Kompiam District Hospital Medical Superintendent Dr David Mills told David Gilchrist why cultural understanding matters.

Dr David Mills said the PNGU training facility is important because around 80 % of the PNG population live in rural areas and medical education covering rural and remote medicine is essential.Nonetheless, he says that there is an argument to also support Nurse Education in a system of care that is largely nurse-driven care. 

Dr Mills says that as most PNG districts a remote and rural, many without doctors or with very few doctors, “it is completely impractical to follow a doctor-led Australian model.”“Here, nurses and what we call community health nurses that are slightly less trained than nurses, do most of the diagnosis and treatment. Doctors deal with more complicated cases,” he said. 

He said in the PNG system nurses are largely responsible for outpatient treatment and admissions. “Even some of the surgery is done by nurses in some places.”He said that while that highlights the need for nurse education, he emphasised that all doctor and nurse education need strong cultural awareness.

He said it is essential for medical and health staff to understand the conditions and the sort of things that all nurses and doctors will be required to confront.“That is part of the problem, we do have people from time to time that want to get involved in education, but they do need to know about the context and the issues here. That is part of the problem, there are not many people who are PNG orientated.”

Dr Mills hard at work at Kompiam Hospital

He says that understanding prevalent disease like tuberculosis, HIV, and malaria and then being able to take a patient’s medical history requires a strong cultural understanding. He says that means understanding how people respond to and understand questions is important.“I tend to find that people who are trying to impart technical knowledge will find themselves more useful. Like those that are teaching obstetrics or anaesthesia. In my experience people come and they are pretty wide-eyed, and it takes them quite a while to realise how big the differences are in the more nuanced stuff of general practice whereas technical stuff you can pretty much go straight to it and start teaching people from day one,” he said.

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