HOPE4HEALTH has established a community support program in rural Papua New Guinea (PNG). Alongside Queensland Rural Medical Education (QRME), we have established a connection with two hospitals – one in Kiunga and one in Rumginae both located in Western PNG.
In 2013, our annual gala ball, the Jazz Dinner Dance, raised $20,000 to support the program thanks to the generous support of the wider gold coast community and Griffith University health students. Our first significant investment with this money has been the purchase of an ECG or 'heart monitor'. The need was identified following reports that heart attacks were being missed due to lack of detection protocols which at the core of detection is via the information provided by an ECG machine.
We plan to sustain funding for the purpose of providing medical equipment, medical supplies and educational materials for these hospitals and the surrounding communities. Currently, a significant portion of medical care is delivered to locally trained, community health workers in these areas. We have begun to facilitate the continuing education of these individuals through the provision of text books as well as basic medical equipment for their practice and use.
Along with material assistance, HOPE4HEALTH members are undertaking their final year medicine elective at these clinics which was initiated by QRME under the guidance of Prof. Scott Kitchener. QRME is an organisation involved in the training of Rural Generalist Medical Practitioners in QLD and will oversee the electives both in terms of logistics and as medical supervisors for students placed in PNG.Students live and work in the western province of PNG over a 6 week period and provide valuable assistance to the local health care system. Being general hospitals, the students will experience all aspects of medicine including, emergency, general medicine, surgery, obstetrics and infectious diseases. Having H4H members in the area would also allow us to monitor and better control the aid element of our project. Students have also been educating the local health workers in skills such as ECG interpretation.
The areas of need have been identified as follows:
- Funding for basic medical equipment (stethoscopes, BP monitors, blood glucose monitors, etc)
- Funding for medical supplies (including all gloves, bandages, medicines, disinfectant gel)
- Educational materials (including text books, educational medical supplies, etc)
- Funding for medical student related placement expenses (including HIV prophylaxis kits, infectious disease medications and a basic travel allowance)
In consultation with QRME, the aim is to send 20 students per year to create a sustainable response to areas of health workforce shortage, which means a fair cost involved. Students will be expected to engage in the following tasks while on placement:
- Assist and support medical practitioners at the hospitals in managing inpatients and outpatients at the hospital
- Assist in the education of local community health workers
- Develop an appreciation for medical practice in countries with less developed health systems compared to Australia
Benefits to the wider community
PNG has one of the least developed health care systems in the world. People living in PNG suffer a significant burden of infectious disease including high rates of tuberculosis and HIV. In addition to this, other problems include poor nutritional status, poor maternal health as well as trauma.
There is a real need for medical help in the rural areas of PNG that attract less attention from NGO's, PNG Government, expats and mining companies. In contrast to Australia, approximately 85% of PNG citizens reside in rural areas (World Bank data). Not only would getting this project up and running truly benefit the PNG people, but this will also give Australian medical students a real chance to experience making a difference and hopefully inspire them to continue to develop the health care system in PNG through their professional careers. It will give them life skills and knowledge that they can pass on to their own community for the great benefit of many more people.
4th Year QRME Medical Elective Testimonial - Ashleigh Heron
My name is Ashleigh, I graduated from Griffith in 2013 and am currently an intern at Toowoomba Hospital. In my final year of med school I travelled to PNG and spent 6 weeks working in Kiunga Hospital, located in a small rural town in the North Fly region of Western Provence.
When I visited, the hospital had 2 doctors, an emergency physician and a surgeon (those titles are purely arbitrary as their roles in the hospital encompassed everything from paediatrics to obstetrics to orthopaedics and infectious disease). I spent a week in the obstetrics ward where I assisted in the delivery of many babies, included normal deliveries, twins and breech deliveries and emergency caesarean sections in which the neonates required resuscitation.
I spent a week in the emergency department where I saw patients on my own, trying to gather history in broken english with nurses and community health workers trying to interpret for me. I had to work the patients up with limited investigations and decide what treatments they required and whether they could go home that day or if they needed to be admitted to the general ward.
My week in surgery was an interesting and exciting experience. I assisted in many surgeries from debridement of wounds to amputations of limbs as well as tubal ligation and appendicetomies.
My favourite experience was trekking to the remote village of Kungim located near the border of Indonesia. which involved 10 fully-grown adults, and all our luggage, crammed into a troop carrier rocketing along narrow, slippery, winding dirt roads, an amazing trip up the river and hike in the rain!
Our stay in the village was fantastic, we helped out at the little health centre during the day and played football with the local kids in the afternoon. I was very sad to leave Kungim.
Overall PNG was a wonderful and challenging experience. I was recommend it to any student looking for an exciting and adventure filled elective with lots of hands-on, third-world medicine.
5th Year Dental Elective Testimonial - Mengzhu Wang
On the 27th of September, 4 final year dental students flew to Kiunga, PNG for 16 days on the first ever organized dental placement at Kiunga District Hospital.
Below: Dental Team L-R Philip Ho, Ben Greenlees, Dr Beatrice Solok, Emad Ahangari and Mengzhu Wang
We brought donated equipment from various sponsors including instruments, a large quantity of glass ionomer cements, composites, bonding, polishing, local anaesthetic and PPE.
The experience was possibly one of the best placement experiences a final year student could have. The students were supervised voluntarily by Dr Beatrice Solok and stayed in provided accommodation from the Kiunga District Hospital and OTML.
We saw 190 patients and performed 91 extractions. We were able to observe and assist with dental expertise on a case involving an acute odontogenic abscess in the lower right wisdom tooth of a patient who was 5 months pregnant. After IND was performed (with us students observing), a student performed the final extraction of the tooth which caused the abscess. It was extremely satisfying to see the whole case through from beginning to end.
We visited two local schools, a high school and a primary school, to give oral health promotion. We tailored each message to the age group of the students and received an overwhelmingly positive response. We were also able to present a basic session on oral health to the Kiunga District Hospital staff. At these sessions we emphasised the risks of oral submucous fibrosis from betel nut chewing, a common local practice, posed as a pre-malignant lesion.
Left: Oral health promotion at a local primary school
The hospital and Dr Solok were able to arrange for us to go on three patrols. Firstly, we went to Rumginae Hospital where we stayed overnight. We utilized a room in the hospital and did 16 check ups and from those, 15 extractions and two fillings were done.
We also visited two villages by boat. The first was Ulauwa, where the locals were very shy having never seen a visiting dental team before. We performed two extractions, several more checkups and were able to engage with the community and show children around the dental setup so hopefully they will feel less apprehensive of future dental visits.
Left: Betel Nut stains in a middle aged female patient. The student extracted the supernumerary paramolars.
Our second boat patrol was to Moian I where we screened the entire elementary school junior classes – 45 children. We were able to report on the children’s dental status to the principal who will pass this data onto parents and caregivers. We referred two toddlers for general anaesthetic and full clearance (extraction of every single tooth in the mouth) due to rampant caries (whole mouth decay). We also performed four extractions on adults and saw a few more for consults including one for a loose denture.
Below: On patrol to Moian 1 village
We were made very welcome by the local and hospital community. Some staff made us elaborate dinners; we also participated in two trivia nights, swimming lessons for children and birdwatching with staff and the medical students.
Our learning experience was priceless. We performed procedures that are not as commonly seen in Australia, and we were able to perform many extractions on severely decayed teeth and managed to get patients out of pain.
The dental team is extremely grateful to everyone who made our project possible. Our thanks to go Mr Graeme Hill and Dr Beatrice Solok, two key supporters without whom the project would have never gone ahead. Graeme has advised and assisted us logistically for a year – our flights, visas and accommodations to give a few examples. Dr Solok supervised us for the two weeks and treated us as fellow dental colleagues, and we were extremely grateful for the trust and confidence she had in us. We are also highly appreciative of the logistical support provided through Hope4Health who provided personal grants, funding for for equipment purchases and practical advice and contacts.
Below: Paediatric extraction at Rumginae
We hope in the future to have more teams of dental students visit Kiunga. Through continuing visits, we hope to not only benefit student education but also promote good oral health throughout the community and providing a dental service to the community.