Papua New Guinea’s way of lifestyle is one in a million – it is unique compared to the rest of the world and with the 800 plus languages we have, including the diverse cultures, there are many challenges ahead. Maureen Gerawa highlights an important aspect of our lifestyle – health and its challenges.

THE challenges facing the delivery of health services in this country are too many and it will need more than the health sector response to ensure that majority of the country’s population access basic health care.

It will need a “wholesale” response from the Government, which requires all its agencies to work in close collaboration from the transport sector to communication, education and the central government agencies as well as the private sector.

But even more, it will need committed Papua New Guineans in these agencies to look beyond their salaries and ensure that services reach the most remotest areas of the country.

It was done before independence when health patrols reached remote areas because workers cared more for people than their pockets. Unless this is done, it will remain a difficult task to ensure basic health care is available to the majority of the people.

Currently, Papua New Guinea is regarded in the Asia-Pacific region as having the poorest health indicators. Its maternal mortality rate remains high so that a woman bleeding to death in a rural village has become a common story.

Statistics from the recent Demographic Health Survey (DHS) shows that the maternal mortality rate has doubled in the last 10 years so that it is no longer 340 per 100,000 women dying due to childbirth annually, but 733 per 100,000 annually or about five women a day.
The health of young children aged one to five has improved slightly, according to that same DHS due to improved services in child health programs, but it is still low.

A mother that runs to the aidpost or nearest health centre to get help for her child will not always get it because basic drugs are not always available. The lack of drugs such as anti-malarials and antibiotics in health centres result in unnecessary deaths, including malaria and pneumonia.

While these top the country’s list of killer diseases, they have either been eradicated or no longer pose danger to citizens of other countries because of the availability of health services. These countries are now concentrating on new diseases or lifestyle diseases such as cancer and diabetes. These are also now becoming major diseases for PNG to contend with as more and more of its citizens rely on processed foods rather than their traditional foods.

Tuberculosis which was at one stage not heard of in some parts of the country has become a major killer disease, after malaria and pneumonia. The disease is now often co-joined with HIV/AIDS, another growing epidemic in Papua New Guinea and is threatening to decimate populations in rural areas where there are often no health facilities for people to access health care.

The fight against TB has gained momentum two to three years ago due to an increased funding support from the Global Fund Against TB, HIV/AIDS and Malaria. But it will take a long time before any signs of improvement in statistics will be seen because it requires much more than treatment and advocacy for people to seek medical treatment.

Like other diseases, many people in rural areas die from TB because they are not being diagnosed early due to health care facilities not adequately equipped to respond to TB. Health care workers in rural areas need training to be able to diagnose TB and also need equipment such as microscopes which are not available in all health care facilities.

The nearest health facility which is often a provincial hospital that may have this equipment may be about a day’s travel by boat and a villager may refuse to travel because of no money. By the time he does decide to travel to the health facility, it may be too late and he dies.

There has been stories also of people being sent back home and given drugs to take for sometime and return, but not all return because of many reasons, including lack of funds and a place to stay while they get treatment.

Transportation from rural villages to the nearest health facilities is often a big problem. Where there are no roads, people need boats, but these are not easily available.

Many airstrips have closed in the last 15 – 20 years after the third level airlines that serviced these areas have ceased their operations. For instance, the people of Aragip area in the mountains of Rabaraba District have not seen a plane land for almost 10 years after the Airlines of Papua New Guinea ceased operating in the area. As a result, people walk for days over mountains and cross numerous creeks and rivers to get to the government station at Rabaraba where there is a health centre.

Transportation and communication to and from the health facilities is far from a reality in most parts of the country. It used to be easy to call for a medivac in some outstations before independence, but that service has long ceased.

Unless these are addressed, health services and many government services will remain inaccessible to majority of Papua New Guinea’s population.

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