“Doing international volunteer work was always on my list of things to do,” said the paediatric nurse and health administrator, who took time out from a successful career that most recently included projects with the Royal Children’s Hospital in Melbourne and the Department of Human Services VIC.
“In PNG because there is such a shortage of doctors – just one per 7,900 patients – nurses and community health workers operate at a different level to nurses here in Australia. Limited resources mean that health workers take on considerably more responsibility in the diagnosis and treatment of common conditions using standardised treatment guidelines.”
Based in the port town Kiunga with frequent travel by boat, plane and foot to outlying areas, Louise was tasked with trying to expand ADI’s volunteer doctor deployment program from North Fly to South Fly (which is just five kilometers away from Australian territory); conducting maternal and child health (MCH) checks during a 10-day patrol to Boset, an area afflicted by leprosy and domestic violence; managing ADI’s field office and supporting the Catholic Health Service in Kiunga; improving drug supply to health sub-centres; and facilitating an in-service training seminar for 59 health workers and hospital staff.
“For many, this was the first clinical seminar they had attended since their original training,” said Louise, listing tuberculosis, filariasis, HIV/AIDS, drug supply, snake bite and perinatal care as some of the essential topics covered. “Many had to travel long and difficult distances to attend e.g. 14 hours in a dinghy for some, and two days walking on foot for others.
PNG has the lowest status of health in the Pacific, according to WHO, with communicable diseases responsible for half of all deaths. Louise says it was heartbreaking – not to mention frustrating – to see patients in an advanced stage of disease and have nothing to offer them, especially when she knew they could be easily treated in Australia. She remembers with particular regret a young boy with a bulging eye tumour where nothing could be offered except palliative care. (see photo).
Louise, who holds a Masters in Health Administration and degrees in nursing, experienced an alternative education in PNG. She discovered that things work differently in a developing country and require lots of patience; that systems are often lacking for even the most simple stuff (which make the complicated stuff even more complicated!); and that while it’s is okay to go in with big ideas and grand plans, you need to start with the basics if you want to effect change.
“I think I made small inroads and provided a way forward for the next person to make a significant difference. [But] it takes time to be accepted,” she said, laughingly revealing that the local children are sometimes told that if they misbehave the white people will ‘get them’.
Some other cultural observations from a nurse’s perspective included: sick or premature babies are not named until they reach good health; people pray before they undergo a medical examination and when a woman goes into labour; families provide bedside care for relatives in hospital, this includes providing their meals or otherwise patients must cook for themselves; people believe cancer is contagious and that antibiotics are appropriate treatment for almost everything including muscular-skeletal pain.
Louise’s other experiences in PNG included: driving the local hospital ambulance (and trying to avoid getting bogged); adventures on the Fly River, such as getting lost for 14 hours and having to sleep on the boat surrounded by hungry mosquitoes; being drenched by countless tropical thunderstorms; learning the countless ways to cook the starchy local staple, sago; and enjoying balmy evening walks where everyone says hello.
You can read her PNG patrol reports on http://www.adi.org.au/index.php?topic_id=462
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