Dr. Matt serves at Bana Health Centre

Bana Health Center lies deep in the heart of East Sepik province in Papua New Guinea. Run by two fantastic nurses, Buckley and his wife, Charity; Bana is the only medical facility for 15,000 people spread across several mountains. (Due to the difficulties in acquiring an accurate census, it’s probably much more than 15,000.) The people of this region rarely have any contact with the outside world. Their livelihood is maintained by the incredibly fertile and muddy landscape. Houses are built with local materials, food is planted or gathered, and life is simple, but hard.

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A typical house by the river made with simple tools and bush materials.

With physical exams and a portable ultrasound machine, I attempted to do in four days what nearly forty doctors in America would do year-round for a population of the same size in the U.S.

After a four-hour drive from Wewak (the small capital town of East Sepik), we embarked on another two-hour trek through the bush to reach the clinic. The clinic sits in a fairly central location for its catchment area, with the farthest people group having to hike approximately twelve hours. Due to chronic government financial issues, Bana was at risk of closure last year until over half the population residing within the clinic’s catchment donated 20 Kina each (~$6, a significant sum for most locals) to keep the clinic open. The money was well spent as this clinic provides critical health services for many without access to any other form of healthcare.

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Screening table with Mr. Buckley.

After graduating from Kudjip’s nursing school 6 years ago, Buckley and Charity decided to forgo the comforts of life near their family at Kudjip and a higher salary to travel across the country to Bana. They saw the need, so they went. With the help of a Community Health Worker, this trio does everything from treating extremely complicated traumas and obstetrical emergencies, to fixing solar panels, to overseeing administrative paperwork, and even sweeping the floors at the end of the day. When they first came, Buckley would walk with several other men through the jungle for days to administer vaccinations to everyone in the catchment area. Due to issues with power for their refrigerator and supply of vaccinations from the government, there have been no routine vaccinations since 2016. Despite limited resources, many patients travel from outside of the area because they’ve heard of the care this dedicated trio demonstrates at Bana.

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Pharmacy and treatment area with Sister Charity.

Over the course of the four days, nearly 500 patients were screened by Buckley. I saw nearly 400 of those patients. The majority of cases were chronic in nature, such as gastritis, arthritis, COPD, and cataracts. However, we did see a number of cases that involved new diagnoses. Unfortunately, many of these new diagnoses, including patients with metastatic cancer, cerebral palsy, congenital heart disease, and traumatic brain injury, do not have any good treatment options in this region. Despite a lack of medical alleviation, I could at least offer these people and their families some education and pray with them.

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The women carry limbum baskets made out of strong leaves of a black palm tree. They thought it was hilarious I picked up one of their baskets filled with fire wood. I soon found out why so many were coming to the clinic with back pain.

There were a few cases, however, that made the grueling trip to Bana a bit more medically motivating. I was able to help some patients with several cancers that had not spread, nephrotic syndrome (a type of kidney disease), gallbladder stones, preeclampsia, and tuberculosis. Some of the best moments involved seeing the faces on pregnant mothers as we looked together at the ultrasound screen while doing prenatal screenings. For these women, watching their own child in-utero was something that they could never have imagined. Many were quiet as I showed them their babies, but were then talking nonstop about the experience with their families after leaving. I also attempted to convince the mothers to deliver at the health center. Doing a simple calculation based on the number of deliveries in a clinic in PNG yearly (23 per 1000) and translating that to Bana’s yearly deliveries (20 per 15,000), only about 5% of births are delivered in the clinic. This leaves the other 95% that likely deliver in the bush unsupervised.

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Prenatal ultrasound screening.

Following the long work days, my daily routines involved living and eating like a Papua New Guinean. We made time to explore the beautiful jungle around the clinic as well as eat, a lot. Our hosts always boiled or fried the food (all organic and grown in the bush) over an open fire. It tasted incredibly fresh, delicious, and healthy—even if it lacked much in the way of proteins.

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Another satisfied patient after I took a stick out of her foot.

One year ago, I transitioned from a high-volume American trauma center to Kudjip Hospital, a nearly as high-volume hospital in rural Papua New Guinea with just a fraction of the doctors (about 10 at Kudjip vs. about 600 at the hospital where I trained). That was my first glance at the disparity of medical services available around the world. However, moving from Kudjip to Bana was another step deeper into some of the most remote places in not only this country, but the world; and the difficulties that living in these secluded areas bring alongside its beauty and simplicity. It was a fantastic experience working alongside Buckley and Charity in the service of the hard-working and hospitable people of East Sepik.

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Tammy’s favorite picture from Bana.

I would also like to say a big thank you to all of our supporters who make trips like this possible. First, to the people who give regularly to help us stay here. Second, to all the people that give randomly and unexpectedly to allow extra service opportunities such as this trip. And finally, to all those who gave specifically for the handheld ultrasound, it was a very useful tool in this remote place.

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