PNG: Excerpts and Lessons Learnt

A month of my life that changed my world-view. Where, twenty days home, I can still hardly remember whoever I was before I left.

Here are a few excerpts from my journal that might explain some of why this place gets under your skin and stays there.

First impressions:

As we walked towards the hospital, I wondered what on earth we had gotten ourselves into. Here we were, looking at a hospital built in the 90s by the Japanese. A hospital that, despite its windows, looked like what I would imagine for the Ministry of Love from 1984. It looked like it would sap away one's soul. Dirty, ugly and a growth out the dry, hot land. We walked in, past sick families gathered at the hospital, past women with small children, past people who looked very sick. We made it in the doors, to a smell that wasn't at all familiar. A mix of sickness, dirt, sweat and humidity. A mix of things we're not used to in hospital. The hand rails were torn off, windows smashed in, bars on windows forced open or missing. Signs were damaged. Only written in English. Long queues and congregations of people gathered at junctions in hallways. What could we possibly do to help here?

The wards look much safer. Like I'd almost be happy being a patient here. The ICU looks like something out of the 1960s - but state-of-the-art 1960s. People smiled at us. I started to feel a little like I could cope here.

The paediatric ward had a little school up the back. The surgery area looked very hygienic. The surgical wards were full to the brim but functional. The high care ward had fancy new beds. 

We walked past a man whose face had entirely been stitched back together (Little did we know what this meant at the time. Tribal violence.). I wondered how the scars would heal.

We visited the Heart Research Institute, apparently funded by the wife of an early PNG politician after his death from a heart attack. So many of the politicians here seem to be Australian or married to an Australian.

We arrived to find the birthing suite - all 24 beds (in a ward that has 40 births a day) - air-conditioned. We thought we could probably handle this. The cool made us feel that much more positive. The antenatal care area was filled with women waiting patiently. So many women. So many pregnancies. It's no wonder, in a country that has >50% of its population under 15 years old and where the population has doubled in the past few years. Incredible.

Just as we were starting to feel comfortable, the doctor told us about the time his car was stolen. At gunpoint. With his baby son in the car. They only just managed to get their baby back. This was only a few months ago.

What have we gotten ourselves into?

Adaptation

Our second morning. We wandered down to the hospital - seeing things we didn't see yesterday. Realising how quickly you get used to things. The broken handrails, the smashed windows all seem normal now. The smell of the hospital hits us less strongly.

We went to do ward rounds and switched between doctors as they spoke to patients and then did the paperwork. Listening intently as they gave us lessons. Constantly awed by their immense knowledge and the frustration they must constantly feel knowing the answers but not having the resources. In a full ward teeming with tiny babies, they hold their cool despite the prevailing heat.
The mothers all loving and caring for their babies, seemingly unperturbed by their tiny size. No tears. Mothers crossing the ward to speak with friends. So many beds all in a row, all covered with their own sheets because none are provided. 

How are people at home not aware of how lucky we are there? And why do we know so little about PNG?

One of the doctors took us up to the snakebite research labs. They have so much technology in that little room. You wouldn't know you were in PNG there. Or that POM Gen was only metres away. So many of the health professionals here have spent time training in Australia or elsewhere in the world. They've seen the most amazing health facilities and the ability order any test you like, whenever you like. They've also come home to X-ray machines that don't always work, to blood tests that take three days to turn around. But they keep on keeping on. They're really passionate about the health system here. Passionate about making it better.

One of the patient's my travel buddy admitted was screaming, in Tok Pisin, "I will report you ALL to my Daddy" over and over while he tried to take some blood for a test. I guess kids get pretty upset about needles here too. Here was a kid with a fever who was stressed by her illness and by the hospital. She was scared.

We saw some young boys and men playing football in the space around the hospital. A safe space to relax, to enjoy some time while family are sick. A bonding of community. It was really beautiful.

Time away from hospital makes me feel lonely.

Where is the hand rub?

The first person we saw on our first trip to ED was a guy with a spear in his abdomen. A spear. In his abdomen.

I'm a tiny fish in a wild ocean. And I don't know what I can do to control the waves pummelling the world around me. Swim, I guess.

How can people attack their partners? Even if you don't love them, surely there's some basic respect for their being human?

Today, we postponed a death. But only by a little. Only by an hour.

A few messages from home were the only quiet reminders that it was Christmas.

Yesterday, we saw a tiny little tot in the NICU. The little thing needed the heat lamp on and a pair of gauze protective sunnies. Today, that bed was empty. He died. Life is so fragile. Precious.

Today, I assisted on my first ever surgery. A C-section. I was so excited to see how they do surgery here. And to bring a little baby into the world. But the baby was stillborn. Apparently gone for a few days. I can't imagine what that must have been like for the mum. Standing there, even with my very minor role, I was so aware of how if I stuffed something up, it could be fatal for mum. And that's really scary.

The city

The buildings mostly looked weathered by age and the climate. Untended. There were very few people on the streets and next to no traffic. Everything was locked up. Most of the buildings were banks or industry. Fancy ANZ and Westpac offices on the man-made extension to the promontory. It was so quiet. It was eerie. It felt like a ghost town.

Drifting through the markets, items were labelled with costs rather than leaving us to barter. I was surprised by how expensive everything was.

Life lessons and realisations

At the moment, this is my life. Here. In PNG. Where the most stressful thing I do is admit a patient and the most life stress I have is getting TB. Life here is visceral. You're in the moment. You worry about the patients NOW.

It's great to be living in the present. My assessment is how well I do each task and how little I make the kids cry. The focus when I'm free is reviewing what I'm learning. I'm here. Now. Being. It's so refreshing. I'm not worrying about next week or tomorrow.

Medicine isn't the answer - we might patch people up but what stops these things from happening? How do we reduce infectious diseases? How do we reduce tribal violence?

Life is no longer a me. It's a we. We do this and that. We're a good team. Despite having hardly spoken before coming here, we've had a lot of fun and gotten along really well. It's great having someone around who understands life and home and has many of the same feelings of being overwhelmed.

There's something about new friends, about fresh friendship, that's wonderful. Every moment is special. New. Exciting. And it doesn't really matter if you end up being friends forever or just for a moment.

Everyone seems sad that we're leaving. Either we made a mark or people just get rather attached here. That said, I'm going to miss POM Gen and the people. But I'm the one passing through. People here have their own lives, their own friends and things to occupy them. It seems special for them to miss us.

I'm learning so much. You really do learn by doing. I can feel the progress. I'm starting to understand how everything works. And I'm getting excited about medicine.

I cannot believe the dedication of the doctors here. They work their behinds off day and night without complaint. They improvise. They work with minimal resources. But they do a great job. And I never feel like anyone is getting sub-standard care.

It doesn't really matter what a place looks like, you end up coping. You make it work. Because you have to.

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