Minister giving K1.5 mill to YWAM is infuriating as health facilities face medicine shortages

puk

As Papua New Guineans struggle with medicine shortages in nearly all  public health facilities, Youth With A Mission (YWAM) statement showing a smiling minister for health presenting a cheque of K1.5 million has enraged many Papua New Guineans.

The reason for the anger is because it is quite insulting that  the  Health Minister  moves quickly in  funding an already well funded international  organization  with taxpayers money as  the existing health system collapses  all around us.

In the long term, the YWAM program is unsustainable in PNG. Let’s face it.  They come and they go. In the downtime, the heavily burdened health system is left with the same patients and the same problems.

There are very basic  systematic problems  that need to be fixed.  Problems like  the flow of medicines from the area medical stores to the clinics and hospitals.  If there is someone stealing or abusing the process, it is the Minister’s role to commission an investigation (if the Health Secretary can’t do it) and get to the bottom of the problem.  Resolve it, for goodness sake.

While I have the greatest respect for the YWAM program, it  is a band aid solution. It looks good because politicians are “seen to be delivering services.”  It is It is a  politically cool option.

But why can’t we spend  that money to fix our systems? Why can’t we fund our own outreach programs and develop our own staff like we used to.   Make it cool to be a community health worker or a nurse who goes on regular government funded patrols.  Put them on boats like the YWAM guys and get them out there.

We have to be able to go to the National Cancer Center in Lae  when our relatives are ill.  Have you checked the price of one tooth extraction lately?   Have you checked if the dental clinics  can fill cavities?  You will be surprised how  much we have come to accept the poor state of public health services.

I’m not saying reinvent the wheel.

Papua New Guinea has a GOOD health system. It is people focused. There are staff that are committed and the medicine is provided free.  Where did we go wrong?   It’s a question best answered by those with intimate knowledge of the health system.

I say again, there is a  medicine shortage. Don’t point fingers. Just get someone in those comfortable offices to  go to Lae and other centers  and see  the problem for themselves.

 

Advertisements

Let’s be honest! Nearly every public health facility is facing a medicine shortage

clinic
Merut Kilamu being given the last bottles of Amoxycillin suspension for her baby.

In Lae City,   there are  seven urban clinics each serving between 100 and 150 patients a day.  They get their medical supplies form the Government Area Medical Store (AMS) in Lae. The AMS  in Lae also supplies the Highlands and the rest of Momase.

For the last six years, staff at the clinics have  been battling  medicine shortages.  You can see,  first hand,  how the medicine  shortage affects people in Lae.

At Buimo Clinic on Friday,  a mother and baby came in  for treatment.  She  was  told that the last bottles of Amoxicillin suspensions would be given for her child  and that she  would have to go to a pharmacy to complete the treatment course.

The woman’s name is Merut Kilamu.  She lives with her family at Bundi Camp in Lae.  She is NOT just a statistic.  She is a real person who is bearing the brunt of the ongoing medicine shortages.

“Sometimes, we are able to buy the medicine,” she says. “Other times,  when we don’t have the money, we can’t buy what we need.”

Patients go from the clinics to  Angau Hospital in the hope that they will get  the medicines  they need. But Angau can’t handle the numbers.  Hospital staff have even  posted on Facebook saying they too need the basic supplies of antibiotics, antimalarial drugs and consumables like gauze, gloves and syringes.

Hospitals and clinics have become little more than prescription factories channeling their patients to pharmacies who charge the patients upwards of K40 for medicines. Pharmacies are profiting from the desperation and ill health of the Papua New Guineans.  In 2017, when clinics ran out of antimalarial drugs, pharmacies increased the prices.

In some instances, officers in charge of clinics felt the need to negotiate with pharmacies to keep their prices within an affordable range.  It is difficult for staff in smaller clinics to send away patients knowing they can’t afford  to pay for medicines.

“Sometimes, we can’t send them away. Staff have to fork out the money to help them pay,” says Miriam Key, nurse manager at Buimo  clinic.

This is a NATIONWIDE MEDICINE SHORTAGE!

As much as  the politicians dislike it, social media gives a pretty accurate dashboard view of the health system from the  end user.  Charles Lee posted on Facebook about  how the medicine shortage was affecting his family in Mt. Hagen.

“Relatives in Hagen have flown to POM to seek medical treatment because of a shortage of drugs in Hagen.”

His post drew more than 20 comments.

Gloria Willie  said from Mt. Hagen:

“They just discharged a relative from ICU and we are taking her to Kundjip (Jiwaka Province)  today and if they are not allowed to receive  medical attention then, we are also planning to bring her to port Moresby. It is really frustrating.  But because of our loved ones, we are trying any possible way to have them treated.”

Melissa Pela responded saying:

“Same here in Kavieng. Patients told to buy Panadol and keep at home. If you feel something like fever/running nose etc.. just take it. They say treat it before it becomes serious because there is simply no medicine.”

The officer in charge of Barevaturu clinic in Oro Province, Nigel Tahima,  said by phone,  the  they are seeing an increase in the number of patients  because other clinics just don’t have  medicine.

The reports are flooding in from all over the country. There are too many to mention in one blog post.

If urban clinics are  a gauge to measure the flow of medicines from the AMS to  the patient, you can imagine what rural clinics are going through.  They are too far from the AMSs and too far to adequately monitor. The only way to get an understanding of their problems is when staff make contact or when you go there.


NOTE:  I personally sourced this information. 

Patients told to buy medicines at pharmacies as Lae’s urban clinics run short

medication-transparent-4Hundreds of patients are being referred to Lae’s  Angau Hospital and pharmacies as  urban clinics in city  run short  of basic drugs and medical supplies.

At Buimo Clinic, staff showed a near empty dispensary.  They have run out of antibiotics and antimalarial drugs including  the government approved  Mala 1,  used in the first line of treatment at  smaller clinics.

“We don’t have antibiotics like amoxicillin, septrin and chloramphenicol,”  says Miriam Key,  the officer in charge. “Not even primaquine which is used in combination with Mala1.  Primaquin is used to treat malaria parasites in the liver.”

Many of the staff at Buimo Clinic have never openly spoken about the drug shortages out of fear that they might be penalized.  But after battling with the problem for three years,  they have now  revealed  that the Government Area Medical Store has not been providing a regular supply of  the Mala 1 antimalarial since 2015.

Much of their medicines come from donor partners who should, ideally,  be supplementing the main government supply.  Along with bed nets, the clinic gets antimalarial drugs from Rotary Against Malaria – a volunteer organization which has become an important partner in the fight against malaria.

In August and September 2017,  when the supplies of antimalarial drugs ran short,  clinics throughout Lae continued to  refer patients to pharmacies for their medical supplies.  Pharmacies in turn, increased prices from an average of K40 per treatment course to K80.

“In that period our malaria stats rose significantly,” says Miriam Key.  “Many people can’t afford K40. They can’t even afford K2.

“We are dealing with the urban poor who can’t afford the pay.  We keep the clinic open even when there is no medicine just so we can give them proper diagnosis and then refer them to a hospital or a pharmacy.

“I’ve told families not to contribute money to funerals but to contribute to pay for medicine when one of them gets sick.  Lives are more important.”

The story is the same for  Malahang Urban Clinic, one of the busiest in Lae City.   Staff report that they received half of what is needed for the months of September and October.

“Patients often come back to the clinic because they can’t afford to pay for medicines at the pharmacies,” a staff member said.


This is a developing story. If you have any further information, please contact me. 

Stephanie fights a Kairuku crab in an epic battle of skill and guts

Had a fight with a Kairuku crab last night. It was an epic battle.

“On Guard!” I called, but the sneaky bugger charged for my toes. By now it was, it was on the kitchen floor with its claws raised and ready to attack.

It was captured at sea, and bound up so well and delivered to my humble abode yesterday.

We were yet to decide on its fate, when it masterfully managed to undo the cuffs and scuttle out of the dungeon’s cauldron.

The knight on duty tried to capture it, but with little experience dealing with the skilled Kairuku opponent, It slip through his fingers, almost chipping off a bit of the knight’s pointer with it.

An alarm was raised, and I was called in, I had my trusty bush knife on my side, a kitchen tong, and a saucepan lid, wide enough to use as a shield.

The battle measured skill, talent (and haircut) and experience and lasted for a good 30 seconds. I managed to blind him with a tea towel and dropped a pot over it.

That was the pot the we used to boil the water in, same speed.

crab
This is the culpit, by the way….

———————————

PS. My sister, Stephanie, has a day job at the green bank. But, as stated, she also has crab fighting powers and makes no secret of that amazing fact.

Lessons from a Japanese Foreign Service Officer: ‘Work is a gift and work is sacred’

work

On a bullet train from Tokyo to Nagoya,  I sat beside a  Japanese foreign service officer  who previously served in Papua New Guinea.  I’ve always found Japan fascinating and I  asked a lot about Japanese culture  and attitudes to various things including work.

He gave me a  few gems of wisdom which stuck ever since.

He said the difference between Papua New Guineans and Japanese is the manner in which they view the concept of work.

From my earliest memories of Sunday school, teachers taught that our daily toil was a form of punishment for ‘man’s’ transgressions at the time of Adam and Eve.  It is a narrative that affects how many people view work.  There is an ever present need to seek the pleasure of rest in the aftermath of work instead appreciating work in the present.

My friend said the Japanese, however, view work as a gift from the gods.  It is sacred and must be cared for and tended to like you would a garden.   The Japanese concept of work made a lot of sense to me personally.

Taking care of a job you have or the work you do and nurturing it is an act of prayer in itself.  It is thanksgiving for your physical abilities, your sight, your hearing, your intellectual ability and your very existence.

The work you do (and I do not mean just employment)  is like a seed given by a higher power. It is a gift that allows you to excel depending on how much effort you put in.   I am no expert in Japanese culture, but the Japanese have a word called ‘ikiagi’.  It’s easiest to think about ikiagi as an intersection or the common ground between:

For many, the mistake we make is to focus on the short term pleasures of rest instead of the high of long term achievement.  Sometimes, it’s difficult to explain why every aspect of life should be savored instead of dulled with intoxication.

The thrill is in the current. NOT in the aftermath. If you focus on the pleasures of what is to come AFTER work, it will be difficult to see the value of the fleeting present.

Work is a gift that exists in the present.

The Banab bridge in Madang still has NOT been fixed…eight months nau

Since the Banab bridge broke earlier this year,  both travelers and  locals have been  severely inconvenienced.   Every trip for  those headed for  Bogia and East Sepik,  costs them a lot to travel.

They pay  a toll to get across the bridge built by the locals.   They pay for  transport. And the local people have had to put up with conflicts  triggered by the rising lawlessness.

Earlier this year, a contractor was killed  at the bridge.  The killing further delayed progress.  The bridge parts have been lying idle  at the location.   For now, the locals say they are fed up with the delays.

b1b8b6b3b4b5b2b7

Alcohol abuse, a crisis that remains largely unacknowledged in PNG

OLYMPUS DIGITAL CAMERA
Taken from Indo-Pacific images 

In September, I went to the 70th anniversary  celebrations of my old high school in Popondetta.   I had not been back for 26 years. The place had  drastically changed in many respects.  Along the way on the Bishop’s 10-seater, we passed so many young men drunk on steam being pulled off the road by their friends.

The place had indeed changed.

When  we arrived at the school, the crowd was bigger. More young men drunk at the school entrance.  Some came from the village. Many others were students.  It bothered me a lot. You don’t realize how big the problem is until you go outside of Lae City.

In Popondetta,  the police have lost control.  I bumped into a senior officer who was in the school yard while we were  shooting pictures.

“We arrested two students,” he said.   They arrested two and let the others roam wild and free.

Many Papua New Guineans see the alcohol crisis in isolation when we shouldn’t.  Alcohol abuse is affecting everything around us yet we refuse to accept that we are experiencing a crisis that is destroying  us as a country.

Every one of us knows a relative or a neighbor who beats up his wife every Friday.  ‘He came home drunk.’  The verbal abuse, the rapes, the public harassment…  Nearly every major accident is caused by someone under the influence.  You can go to the accidents and emergency section of any major hospital and ask the emergency physician and they will show you the stats.

Last year, Dr. Alex Peawi, who heads the A & E section at Angau Hospital told me that eight out of every 10  cases brought in to the hospital after 10pm is alcohol related.  These are women beaten by their partners,  youths  stabbed during a fight in a block and so many other cases.  I bet you a hundred bucks, the stats have not changed.

In 2012, when I returned to Lae,  clashes between ethnic groups were very common.  Root cause?  Some drunk idiot harasses members of the community, he gets beaten up  them mobilizes his wantoks.  Boom! Ethnic clash! People displaced.

Police are sick of it.  They’ve seen enough of it.

In Lae, acts of being drunk and disorderly have become  largely subdued.  The police are able to pounce quickly and remove the culprits before  they cause harm to the community.

With  Lae’s  police toll free number,  citizens feeling threatened can call in anonymously, provide details and the drunk is removed quickly.  Again,  almost always,  clashes involving different ethnic groups start from  a single drunk or a group of them. Police have since been nipping the problem in the bud.

I see relative success in Lae City. But I see a steady decline in other smaller centers.
The police systems are weak and the community is afraid to take ownership of the problem simply because they don’t have back up from the law.

I say again that it is a CRISIS in every sense of the word. It’s not just the ‘drug bodies’ who are part of the crisis.   Every week, someone in Papua New Guinea  is disciplined and sacked for abusing  the company vehicle while drunk.  It’s become a common excuse.

“Sorry, em no mekim wok hariap…em kisim wara liklik lo nait na em silip.”

“Em spak na bamim kar.”

Every day, some drunk cop physically abuses a member of the public. Kids finishing off their grade 8 exams feel they need to ‘celebrate’   because everyone is doing  it.  I think we’ve gone wrong somewhere.

It’s a crisis that needs an acknowledgement by us as a people.  We have to admit that we have a problem and get help.