains of Australian bucks. '”She'll be oright mate!” Sorry cobbers I know it wasn't directly from your personal wallets but development don't work like that.
It is many years since I heard the NGO mantra about the dilemma of giving a poor man tin of fish or a fishing line. It was true then and remains so.
So wonderfully blessed with untold amounts of resources yet PNG has been turned into the biggest beggar of the SW Pacific by the handouts not only from Oz but other wealthy nations and international organisations all seemingly fuelled by their guilt complexes of being in the western, world, wealthy or even in a sort of reverse racialism of not being black.
From Sept 16 1975 Australia should have 'laid down red lines' or 'lines in the sand' that all aid WILL BE monitored closely. Australia by just having an overseas budget of hundreds of millions annually (just like UK and its guaranteed annual 0.7% for Overseas Aid donations It was expected to be almost K60 Billion before Covid hit) allowed all the PM's from Somare to Marape to count on it to balance budgets. Actually it allowed PMs, Ministers and MPs to get into the corruption business – Big Time!
In my 9th decade I have seen top politicians of all ilk telling us peasants “We do not support corrupt leaders that is why we target our grants, cheap loans towards health education sanitation etc etc.” They appear to suppose us to be extremely naïve. An example: If they made funding for re-building all the health centres in PNG when in practice it only means the Bigmen can then divert domestic funding for their own private fiefdoms ready for the next election. Or as potentates world wide have done build eye catching often pink elephant memorials to their grandeur. Many have decided they want to have their private jets (PNG's Falcon that may still be in use despite parliament ordering it to be sold ) tanks, even submarines or like India have a space programme. Yet the level of poverty in many such nations is mind boggling. Poor old PNG has to have the basic WASH project and supply sanitary pads to school girls.
Sadly the misuse of funds was brought sharply into focus not only by the Pandemic but also in the end of life for PNG's first PM. His daughter reported that PNG has an inferior health care system and that he has needed to go overseas to be treated. As did and still do most elites of his nation. Now hidden a little from public ken by having a private hospital in the capital that recently has been augmented by a new private clinic in one of a logging billionaire's super markets.
Get a grip all you donors no more tins of fish. Warn Marape and his successors you have to pay your way and accept the wisdom and advice of your benefactors whoever they may be. Resources exploitation in PNG must firstly benefit PNG.
Some of you may have seen the irony of a press release by Puma Oil in Moresby last week:
2021/03/09 Firm concerned over lack of forex The National of PNG- Business
'THE lack of foreign currency (forex) TO IMPORT CRUDE OIL in a timely manner is a concern for Puma Energy PNG Ltd, says country manager and director Hulala Tokome' (has 30 year Kutubu ceased production ?)

With many relatives in PNG I pray that the nation can be spared the horrors of Covid exacerbated by too many years of corruption and wasteful neglect for the 80% of its rural people about to see their hopes dashed for years to come by this plague.

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