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Difficulties of Delivering Healthcare in Remote PNG

Image: Billy Kapi on his usual route to and from Mt Au Health Centre in Kambia. 

Health officers in the most remote parts of Papua New Guinea spoke of the challenges they face while serving the community health centers.

To put things into perspective, EMTV Online had a whole day of traveing by car.Then two days worth of walking before reaching the health centre.  The health centre is again 6–7 hours walk from the air strip.

 

Mr Billy Kapi, a young Nursing Officer has served at Mt Au Health Centre in the Kambia area of Jiwaka Province for nearly two years. The acting Officer-in-Charge told EMTV Online of the many challenges he faced when he was working there.

From 2014 January – July 2015, Kapi  worked with a team of two young community health workers, Simon Khin and Helen Tongai; and a senior staffer, Peter Ondku, who was the former Officer in Charge (OIC).

Being the nearest health facility in a landlocked, isolated part of the country, Mt Au Health Center serves the East and West Kambia areas which are part of Jiwaka, Western Highlands and Southern Highlands provinces respectively.

Among the many challenges faced by Kapi and team, the main issues include; transportation of medical supplies from main centres and between communities; personal travels to home and back; electricity for the storage of medical supplies like vaccines; referring of patients who are in critical medical conditions; lack of right tools or instruments; improper or unsafe waste disposal of contaminated wastes; and the communication barriers that exist when relaying health information during clinic outreaches to locals.

Medical supplies are sourced in Mt Hagen, Kapi says. The rural airline service, Mission Aviation Fellowship (MAF) is usually paid to fly the supplies to the nearest airstrip in the region, where it is then moved by foot to the health center.

“Sometimes when funds are not made available by district or provincial offices, we cancel the MAF bookings and transport the medical supplies by car to Gumine in Chimbu Province where we ask the people to carry the supplies on foot to Mt Au.”

Unlike setups of hospitals and aid posts in urban areas, Kapi said the rural medical facilities lack proper equipment and proper facilities.

“I am a trained nursing officer and I know which tools to use, but most of the time I had to use any tool or instrument that is available to treat patients, even when the tools used are not the right ones.” reiterated Kapi.

In 2014, there was a ray of hope when the Japan International Cooperation Agency (JICA) presented Mt Au Health Centre with a solar-powered refrigerator complete with six solar panels. Kapi adds that the much needed item kept all the vaccines plus other fragile medical equipment secure, and safely stored.

However, during cloudy weather, the refrigerator would stop working; rendering the vaccines to become unusable as the health center does not have back up electricity.

As part of their job, the team also conducts health awareness education in communities which Kapi said, most people do not understand what they say because many are illiterate.

Tried and tested to the full extent of their wits, the young community health workers and OIC Ondku, left the health center and have never returned.

Kapi, the eldest in his family, was without pay since he started working in 2014. He has decided to quit serving at the health center after consultation with the Provincial and District Health offices.

“Because our dad died, I left to do marketing to pay for school fees for my younger brother and sister who are also studying Nursing at Kudjip Nazarene Nursing College”.

He said his salary has not been fixed by both the provincial and national health department as promised and he is still waiting.

Kapi is pleading to the National Government and the Department of Health to look into the needs of officers in the remote areas of PNG; and to also build and improve facilities. This, if the government is serious, will strengthen primary healthcare and improve service delivery for the rural majority.

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