Saturday morning we had a leisurely time waiting for our transport around town. The wontok system in PNG is rife and whether you know it or not you become part of that system by your mere presence. Wontok is where family members and relations, however distant, sort you out. If you need a place to stay you go to your wontok, if you need money to travel to the health centre you discuss with your wontok and they'll sort you out. We were going to be driven around Wewak by a family friend.
The vehicle arrived at 10 and we went to the local stationary shop to buy exercise books and pens for the people who were going to attend the training sessions. We did not see another white person anywhere. Then we went to the local supermarket that had hordes of people spilling out onto the streets. It was shoulder to shoulder, hip to hip in there, so we kept a close handle on our bags. I saw one old white lady and a young guy. There was a reasonable variety of food available – plenty of items that we see on our shelves as well but very expensive. We stuck to simple and cheap – tins of tuna, dry crackers, weetbix, milk powder and then lashed out and bought some bread rolls for lunch with cheese. Next we stopped in at the local market to buy some tomatoes, greens and peanuts. As we walked to the market, our driver Peter, spotted his sister-in-law who is the Director of Nursing at Boram Hospital – the main hospital in Wewak. He introduced us to her and mentioned that we were hoping to visit the hospital and meet with the Obstetrician. Classic wontok action!! She made a few calls to the hospital and arranged for us to meet the hospital supervisor after lunch.
The hospital is way out of town on a very flat piece of ground that looks like it floods regularly. We were met by Sister, the hospital supervisor. We were welcomed warmly and she took us to the maternity section of the hospital where we met the midwife in charge of the postnatal ward and had a bit of a chat. It really was a shock to see as the condition of the building was really bad – flooring lifting and peeling, holes in the floor, wooden doorposts rotting, the bathroom was smelling of urine. The midwives we met had been recently trained by Australian midwives in Madang – their documentation was really good, but they were working in difficult conditions in a building that if it was in Australia would have been condemned and bull dozed years ago. The beds had very poor mattresses on them that were ripped and had no covering. Many of the women were lying on the floor because it was cooler there. The one hand wash basin that I saw was stained black, had one normal screw tap and a bottle of hand wash detergent in a recycled tomato sauce container. The infection control was out of control. At that moment a rat raced past my backpack.
After a little while Dr G arrived and he was full of beans. He was super friendly and showed us around further to the labour room where a woman was currently in labour at 8cm, behind a flimsy curtain. The beds (2 of them) in the labour room were the original ones from when the hospital first opened in 1962. They had rusty legs and were really in bad shape. Here the midwives are allowed to do Vacuum Extraction – 2 pulls only though. There are no epidurals, only pethidine and that is limited to 2 doses per woman as well (50mg per dose). Dr G is the only Obstetrician, he has a Registrar and a resident. They deliver over 2000 babies per year! He and his registrar are the only doctors in the whole of the East Sepik Province that are able to perform Caesarean Sections (population 500 000). There is no Paediatric doctor so Dr G and his team cover that area as well!! They are desperate for equipment – he said he puts in submissions for equipment and medical supplies, but only some items come through. The government has promised to build a new hospital, but there is no evidence of that happening as yet.
While chatting, the midwife came rushing in to ask for assistance as the woman had delivered her baby, but it was flat. Debbie tagged along to help if needed. She said the baby was as flat as a pancake and needed lots of stimulation. They used the neopuff on one of the resus cots, and eventually after what felt like quite a while, the baby responded and started breathing on his own.
I talked to Dr G about what Living Child was doing in the villages and he had some great suggestions and insight. He was supportive of what we were doing and acknowledged that the Health Centre in Bunam was probably feeling isolated and neglected from Wewak because of the distances. He said any encouragement and support will be a good thing – little did we all know then that the centre was closed and had been for nearly 2 years!! He also was very supportive of trying to introduce a Family Planning initiative which I learned about through Rotary. Ticks of approval from the locals – that's always a good sign and makes you feel a bit better!
I showed him my form to record the stories of deaths of mothers in remote villages and he was rather impressed, saying that we were one step ahead of them as this is what they were thinking of doing. Many people are illiterate he said and so filling out the 'official' maternal mortality form is a step too far. I left a copy with him. I also asked him to write down a list of priorities of equipment for the maternity section of the hospital because we have contacts here in Perth who may be able to help in getting some items over to them. Deb Badger was given a neonatal resus bag and mask which we handed over to them as well as a few neonatal ETT tubes and suction tubes. Such small items and yet they meant a lot to these health professionals who work with very little.
I came away from Wewak Hospital feeling pleased that we had made contact with Dr G and met some of the midwives, but also feeling really overwhelmed by the needs of the place. How could the main hospital come to be in such disrepair? Is it worth doing anything about? Yes, I believe so. We can encourage them. We can support them to make the changes they know need to happen, but which right now they feel are not able to achieve because they feel overwhelmed by the size of the task ahead. But one step at a time.
So, from a distance the seaside town of Wewak looks like a tropical paradise, but when you dig deeper, the cracks and problems are vast. Does it mean that we turn a blind eye and pretend its all ok or do we roll up our sleeves, swallow our pride and get in alongside them to offer support and help as requested? YES! Let's do it!