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 second update from Dr. Chris as he is affectionately known. Bio below.
Dr Chris McCall Reports from Kiunga
Kiunga is currently a Covid-19 hotspot but in the centre of the town there is little social distancing, and vaccine uptake has been slow. Markets still operate as usual, although some shops at least are insisting on customers wearing face masks.
If you think you might have Covid-19 here, there are few places to test you. The hospital is one. But Kiunga Hospital has been under a lot of stress and had to severely cut back its services at times due to Covid-19 infections among its patients and staff.
In reality, testing so far has been very limited and that means that the true extent of the outbreak in Western Province and the North Fly district is hard to assess. Recent figures that are available, however, suggest that this is currently one of the worst affected parts of the country.
Kiunga Hospital is old and its buildings are all made of wood. Outside the hospital there is a white triage tent. In theory, if symptomatic you can get screened there, but you may have to wait hours. The hospital has ‘rapid detection tests’ and nasal swabs, and fortunately at least some gowns, masks and face shields.
If you are symptomatic you should have a nasal swab and a rapid detection test, which should give you an answer within a few minutes. Swabs are sent north to Tabubil for further testing, at another hospital near the giant Ok Tedi mine.
If you are seriously ill, you may get sent to ‘Outpatients’, Kiunga Hospital’s de facto emergency department. Attempts have been made to segregate Covid-19 patients. But as with everything the hospital is hampered by lack of facilities, lack of space, lack of equipment. The hospital lacks many simple items that hospitals in developed countries take for granted. Furthermore, treating Covid-19 patients in hospital carries a big risk of cross-infection to other critically ill people and there is considerable pressure to treat people at home where possible.
Kiunga Hospital has set aside a special ward for patients suffering from severe Covid-19 and there are some facilities for giving supplemental oxygen there, although the hospital’s capacity to do this is limited.
Once they start to improve, most are discharged into home quarantine, typically for a period of 14 days. There are attempts to monitor compliance with home quarantine, but in practice some people have ‘escaped’ before their quarantine period is over.
It is not easy to see a way out of this. In Papua New Guinea, people live in crowded houses. Social distancing and mask wearing are hard to enforce and simply going shopping or joining a queue at the bank are liable to bring you into contact with the virus. The only clear answer appears to be vaccination, but so far many people have been reluctant to have one.
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’.