Air support critical in the PNG highlands

Kompiam District Hospital Medical Superintendent Dr David Mills told David Gilchrist how philanthropy sustained Kompiam Hospital.

Dr Mills says that while the Covid-19 pandemic is another addition to the infectious disease burden against which the hospital works, the national response to the pandemic proved a significant threat to hospital remaining open.

David Mills said that from a health perspective, Covid-19 did impact on the health services including taking the lives of two staff. “But you have to keep that in the background,” he said, “this is a place where there is so much infectious disease and so much death from infectious disease. So, it is just another thing that is in the mix. We don’t see nearly as much death and morbidity from Covid as we see from something like tuberculosis or HIV.” He said that it was unfortunate that the response to Covid has seen substantial economic damage.“ For example, most health services like us have taken a 90 percent cut to their operational grants from the government.” Dr Mills said.

He said that the level 4 upgrade does provide funding for medical and health staff, the funding for service provision has “been cut to the point where you just can’t do it.” He said international philanthropic support has managed to keep the service open while several other hospitals have closed completely.In March 2021, Boram hospital in East Sepik closed its emergency department. Mount Hagen hospital in the country’s highlands closed adult and children’s outpatient services from next week. In the highland’s regions, Mendi hospital was set to close its operating theatres because it had run out of anaesthetic agents and lab reagents. The Wabag hospital is also on the verge of closing due to lack of funding.“It has been quite tragic really. So, in that sense it’s still a real battle,” Dr Mills said.

He explained that the building work has continued because philanthropic donors have targeted individual stages of the hospital development and Kompiam hospital have quarantined that money for the building projects.“In terms of finding money for fuel for cars or paying support staff like cleaners, it’s been a real struggle,” he said.He said in 2021 donations from previous medical students and from what Dr Mills called “mum and dad” Kompiam District Health Service would have closed.

“To be honest, it still is very tight,” Dr Mills said. In November 2021, PNG Prime Minister James Marape said about 40 percent of the health dollars will go to capital spending, to help counter the problems revealed by the pandemic.The government will also move to incorporate some of the church run medical services into the state system.”Health comes first, we cannot compromise lives and livelihood of our people,” Marape said.

Mountains of Tears

While tribal fighting is not new to PNG or the Highlands, changing tribal structures and the introduction of modern weapons have led to the situation worsening in the last 20 years.

In 2021, communal violence displaced approximately 30,000 people causing some highland regions to be considered as mountains of tears, such is the intensity of the violence.Within the mountains, that are home to the Kompiam District, tribal violence is not unfamiliar although it is somewhat quieter here than in some neighbouring regions. Nonetheless, when it happens tribal fights are brutal.

The aim is simple – to destroy the enemy, mentally and physically. Fights generally take place in or around remote villages without access to medical assistance or law enforcement. While that might go some way towards explaining why Kompiam Hospital has not fallen victim to violence, perhaps the rest of the story comes down to David Mills’ pragmatic attitude and understanding of Highland culture. He says that visiting doctors can avoid getting caught up in tribal fights, “unless you do something stupid.”

“In PNG, violence is very much tribal oriented or politically oriented and so if you’re not involved in the politics or you’re not involved in taking sides then you’re really not troubled by it.” Dr Mills says that is why he doesn’t feel threatened by Highland tribal violence.He says, while tribal violence does potentially impact on the workload of Kompiam Hospital, it also has a devastating economic impact.

It affects the economy and the local economy and provision of more general services so, in that sense, everyone is affected.”

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Additional video material: Title ICRC PNG DRAMA PROGRAM, Chris Phillips, CopyrightTitle: Medivac Kompia, MAF PNG, Copyright png hospital overcomes pandemic png hospital overcomes pandemic