In the US, you can find a doctor in almost every town, and can reach a hospital usually within an hour of driving, depending where you live. In PNG, that definitely isn't the case. There are hospitals in each of the provinces, and other hospitals within some of smaller districts, but for many people in PNG, the hospital is a lot farther away than an hour's drive. Where there isn't a hospital, you can often find health centers and aid posts, like a small clinic with a nurse or health extension officer (similar to a nurse practitioner or physician assistant in the US). The health centers and aid posts are the first line of care for most everyone in PNG, and there is one of those in most villages (unless they live in a real remote area). Within an hour of Kudjip, there is a hospital either way on the road and multiple health centers and aid posts, which can provide care.
Despite the number of medical facilities in the country, not everyone goes to the closest hospital, to them, for care. Everyday we see people who travel 1-4 hours, regularly, to get to us. The majority come from a short distance away, but others come from great distances to be seen. Last week 2 guys came at the end of the day from Eastern Highlands Province, at least 5-6 hours away. They easily bypassed 3 other hospitals, if not more, in getting to us. The patient had been sick for 3 months and was quickly diagnosed with tuberculosis. TB is a very common diagnosis here in PNG, and a diagnosis that all hospitals should be able to make. When I asked the patient why they came to see us and bypassed the other hospitals he said that he heard that we were the best hospital, and so they traveled all the way to us to be seen. They were very happy when I was able to tell them what was wrong and that we could help him.
This week a patient came in to get her blood pressure medicines refilled, as she had every month for a number of years, evidenced by her 2 scalebooks that were stapled together. When I asked her where she was from, she said Lae - which is about 8-10 hours away (depending on the road conditions). I asked her if she gets a PMV every month to be seen by us and she said yeah, she is from a village about 15 minutes away from our hospital, and so despite the distance she keeps coming for care.
The people of PNG have sicknesses and illnesses like anyone else in any other country. They are looking for help, for medicines, for someone to tell them what is wrong and to make them better if possible. They go to their local health centers and hospitals, but often are met with locked doors, with a facility without workers, with long delays to see the doctor or get a surgery scheduled, with no medicines or more - so they keep looking until they find someone who can help them.
We are thankful for the opportunity that we have to care for many in PNG, all those in our area, and those that travel long distances to get to us. There is a reason patients travel long distances to get to us. We are open, we see patients and provide good care. We wish we could do more, we wish we could do surgery on everyone that needs it, or admit every patient that comes to us who would benefit from inpatient treatment. Unfortunately, our resources - staff, money, capacity, etc - don't allow it, and we might have an even harder time soon, doing what we are doing.
The government is now saying that there is going to be "free primary care" for everyone in the country. No one is really sure what that looks like yet, but there are many concerns regarding this. Will all the health facilities be overrun by patients who come for the free care? Is there enough medicine to care for all these patients who will come? How will facilities that rely on patient fees to help with the cost of running their facility make do if they aren't getting the same patient fees? If more patients come, how will they all get seen, where will they all sleep? There is a lot to be worked out in the weeks and months to come.
Romans 10:14-15 says "How, then, can they call on the one they have not believed in? And how can they believe in the one of whom they have not heard? And how can they hear without someone preaching to them? And how can anyone preach unless they are sent?" It could be rewritten for this situation as "How can a patient get care unless there is someone to care for them? And how can there be someone to care for them, unless there is a facility that is functioning where they can be seen? And how can there be a facility, if there isn't money to run the facility?
Pray for us, as we try and work out what this means for the hospital. Pray for our admin team as they try and work with the government to get us the funding we need to continue to do what we are trained to do. Pray for the patients who are sick and need care, and may find it hard, despite "free care" to actually be seen, if facilities can't stay open because they don't have money or enough staff to care for everyone who comes for care.