Arrived PNG

After a 7-hour flight, I landed in Port Moresby yesterday. I was picked up by a driver and taken to the MSF office where I received a briefing from MSF Head of Mission in Papua New Guinea (PNG); and also got to meet with the rest of the mission coordination team. From these discussions, I was able to get a better understanding of the PNG’s history and the context of the MSF missions here, as well as of the security concerns that I should be aware of. I spent one night in Port Moresby. This morning, I woke up at 5.30am to catch my 9.30am flight to Tari. Apparently, people with confirmed tickets often arrive at the airport to find that they weren’t so confirmed after all, and I needed to arrive early to make sure I was able to argue my way onboard if I got bumped from the flight. Along with my own backpack, I brought with me a massive coolbox of food supplies for the team at Tari – meat, butter, cheese and the like. Whilst vegetables are readily available in Tari, items such as meat are extremely expensive to come by, whilst supplies of dairy and cereals etc are basically nonexistent. I got through check-in with minimal hassle and settled down for a long wait – which got extended as my flight was delayed for two hours. Still, I had the chance to talk to several people at the airport to pass the time and learn more about the country. Everyone was friendly and helpful. I was shocked to learn that I had to pay 5 kina (HKD $20) for a small bottle of water though – I had heard that prices in PNG were expensive and got my first taste then. PNG has virtually no manufacturing (most of the country’s income is derived from the export of commodities – natural resources such as copper) so most consumer goods are imported and extortionately priced. I flew to Tari on a tiny propeller plane and landed in the airport 90 minutes later. The descent into Tari was stunning, with gorgeous views of the mountains. The airport consisted of one dirt track – we were told to stand off the runway (it was raining by the way) whilst the crew unloaded the luggage. Tari is located in a region of PNG that academics and the Government claim to have only been ‘discovered’ in the 1930s. Prior to that, few people from the coast and from Port Moresby had ever travelled deep inland, so when explorers delved into the highlands in the 1930s they found communities living in essence unchanged since the stone age. Since then, communities have undergone massive change – adapting to a central ‘westernized’ Government and being open to commerce and industry (recently it was discovered that Tari had vast reserves of natural gas, and an influx of workers have arrived here). After being picked up by the project logistician, I was shown round the hospital facilities by the project coordinator and got to meet both the expat team as well as national staff. One of the things that struck me was the difference between the extremely friendly, soft-spoken people and beautiful mountain surroundings; and the tales of violent incidents that bring patients to the hospital – plus the fact that outside of the hospital grounds it is very common to see people walking around with machete. MSF services in Tari include medical interventions and psychosocial counseling for victims of physical and sexual violence, and surgical services. Our operations are run alongside PNG Ministry of Health services in the same hospital. I met the triage nurse Evelyn, whose job is to register the patients and assign them to get relevant treatment. She is a young woman with interesting tribal tattoos, and is from Tari itself. She told me that normally, up to 50 patients come in daily seeking medical assistance from MSF, most of who are victims of domestic and sexual violence. I was also able to meet a minor surgery operating theatre nurse who has been with the project pretty much since it started three years ago. Also a member of the Tari community, she says that MSF has made a huge impact since it began operations, however there are still many problems. In the past two years, the levels of violence seem to have increased for one, and secondly, there are still many patients who are unable to access the facilities and get treatment. This is because the area has many clan factions and different tribes that are fiercely territorial, and often a patient’s path to the hospital would have to take them through a different tribe’s land. On top of this, sole women are at risk of sexual attacks if they travel to the hospital alone. Some of the other national staff also highlighted the difficulty patients have in coming to the hospital because of the region’s poor infrastructure. The roads are bad, and many cannot afford the travel fare to reach the hospital. I was told by a psychosocial counselor that some patients live as far away as 2-3 days’ travel, and for those patients, often they only come for counseling once or twice. This is different to those who live near the hospital and usually come in for at least 5-6 counseling sessions. Despite the concept of counseling – of talking through your traumatic experiences – being a pretty new idea of treatment to most of the local people, they are generally receptive to it, and it is the lack of transport that deters many patients from accessing psychosocial care. There is definitely great work being done here, however there are still many difficulties. Tomorrow, I will be sitting down for a nice chat with a local nurse who is herself a beneficiary of the services here. I will also be shadowing the logistician to learn more about the day-to-day task of keeping the hospital functioning – how electricity is generated, waste managed, security problems overcome etc. I’ll keep you posted on what I learn! Laura LEE (MSF office staff)