Rural Block Adventure 2000

As part of my community medicine block in the 5th year of my medical degree, our whole year had to spend 2 months in a rural outpost in Oro Province.  Upon arrival in Popondetta we were spilt into two groups, my group was based at Oro bay and did the daily half hour drive to Popondetta Hospital where we were subject to a week of lectures and briefings from our lecturers as well as local health managers and clinicians.  There was a sense of excitement in the air, from us naturally but also from the locals and our lecturer. It was an adventure and one of the most memorable times of my undergraduate medical training.  Looking back I see what they (the speakers) may have been hoping for in us as they gave us their take on the health systems, the difficulties they faced and their ideas of what was required to fix the “whole mess”.  I remember a recurring phrase that came from several speakers: “We want to do this and that and we’ve applied for funding, but whether we’ll get it or not…..we don’t know” (Later after a few SP’s, this became a bit of a personal joke amongst some of my friends as we imitated these speakers, while at the same time, off course, appreciating the difficulties that soon was to be our own.

2000: Oro Bay Beach.

From bottom left clockwise: Me(Dr. Poyap J Rooney), Dr. Jeffery Tore, Dr. Desmond Aisi, Dr. Tony Tongia, Dr. Sonny Kibob, Local Oro Bay Kid, Dr. Frank Apamumu.

After the weeklong briefings and lectures we were further divided into smaller groups of about three, given our K300 allowances (which a few blew on that same night) and equipment and started to make arrangements to travel to our designated health centre to spend the rest of our two month rural block.  My group was designated to go to one of the most isolated areas in Oro Province, the Afore district on the foot steps of the Owen Stanley ranges, the geographical backbone of PNG.  We had to wait and pass time for a couple more days at Oro Bay until a driver was found who was willing to take us up the there.

Passing time on the serene Oro Bay.   

War relics – Oro Bay.  “I was assured by locals that these bomb shells were not active!”

After a few days of swimming, fishing, drinking and basically blowing up most of our allowances he (the driver) finally arrived and we embarked on our bumpy, arse numbing trip to the Afore/Sakarina district.

The trip was truly a challenge, but with the experience of “The Man” Sylvester we manage to reach our destination just as the sun was setting over the Owen Stanley Ranges.  We had a flat tyre relatively early in the trip which meant if we had another, we would have to decide whether to press on by foot or return back to Oro Bay and start again, luckily that didn’t happen.

The crew after the tyre change. Far left: Dr. Tukutau Taufa – Head of Community Medicine UPNG.

The first drop off was at Afore where Seni, Henry and Jack were going to spend the next 6 weeks.  We spent about ten minute off loading them and their stuff then the rest of us continued up the mountain.  This leg of our journey was the worse.  We were bogged down several times, and on occasions had to cut logs to lever the vehicle out of the bog.  As we neared the Sakarina out station (where we were going to spend the next 6 weeks) and the community caught the sound of the vehicle, about 30 children and young men came running down to greet us and helped us literally pulling the vehicle up to the health centre.  The Head of Community Medicine Professor Tukutau Taufa had accompanied us on the trip and after spending 30 minutes explaining to the Officer in Charge (OIC) of the Health Centre our purpose of being their, which was basically to collect data for our little research and conduct clinics.  The three of us stood and watch as Dr. Taufa and Sylvester drove down the muddy road towards Afore and back to Oro Bay.

The OIC was very happy to have us on board and that night put on a hearty feast for the three of us at our two-room thatched house.

We spent the next 6 weeks, working at the clinic mainly treating patients where we could and writtinf referral letters for those we thought needed to go to Popondetta hospital, we conducted a couple of antenatal clinics and maternal and child health clinics.  In the afternoons we’d bring out an old rugby ball and get a game of touch happening.  It was a nice change playing in the cool mountain air as apposed to the mucky Port Moresby atmosphere.

We collected as much data as we could for our group and individual projects and visisted several surrounding villages and their aid posts.  The overall story is not much different to many part of rual PNG: A story of runned down health services, lack of maintanence, lack of drugs and other supplies.  But one thing that was not in short supply was the enthusiasm  of the local health workers, they wanted to work, they wanted to see improvements they had a genuine desire to see improvements in health services to their people.  Sadly, as I write this 12 years later, nothing much has changed for these people.

After looking at the immunisation records of the children we noticed that for many there had not been any vaccination done for several years.  We decided that we would do a catch vaccination and made arrangements to do this.  We had to organise this with the Popondetta Hospital and the Anglican Health Services which looked after the Sakarina Health District.  We were lucky that a coffee buyer was passing through (the district apparantly produced some of the finest coffee in the world) and so we hitched a ride with him back to Popondetta to source our vaccines and kerosine of the kerosine operated refrigerator.  We spent a couple of days organising our supplies, then headed back into the mountains again with Sylvester as our driver.  Before the trip we had a few shots of Rum to numb our backsides, without any cushion seats to sit on, this approach work quite effectively to make the trip up more comfortable.

Word was sent out to the a couple of the central villages we proposed to visit so that the villages could prepare to bring their children along for their shots.  The walk to the first village took us about 4 hours.  We got their around midday and after some lunch and a chat with the local aidpost orderly we started vaccinating children until well past 7pm.  The turn out was amazing and illustrated that the people knew how important the vaccines were in protecting their children.

That night we had a tree kangaroo for dinner – and all slept by the fire of the Aidpost orderly’s kitchen.

The next day we did more vaccinations in another village.  As we were walking there we saw a man with surgical emphysema and suspected fractured rids from falling off a betal nut tree. We referred him ahead of us to Sakarina Health Centre.

Heading back that afternoon, we had to cross many little creeks.  This meant me having to take off my boots everytime and sort of slowing the group down who were in a hurry to be back for the the afternoon card gambling session.  David, one of our guides finally convince me for him to carry me across to expedite our return.

This picture has a lot of personal significance to me… more on this thought later..

The next day, when we got back, we reassessed the man with suspected fractured ribs and decided to have him referred to Afore Health centre where, if needed he could be referred on to Popondetta hospital.  The Village health workers, built a “stretcher” from freshly cut wood, which must have weighed about 5oKgs, the patient was quite a big man weighing about 85kgs so you could imagine the difficulties we had “stretchering” him for the 2 hours walk to Afore, but we got there.  I am amazed by the pound for pound strength of these mountain villagers.

We spent a total of about 6 weeks up at Sakarina, did a lot of wrok, had a lot of adventures and got a real intimate understanding of the challenges faced by people living in some of the most isolated places in PNG.  We were treated with respect and they showed a lot of generosity and welcomed us fully.  I plan to return there one day.

About Dr. Poyap J Rooney

Dr. Rooney is a medical doctor who has gained both his undergraduate medical degree and more recently his post graduate masters degree in clinical biochemistry at the University of Papua New Guinea.
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5 Responses to Rural Block Adventure 2000

  1. SPMT says:

    (as written on Dr. PNG Facebook group: By Dr. Frank Apamumu) I found this article shared by one of my colleagues, dr poyap Rooney. This was in 2000 in our final year at upng medical school. I believe not much had changed in terms of the health centres that we experienced our first practical experience, knowing the state of many in the other provinces. Colleagues and health professionals working there now can update on the latest, if things are much better there, that will be great as that is not the case in many health centres and aid posts in many provinces, either they are non-functioning or barely functioning. More than 80% of PNGs live in the rural areas and the closest health facility to them are aid posts and health centres. Sadly as stated most of these cannot serve our people thus they have to find ways to get to the hospitals. I was going through some of the maternal deaths, women who died from child birth, that were reported to health authorities in 2011, thanks to professor mola for ensuring these reports are send monthly and compiled. PNG has one of the highest maternal mortality rate in the Asia Pacific. It’s so sad to say that most or we can even say all of these deaths were preventable. If only the nearby health facilities were functioning and equipped these women would have had a safe delivery and lived instead of travelling or waiting for so long to get to a hospital. If only health professionals had funds available they will travel to rural areas once or twice in a month doing antenatal clinics and identify women who are high risk so they can be advised to have their babies in hospitals. The rough seas in Milne bay and many coastal areas, the rugged rough mountains, fast flowing rivers of the highlands, the great rivers in sepik, gulf, western, filled with crocodiles etc. these were the barriers that prevented these women to get to functioning health facilities that would have kept them alive today. Every year it’s the same old story how women died in childbirth which is supposed to be the happiest moment in a family. So much being said about Free Medical Care, why not use these money to revive the health facilities closest to the rural population, of course we all want free medical care, but a quality care. No point arriving at a health facility only to be told no medication or closed. The same health care accessible by urban population must be accessed by rural population, so women in rural areas deserve to be seen by drs, midwives, heo thus funding for rural visits must be always available. Fix all these first then free health care along the line maybe sooner or later. This will be a good way to suppress the rural-urban drift cycle that is increasing, people thinking they get quality life in towns and cities. Our multiculturalism and complex geography may make it difficult for success in our health and education programmes but with good political will, good administrators, good advisors, good satisfied happy workers, we will achieve this “Free Quality Standard Medical Care”. God bless PNG…………..

    • Roberta says:

      That was funny….I must admit the carrying of you, Poyap was hilarious. Was a great read too. I did not realise how much torture they put you Medical students through…someone needs to lay a complain….!!!
      SPMT….I am no Doctor with data info…but just the same a friend sharing the same opinion as you. I too have been to rural areas as required by my position (short as it may be) whilst in PNG had experienced the same sights and suffering our people have to adhere to. You do make a great point of care and education. Totally agree with you.

    • Highlands M/O says:

      I recently stumbled across this blog and I find it fascinating. I currently work in the Highlands as a physician and we hope to have medical students come for their rural block next year. I find it intriguing that Dr. Frank Apamumu makes this commentary about having the government fix the provision of quality health services for the rural majority of Papua New Guinea before providing free care. I agree – having free low-quality care at under-resourced facilities is not helpful. However, how many physicians in Papua New Guinea practice in rural areas? Since most physicians choose to remain and practice in Port Moresby and Lae, surely they should carry some of the burden of the disadvantaged rural population living without access to care. It is time for physicians in PNG to go to the rural areas and serve people, rather than waiting for the government to provide better services or forcing the rural majority to go to higher-level facilities for adequate care. (See the article in the National regarding PM’s plan to mandate facility-based deliveries and compulsory travel for pregnant mothers … http://www.thenational.com.pg/new-plan-women/

  2. Pingback: Studying Medicine in PNG – My experience | South Pacific Medical Technologies

  3. centygal says:

    Very Inspiring Dr. Rooney

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