Treatment and Referral

The Integrated Health Patrols
in remote PNG Provinces

A patrol in New Ireland includes a team of PNG dentists, physiotherapists, maternity and child health nurses, eye nurses, HIV, STI and TB officers, and lab technicians. Other specialists may also join.  A patrol in Western Province is much smaller and consists mainly of ADI staff, local Community Health workers and logisitics support.  Namatani Hospital is a hospital based placement, supporting obstetrics and general illness.

The teams are continuously travelling throughout the rural and remote areas of Western Province and New Ireland. 

 

A Patrol In Action

Location

On an island in New Ireland Province, six hours by banana boat across open sea from the nearest hospital (in Caving), Dr Tim Baird is presented with a two-week-old baby.  The island has one health center without the required medical resources to treat this patient.

Patient’s diagnosis

  • Sepis
  • < 2 kilograms, severely malnourished
  • Severe respiratory distress

Urgent management

Oxygen, intravenous antibiotics, and rapid increase in nutrition.  

Insitu treatment

Intra-osseous line in the baby’s tibia allows us to give fluids and antibiotics, and place in a nasogastric tube to give enteral feeds, to keep the baby alive. The question is how to get to the nearest hospital?  The health center’s boat is non-operational and there is virtually no fuel available.

Community-based services

Word is sent out to the local villagers to find a boat and ‘skipper’. Many of the locals believed the newborn would probably not survive the evening and came to say their goodbyes at the health centre.  Others tried to frantically arrange transportation in case the child pulled through.  The whole island had a real community feel about it and it is certainly a very sobering occasion.

Medical evacuation

Departing at sunrise with patient still alive, two ‘intravenous poles’ made out of sticks are attached to the small boat and the intra-osseous line and nasogastric tube fastened in place with fluids and antibiotics running for the six-hour journey.

The baby, the mother and grandmother, our health staff member, the skipper, and even a critically ill ‘default’ tuberculosis patient, are sent on their way in less than ideal sea conditions.

Changing lives

The community on the island gathered on the beach to wish the baby a safe journey and to say their prayers.  Later that evening we get radio word that the baby has survived the journey and is in a stable condition at Kavieng Hospital. That evening the island held a traditional celebratory thank you dinner for the team.

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