“An emerging public health crisis has already hit our nation. A promising nation lost in paradise with bad politicians and a weak bureaucratic system and institutions that can’t turn the tide around after 46 years of independence” - Jerry Kuri Mandara (Twitter @KuriJMandara)
NOOSA – Yesterday the ABC’s Papua New Guinea correspondent Natalie Whiting, in conjunction with her colleague, producer and journalist Bethanie Harriman, published an evocative but brutal article.
It was based on the fact that PNG’s entire health system is collapsing - overstretched staff, no money, limited medical supplies, a population in desperate circumstances with out of control Covid and the constant, unforgiving burden of other disease.
The beauty of the story, which you can link to here, lies in the writers’ clever weaving of the health crisis with the predicament of the stoical and unfortunate villager Robin Balo, brought down by a solitary arrow.
What happens to him then makes for an enthralling piece of journalism as Robin is subjected to the full force of a shocking chain of events.
It is a story that brings shame on the governments of both PNG and the country where it has most frequently looked for guidance, Australia.
Both governments have shown a monumental incompetence over very many years in protecting PNG’s health system: PNG has failed a primary duty of government to keep its people safe; Australia has failed because an adjacent nation, whose performance profoundly affects Australia in many respects, is weak and vulnerable.
Two stories in PNG Attitude – Friday’s on the ambitious cooperation goals agreed by China and the Solomon Islands, and yesterday’s about Bougainville’s decision to reopen the Panguna mine (a K30 billion exercise) – point to just how exposed PNG is to newly expansionist China.
In this article, four Australian writers well known to PNG Attitude readers, tell of their own experiences with PNG’s appalling health care system, including Chris Overland who astutely perceives that “the Chinese might step into the breach before us”.
That is neither an outrageous nor eccentric thought. Indeed, today it looks more likely than not.
HOW TO REMOVE YOUR OWN APPENDIX
It was 2014 and the resupply order for the hospital at Awaba, on the Aramia River in Western Province, had been constantly ignored by the authorities for two years.
The orders included just about everything you could think of from antivenin for snakebite through to spare parts for the hospital refrigerator that had broken down and couldn’t be repaired.
The frustrated matron was at her wit’s end with ‘making do’ when she pleaded with me to try to kick free the logjam.
So I decided to personally take copies of the orders with me to Health Department headquarters in Port Moresby.
After a lot of yelling and pointing and some cash under the table, I was able to secure about one-third of the supplies and put them aboard a plane to the hospital.
The remaining two-thirds of these basic supplies just weren’t in stock – not even in the national capital.
Working in mining exploration camps and later undertaking social mapping studies all over PNG, it was a common occurrence to come across abandoned aid posts established under the colonial Administration.
It was also common to come across health personnel – medical assistants and nurses – who had continued to work without pay or supplies, supported as best they could by the local people.
All the big mining companies in this remote but resource-rich corner of PNG had well equipped medical facilities with trained personnel but many, like Exxon and Chevron, had a policy of refusing to allow villagers into their clinics or hospitals.
There was a sad case where an Oil Search security guard sought help for his baby daughter who was very sick with malaria at Lake Kutubu. He was turned away and his daughter died. I can tell you it did nothing for morale at the camp.
While working in Western Province we talked one of the companies into building a new aid post which a retired nurse in the area said she would voluntarily staff.
One useful thing I did in these trying circumstances was purchase and distribute copies of the excellent publication, ‘Where there is no doctor’.
It contains heaps of useful information along the lines of ‘how to remove your own appendix’. It’s still available and there’s a link here if you’re interested.
PUTTING OUT THE WELCOME MAT FOR CHINA
At Mendi Hospital in 1999, I witnessed scenes similar to those described by Bernard Corden (below) and referenced in Nat and Bethanie’s article.
The nurses in emergency were working with bugger all equipment managing presentations ranging from births going wrong to spear and shotgun wounds.
The hospital had no working equipment - no autoclaves, no oxygen concentrators, no IVAC pumps to deliver antibiotics, pain relievers and similar fluids. There’s wasn’t much of anything else either.
The food was cooked in two cut-down 44 gallon drums in a lean-to annex.
Back in Australia I persuaded the board of the hospital of which I was CEO to pay for our chief biomedical technician to spend four weeks in PNG.
During this time he worked with Mendi Hospital’s only biomedical technician to repair every piece of equipment and get it working. He called in favours with suppliers all over Australia to get this done.
Our board, now fully aware of the desperate need of such hospitals, subsequently released him for three months each year to do the same sort of work in Fiji, Tonga, Vanuatu and, of course, PNG, this time funded by various aid agencies.
The PNG Department of Health was useless. The hospital employees had not been paid for many months and were living on gifts and donations.
My friend and former colleague David Vorst is currently the CEO at Mount Hagen and he says the situation has not materially changed.
Only the dogged commitment of the staff to keep working prevents the total collapse of the system. It is shocking and it is a disgrace.
The best solution is for Australia to simply take control of the entire system on the basis that it will fund it if the PNG government gets out of the road.
Of course, the Chinese might step into the breach before us. They have plenty of capacity and it would be an easy win for them in the contest to win hearts and minds in PNG. Personally, I would cheer them on if they did.
AN INTRODUCTION TO PNG HOSPITALS
Within a month of my arrival in Lae in April 2006, an employee from a logistics company working outside our factory late one Friday afternoon fell several metres from a ladder to the road.
He cracked his head on the concrete gutter and was quickly bundled into a utility and taken to the Angau Memorial Hospital.
The next morning I drove to the hospital to check on his condition.
He was on life support and his grieving family were surrounding the bedside as I approached.
I was stopped urgently by a doctor and thought I had inadvertently breached some cultural protocol.
But the doctor was frantically pointing to the floor where I was about to step to reach the bed.
There was a gaping hole encircled by rotten floorboards infested by termites.
The victim never regained consciousness and my introduction to the PNG health system had begun.
A couple of years later, in 2009, I vividly recall taking a young Papua New Guinean to Angau’s emergency department during the silent hours of an early Saturday morning.
He had been attacked in the Eriku settlement by a man wielding a broken beer bottle and was covered in blood which was pouring from the gaping wound in his head.
After receiving a frantic call from one of our security guards, I picked him up at the company gatehouse near Lae wharf.
The hospital’s emergency department was like a scene from Bedlam and the floor of the waiting room was dense with the sick and injured and wailing relatives.
I was stepped gingerly through the bodies on the floor looking for medical personnel.
Then I spotted the beleaguered duty doctor, his only identification the stethoscope hanging from his neck.
He quickly rallied a nurse and they eventually stemmed the flow of blood and stitched the wound. The patient was as stoic as they were noble.
As dawn broke over Lae, I was assured he did not need to stay at the hospital so took him back to my accommodation block where he was able to shower and I gave him a change of clothes and breakfast.
His family were beside themselves with relief and joy when I drove him to their settlement 20 kilometres along the Highlands Highway.
THERE WAS A TIME OF COOPERATION & PROGRESS
Lindsay F Bond
Thanks to Natalie Whiting and Bethanie Harriman on ABC news last night, Australians saw a report of the present day to day reality of PNG health service provisioning.
There is insufficiency in that delivery, and absolute absence of needed equipment and medications.
Covid-19 hardly gets a mention, the emergence of cases having already inundated communities and medical staff.
My own experience at Oro Bay in 2005 was of a hospital in such dire need that tears whelmed as I recalled our two children born there in 1969 and 1971.
That hospital was, in 2012, largely rebuilt and equipped by providence of humanitarian folk in Australia (inclusive of religious groups and more broadly in the community, all support by and in cooperation with the PNG government.
So, as this example shows, things can be improved where goodwill gives rise to participation and cooperation.
At Kabwum there are matters difficult to comprehend and harder to accept, that after many months its demolished health centre has gone to make way for a new facility but has so far only had the slab poured.
I hope that the contractor is active and able to achieve construction objectives.
We hope the PNG government (not only the Health Department) is also awake, aware, arranging auspiciously, and likewise assisting achievement of the objective.