Harsh health challenges tackled by ambulance

Sammuel Maia’s eldest daughter complained of labour pains when the family sat down for Sunday breakfast. She was in her 3rd trimester and almost reaching the full term of her pregnancy.

She had complained of similar pains two days prior and the family rushed her from Vanapa Brown to Port Moresby General Hospital but only to find out it was false labour.

Vanapa Brown is an LLG in the Kairuku-Hiri District of Central Province. Due to the road condition, it takes a little over an hour to get to Port Moresby.

The family thought it was false labour again that Sunday, but it wasn’t. As the contractions became frequent and the pain unbearable for the first-time mum, the family felt helpless.

The little savings they had was spent during the first trip into Port Moresby and the two days spent at the hospital. They had to return to the village because it was expensive in Port Moresby and they had no family with whom she could stay in the city.

The nearest health centre was 15 minutes away by road but not staffed on weekends. Maia said the district has a community ambulance, but he did not know the number of the driver. That is the only means of communicating if they needed an ambulance help. But even if he had the driver’s number, he had no phone credits to call.

In the midst of contemplating what to do, they thought of St John Ambulance.

Maia promptly dialled the toll-free St John emergency number 111.

His call was received at the St John Emergency Coordination Centre in Port Moresby and an emergency ambulance was immediately dispatched.

It took the crew an hour to reach Maia’s residence. The soon-to-be grandfather was anxiously waiting at the main road and when the ambulance arrived, he was relieved.

Three months later and Maia says his daughter and granddaughter are doing well.

“If St John had not arrived, my daughter would have given birth in the village unsupervised by a health worker. It was a Sunday and only a few PMVs [public bus] were on the road. I had no phone credits. I didn’t know what else we could have done because we were at the point where we had literally nothing. An open-tray public bus is no place for a woman in labour.

“I can’t say thank you enough for St John Ambulance for dispatching the ambulance crew as soon as I called.  When she got on the ambulance, I knew she was in safe hands and I had no doubt if she was to give birth along the highway, the highly-trained ambulance professionals would be able to assist.

“My daughter has given birth safely at Port Moresby General Hospital thanks to St John.

“She has returned to the village with a healthy baby girl,” the proud grandfather said.

This is one of the many noble stories of St John making an impact to maternal survival in Papua New Guinea.

St John’s Chief Executive and Advanced Paramedic Matt Cannon said the story highlights how better coordination of ambulances will make a further impact on maternal care and the ability for women to give birth in the care of health workers.

But this is not the case for women who live outside of the areas covered by St John.

Statistically, 60 percent of women in PNG give birth without a health professional present. 61 percent of women are more than 2 hours away from an obstetric and newborn care facility.

Child mortality in rural populations is doubled that of urban children.

Approximately 30 percent of all rural Aid Posts are closed and medical facilities have inadequate medical supplies for up to 83 percent of the year.

Outside of NCD, only 51 percent of health facilities have an ambulance but these are not part of the coordinated network and about 74 percent are out of service due to maintenance.  

And only 1 million people out of a population of 8 million can call 111 for an ambulance.

Access challenges is the harsh reality contributing to the sad statistics of 1 in 30 women dying in labour.

In rural communities, a single ambulance has proven to reduce maternal deaths by 50 percent.

Papua New Guinea has St John to help address the access challenges and help reduce the statistics and give women and children and the overall population the quality and timely healthcare they deserve.

Minister for Health Elias Kapavore said the National Ambulance Service led by St John is intended to form a network of ambulances to bridge the gap between individuals, communities and safe healthcare.

The NAS – as it is called – is being led by St John and funded by the National Government to connect all existing community ambulances to one nationwide network of ambulances coordinated by the emergency 111 coordination centre in Port Moresby.

When the network is fully operational, a person affected by an emergency will be able to dial 111 and know that the nearest ambulance that is available will be sent to them.

In the coming months, the network will be piloted in East New Britain, Morobe and Central provinces.

The establishment of the service relies on the timely release of funds from the National Government, which has proven difficult in recent times.

The ambulances connected to the network will have GPS trackers and the operators will carry a pager device working on the Digicel GSM network. Each ambulance will have a mobile data terminal fitted that will enable the crew to be guided to the patient’s location by GPS information sent from the St John 111 Centre in Port Moresby.

In the second phase of the pilot, all ambulances that are part of the National Ambulance Network will be formally accredited by St John to a prescribed standard. The accreditation will involve the delivery of training to health workers and purchase of basic life support equipment that will enable the sustaining of life and the management of neonatal emergencies and post-partum haemorrhage. 

Press release