Story by Sally Keat, Matthew Tate and Alex Bown (Visiting medical students from Sheffield Medical School, England)

We are Sally Keat, Matthew Tate and Alex Bown, three fourth-year medical students from the University of Sheffield in the north of England. Our elective period allows us to experience medicine in a different health care setting; as all of us had long been interested in visiting Papua New Guinea, we jumped at this opportunity. Goroka General Hospital was the natural choice when we were looking at where to spend our elective as it is one of the foremost hospitals in PNG and we had heard very positive things from previous visiting students.

During our time at GGH we rotated through the various departments: adult medicine, paediatrics, labour ward, ophthalmology and the Michael Alpers clinic. Each department made us feel very welcome and the staff were unfailingly friendly, helpful, and enthusiastic for us to get involved.

Our first impressions of the hospital were that it was obviously very different to the hospitals we were used to at home. Despite the limited resources however, we were immediately impressed by the staff´s ability to deliver efficient and effective health care to the populatin of Eastern Highlands province. In the UK, doctors are increasingly reliant on expensive and complex tests and investigations. Doctors here must rely heavily on their own clinical judgement, and so excellent practical skills are vital. We shared the frustration of the staff that simple investigations (such as X-ray and routine blood tests) were sometimes not available, but the healthcare team worked tirelessly to minimise the effect of this on patient care.

Part of the reason we wanted to come to PNG was expose ourselves to a very different disease spectrum and gain experience in the management of problems that we see only very rarely at home. The main burden on the healthcare system in PNG is infectious disease rather than the lifestyle diseases (such as heart disease and diabetes) that we commonly see at home. The main problems we have encountered have been tuberculosis (often advanced and involving multiple body systems), HIV, typhoid, malaria, pneumonia and diarrhoeal illness. Although we don´t see a great deal of these problems at home, they form a huge burden of disease globally and are very important to have experienced and have a good understanding of.

Each of us has had the opportunity to improve our own set of clinical skills by working alongside the doctors on the wards and in A&E. As well as gaining lots of experience of day-to-day ward work that will be invaluable when we start work as junior doctors next year, we were also very lucky to have had training and been supervised performing a number of procedures that are not usually taught at this stage in our training in the UK.
We were able to see cutting-edge cataract surgery in the ophthalmology department which is not available anywhere else in PNG, and for which some patients had travelled hundreds of miles.

Although understaffed, the highly-skilled doctors and midwives on labour ward provided a very high standard of care for expectant mothers.

The Michael Alpers clinic is working in conjunction with the Clinton Foundation to implement high quality HIV care and provide education to the community about HIV/AIDS as well as sexual health issues.

The doctors on the adult medicine and paediatric wards have to be true generalists to deal with any medical presentation, which they do expertly.

Although Goroka can be a frustrating place to work, with limited resources, it is also a highly rewarding place to work. We would like to thank all the medical staff for allowing us to get involved and taking time out of their busy days to teach us. We would also like to thank all of the administration staff who have helped to make our stay so enjoyable and productive.

We not only learnt a huge amount during our time in Goroka, we were also able to spend time in an amazing country, one which we all hope to return to in the not-so-distant future.