“I am relaxing at the end of a long day after a busy medical clinic when I get a phone call from the local Clinical Health Worker (CHW). He tells me that an elderly lady has just been brought in after a fall. I grab my medical bag and my medical students and I walk back to the clinic we had just left, where we see a small lady who must be in her eighties with her forearm splinted with a banana leaf in obvious pain. Together with the CHW, we get the woman inside the clinic and onto the bed.
Back in Australia, she would be seen in a well-equipped Emergency Department with access to x-ray, blood tests and a large medical team including orthopaedic surgeons. In rural PNG, however, we have a corrugated iron clinic with creaky wooden floorboards, the air thick with tropical humidity. Luckily, we have some pain strong pain relief and we are able to give it to her to relieve some of her pain. The relatives tell me in Tok Pisin that she fell over on her way to the toilet last night and they carried her down to the health centre from their remote village today. Our elderly patient has a bruised forehead, back pain and her forearm is bent into the “dinner-fork” deformity that is classic of distal radius fractures.
Working as a team with the CHW and medical students (and with some strong pain relief on board), we are able to straighten the arm back into its normal position with a pull and apply a cast.
We are lucky – it was the last day of our patrol and this lady would most likely have been sent down the river for several hours on a painful journey for further treatment if we had not been there. This clinic also had the pain relief and equipment needed for us to be able to care for this lady, but many clinics that I have been to in Western Province do not. We admit the lady to the small inpatient ward for some pain relief and observation and we’re all delighted to see her smiling broadly at us before we leave the next morning.”