Transcript
At Port Moresby General Hospital, the gynaecology department's been out of drugs for weeks. The head of department, Glen Mola, says they're running low on most things: painkillers, bandages and, recently, syphillis testing kits.
"Syphilis testing is really important in our practice because four percent of our pregnant ladies are found to have syphillis in their blood by testing. So that's about 100 a month. We deliver nearly 1,500 babies a month. But the important thing is you have to test everybody, you can't predict who the four out of 100 will be."
Professor Mola says a bulk supply of kits is supposed to come about twice a year. The latest one is two months overdue. He says babies have probably died because of the shortage.
"we've had more stillbirths. We just don't know because we can't test. So you know, you get to the audit meeting at the end of the month to see why babies die, and then there's some big babies that didn't make it and you just have to wonder, could it be syphillis? We can't test. So you're just left thinking 'goodness gracious' perhaps we could have saved this baby's life, we don't really know."
It's not just testing kits. Last month, the country ran critically low on antiretrovirals, the drugs used to control HIV in the country with the highest prevalence of HIV/AIDS in Asia. When the order didn't come, Professor Mola's hospital ate into its buffer supply, then doctors went around other clinics in the city trying to scrounge together some stock. He says the drugs are critical, and if treatment is interrupted, a drug-resistant form of HIV can develop.
"We don't have the drugs for the resistant virus, they're much too expensive for us. In other countries, New Zealand for example, if you're found to have resistant virus because you've interrupted your treatment, then you would be put on second line or third line antiretrovirals which are about 100 times the price. We can't afford these, so if people interrupt their treatment and then their bodies get taken over by resistant bugs it's just bad luck now, you're gonna die from AIDS."
When the antiretroviral shortage hit the headlines last month, the government finally ordered in an emergency supply. But that got stuck on the wharf for a week because, as the health minister told parliament, the woman at customs who could sign the drugs into the country was missing. Professor Mola's situation is not unique. 40 percent of the country's remote aid clinics have closed because of shortages, while others don't have supplies of power or water. The head of the PNG Institute of National Affairs, Paul Barker, says there's been no consistent health funding for years, and crippling shortages have become too common.
"Every so often there's a report, 'oh look it's just been fixed, we've got something in.' But then of course a week or so later we sort of seem to be without again. You can't just provide it one week and then have a big gap - it's absolutely crucial that you have regular provision."
Dr Barker says the crisis is part of a wider cash flow crisis that's seen teachers go unpaid and public servants locked out of offices because departments haven't been paying rent. A few years ago, anticipating great riches from a liquefied natural gas project, the government brought in free healthcare, and banned clinics from charging patients. But Dr Barker says the oil money never came.
"We introduced the tuition free education and the free health. Service providers were then being told 'you can't collect these funds' and therefore the money that was being available for the government and church health services was actually having to be stretched further because that supplementary revenue wasn't able to be gained."
The health minister, Sir Puka Temu, is yet to respond to requests for comment, but insists the government is working hard to solve the shortages, and has actually increased the health budget. But obstetrician Mary Rose Bagita, who says she's recently had to work with no running water, says the money's not reaching the hospitals.
"So even though we are told that there's some money available and it's to help the health system. Unfortunately, those at the health facility levels, we don't seem to see the effect of that money."
But Professor Mola says part of the problem is priorities. When the government was confident of oil riches, it went on a spending spree in Port Moresby: flyovers and new stadiums popped up, and for two days this year, PNG will host the glitzy APEC summit, for which there will be a new multi-million dollar conference centre.
"A lot of money is being put into APEC, hundreds of hundreds, perhaps a billion or something, has been spent on infrastructure for two days - the meeting's for two days. I mean I'm not an expert in this area but it just doesn't seem logical to me. Meanwhile there's no money for health."
Everyone in a health sector on its knees says there needs to be urgent - and substantial - reform, from the way drugs are procured, to the bureaucracy that gets them in, to how staff are paid. Paul Barker says that push for substantial reform is even coming from overseas. But so far, as PNG goes through its latest crisis, there seems little prospect for change.