MY PLANE DIPS INTO KAVIENG late at night, soaring through a sudden tropical downpour and landing in a laid-back island paradise.
New Ireland is remote and its white coral beaches, exotic marine life, World War II dive wrecks and uncrowded surf breaks deserve to be better known. But that is not why I’m here.
I have come to travel around the region with the not-for-profit medical relief agency Australian Doctors International (ADI), which sends volunteer doctors on health ‘patrols’ to assist remote and rural communities.
In New Ireland, ADI has partnered with the provincial government, which contributes considerable funding and dedicated health staff for patrols.
Last year, ADI’s volunteer doctors treated almost 3,000 patients and provided over 550 hours of on-the-job training for health workers. It also distributed medical equipment worth over $145,000 donated by Australian and PNG organisations to needy rural health centres.
“When we go out as an integrated team with ADI, people get health services that the government otherwise can’t routinely provide,” says Dominic Sahamie, Director of Health for New Ireland Province.
Health is, according to some of the communities we visit, the only government service currently reaching rural areas.
Most of the province’s 160,000 people are subsistence farmers who exist in simple villages without running water, electricity, phone coverage or proper roads.
Even Namatanai Hospital – just 270 kilometres south of the provincial capital Kavieng – lacks running water and reliable power.
Merrilee speaks fluent Tok Pisin, learned as a medical student in PNG’s Madang and Lae Provinces 30 years ago, and has expertise in public health, tropical medicine, obstetrics and surgery. She’s also worked with Aboriginal communities in Australia.
“PNG is Australia’s nearest and poorest neighbour,” she says. “All my life's work seems directed towards this choice.”
The local patrol team members include eye nurse Roland, TB coordinator Wilson, HIV/AIDS educator Audrey, women’s health nurse Jennifer, water and sanitation inspector Eremiah, and dental therapists Simon and Matthew, who are all very committed.
“These integrated patrols are our only opportunity to reach the rural people in faraway places,” they explain.
Our destination is the isolated West Coast. We set off in 4WD troop carriers down the Boluminski Highway on the East Coast, planning to circumnavigate the island.
Flanked by palm trees, we pass picturesque villages with swept sand gardens and trade stores selling rice, bully beef and other basic supplies.
Smoke from kitchen fires cooking kaukau (sweet potato), taro and yam billow through sago leaf roofs.
Laughing kids kick balls across hot, dusty fields. Plantation workers wield knives on impossibly long handles to fell coconuts and palm fruit, key sources of regional income.
Five and a half hours later, the West Coast offers much less and is very isolated. We drive over the island at Labur and head north along an unsealed, potholed goat-track surrounded by dense encroaching jungle.
Pigs darting out of bushes are the only indication we’re approaching another village. Huts are wholly constructed from wild bush materials; there are no markers of modernity.
We slow down beside people walking to their gardens and women washing by the river to give tok saves (announcements) about the team’s health services.
“Come tomorrow, the next day, or the day after to your health centre to see a dokta, get treatment for your eyes, teeth, PAP smear, HIV test,” Audrey the straight-talking HIV/AIDS educator calls from our vehicle. To me she says, “The West Coast is forgotten.”
Our first stop, Messi Health Centre, is painted blue and yellow and presided over by a jungle-covered limestone escarpment with a giant bat grotto at the top.
At 7am the village bell – an old WWII bomb case – bellows to announce the health team’s arrival. Patients come from near and far, some riding in the back of the old school truck, others walking for three dusty hours.
The ADI doctor, Merrilee, treats a baby girl with hydrocephalus (fluid on the brain), a man with elephantiasis and a young mother with severe mastitis.
A village elder embroiled in land disputes presents with difficulty swallowing, proposing witchcraft as the cause. Instead he’s diagnosed with oral cancer, likely related to chewing buai (betel nut), PNG’s narcotic equivalent of coffee and tobacco.
There are also lots of musculoskeletal aches and pains. For locals labouring all day long in gardens and carrying home heavy loads of root vegetables and firewood, the physical cost is high and basic painkillers are either unaffordable or unavailable.
“The last ADI patrol gave us new ideas on how to deal with patients and taught us about the different treatment options,” says Sister Margaret, the hard working nurse who runs Messi Health Centre. As part of ADI’s program, local staff assist the volunteer doctor during clinics to gain on-the-job training.
On the other side of the health centre, the women’s health nurse conducts PAP smears (the slides are shipped to Australia for analysis – 900 women in PNG died of cervical cancer last year).
The eye nurse does vision tests and distributes subsidised spectacles. The dentists pull rotted teeth from adults and even young children – they’ll only perform temporary fillings if the patient can get to Kavieng, five potholed hours away, within one month for a permanent filling.
Most patients know they’ll never be able to muster the 60 kina return truck fare, so they opt for an on-the-spot tooth extraction.
“Proper dental work such as fillings can’t be done here due to the lack of equipment, running water and electricity,” explains the dental therapist Matthew, who hails from the province’s even more remote Anir Islands located over 165 kilometres away.
We stay at the church guesthouse and bathe downstream in a cool crisp river. On the beach at dusk, villagers light a campfire using driftwood and dried coconut husks, and invite us to join them.
They sing and tell stories about their local shark callers, who continue the ancient tradition of serenading sharks using rattles made of coconut shells. Anything is possible in this beguiling land.
Tomorrow: Part 2 - Crossing flooded rivers to reach Panaras