ADI is delighted to present this occasional series of blog posts from one of our volunteer doctors currently on patrol in remote PNG. This is the third update from Dr. Chris as he is affectionately known. Bio below.
Imagine a land where to go almost anywhere you must travel by water, through a maze of confusing river and lake channels, around floating stands of grass that constantly move. But boat fuel is hard to come by and expensive. The water that surrounds you is polluted from years of run-off from mining upriver. There are crocodiles and poisonous snakes in it. Many villages have no real health service, not even a small health post, although tuberculosis, leprosy and malaria are common, while those communities with a small health post may still not have round the clock electricity to power a fridge which can store vaccines or snake anti-venom.
Such is the Bosset region of Papua New Guinea’s Western Province, part of the Middle Fly district, a vast, flat, swampy area with spectacular vistas and impressive bird life, where white herons walk in the water around every turn. For its human inhabitants, it is a land with a lot of health problems where the options for treatment are limited by its difficult geography.
Most of its people belong to the Boazi tribe, the region’s traditional inhabitants. Some are only semi-literate, but most are at least bi-lingual, and many are multi-lingual. As well as the Boazi language, Pidgin and for the more educated English, many also speak Malay, as they have relatives and traditional lands across the border in Indonesia. It takes less than a day to reach Indonesian territory by water, and there the official language, Indonesian, is a variety of Malay. Although Papua New Guinea’s borders have been officially closed due to the Covid-19 pandemic, it has been hard to stop these people crossing into Indonesian territory to trade, fish, hunt, visit family. That carries with it the risk that they will come back to Bosset with disease and spread it, in particular with Covid-19.
Bosset is a hot and difficult place to live. Few people have electricity in their houses, or running water. What electricity there is comes from limited and fragile solar power installations. The centre of the community is built around an old airstrip which sticks out into a large lake, and most people live by fishing and subsistence farming. The health clinic only has power during the day, as the batteries that should supply power at night do not work. The main way to surrounding communities, whose names include Aimbak, Wanga Wanga, Mipan, Kwem and two villages both called Manda, is by boat, frequently a dug-out canoe with a motorised engine attached to it. But boat fuel is scarce and expensive and without fuel it is hard to travel any distance.
To travel to Bosset from Kiunga is a long day’s trip, often under hot sun. For part of the way the mighty Fly River forms the border between Papua New Guinea and Indonesia, although there is nothing to mark the boundary and locals come and go across the river freely. Floating grass in the river is constantly moving, and the river and its tributaries may look very different from one day to the next. Finding the way can be hard without a boat captain as guide who knows the area well, and monitoring fuel usage is essential in order not to be stranded when the return trip comes.
With limited internet and mobile phone coverage, some of the riverside communities mainly receive news of the outside world by word of mouth from travellers who have been upriver and downriver. They have heard of Covid-19 but many do not understand truly what it is or that it could represent a threat to them. Belief in sorcery is still strong. Many people prefer to believe scare stories about Covid-19 vaccination circulating online, often reported to them second-hand or third-hand as they mostly have no internet access, than the scientific facts presented by visiting medical teams.
Nevertheless, thanks to some strong persuasion from their local leaders, some of these communities are now opening up to the idea of Covid-19 vaccination. Others have totally rejected it for now, often saying they want to think about it. Simply maintaining the cold temperatures needed to transport vaccines is a major challenge in these conditions, and depends largely on frozen ice packs and portable vaccine carriers, kept out of the sun during the long journey down the Fly River, and occasionally re-stocked with new ice from a portable, solar-powered fridge. It has been hard to explain that if the residents do not take the opportunity to be vaccinated when a visiting health patrol comes, they may wait a long time for another chance.
Dr. Chris McCall was a foreign correspondent, writing at various times for Reuters, The Economist, Agence France-Presse and few other bits and pieces you might know of. Then something possessed him to re-train as a doctor. Now he finds himself in Papua New Guinea as a volunteer doctor with ADI, based in Kiunga, Western Province. Most of the time these days he is a remote area GP in far-flung parts of Australia.
He likes languages, strange places, taking photos and speaks French, Spanish and Malay/Indonesian in addition to his native English. His patients mostly call him Chris, or if being really formal, ‘Dr. Chris’.