BEGA doctor Duncan MacKinnon at the end of the week is heading off again to bring more medical relief to those living in the highlands of Papua New Guinea.
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Papua New Guinea is a country of extremes, rich in natural mineral deposits on the one hand and struggling with extreme poverty and lack of basic infrastructure on the other.
Dr MacKinnon has experienced first hand the inadequacies and hardships Papua New Guineans face, particularly in relation to the availability of health services in a country that has the highest incidence of HIV and AIDS in the Pacific region and widespread malaria, an infectious disease commonly associated with poverty.
This month Dr MacKinnon will be making his fifth visit to a hospital in Mount Hagen, located high in the western highlands of PNG, where he is gradually improving operating theatre practices within the hospital and generally assisting in any other way he possibly can.
“Mount Hagen is a beautiful area with a nice climate which produces great conditions for growing fresh fruit and veggies.
“It’s not a very safe town though and it is not advisable to go out after dark there as crime is a big problem.
“It’s definitely not a tourist destination and there is huge unemployment, as there is nothing to do.
“But at Mt Hagen they don’t have to do a lot to survive because they can grow almost anything there, so there are very few people out begging and malnutrition is not a big problem because of the subsistence-based agriculture.”
Disrepair stems from corruption
However, Dr MacKinnon said since Papua New Guinea gained its independence from Australia almost everything has gone into disrepair particularly in the health sector, due to corruption in the Government.
“All the infrastructure worked beautifully when the Australians ran it ... roads and telecommunications were good, water and sewerage all worked, but now there are pot holes in the roads the size of bath tubs, one after the other in the worst cases - making it easy for the rascals to hold you up.
“The people are really poor - they don’t see the wealth, and they’re the ones who are suffering even though New Guinea is a rich country with natural gas, gold, silver, copper, timber and fish.”
The town of Mount Hagen has a population of about 40,000 with just the one main hospital consisting of 360 beds.
“It’s a very sad situation,” Dr MacKinnon said.
“But it makes you proud to be Australian because when you go there you can see how much work AUSAID has actually done.
“AUSAID has built two big hospital blocks, a new operating theatre, built new covered markets - known now as the best markets in PNG.
“Literacy is low, I think next year or 2012 will be the first year kindergarten will be free for children.
“So, it is moving forward but it is hard work to make progress.
“When I go there I am overwhelmed by everything; it’s just an absolute disaster.”
An interest in teaching and anaesthetics
Dr MacKinnon’s interest in his profession as a doctor is teaching and anaesthetics.
He has been travelling to Mount Hagen twice a year for a week at a time, usually accompanied by a local nurse, and all expenses are paid for out of their own pockets.
“When I visit this time, I will be going by myself.
“Once I took my daughter and she spent the week just cleaning the operating theatres on her hands and knees scrubbing the floors, because they don’t have any idea about bacterial infection.
“But if you can make one little change in their practice it helps enormously.
“One little change provides great benefit in years to come,” he said.
“I watch what the doctors and nurses do and how they do it in the operating theatre and I try to see if there is just one thing I can change in their practice that is teachable.
“Then I go back again for a week in the same year to make sure they are still practicing what was taught to them last time.”
Dr MacKinnon also tries to take donated medical supplies and equipment with him on each visit that he notices are lacking in the operating theatre or the hospital in general.
In previous visits he has taken with him simple things like large yellow kidney dishes for all sharps to be put in that can be re sterilized and protective eye goggles.
“They threw out all their old small kidney dishes, which is a big deal for them because they don’t have those resources, and half of them wear the eye goggles we bought them, the other half wear them on their heads like a piece of jewellery, but it doesn’t matter because half of them are still doing it ... so they are learning.”
Oxygen concentrator machines have also been donated to the hospital, with more on the way.
Dr MacKinnon could see there was a real desperate need for this equipment as Mt Hagen hospital gets its oxygen in metal cylinders from Brisbane.
It’s a very complicated lengthy process to have their empty cylinders shipped to Australia, refilled, taken back by ship to the closest port of Lae, then nine hours by road to deliver them back to the hospital.
“That’s the only way they have their oxygen, so they always run out of oxygen at the hospital, meaning they cannot operate without it.
“Just one oxygen concentrator replaces 50 cylinders a year, it can run 24 hours a day, seven days a week, 365 days a year and needs no maintenance ... it’s fool proof.
“I am taking two more with me on the next visit,” he said.
“The last time I took a concentrator the ear-nose-and-throat surgeon burst into tears and said this is just what the kids need.
“There are other things that I can see and I think ‘this is terrible’ but it’s too difficult to address it right now. But I will teach that to them the next time I visit.”
Much of what Dr MacKinnon is doing would not be possible without the support of Rotary.
“Rotary here is really great ... they actually sent three pallets of equipment donated by the private hospital to Mt Hagen in April but it just disappeared; it never got to the hospital.”
Dr MacKinnon said there is always a chance of this happening if you don’t actually travel with it.
“I have to get permission to carry excess baggage every time I go, but it’s necessary.
“Last time I got on to the CEO of Air New Guinea they allowed me 30kgs excess luggage.
“I only take a small pack with me, so I get to take 15 kgs of other donated stuff and 30 kgs of the rest.
“It does get expensive but it’s the only way I can guarantee it gets there.”
Up to $80,000 worth donated already
To date Dr MacKinnon has taken over with him between $60,000 and $80,000 worth of donated items, some new, most used but still in good working order.
“This time I’m also taking crocs as the staff don’t have any theatre shoes they can wear in the operating theatre, not ones that can be washed or cleaned.
“Crocs are just rubber, so are simple to wash.”
The first time Dr MacKinnon went to the hospital he went as an observer.
“At the end of the visit I told them I would come back and work with you.
“I went back six months later and they cried, because people just don’t go back.
“They go as medical tourists, but there’s nothing nice there to go back to... it’s just too hard and it’s not very pleasant.
“So they were really surprised that I came back.”
Dr MacKinnon said staying for a week at a time is better because there is less time to become too frustrated and overwhelmed with it all.
High on his wish list is the purchase of a skin mesher machine for the large number of burns victims, mostly children, treated at the hospital.
“Because it gets cold in Mount Hagen a large number of people have open fires on the floor in the centre of their house.
“The kids sleep by it and roll into it during the night.
“The nighties and pyjamas they wear are cheap and highly flammable and upon contact with fire, they instantly go up like a match.
“I have never seen so many terrible burns on little kids - they get burnt from their knees to their nipples and they need major skin grafts.
“However it’s difficult to get enough skin at a time to graft onto their burns, because their limbs are so small, and you need a flat surface, so you only get a little at a time to cover their whole body.
“It can take three months to completely do it.
“There’s no pain killers, it’s just awful.”
Raising funds for a skin mesher
Dr MacKinnon is currently raising funds for a skin mesher to speed up the treatment process.
“A skin mesher never wears out; once you have it, you have got it forever,” he said.
“In terms of resources it’s a fantastic piece of equipment but it costs $14,000.”
Dr MacKinnon said the one supplier in Australia who sells this equipment would sell it for $11,000.
A garage sale at the Bega Uniting Church was held recently to assist in raising funds and Dr MacKinnon said Rotary will once again provide some funding.
“I haven’t told Mt Hagen yet what I’m doing, because I don’t want to get their hopes up,” he said.
The skin mesher is a big project and will make a huge difference for the children with burns.
“Every time I go to Mt Hagen there are at least three or four kids getting burns dressed and they’ve been in hospital for months, it’s the most terrible thing.
“It’s great how Rotary has been so supportive of the whole project.
“There is an arm of Rotary that looks after a development fund for the South Pacific. “Rotary really has made a tremendous effort and is still doing so.
“Our Church also helps with donations and support and has raised money for the oxygen concentrators and at a teaching dinner with medical students and registrars who we train $800 was raised for one of the oxygen concentrators we are taking, which is half the price.”
Missionary work inspires
Dr MacKinnon took an interest in helping the people of Papua New Guinea through the local Uniting Church minister, Rob Colacino, who has spent time as a missionary in Port Moresby.
“I have always wanted to do something in a developing country, and was thinking about East Timor because of the affiliation Bega has with East Timor, but I went with Rob and found out there is a huge need in Papua New Guinea.
“New Guinea is our nearest neighbour and it has such an enormous need.
“But having said that you can stay right here in Australia and the need is just as great.
“It’s good for us to look outside ourselves and for our community to do this.”
Is it all worthwhile?
“Sometimes I think as it costs a lot to get there and even the accommodation is expensive, that maybe I should just give them that money, but once you do that, then it’s gone.
“But if you teach them something, it’s there forever and changes behaviour forever and that benefits a lot of people beyond the $1000 you might give instead of an air fare.
“You come away thinking “has that been a waste of time’, but if you can just change one thing, each time you go, I think it’s really worthwhile.
“We’re used to being so productive here, but in New Guinea if you achieve one thing in one day, that’s fantastic.
“They have a different kind of philosophy which is hard to break through.
“I may have a list of 10 things to do today, for example, and they’ll get done and there will be another 10 tomorrow ... they’ll have one thing in a week, and it will be lucky if that gets done.
“So you have to be patient and persevere, but it really does pay off.”
