PNG Health Tips

A new triage and patient flow system has been launched in the Emergency Department (ED) at Gerehu
General Hospital (GGH). The system will help identify patients with urgent healthcare needs, so that they
can be prioritised for assessment and treatment.
Dr Ovia Bue, Specialist Medical Officer and Director of Emergency Medicine at GGH ED, said the new system
will help improve the quality of care provided to emergency patients.
“Triage allows us to identify patients who need immediate treatment. The ED is now colour-coded, such
that the patients requiring resuscitation are taken to the red area. Patients with other care needs may be
directed to yellow and green areas. This simple system will help ensure that we can provide the best
possible care to the greatest number of patients,” said Dr Bue.
“All patients who attend GGH ED will now be registered and triaged on arrival. Under the new system,
emergency doctors will see patients in order of urgency, not time of arrival.”
The new system has been developed by the World Health Organization, Médecins Sans Frontières and the
International Committee of the Red Cross, but has been adapted for Papua New Guinea by a team from the
Australasian College for Emergency Medicine (ACEM).
Visiting from Melbourne, Australia, ACEM President, Dr Simon Judkins, attended GGH ED to see the new
system in action.
“I’m delighted to be visiting Gerehu General Hospital to see first-hand how Dr Bue and his team are
working to improve care for emergency patients in Port Moresby. Implementing the new system has been a
collaborative project between emergency physicians and nurses from Australia and PNG, and I am proud
that our organisation has been able to support it,” said Dr Judkins.
The implementation of the new system is part of an emergency care strengthening project funded by the
Australian Government through the PNG-Australia Partnership. With the support of an Australian
Government Friendship Grant, the triage system will also be implemented at Mount Hagen Provincial
Hospital later this year.
President of the PNG Society of Emergency Medicine, Dr Gary Nou, acknowledged the support of ACEM and
the Australian Government in assisting GGH ED to implement the new system.
“We are very excited to be working in partnership with our colleagues and friends from Australia,” said Dr
Nou, a Specialist Medical Officer at GGH. “This collaborative project will help us to provide timely and
quality care for our patients. It is an exciting day for Gerehu General Hospital.”

THE Prime Minister, Peter O’Neill, recently opened the new standalone Tuberculosis Clinic and Pathology Laboratory at the Port Moresby General Hospital.

In his address, he restated that healthcare remains one of the most important priorities of the government.

“We have continued to invest in healthcare and allocated the biggest resources out of our budget over the last five years,” Mr O’Neill said.

“Our government has been the only one that has fully funded the National Health Plan and this is delivering great change for our people.

“There are many challenges in our country, particularly in the delivery of rural and remote healthcare services, we have limited resources, we all have to work with what we have and deliver for our people.

“It is important that we continue to manage these challenges together and be able to overcome the issues that are confronting our communities.

“Dealing with tuberculosis is a very large issue for many communities right throughout the country, but we must overcome this challenge.

“TB is curable, but we must ensure people who contract the disease seek treatment and see their medication through to the completion of the course.

“The increasing number of patients that are going to get treatment for TB means we are making strong inroads in patient care, but we have to do more.

“People who contract TB and do nothing about it have to realise that their families are at risk of also contracting this infectious disease.

“That is why facilities such as this and getting information out to our communities and our families’ right throughout the country is very important.”

He congratulated the board and management of the hospital for the changes that they have delivered in recent years to deliver an outstanding and a continually improving level of healthcare service.

With the opening of the new clinic and laboratory, the hospital can treat TB patients immediately by analysing from results from tests it obtains from the new laboratory.

Long serving doctor at the Lae Angau Memorial Hospital Cancer Ward, the late Dr. John Stokes Niblett received an award for the member of the Order of Logohu for his services in health for cancer management in the country.

The award was received by his wife Mrs Andrea Niblett yesterday at the government house from the Governor General Sir Bob Dadae following the orders of PNG 2017 New Year’s honours Investiture ceremony.

“I’m happy that he received this award. He was still alive when it was announced last year; however he passed away without really receiving the award which I received on behalf of him,”
“I’m so happy that the government recognized the contribution of my late husband Dr John Stokes Niblet for what he has done for Papua New Guinea,” said Mrs Niblett.

Mrs Niblett added that the dream of the late Dr. John Stokes Niblet was to save as many Papua New Guinean’s from Cancer because there is not enough help from the government to curb cancer.
“Why is there a manager when there’s nothing to manage because there is no treatment for cancer, chemo therapy alone is not enough, surgery alone is not enough?”

She further said, “To address cancer treatment there should be radiation therapy, there should be a radiation oncologist and there should be a proper doctor”. PNGFM

THE Modilon Hospital in Madang says it receives two fully fledged cervical cancer patients every fortnight.
Gynaecologist Dr John Bolnga made the comment when more than K40,000 was presented to the hospital for the construction of a cervical cancer surveillance clinic.
“That means we treat 104 women with blown-up cervical cancer in one year,” Bolnga said.
He said that by having the cervical clinic, women would feel free to visit anytime and have themselves checked to prevent the disease reach full-blown stage.
Bolnga said most patients were already at stage one.
He thanked Island Petroleum for initiating the colour-run fundraiser which helped raise K41,528 to construct the cervical cancer clinic.
Island Petroleum Madang branch manager Shahin Das said individual contributions  from the coloured t-shirts raised more than K14, 000.
Bank South Pacific contributed K6500 while a good number of businesshouses supported very well to raise the K41,528.
“Every boy or girl who gave K20 is the same as the person who gave K500, so I thanked all of you in Madang who have come to support to raise funds for the cancer clinic,” Bolnga said.
Modilon Hospital acting chief executive officer Dr Vincent Atua said cervical cancer was a number one killer disease in Papua New Guinea.
Atua thanked Island Petroleum for organising the fundraiser.
Madang will become first province in the country to have a specialised clinic to treat cervical cancer.
Robin Mea, from Bank South Pacific in Madang, announced that Bank South Pacific had committed  K25,000 to maintain another ward at the gynaecology unit where patients were admitted. The National

The decision to evacuate 14 doctors out of Mendi in Southern Highlands has been commended by the National Doctors Association.

Despite a call by the Health Secretary, Pascoe Kase, for the doctors to remain and continue to perform their duties, the president of the association, Dr James Naipao, said they were evacuated for security reasons.

Most doctors and their families were evacuated from the province before the arrival of security forces into the province as a result of escalating law and order problems.

“Loss of lives through high-powered guns, rampage and burning down of properties in the Mendi township and encroaching into setups like the School of Nursing and hospital is deemed absolutely with no connotation a crisis and emergency,” Dr Naipao said.

He said the deployment of security forces was a reaction to the already existing turmoil that has ravaged Mendi town.

The doctor also said all employers should have been in communication with their employees in Mendi.

“The fear of loss of life, insecurity, school children missing classes and lack of freedom in the already red-hot situation in Mendi must not be taken lightly by those in authority.

“The doctors in Mendi were, and are, in constant communication with their immediate employers, and their union affiliates as done with National Doctors Association.

“The decision to evacuate doctors and their families by SHP PHA management and the SHP government is highly commendable,” Dr Naipao said.

“This decision was done before the arrival of the security forces. This shows that these two team leaders respect this human resources in the province.”

Dr Naipao said leaders in management positions and politics who did not care about loss of lives at an already existing crisis or impending crisis should rethink the position they occupy.

The 2014 Cancer mortality profile for Papua New Guinea showed that 56,000 total deaths took place from cancer alone. That is about 0.01 percent of the total population of 7.167 million which is still a significant amount compared to the current status of the cancer treatment facilities in the country.

It is better for Papua New Guineans to consider prevention as a priority to avoid being victimized by this killer disease.  Here are 15 cancer symptoms that you should know so you seek medical help sooner.

Changes in Your Skin

A new spot on your skin or one that changes size, shape, or color could be a sign of skin cancer. Another is a spot that doesn’t look the same as all the others on your body. If you have any unusual marks, have your doctor check your skin. She will do an exam and may remove a small piece (called a biopsy) to take a closer look for cancer cells.

Nagging Cough

If you don’t smoke, there’s very little chance a nagging cough is a sign of cancer. Usually, it’s caused by postnasal drip, asthma, acid reflux, or an infection. But if yours doesn’t go away or you cough up blood — especially if you are a smoker — see your doctor.  She may test mucus from your lungs or do a chest X-ray to check for lung cancer.

Breast Changes

Most breast changes are not cancer. It is still important, though, to tell your doctor about them and have her check them out. Let her know about any lumps, nipple changes or discharge, redness or thickening, or pain in your breasts. She’ll do an exam and may suggest a mammogram, MRI, or maybe a biopsy.

Bloating

You may have a full, bloated feeling because of your diet or even stress. But if it doesn’t get better or you also have fatigue, weight loss, or back pain, have it checked out. Constant bloating in women may be a sign of ovarian cancer. Your doctor can do a pelvic exam to look for the cause.

Problems When You Pee

Many men have urinary issues as they get older, like the need to go more often, leaks, or a weak stream. Usually, these are signs of an enlarged prostate, but they could also mean prostate cancer. See your doctor for an exam and maybe a special blood test called a PSA test.

Swollen Lymph Nodes

You have these small, bean-shaped glands in your neck, armpits, and other places in your body. When they’re swollen, it often means you’re fighting an infection like a cold or strep throat. Some cancers like lymphoma and leukemia can also cause this kind of swelling. Talk to your doctor to pinpoint the cause.

Blood When You Use the Bathroom

If you see blood in the toilet after you go, it’s a good idea to talk to your doctor. Bloody stool is likely to come from swollen, inflamed veins called hemorrhoids, but there’s a chance it could be colon cancer. Blood in your pee could be a problem like a urinary tract infection, but it may be kidney or bladder cancer.

Testicle Changes

If you notice a lump or swelling in your testicles, you need to see your doctor right away. A painless lump is the most common sign of testicular cancer. Sometimes though, a man may just have a heavy feeling in his lower belly or scrotum or think his testicles feel larger. Your doctor will do a physical exam of the area and may use an ultrasound scan to see if there is a tumor or another problem.

Trouble Swallowing

The common cold, acid reflux, or even some medicine can make it hard to swallow once in a while. If it doesn’t get better with time or with antacids, see your doctor. Trouble swallowing can also be a sign of cancer in your throat or the pipe between your mouth and stomach, called the esophagus. Your doctor will do an exam and some tests like a barium X-ray, in which you swallow a chalky fluid to show your throat more clearly on the image.

Unusual Vaginal Bleeding

Bleeding that’s not part of your usual period can have many causes, like fibroids or even some types of birth control. But tell your doctor if you’re bleeding between periods, after sex, or have bloody discharge. She’ll want to rule out cancer of the uterus, cervix, or vagina. Be sure to let her know if you are bleeding after menopause. That’s not normal and should be checked out right away.

Mouth Issues

From bad breath to canker sores, most changes in your mouth aren’t serious. But if you have white or red patches or sores in your mouth that don’t heal after a couple of weeks — especially if you smoke — see your doctor. It may be a sign of oral cancer. Other things to look for: a lump in your cheek, trouble moving your jaw, or mouth pain.

Weight Loss

Of course, you can slim down when you change the way you eat or exercise. It can also happen if you have other issues, like stress or a thyroid problem. But it’s not normal to lose 10 pounds or more without trying. There’s a chance it could be a first sign of cancer of the pancreas, stomach, esophagus, or lung.

Fever

A fever isn’t usually a bad thing. Sometimes it’s just a sign that your body is fighting an infection. It can also be a side effect of some medicines. But one that won’t go away and doesn’t have an obvious cause could be a sign of a blood cancer like leukemia or lymphoma.

Heartburn or Indigestion

Almost everyone has this burning feeling sometimes, often because of their diet or stress. If lifestyle changes don’t work and your indigestion doesn’t stop, your doctor may want to do some tests to look for a cause. It could be a sign of stomach cancer.

Fatigue

A lot of things can make you very tired, and most of them aren’t serious. But fatigue is one early sign of some cancers, like leukemia. Some colon and stomach cancers can cause blood loss that you can’t see, which can make you feel very tired. If you’re wiped out all the time and rest doesn’t help, talk to your doctor.

EMTV

The United States Agency for International Development (USAID) is working with partner organisations to introduce a new drug into Papua New Guinea called bedaquiline, the first new drug for tuberculosis in over 45 years.

The USAID through funding provided to FHI360 and the World Health Organization is working with the National Department of Health (NDoH) to host a series of trainings to help PNG’s doctors safely introduce bedaquiline.

Senior Multidrug-Resistant Tuberculosis Technical Advisor Dr Anh Innes at the USAID Bureau for Global Health in Washington D.C. has returned to PNG to oversee USAID’s donation of bedaquiline and provide technical assistance for the NDoH, specifically the Pharmaceutical Services Standards Branch (PSSB).

“Our main strategy for the safe introduction of bedaquiline is called pharmacovigilance, which is the science of early detection and monitoring of adverse effects,” she said.

“When adverse events happen when you take a medicine, you want to be able to find them quickly and manage them effectively.”

As well as supporting the safe introduction of bedaquiline, USAID and the NDOH PSSB are also using that as a catalyst to build the foundation for pharmacovigilance for all drugs here in PNG.

In Dr. Innes’ three previous visits, she carried out trainings on pharmacovigilance for bedaquiline for physicians in 12 provinces in the country.

“So this time, we’re focusing on working with the PSSB to roll out the ‘backbone’ for pharmacovigilance through the provincial Medicines and Therapeutics Committee (MTC). The first stage of the roll out is happening at Gerehu Clinic this week,” Dr. Innes said.

The PSSB will host a series of MTC trainings that will take place in provinces and hospitals throughout the country.

FHI360 Country Director Daniel Tesfaye added that USAID has donated 85 courses of bedaquiline, distributed mainly to Daru Hospital and the Port Moresby General Hospital as they care for high numbers of drug-resistant TB patients.

“It’s a very good contribution to the country to ensure that people who have multi-drug resistant tuberculosis (MDR-TB) get the best treatment,” Mr Tesfaye said.

“Besides that, USAID and FHI360 are working with PSSB to ensure that adverse events are actually registered in the global system so that PNG can become a full member of the World Health Organization’s Uppsala Monitoring Center.”

Dr. Innes gave a Grand Rounds lecture at UPNG’s School of Medicine on Tuesday July 25 at 4pm on Drug-resistant tuberculosis: Progress toward elimination.

The Grand Rounds are lectures given on a regular basis by UPNG faculty members every Tuesday.

Dr. Innes’ lecture presented key developments for drug-resistant TB control from the past decade.

Last October, Ambassador Catherine Ebert-Gray donated laboratory and clinical equipment, worth K270,000, to Daru hospital.

These are needed to fight the spread of both MDR-TB and HIV/AIDS in PNG.

These machines are helping doctors to provide quality diagnostics to their patients, and will enhance the ability to monitor for TB and HIV.

Representatives from the US Embassy held a public forum on HIV/AIDS at the National Library yesterday to mark World AIDS Day.

According to the Global AIDS Response Progress Reporting (GARPR) statistical data, PNG still has the highest number of HIV/AIDS cases in the Pacific, and is ranked fourth in South East Asian countries.

The commemoration of the day brought to light approaches that communities, advocate groups and NGOs have adapted to produce accurate statistics in order to effectively treat HIV infected patients and bring death tolls to zero.

According to Dr. Percy Pokeya, CDC Senior Advisor, approximately 34,000 are known to be infected with the virus; 16,000 of which are receiving antiretroviral drugs.

One thing that drugs aren’t able to cure is the stigma and discrimination that HIV victims deal with every day.

Brad Coley, Economic Officer with the US Embassy, said it was the main reason for the poor state of many countries surveillance systems and PNG is no exception.

On a similar note US Ambassador, Walter North, in his speech said the government needed to do a better job of reaching key populations: sex workers, transgender people, and men who have sex with men – or with men and women.

They are at high risk for getting infected with HIV and face even higher levels of discrimination and stigma that can scare them away from treatment.

“Many of the current laws of Papua New Guinea on sexual behaviour re-enforce a cycle of exclusion and fear. There is an urgent need to review those laws and to sensitise health centre staff to the health needs of key populations,” North said.

US Embassy Deputy Chief of Mission, Joel Maybury, challenged Papua New Guineans to continue the fight against HIV/AIDS every day and not just on World AIDS Day.

He said HIV/AIDS advocates could only do so much as speak for the HIV patients forced to live in the shadows, but if many are unable to come out in fear of being ill-treated how can we stop the spread of HIV, discrimination does little to help bring this epidemic under control. EMTV

Below are few tips to reduce your risk of geeting HIV or STDs:
1. Always Practice Safe Sex: When used consistently and correctly, condoms are highly effective in preventing HIV. They are also effective at preventing sexually transmitted diseases (STDs) that are transmitted through bodily fluids, such as gonorrhea and chlamydia. However, they provide less protection against STDs spread through skin-to-skin contact like human papillomavirus (genital warts), genital herpes, and syphilis. Have condoms handy if you will be having sex and make sure you know how to use them correctly.
2. Use Lubricant: Condoms should always be worn and used with a water based lubricant which helps prevent condoms from breaking.
3. Get Tested Regularly: (even If you are in a monogamous relationship) and encourage your partner to do the same. If you are not at high risk for getting HIV or any STD (not having sex regularly), it is still important to get tested. Always get tested before starting a new sexual relationship and encourage your new partner to do the same.
4. Avoid Sexual Activity: If you feel you are unable to have sex safely, you should avoid all sexual activity as you may be putting yourself or others at risk. If you are unsure if you have HIV or an STD get tested. If your test has returned positive make sure to listen to your doctor’s advice on treatment and make sure you have the all-clear from your doctor before resuming sexual activity.
5. Have Sex Only Within a Mutually Monogamous Relationship: Two people who have sex only with one another don’t have any opportunity to bring a new STD into the relationship. If you and your partner have been tested and are healthy, remaining faithful to each other is a very good way to reduce your chances of contracting an STD. It is important to be comfortable talking about safe sex with your partner.
6. Never Rely on the Withdrawal Method: Pre-ejaculate of an HIV-positive man may transmit the virus, always use a condom.
7. Only Use Safe Injecting Equipment: Using unclean or sharing injecting drug equipment is one of the most efficient ways of transmitting HIV.
8. Don’t Drink or Use Drugs Before Having Sex: It’s difficult to make responsible choices about your sex life if you’re impaired by drugs or alcohol. When you are under the influence, you are more likely to choose to have sex with someone you wouldn’t otherwise have picked as a partner, and less likely to be able to successfully negotiate safer sex.
11. Be Comfortable Saying No!!!!: You should never have sex unless you want to. Get comfortable saying no. If you don’t feel it is right, that’s ok. It’s your choice to say yes to sex, and it’s also your choice to say no. Similarly, if your partner tells you no, listen.
12. Be Responsible for Your Own Protection: It doesn’t matter if you’re male or female. If you’re going to have sex, you should be prepared. This is not only a matter of emotional preparation but practicality. Bring your own safer sex supplies. The worst thing that can happen is that you’ll have extras. If you are unsure how to use these correctly talk to your doctor.
Remember: Can you use two condoms for extra protection against STD’s and Pregnancy? No, you should never use more than one condom at a time. Using two condoms actually offers less protection than using just one. Why? Using two condoms can cause friction between them, weakening the material and increasing the chance that the condoms might break. No other method of birth control is as successful at protecting people against sexually transmitted diseases as a condom so always use a condom if you are having sex but always only use one at a time.

Source: Port Moresby General Hospital