Delma Bira, who is attached with the Catholic Health Services, works at the remote Biwat Health Sub-centre, and says the numerous challenges faced range from logistical issues to mothers with birth complications.
It is no secret that PNG’s difficult topography poses a huge challenge for the rural populace as well as service providers.
For the medical workers at Biwat Health Sub-centre in Angoram, the rundown or closed government facilities further hamper their efforts in providing basic health services to the rural populace. This leaves the mission-run centres to shoulder the responsibility with the limited resources they have.
Nursing officer Bira, who hails from Madang and New Ireland, said the main challenge they face are maternal complications such as postpartum haemorrhage (PPH), obstructed labour and malpresentation.
“When it comes to referral, for facilities in town it’s easy to reach the main hospital or you can call for the doctors or midwives to assist you over the phone,” Bira said. “They can give you instructions on what to do. But for us, our cases, it’s a really big setback especially with the location and communication.
“Our only way of communication is through a two-way radio with the mission. And it’s only 8 o'clock to 8.15am, Mondays to Fridays. So we have 15 minutes to connect with the outside world. And after that, in the nights, weekends… there’s no way,” she said whilst shaking her head.
Bira said the only way they deal with night and weekend emergencies is to get on a boat and travel for four to five hours to main Sepik to at least get reception to call the Samaritan Aviation.
“But if not then we have to come all the way – four-hour long drive – to Angoram. And then from Angoram we have to find a transport again. If the mother is in critical condition then Angoram staff will call ‘saman balus’ but if not, it’s on the ambulance and another three or four hours’ drive out to Wewak town.
“I lost a mother because of no communication, with PPH, bleeding.”
Bira expressed that the majority of PNG’s population live in the rural areas, hence there is a great need for skilled medical workers like midwives to be stationed at facilities like the Biwat Health Sub-centre.
“We don’t have midwives. It’s just us nursing officers and community health workers (CHWs). So we work with the capability and knowledge we have. And when we come across complications that are outside our limits, then we have to find ways to transfer the mother or find ways to call our SMOs (senior medical officers) to get instructions to manage the patient.”