PNG unable to address doctor shortages

Transcript

Angau Hospital, Lae, Papua New Guinea Photo: RNZI

Papua New Guinea doctors say the country's inability to address staff shortages has reached critical levels with recent figures showing three to six million people have no access to medical care.

The President of the PNG Society for Rural and Remote Health, David Mills, is calling for an immediate international intervention to improve the situation.

Dr Mills told Koroi Hawkins what he finds alarming is that the terrible situation has gone on for so long that people in rural areas have become resigned to their fate.

DAVID MILLS: Really what they are saying is that more than half of PNG's districts at the moment have no doctor present and the average population of those districts is over 80,000 people. And so you are talking about a minimum of three and a half million people who not only have no doctor present but have had no doctor present for often many, many years. So it's a really, really devastating situation and we are trying our best to raise awareness on it.

KOROI HAWKINS: So the consequences of this? People are basically suffering and probably I would assume passing away from basic illnesses that are treatable and preventable.

DM: That's right and I think part of the difficulty is that it has become so commonplace in PNG, it has almost been accepted as the norm and we are really saying, no, that is not good enough. You know we are not going to accept that and not only wake up the public but also wake up the doctors. I mean the difficulty for PNG is that the doctors we do train, 95% plus of them live in the towns. But in PNG for your listeners if you don't know 87% of our population doesn't live in towns. They live in these remote and rural localities so it's an extreme inverse of the doctor and patient distributions that we are trying to combat here.

KH: And the government has been promising to step things up and to improve the situation? Are there any signs that they have been trying to do this or attempting to alleviate the situation?

DM: You are really putting me in the middle now. Look I think there are some people of goodwill out there who really do want to see change but in some cases they feel like they just don't quite know what to do and so that is part of where the society is trying to put its hand up and say look there are people who have got experience in the field out there, lets sit down lets talk together and we can give you some ideas as to how we can move this forward. So you know I don't want to be too critical of government. They have an important role to play and really what we are trying to say is 'look, enough's enough. We really need to sit down and make some decisions because the situation is not just bad it's dire'.

KH: And how would you as a doctor yourself, how could you attract doctors to the rural areas or to live in remote areas and serve populations in places where they don't have access to what they have access to in the cities and the towns?

DM: Yeah, look that's the million dollar question isn't it and it's not just a question for PNG of course it's a question all over the world. In fact I am speaking to you from Darwin. I am at a National Rural Health Conference here and many of these same issues are being talked about. What is different in PNG is that you do have this incredible demographic that's so different. In most countries, New Zealand and Australia, you do have significant rural populations but they are a minority but in PNG we are talking about the vast majority of people are living in these rural places. So that is what makes the issue so acute. So to answer your question, what can we do? Well one of the very, very important things is how we train our medical students and the sorts of exposure we give them to rural health earlier on and many of the donors are seeing this and they have started to contribute towards the medical school. It is an area that our government really needs to take on. The vast majority of our only medical school's funding actually comes from donor sources and not from government which is quite astonishing. But we need to spend money to get medical students out to rural places so that they start to actually see. Because the new generation of educated Papua New Guineans, many of them have lived all their life in the capital and they have never actually been out to rural places and of course that is not good if you are then trying to interest them in getting them back to a bush they really have no understanding of. And so getting the medical students out to high quality district hospitals, giving them very good placements, very good training and exposure to rural health that is an incredibly important starting point.

KH: Is this though, a problem too big for Papua New Guinea? Would you see a role for the international community, for the World Health Organisation and others to step in and assist?

DM: I think I would have to say in all honesty, I think it is too big for PNG, which is not a criticism. It's just that I think we need to be honest and say at this stage of our development that their are certain tasks for which we are going to need help and this is one. You know the logistics are so difficult, getting out to these places, the numbers of staff on the ground are so few at the moment, it may well be that for some years we are going to need outside help to try and address this issue. So a difficult issue, probably a bit of a humbling one for us as a country, but nevertheless I think that is the sort of pill we will need to swallow if we are going to make any progress.