Condition critical: PNG health training is in the ICU

PAULUS RIPA

THE CURRENT STATE of health personnel training in Papua New Guinea is appalling.

We have known for at least a decade that we would be running into a shortage of health workers (see recent article in PNG Attitude here).

Millions of kina have been spent in the last five years or more on meetings and workshops by the Health Department on this issue, and there is still no official directive.

The minister has expressed concern and announced recently that a national policy will be released soon.

The report in PNG Attitude had at least one misleading comment. We are led to believe that it has only been due to the release of Australian funding that midwives will be graduating this year. This is a blatant untruth.

The University of PNG’s nursing division has been working for several years on a midwifery training program (i.e. at UPNG) that could be registrable by the Nursing Council; a task that mysteriously took on mammoth proportions culminating in last year’s batch of students at least eligible for registration.

AusAID funding has been a welcome relief with sponsorship of students, provision of academic staff and now infrastructure development; however this is only for midwifery.

The training of doctors at UPNG is severely hampered by a lack of teaching staff (currently 50% of positions are vacant), deteriorating infrastructure and inadequate financial support (UPNG itself is in the red by K70 million).

The current ceiling for an intake of 50 students a year cannot be exceeded under current conditions. It is only surviving due to supplemental support from AusAID through its HECS (Health Education & Clinical Support) program.

The training of rural Health Extension Officers is also hampered by inadequate clinical training releasing poorly prepared graduates out into the workplace.

A report several years ago commissioned by Divine Word University was quietly shelved as was a report by the Office of Higher Education. Some effort has been made to deal with this but it requires systemic change.

Nursing schools have been poorly funded and supported. We need the opening of more nursing schools. Last year 200 positions for nurses were advertised for Port Moresby General Hospital; there were no applicants at all.

This is compounded by problems with Nursing Council registration in which midwives had been trained for several years but were unable to be registered.

Lastly, the 14 community health worker training schools are all run by the churches and are in considerable difficulty keeping their heads above water.

Moreover there are no mechanisms in place to systematically monitor and ensure regular updating of knowledge and skills of all levels of health workers (from doctors to community health workers).

There are no provisions to have regular licensing requirements so that in fact most of the aging workforce is probably redundant in terms of knowledge and skills.

And still the Health Department has not released an official report as to how it plans to systematically fix the human resources problem.

Comments

[Colin Huggins]

Well the sign says "Haus Sik", I presume this is a recent photo? It looks like a "Very Sik-Haus". Almost to the state of decay and ready to topple over.
Would this be so Paulas?

I was in the then TPNG for 6 years arrived late 1963 for last practice teaching experience in Rabaul) and then back to Lae, where I was put into the one and only " Hotel Cecil" to wonder - what next?

Keith Jackson was in my ASOPA class. I don't know where he did his final practice teaching.

Completely ignored for a few weeks and then told to be at the Lae Wharf to catch the good ship, the MV Morobe which did the delivery route for supplies up the coast - a voyage I will never forget.

First posting Dregerhafen - a young PNGian fellow there was in in charge of the Haus Sik.

Nobody died under his care and his "Haus Sik" was spotllessly clean.

Then off in late 1965 for 18 months at Gagidu (Finschhaafen) on maps.

Now here, and the Lutheran Hospitals at Butaweng existed - but there was a "haus sik" and a "haus tooth", well both way back then had locals in charge.

I developed a terrible tooth ache - so off to the young PNGian dentist.

He was certainly not a registered dentist - a trainee with very limited experience.

Pedal apparatus - scary.

Out came a very long needle, scared the "shit" out of me. It worked, then the drilling and then the whatever stuff they stick into a messy tooth.

Anyhow all ended well, tooth removed, and now a false one on a plate.

So what did I do? I got said "lik lik dentist" to come to the school and look at the kids teeth.

Finschhaafen kids must have good teeth or nutriients?

Only about 3 of over 100 plus kids had teeth problems. Remarkable. Off these three went after their parents were advised and all done!

Actually the three kids in question were VERY BRAVE - no dramas.

So Paulas why way back in the 1960's were health services better, than what we learn from the present day?

I hope that Martyn Namorong can address the health situation in PNG when he again arrives in Australia for a seminar.

Over to you now, Martyn.

[Lei Atua]

This is a real issue catching attention in all forms of media.(radio, television, etc) and poor health service delivery is always a concern in the country.

Health results are poor compared to other Pacific island countries.

When is this issue going to be solved? And how? The only means is for the government to improve its human resources in the health sector so people can go into the most remote area and survive.

[Neil Yamelu]

Thanks Dr Ripa for raising this issue. We need more human resources with better skills and knowledge to serve our nation's hospitals, clinics and aidposts.

Therefore, I urge the government to consider this and fund nursing institutions so they can produce better qualified workers.

[Martyn Namorong]

Hi Dr Ripa

Its good to see you writing about what is a serious problem. We're not training health workers like the late Adolf Saweri, instead we're producing medical entrepreneurs who wish to profit out of other people's misfortune.

Its a rather sad indictment on the health professionals and trainees these days