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Kudjip Nazarene Hospital

Papua New Guinea

Overview

Papua New Guinea is a developing country in every sense, and faces many of the same struggles found in Africa or Asia. Diseases of poverty predominate, and responding with compassion is the Kudjip Nazarene Hospital (KNH). This facility is located in the beautiful Waghi Valley, and includes a clinic, nursing school, community health program, and full-service hospital boasting 850 deliveries per year.

INMED students can anticipate caring for emergency, clinic, and hospital patients. Most will become proficient with invasive procedures, deliveries and surgical intervention. On-call duties and higher patient load is available for those with the requisite interest and skills. Direct supervision by a staff doctor is provided, and KNH physicians are keen on teaching.

Location

The Kudjip Nazarene Hospital (KNH) is located in the center of Papua New Guinea, the island nation just north of Australia. The closest major city, Mount Hagen, is about one hour’s drive away. The hospital is located in the beautiful Waghi Valley, where the weather is wonderful year round. Mornings are usually clear or partly cloudy, warming up through the day, and often with rain in the late afternoon or evening. Temperatures range from lows around 60 degrees to highs in the mid 80s. This site is remote and requires considerable travel time. For these reasons, students must plan to stay for at least 6 weeks.

Become familiar with Papua New Guinea’s culture, history and economy by reviewing the Wikipedia Papua New Guinea Profile. Rich resources for Papua New Guinea health information include the Institute for Health Metrics and Evaluation IHME Papua New Guinea Country Profile and the World Health Organization Global Health Observatory Papua New Guinea Data.

The hospital offers the only medical care for an area of 90,000 people. Most patients are low income and make a living by subsistence farming. Typical income is about 40 to 80 kina per week ($13 to $27 US). Injuries and infectious diseases are common among these people, while cardiovascular disease and cancers are rarely encountered.

The 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.

KNH has 110 beds: a 26-bed adult medicine ward, a 26-bed surgical ward, a 27-bed pediatric ward, a 12-bed tuberculosis ward, and a 19-bed maternity ward. There is a labor suite with 3 delivery beds, and the nursery has a capacity up to about 10 babies. There are two operating theaters and a minor procedure room. The Outpatient Department includes 6 exam rooms and a 5-bed Emergency Department. There are both fixed and portable x-ray machines, and two ultrasound machines, which are used by all of our physicians. The laboratory facilities include hematology, serology, chemistry, as well as microscopy and blood banking.

Each year the facility performs 50,000 outpatient visits, 4100 inpatient admission, 850 deliveries (with an 18% C-Section rate), and 650 major surgical procedures. KNH also provides Primary Health Service that including STD, TB, and leprosy programs prevention and treatment. The campus Is home to the Nazarene College of Nursing and the head office of the Nazarene Health Ministries (NHM).

KNH medical staff presently includes three family physicians, a pediatrician and a general surgeon. All are residency-trained and board-certified. All enjoy teaching, and a small medical library is available. In addition, there are frequently visiting physicians in a variety of specialties.

E-mail is available via dial-up from the computer in the doctor’s office or one’s own laptop. However, telephone outages do occur and can cause e-mail to be quite delayed. E-mails must be small in size (less than 50 KB) to prevent system overload. Airmail to and from the US requires about two weeks.

INMED invites all participants to consider raising extra funds to financially support this facility. While such efforts are not required, they provide opportunity for INMED personnel to become involved in this important aspect of international healthcare.

Travel and Logistics

Visitors should fly into the Mt. Hagen airport, and will be picked up at the airport by a member of the hospital staff. The Mt. Hagen airport is very small, and there are only 2 arriving flights per day, so it is never hard for people to find each other.

Prospective visitors should visit the PNG Embassy website appropriate for their nationality. For US citizens, when arriving at the airport in Port Moresby, proceed to the line at Immigration for those without a PNG visa. A visitor’s visa will be issued, which is good for 60 days. If staying more than 60 days, the visa can be renewed for an additional 30 days. If staying in PNG for more than 90 days, a visa from the PNG embassy in the U.S will need to be obtained. If that’s the case, communication with the staff at Kudjip Hospital is needed about it at least 6 months in advance. United States citizens can visit the PNG Embassy in Washington, DC for details.

Vaccination against typhoid, hepatitis A & B, polio and tetanus should be current. One should consult with their personal physician before traveling, and refer to the CDC Travel Website for the most up-to-date health information.

Travelers are advised to refer to the United States State Department Website for the most up-to-date nation-specific travel information, and to regularly review Current Travel Advisories.

Visiting medical personnel will usually each care for about 20 inpatients in the mornings, and then spending the remainder of the day caring for outpatients and emergency patients. Depending upon their level of interest and training, they may see patients on their own, consulting with staff doctors as appropriate for each patient. Visiting physicians and medical students commonly perform, with appropriate supervision, more procedures than they would in their home country, including thoracentesis, pericentesis, lumbar puncture, suturing of lacerations, incision and drainage, ultrasound, vaginal deliveries, dilatation and curettage, and manual extraction of retained placenta.

Medical personnel usually also assist in the operating theater, and depending interest and aptitude, may perform surgical procedures under the direct supervision of a staff doctor. Students will participate in “on call” duties, with physician supervision. In each clinical area, as appropriate, they will obtain history, perform a physical exam, and present their findings, assessment, and recommendations to the supervising physician. Through this experience, visiting medical personnel will:

  • Gain clinical skills in diagnosis and management of common illnesses in PNG, especially of tropical diseases.
  • Acquire knowledge and experience in the provision of health care in a developing country, including the challenge of health care delivery in the setting of severely limited resources.
  • Gain skills in cross cultural communication and relations.

Previous INMED Learners who served at this training site include these Graduates.

INMED students are housed in rooms reserved for medical volunteers. They will purchase groceries and prepare their own meals. Clothes washing facilities are available. During the dry season (May-September) water is limited and conservation is important to all.

National people view visiting hospital staff as professionals, and expect from them upstanding behavior and dress.

Women: Dresses, skirts or “laplaps” (wrap-around skirts) at least knee-length should be worn in public. Split skirts (which do not resemble pants or shorts), at least knee length, are acceptable. Those who wish to jog or play basketball may do so in a loose skirt or long baggy shorts. Some women have found loose fitting golf shorts meet this need. For swimming, large baggy knee length shorts or a skirt should be wear of the swimsuits. Skirts and blouses or dresses with casual shoes are recommended for church. Hose or high heels are not necessary in PNG.

Men: Shorts should be at least mid-thigh length. Short shorts are not acceptable. Men may go shirtless, but must be careful of sunburn. Casual clothing is recommended for church.

Both: Tennis shoes are the best for working and walking. Plan to bring 2 pair of shoes, one pair to wear, while the other dries out, as the weather can be very wet. For the same reason, rubber shoes or hiking boots may also be useful. A sweater or light jacket is a necessity for evenings in the highlands, as are warm pajamas. In the hospital scrubs (with pants for men, scrub dresses for women) or just everyday clothes are acceptable. Some visitors bring older clothes they no longer need and then leave behind for later distribution.

Visitors will have an opportunity to take trips to town. Most trips will be accompanied by a national watchman for safety. Many of the hospital staff enjoy hiking, area cultural events, bird watching, swimming in the river, and making visits into the bush. Most of the time they are glad to take volunteers along.

Visitors should bring copies of all healthcare profession licenses, diplomas, or certifications. It is also recommended to pack a carry-on bag that has essentials items just in case one’s luggage becomes lost. Bring clothes appropriate for the weather. Useful items include a journal, flashlight, sun screen (can be hard to buy here), mosquito repellant, umbrella, rain jacket, Kleenex, hand wipes and hand sanitizer, alarm clock, sunglasses, chapstick, camera, film or memory cards, extra batteries, camcorders & tapes, personal medications. Voltage is 220, and transformers are available for 110 volt appliances.

Note: Not all INMED learners post a blog regarding their international service-learning. Only completed blogs are listed:

Christine Hoover

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