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Papua New Guinea
Summary
Kikori Hospital is located on the southwest peninsula of Papua New Guinea (PNG), near the capital city of Port Moresby. The setting is extremely rural, with few roads. Travel is frequently by boat. Most people make a living by logging or subsistence farming. Infectious diseases are particularly common in this region, including typhoid, malaria, TB, and HIV complications, as are traumatic injuries from logging, snakes and crocodiles.
Medical students regularly serve at Kikori Hospital, and are supervised by the staff physician. Responsibilities normally include inpatient care, obstetrics, surgical procedures, and outpatient clinic. Students are encouraged to take on as much responsibility as they are comfortable with. English is the official language of Papua New Guinea, and visitors can communicate adequately through English.
LocationKikori Hospital is located on the southwest peninsula of Papua New Guinea (PNG), near the capital city of Port Moresby. The region is marked by tropical forest, and the hospital is on the banks of the Purari River. There are few roads, and most travel is by boat or by air. Average temperature is around 30 C, and varies from about 40 C to 22 C with high humidity. The wet season is from June to September. There is a pleasant breeze at times. This site is remote and requires considerable travel time. For these reasons, students must plan to stay for at least 6 weeks.
TransportationInternational visitors initially fly into Jackson Airport in the capital city of Port Moresby. If accommodations are needed for an overnight, these can be arranged by Kikori Hospital but must be requested at least two months in advance. From Port Moresby, a commercial flight is taken to the Marsden Matting Airport, which is located right beside Kikori hospital. Those at Kapuna Hospital can travel to Kikori Hospital by boat, which takes about four hours.
Visa RequirementsProspective visitors should visit the PNG Embassy website appropriate for their nationality. The PNG America Embassy website is http://www.pngembassy.org/migration.html#9. Visitors visas are available on arrival at Jackson's airport in Port Moresby. Visitors and students can usually obtain a 60-day tourist visa in the international terminal, but should have a letter of invitation from Kapuna Hospital in the case of difficulty. Longer visas must be obtained from your nearest PNG High Commission.
Traveler's Health & SafetyPlease check the CDC travel website for the most up-to-date information: http://wwwn.cdc.gov/travel/default.aspx. Mosquitoes are common and necessitate sleeping under a mosquito net. Malaria prophylactics are essential, and mefloquine is generally recommended. Vaccination against Japanese Encephalitis, typhoid, hepatitis A & B, measles and tetanus should be current. Visitors are advised to regularly check the U.S. State Department website for the most up-to-date information regarding travel advisories: http://www.state.gov/travel. Visitors are advised to regularly check the U.S. State Department website for the most up-to-date information regarding country specific travel information http://travel.state.gov/travel/cis_pa_tw/cis/cis_1765.html
FacilityKikori Hospital is associated with Kapuna Hospital, and both operated by Gulf Christian Services. Kikori Hospital has 70 beds spread over four wards, radiology, an operating theatre and a basic laboratory. Typhoid, malaria, TB, HIV complications, and injuries from logging, crocodile and snakebites are common, with about 1,000 admissions per year. About 300 deliveries are performed each year, and obstetrical complications are commonly managed.
The outpatient clinic is busy, with about 38,000 contacts per year. It provides antenatal checkups, immunizations and well-child care. About 200 TB patients are cared for, and a new outpatient program is in place for HIV/AIDS treatment.
PatientsPeople coming to Kikori Hospital for care are usually grassroots villagers who subsist by farming. Some are employed by the oil and logging companies. Injuries and infectious diseases are common among these people, while cardiovascular disease and cancer are rarely encountered.
Health Profession StaffKikori Hospital has a staff of 27, including the administrator, medical director, nursing officers and community health workers (CHWs). Physician leaders include Dr. Valerie Archer and Dr. Lin Calvert.
LanguagesThe official language in PNG is English, and most people understand English and speak it with varying proficiency. The other 2 main languages are Pidgin and Motu.
Student ExperienceMedical students and resident physicians get as much hands on experience as they are comfortable with, and often are first on call with the doctor on standby. CHW students also come over from Kapuna for their practical experience.
Student Blogs Student Lodging & MealsThe facilities include dorms for men and for women, and 14 staff houses. Visitor accommodation is available in most of the staff houses, depending on one's requirements and tastes.
ExpensesAny money brought should be in the form of Australian travellers' cheques.
These may be changed for PNG currency, the Kina, Jackson's airport on arrival or at a bank in Port Moresby. It is not necessary to hold large amounts of cash in the bush as there is little to buy.
Outside CommunicationCurrently, Kikori does not have a V sat phone, though one is planned for the future. At present there is only one phone line for the hospital that is run through a radio link, and is often not working. The Oil Company up the river, about 45 min drive, has a satellite phone and is generally very good at letting visitors use their facilities.
Facility SupportINMED invites all participants to consider raising extra funds to donate to support the facility. This is not required but allows INMED participants to become involved in every aspect of medical missions.
DressCool, loose fitting cotton clothing is ideal wear for this climate. Women wear knee length skirts or dresses, especially when attending church. Women can also wear long shorts (Bermudas) and these are very practical, particularly for canoe travel. Short shorts and swimming suits are not accepted in this culture for women. (Women bath in their skirts or dresses). Women's tops should also be modest covering the midriff and not too tight. Few women wear sleeveless tops in public, but if the top is otherwise modest it shouldn't be a problem.
Both men and women should bring one long-sleeved shirt or light sweatshirt for cool mornings and early morning canoe travel, and to protect arms from the sun, and long trousers are good for evenings to prevent mosquito bites. A folding umbrella is useful both as a sunshade or when walking between buildings in one of the regular tropical deluges. Also consider brining a light nylon parka, sun hat, sunglasses. Many people at Kikori go barefooted or wear sandals, flip flops or thongs and it is unlikely one would require any other sort of shoe except perhaps one other pair of good shoes for travel between New Zealand/Australia and Port Moresby.
What To PackSpare camera film, flashlight, sunscreen lotion, insect repellent, hydrocortisone or Solarcane for insect bites, moisturizing cream, photos of your home and family for everyone will be interested in these, small snacks or sweets, and any food you can't do without! Medical students should bring their stethoscope and otoscope/ophthalmoscope set.