WARANGOI – Where It’s All Happening! –

Situated in luscious Pomio District of East New Britain province the 28 bed Warangoi Rural Hospital has been undergoing some exciting changes for the better this year.

July 2022 saw Warangoi Rural Hospital take on their first 5th year medical students from the University of Papua New Guinea for their rural attachment. Since Dr Micah Misivet began working at Warangoi Rural Hospital in 2020 he had been keen to have medical students and resident medical officers do training rotations at the hospital. However, due to housing constraints it had been a struggle until recently when suitable accommodation was arranged in the local community and Warangoi saw the arrival of his first set of students. Dr Misivet was excited to have his first set of students whose presence he felt “It (would) really enhance myself and my staff academically” as having the students required guidance and teaching from them each day of their 6 week stay.

Dr Micah Misivet is the sole doctor at Warangoi Rural Hospital and with the help of his in hospital staff, 3 of his 5 functioning aid posts and health patrols, they provide healthcare to the approximately 14,686 people who reside in the 8 wards of the hospital’s catchment.

UPNG 5th Year medical students on rural block rotation
Susan Walizoba (L) and Bevris Boone (R)

A few days after the arrival of the students the internet wifi by Light Speed was installed at the hospital. Dr Misivet is a MMed Rural Medicine (UPNG) trainee. Part of the MMed Rural Medicine program’s initiative is to equip their trainees with effective, quality telecommunications capabilities to allow them to access virtual continued medical education workshops, tutorials and other online learning facilities as well as allow them to network and communicate with other fellow colleagues as rural practice can often be very isolating experience.

This new satellite set up came on the brink of the PNG Rural and Remote Health Society commencing its inaugural monthly virtual CME conferences. As a result Dr Misivet and his students were able to join that CME conference discussing Anaesthesia in the Bush.

Many of the rural or district hospitals across the country do not have reliable telecommunication services available to them. The installation of the Light Speed satellite has dramatically improved the telecommunication capabilities of Warangoi Rural Hospital. Now communication for referral of patients is more reliable and a WhatsApp referral group has been created between Warangoi Rural Hospital and the medical officers and SMOs of Vunapope Hospital and Nonga Hospital adding to this convenience. Dr Misivet uses the new wifi for internal CME conferences for all staff at the hospital as well as attending external CMEs being hosted by the UPNG and the PNGSRRH.

L-R: MBBS 5 student SusanWalizoba, Dr Micah Misivet, Dr Gabriel Yohang, MBBS 5 student Bevris Boone

Later in August saw Dr Yohang, Head of Rural and Generalist Medicine, drop by Warangoi during his East New Britain supervisory visit of Vunapope, Warangoi and Palmalmal hospitals.

As the new department of Rural and Generalist Medicine of the School of Medicine and Health Science (UPNG) establishes itself, integral to its development is ensuring its trainees – medical students, resident medical officers and MMed registrars – are well supported to achieve their training objectives. Dr Yohang’s visit was a welcome encouragement to the trainees and their respective hospitals.


Medical Officers and RMOs from Vunapope Hospital, Warangoi and Palmalmal Medical Officers with Dr Yohang

JULY VIRTUAL CME

Featured

Dr Siaelo Panta is MMed Rural Medicine registrar working at Misima District Hospital on Misima Island in Milne Bay Province

In a bid to help our MMed Rural Medicine registrars prepare for their part 1 exams we have asked a few of them to share on topics relevant to their surgical assignments and upcoming exams.

Brush up on your surgical infection knowledge, push our registrars to expand their learning or tune in to help your own preparation to complete your surgical assignments and exams.

In Service Is Key

June 6-9th 2022 saw the Nazarene Health Ministries (NHM) reach out to the officers-in-charge of their 9 rural health centre facilities and bring them to home base for some long overdue investment in their professional medical knowledge.

Per the words of Dr mark Crouch:

What a privilege to take part in teaching and training for the Officers-in-Charge at NHM’s Rural Health Services clinics.  Coming from Madang, Southern Highlands, Morobe, Jiwaka Provinces – as well as NCD – it was the first time NHM collected these impressive people together to create fellowship and impart some practical tools for improving the care they provide at our rural health sites.

Included in the week’s activities were updates on record keeping and reporting, refreshers on TB and HIV care, a maternity skills workshop, and training in the proper maintenance and use of solar power.

Pleased to be a part of this and many thanks to our workers and our Rural Health Services director – Gabriel Mahisu (DGN, MPH) – for making this happen!

Dr Mark Crouch seated with Sr Leah (OIC PHS, NGH) practising vaginal delivery manoeuvres on the mannequin

Dr Mark Crouch demonstrating the same with NHM rural health facilities OICs

Nazarene Health Ministries operates the Nazarene General Hospital in Kudjip in Jiwaka province as well 8 health centres scattered throughout the mainland of Papua New Guinea.

Monthly Virtual CME

In a bid to continue to connect doctors and the entire cadre of health professionals serving in the rural areas of Papua New Guinea the society will on the first Thursday of each month host a virtual medical education seminar open to any medical professional.

As all health workers know medicine is an ever evolving art and we are students for the entirety of our professional lives.

Commencing this afternoon the PNG Society for Rural and Remote Health will be hosting monthly virtual CMEs open to its members and any interested health workers.


Apologies on the incorrect date which should be 7th July 2022. Our very own former society president, Dr David Mills will kick off the monthly seminar. Please find zoom links as follows: Meeting ID: 884 6136 8026 Passcode: 261340

Annual PNG Rural Society meetings Sept 4th and 5th, 2015

This years meetings of the PNG Society for Rural and Remote Health are being devoted to the issue of “Encouraging and Supporting Careers in Rural Health”.

Download the program here. Program 2015

Given the media coverage and social media debate this year on this important topic, we decided to make it the theme of our entire meeting.

We will be having a series of speakers, from Secretary of NDOH, Pascoe Kase, Deans of both SMHS (UPNG) and Divine Word University’s Faculty of Health Sciences, CEO’s of WHP and Milne Bay PHA’s (James Kintwa and Billy Naidi) , Professor Glen Mola (discussing the residency program), as well as current serving rural doctors, residents and medical students.

The aim is to get as wide a perspective as possible on this critical issue, and aim to make resolutions that can give us a roadmap for the way forward.

There is a strong feeling that something needs to be done NOW, before our medical culture becomes ossified into an urbanized, privileged clique that is not only unable to help the rural majority, but culturally unqualified to do so.

Health Extension Work - Kerowaghi District

Health Extension Work – Kerowaghi District

The PNG Society for Rural and Remote Health will be holding its meetings on Friday Sept 4th at Holiday Inn (Ballroom 2 and 3) and on Saturday Sept 5th at SMHS (UPNG), New Lecture Theatre 2.

Registration is not required to attend the Society meetings only (but is required to attend the preceding symposium). Food is complimentary.

Get along and have your input. We expect it to be a vigorous discussion!

More than half of PNG’s districts have no doctor.


“Doctors Short!” Stating the obvious perhaps, but this was the screaming front page of the Post Courier on May 25th.

Doctor distribution - May 2015

Reviewing the current status of the medical workforce outside NCD, 49 of the 88 districts had no full time doctor present. This represented a population (using 2011 census data) of over 3.24 million people without access to medical care.

Given the fact that doctors based in provincial centres are for the most part not covering populations outside the LLG in which they reside, it is certain that a LLG by LLG breakdown of this data will give an even greater sense of urgency to the crisis.

Debate pending during the Annual Medical Symposium

This years Annual Medical Symposium, to be held at the Caritas Hall, East Boroko in Pt Moresby promises to see the debate on rural doctors pressed further.

At Tuesday lunch, a formal debate will be held on the resolution “Training doctors to work in rural areas is likely to make NO significant difference to the health of rural Papua New Guineans.” 

So far as we know, its the first time a debate has ever been conducted at the Symposium and comes at a time when the discussion has been hot in the media. Headlines such as “Rich Doctors” (refusing to go and work rural) has seen plenty of passionate comments exchanged on social media platforms.

There will be 8 debaters; For the Affirmative Team – Dr Trevor Kelebi (Rural Specialist, Sandaun PHA), Dr James Naipao (National Doctors Association), Dr Athanasius Kari (MMED Rural 2nd year and Med Super at Raihu Hospital), and media personality Scott Waide from EMTV news.

For the Opposing team we have Dr Magdelene Taune (MMED Rural year 6 from Mingende Hospital), Dr Nora Dai (Womens Doctors Association), Prof Glen Mola (needs little introduction to all doctors in PNG), and Dr Kapua Kapua (final year resident – representing the undergraduate trainees.)

It promises to be a very lively event and hopefully will continue to stoke the discussion about the inequities in health care in PNG.

5th year UPNG MBBS students going rural – and loving it!

The last 2 years as seen the School of Medicine and Health Sciences at UPNG revive its rural exposure for final year students.

During the 1970’s PNG had a rural health program for medical undergrads that was world leading, but unfortunately this was allowed to slide. However with assistance from the Australian Govt through its HECS program, the School has now invested in this important 8 week rotation. Students are being flown all over the country to rural hospitals, often partnering with MMED (Rural) grads or registrars.

Buckle up - flying to Lapalama HC

Buckle up – flying to Lapalama HC

The result has been a tangible excitement amongst the 5th years for their upcoming “rural block”. Currently students are being sent to Mingende (Simbu), Kompiam (Enga), Raihu (Aitape, Sandaun), Veifa (Central), and more recently to Vunapope in ENB. We are looking to expand the number of hospitals being used, so contact the Society if your hospital may be interested in hosting 5th years.

Around the fire - Tekem, Enga

Around the fire while on patrol – Tekem, Enga

PNG’s first rural specialists!!

The 9th of April 2014 was a major landmark in the journey of rural health services for PNG, when Drs Trevor Kelebi, Gabriel Yohang and Felix Diaku, became the country’s first graduates of the MMED (Rural) program.

After 7 years of arduous post graduate training (all done while holding down full time Medical Superintendent jobs at their respective rural hospitals), they successfully completed their Part 2 exams in October. With completion of their last assignments and research project, and it was all finally done.

The first MMED (Rural) graduates - 2015

The first MMED (Rural) graduates – 2015

For those of us cheering them along the way, the graduation of these three young men represents a new beginning – with more coming through the program and with interest steadily growing, we are very hopeful that we will see a renaissance in interest in Rural Medicine amongst the medical fraternity, as these graduates increasingly become the advocates for change.

New Files added under Continuing Medical Education.

Two new files have been added under the Continuing Medical Education section on the site.

1. Neonatal Care Minimum Standards

PNG Med J 2000 Mar-Jun;43(1-2):127-136
The effect of introduction of minimal standards of neonatal care on in-hospital mortality
TREVOR DUKE1, LENA WILLIE1 AND JOYCE M. MGONE1
Department of Paediatrics, Goroka Base Hospital, Papua New Guinea

2. The Clinical Use of Oxygen March 2012

The clinical use of oxygen in hospitals with limited resources
Guidelines for health-care workers, hospital engineers and managers

The World Health Organization
Editor: Trevor Duke
March 2012