Papua New Guinea

1. Papua New Guinea By Hannah Ellis

2. Planning • Why did I choose Papua New Guinea? • Third world • Established elective opportunities • Somewhere ‘different’ • Partially English speaking • Different culture

3. Where is Papua New Guinea?

4. What’s PNG like? • Mountainous terrain with coastal lowlands • Tropical climate • Prone to natural disasters • Chief of State Queen Elizabeth II • 85% of population subsistence farmers • Exports oil, gold, copper ore, logs, palm oil, coffee, cocoa, crayfish & prawns (CIA 2004)

5. How did I plan my trip? • Searched internet for possible elective opportunities • Used MMA Healthserve site • Downloaded AHS application form and applied by fax, post & email • Called the office to ensure application had arrived • Applied for visa • Found out about vaccinations

6. My Rough Budget • Flights + Tax £1430 • Insurance £83 • Visa £7 • Vaccinations + antimalarials £200 • Accommodation + Food with Health workers whilst on placement £130 • Extra food + bottled water £200 • Equipment (mosquito net, medical pack, clothing etc) £200 • Accommodation en route £150 • Contingency (e.g. 2 changes of flights at £50 each) £100 • Total £2500

7. What were my concerns and difficulties? • I might not be accepted – waiting for ever • I don’t have enough money • I know nothing about the country • How would I plan everything • Would I be ok without friends and family • It’s a bit far if anything goes wrong • Other people’s reactions/worries

8. How did I overcome my concerns and difficulties? • Reassurance that other people were in similar situations • Reading up on the country and culture • Going on an elective preparation day • Applying for funding from plenty of people • Being very organised and getting as much info as possible

9. How did I get funding? • Freda Ashmore – unsuccessful • RCN Travel Award - unsuccessful • Other funding opportunities - 15 letters - 7 Negative - 8 Positive • MMA Healthserve Grant • Total Funding Promised: £2025

10. First Impressions • Climate • The very basic health centre • My accommodation • The facilities – or lack of! • The people

11. Outline of Healthcare System • Churches provide 50% of healthcare • Remote villages do not have access to healthcare facilities • 85% of people live in rural communities • Use of Aid Posts & Clinic Patrols • Only 7 Drs per 100,000 people • Most doctors work in urban hospitals (Sources: AHS 2004, UNICEF 2002)

12. Health Issues in PNG • Poor immunisation coverage • Poor antenatal care • Malaria, measles, pneumonia and diarrhoea major causes of morbidity and mortality • Clean water and sanitation limited to urban areas • Domestic violence is common (Source: UNICEF 2004)

13. Clinical Speciality • From birth to death • Clinics • Deliveries • Tropical Medicine • Trauma • Minor surgery • Education

14. My Role • Jack of All Trades!! • Screening in OPD • Giving treatment & dressing wounds • Delivering babies • Prescribing drugs (under supervision!) • Clinic Patrols • Patient referral & education

15. Differences in Healthcare system • Role of the nurse • Lack of facilities • Distance travelled to health centres • Lack of education • Paying for treatment • Commitment of staff • Voluntary input

16. Language and Cultural differences • Over 700 languages spoken in PNG • 66% of population are literate • Life expectancy 57 yrs • 44% Protestant, 22% Catholic and 34% pantheistic beliefs • Indigenous beliefs very important, often underlying approaches to health (Sources: UNICEF 2002, CIA 2004)

17. How did I cope? • Learning Pidgin English – compiled own list of phrases • Buying & eating local foods • Dressing appropriately • Accepting the way of life • Making the best of every situation • Going with the flow

18. Main areas of learning • What is normal for us is not normal for everybody • The skill of symptomatic diagnosis • Patience • The importance of education • We are so lucky • I can make a difference

19. The Experience • Most interesting thing: learning Pidgin English • Most shocking thing: the fate of triplets • Most exciting thing: going on village patrol • Something I thought I’d never do, but did: deliver babies

20. For Future Travellers • Water purification tablets • Maglite • Mosquito repellent • Leatherman • Sunscreen • Sarong • Personal CD player • Decent walking sandals • Zip-off trousers/skirt • Non-sterile gloves Top 10 most useful things to take:

21. Top 10 most useful tips • Have a few days in Cairns on route to alleviate jet lag • Don’t believe the Aussie tales about PNG • Change all money needed for PNG before arriving there • Wear a money belt (for own peace of mind) • Have a place booked in Australia for return journey • Take photos of family, friends, house, city etc etc • Go with an open mind • Remember everything you see is ‘normal’ for the people • Eat the local diet (within reason!) • Don’t make promises you can’t keep

22. Further Information • Lonely Planet Guide: Papua New Guinea- see also www.lonelyplanet.com (Info on country & culture) • www.ahs-png.org (Anglican Health Service) • www.healthserve.org (Medical Missionary Organisation) • www.fco.gov.uk (UK Foreign Office) • www.lifesystems.co.uk (Equipment and advice for travel) • www.unicef.org/infobycountry/papuang.html (PNG info & stats) • http://www.cia.gov/cia/publications/factbook/geos/pp.html (PNG info & stats) • www.calibercreations.com/pisin (Pidgin English dictionary)