Volunteers

Lucy was my mentor and companion during my visit and I thank her for her friendship and for sharing so much of the ‘ways of doing things in Goroka’. The group photo is of the Monash Goroka Alumni and in the meeting we had there was so much energy and enthusiasm with each person talking about what they have been doing in their nursing career since studying at Monash and their hopes for the future. We spent time talking about research and nursing leadership and how it is up to us as individuals, within the organisation, to make a difference in the care we provide and to help others to reach out and to do the best possible. There are many examples of good practice, in health care delivery, within the hospital. The request for further undergraduate programs was taken to the Head of School and the Dean of the Faculty of Medicine, Nursing and Health Science and we are forming a committee to look at how and when we could implement such a program again.

Working with all the staff was for me enjoyable…I aimed to have them tell me of their good work and achievements and how they do so despite a poverty in essential resources. They were able to recognise that even though there are limitations in equipment and qualified staff, it is still possible to create culturally appropriate and sensitive care for unwell people and their families and to be person centred.

Diane and Simone also achieved their aims, to provide antenatal care and to be with birthing women, to work with the local midwives and to maintain high standards of care. Care that would meet the Australian Nursing and Midwifery Council standards of practice. What was important in this for me, was to see how these students translated their skills in a new and challenging culture,  in practice, in environment and among people who understand and speak a different language and experience a different lifestyle.

We received a wonderful welcome by all we met, those in the hospital and people in the streets and markets. Sonia  always kept us safe and ensured that we were able to experience wonderful opportunities such as a local wedding and a lunch with friends, sometimes we spent many hours at night talking, talking, talking about everything! As only friends can do. In what we were experiencing, sharing our thoughts, telling stories, and writing our journals, Sonia was always supportive. Thankyou ever so much. Thankyou also to Dr Jo and your many colleagues who made us welcome too and for the provision of vehicles and drivers to ensure we were able to get out to the health centres, to shop for provisions to give to the birthing women, to the markets to buy fresh produce.

Many people shared their plans and hopes for a bright new hospital, and we wish you well on this quest. But in the meantime we send you our best wishes and our thoughts, and thank everyone for what can only be described as a remarkable experience with remarkable people.

Kind regards

Dr Kay McCauley-Elsom
Senior Lecturer
Bachelor of Midwifery Coordinator
School of Nursing and Midwifery
Monash University

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.

Story by Jenny Balnaves (Visiting midwife from the Highland’s Foundation)

We arrived here, four midwives from Australia.

One, Nicole returning for the second time and the other three Deb, Mary and Jenny who were here for their 1st experience in PNG.  Our expectations were all different.  Nicole wanted to focus on neonatal nursing as her recent background is working in a Neonatal Intensive Care Unit in Melbourne.  Deb and Jenny have been midwives for some years and Mary is a student midwife that has almost completed her training.  Mary’s focus was to complete her clinical experience in order to attain her qualification on return to Australia.

One major plan was to ensure the safe delivery of a container full of health equipment, mother / baby packs and other health necessities but unfortunately this did not arrive due to unforeseen problems.  what is in the container is meant for many of the outreach health clinics as well as Goroka Hospital and we hope that when it finally does arrive the staff here will work out Nicole’s plans and ensure all those goods meet their appropriate destinations.

We have encountered many different people and fortunately our contacts with PNG people have been without incident.  The people here are a gentle race and are beautiful in the way they respond to our greetings.  The labour ward is a constant hive of activity with women arriving in labour at any time of the day or night.  The full time team who work within the ward must feel great satisfaction in knowing their job is to ensure safe birthing for both mothers and babies.  The many “pikaninis” whose births we have witnessed will at some stage be reminded by their mothers that they were touched by white “meri’s” who came to work with the local staff.  Having come here has given us strong objectives for our next trip through the Highlands Foundation and we are immensely grateful for having had this experience.

We would very much like to thank Sonia, and Lucy for showing us their PNG way of life.  Sonia took us to her village one weekend and this gave us much insight into her “wantoks” world away from the hospital.   Through the Clinical outreach Group we visited Nupuru and Kainantu.  We saw conditions that are very basic, and the main impact for us was how the hard workers cope so well with so little.

There are still great inroads to be made in this environment as equipment is minimal, but through it all people work with a hope for the future.  With confirmed support from such groups as the Highlands Foundation there will be a future for all.

So many stories and so little time to say what we feel.

Tenkyu tru Goroka.

Lookim yu bihain.

Story by Tom Blanks and Will Kerss (Visiting medical students from Nottingham Medical School, England)

We are Tom Blanks and Will Kerss, two recently qualified doctors from Nottingham Medical School, England. We are given a 9 week elective period following completion of our final exams. We heard good reviews from other English medical students about the hospital and decided to travel to Goroka General.

Having arrived at Goroka airport from England after a long series of flights, we were immediately taken under the wing of two residents and one registrar, who took it upon themselves to get us sorted out with accomodation in a local hostel.

On our first day at the hospital itself; the DMS, Dr. Frank, took us on a tour of the hospital and allowed us to familiarise ourselves with the layout and grounds of the site. We were allowed to set our own itinaries, splitting our time between Internal Medicine, Surgery and Paediatrics.

Will began on Internal Medicine being thrown in at the deep end by joining on a ward round.  Each day the ward rounds continued until lunchtime and were followed by ward work in the afternoons.  the doctors were incredibly keen to get me involved with procedures which spanned from placing nasogastric tubes, to performing pleural and abdominal taps as well as lumbar puntures solo.  This  improved my skill set as back in England doing such procedures at our stage of training would not be possible.  I was also exposed to illneses such as Typhoid, TB and malaria, all of which are very rare in the UK and hence broadened my knowledge of such pathologies.  After medicine I spent some time on the surgical ward and was able to assist during theatre, and perform incisions and suturing during the minor operations.

Tom began on Surgery and from the first ward round onwards noticed the massive difference in pathologies from the UK. On this ward round I was exposed to abdominal TB, neurofibromatosis and typhoid perforations; conditions unheard of in the UK and as such fascinating. One of the most impressive aspects of the ward-work was the ability of the residents to adapt their techniques and skills to fit any situation and get a job done despite setbacks. My time spent in theatre was equally impressive, with residents at our stage performing single-handed appendicetomies, abscess drainages and suturing; tasks performed by much higher grades back in the UK. I was allowed to take a very active part in both ward work and theatre; from suturing to plastering. I then moved to Medicine; and was thrown straight into performing lumbar punctures amidst a vast array of TB presentations; again a extremely interesting experience. My final attachment was in Paediatrics, where again I was allowed to perform venepuncture, cannulation and lumbar punctures; vastly broadening my practical skills and clinical experience.

Both of us would like to thank all of the residents, registrars, nurses and consultants that made our stay such an incredibly interesting and enjoyable experience. We both had a fantastic time and return to the UK with a far wider understanding of medical challenges faced by other countries, as well as a greatly improved set of clinical skills! Another thank you to all of the administrative staff that helped us with accomodation, internet usage and settling into life in Goroka; and a last thank you to all the staff of the IMR, especially Lawrence for all his help.

Story by Sr. Lucy Mahabi (Deputy Director Nursing – Rural Outreach Services)

The Rural Outreach Services team was up at 7am and left at about 8.20am for the Nupuru Health centre visit on the 29 /04 /09. When we arrived the patients were waiting to be seen by the team.  We quickly sorted ourselves out to the rooms allocated by the health Centre staff. Then we started seeing the patients booked for us.

We had two Australian Visiting midwives from the Highlands Foundation (Debbie & Jenny) with us that helped with screening of all antenatals. And prior to that we gave some baby packs to the waiting mothers which they were asked to bring with them during labour. This is one way of encouraging women to deliver at the Health centres rather then a village delivery without supervision.

We also handed out knitted wollen baby clothes kindly donated by the Highlands Foundation and Rotary to several children that were waiting with their mothers.

There was one delivery attended to by the Australian visiting midwives and in the true spirit of Highlands culture the mother decided to name her newly born baby boy after Debbie’s husband. Although we had to improvise during the birth our Australian friends seemed to cope very well.

The total number of patients seen on the day was about 112 (Paediatrics 4, Medical 37, Surgical 3, Physiotherapy 14, Dental 14, Gynaecology 20, Antenatals 20 and 1 delivery).

All on all we had a very productive and rewarding visit to Nupuru Health Center – we finished at about 2.30pm, had a late lunch and left to return to Goroka at about 3pm.

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