News

Here is the latest news from Rural Health Services in Papua New Guinea.

It’s all through Prayer

A brand New Year 2015 came with a brand new Land cruiser for Rural Health Service (RHS) division of Nazarene Health Ministries to assist the work of Rural Health Services in PNG. The vehicle is one of the greatest needs that God has answered through prayers of the Christians who continually praying for the work of RHS in PNG. The vehicle will be used for administering RHS program and activities with mostly delivering medicines, medical supplies, equipments, transporting staffs and patients in and out of the rural facilities and setting up of new health facilities through partnership arrangements. On behalf of RHS I would like to thank those who have contributed enormously in New RHS Vehicleprayer, seeking funding and giving of this vital tool for Nazarene Health Ministries to extend the gospel of Jesus Christ into the underserved and unreached rural areas. May His Name be glorified.

 

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New calling faces Challenges in rural

On the 5th of March 2014 was a memorable day for the people of Wam and Bana in the East Sepik province of PNG. After many years of praying for health care has come true to the lives of 15,000 population consisting of 8 ward councillors. Nazarene Health Ministries moved in with a newly graduate nurse-pastor to serve in the new established health sub centre. Buckley Mann sensed the call to serve the people of Bana who have been neglected from health services for the past 20 years. Buckley treated 60 to 100 patients everyday. The demand for health care in the area is very high that medicine supplies ran out within the first two days. The clinic is in desperate need of infrastructure. No permanent buildings were built however the people took initiative to build a bush material house for the staff and a clinic to operate. People felt relieve of carrying sick patients on bush stretcher by foot or walking long distance. Many mothers died on the way before reaching the nearest health facility which 6 to 7 hours walk.

Buckley is newly married to wife Charity. It was very sad scenario of separating the two newly married couples that the wife had to work at Nazarene hospital while husband sensed the call to serve at Bana in another province. The both couples could have been together but because of the funding and unavailability of positions for both, one has to sacrifice to serve the very needy outside.  We are continually praying for open doors for Buckley and Charity to be together. Buckley need Charity to help him in the area that he is serving right now. Not that but as newly married couples they both need to be together to strengthen and comfort each other physically and spiritually because Buckley has given another responsibility to minister as a pastor to a church and congBuckley shaed his testimonyregation.

The greatest rural health need for the Bana is infrastructure. We need funding for staff houses and clinic building that will cater for birthing centre, admission, outpatient, immunizations.

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The difficulty of getting supplies into remote areas

The Airline company refused to carry refrigerant for refilling the refrigerator for the vaccines in Sangapi Health Centre. I asked for a 4WD Land cruiser cannot go any further.charter and the Dangerous Goods (DG) declaration in order to send it through. However, the answer was “No you cannot, because your cylinder is not UN approved” so the airline company declined to board the cylinder. I had another thought of sending the entire refrigerator out so that it can be refilled, but then realizing that the vaccines kept there would then be destroyed. A charter is needed for taking it but that is so expensive and would require the same regulations. It would also take a while to get it in because of the irregularity of the flights. The outcome would be the children who are due to receive their immunizations would be delayed for months and our target numbers would not be met.

Finally a thought came to my mind to find somebody who can carry the cylinder and take a walk using bush track into Sangapi. A three day walk, with a 13.6kg bottle is too difficult for one man. Thank God that He sent two gentlemen to me, after a week of thinking about the possibility of hiking the refrigerant in. I asked the two gentle men and they agreed to find another two to add to their number so that they can assist each other with the cylinder.

A day was set on the 7th of October, 2011 to drop the four guys at where the road stops. We drove 110 kilometers right into the jungle where the road was newly built, up the hill passed the PNG Defense
Force PNG Engineering camp and down towards Ruti valley. Finally, we could not go any further because of the terrains, cliffs, and deep holes that the 4wheel cruiser could not pass through. So we managed to drop the four men off and they began their journey. Even though we drove to shorten the distance, it still took the four men 3 days and 2 nights walk on a bush track to reach Sangapi Health Centre.

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Going Mobile – a blog by Dr. Stephanie

The following is from a blog by Dr. Stephanie on her blog http://stephdoenges.multiply.com
Nazarene Health Ministries started a cervical cancer prevention program some years back.  Pauline is a community health worker who runs the clinic.  Women come to the White House for pap smears on Tuesdays and Thursdays.  She screens 20 patients or so every week, or about 6000 since the program began.  They pay 4K (about $1.50) for the test.  Pap smear slides are mailed to Meripath, a non-profit organization in Australia that provides pathology services to more than 20 cervical cancer screening programs around PNG.  After 2 months, patients return to the clinic to get the results.  Those with abnormal pap smears are referred to me.  I examine them and look for signs of cervical dysplsia, early changes that could someday become cancer.  A simple procedure can cure the patient long before her dysplasia progresses to cancer.  Every time one of those procedures is done, a woman’s life is saved.
The biggest challenges to the program are information, transportation, and follow-up.  Many women do not know that they need to have a pap smear or about the services that we provide.  Some are afraid to come for an exam.  Others are unable to travel to Nazarene Hospital because the road is bad or they don’t have the money.  We also depend on women to follow up at the clinic for results.  If they don’t return or have a working phone, we have no way to notify them of their need for treatment.
A few months ago, we began to dream about how we could expand our program and reach more women in outlying areas.  Primary Health Services is the division that provides services such as prenatal care and immunizations to the surrounding communities.  Mr. Gabriel is the director.  He agreed to do a pilot project in which PHS would partner with one of the local health centers for a mobile pap smear clinic.  He selected one of the bigger and more remote health centers at one far end of our valley.  Nondugul turned out to be the perfect place to start!  Pauline’s husband is from that village and she sometimes works at the health center on weekends.  Mr. Gabbie and Pauline made a visit to Nondugul to talk with the health center staff about cervical cancer and the proposed partnership.  They were just as excited about the project as we were, and began recruiting patients almost immediately.
On Friday morning, Pauline and I met at the White House to gather up the supplies we would need.  We spent some time in prayer as we waited for the rest of the team to arrive.  Mr. Gabbie, Pastor Kiap, and a reporter from one of the local newspapers pulled up in the green PHS cruiser.  We loaded our stuff, recruited one of the nursing students to join us, and headed out to Nondugul.  The fog was just beginning to lift as the cruiser climbed out of the valley and to the surrounding foothills.  The view was spectacular.
We arrived at Nondugul health center about 45 minutes later.  We were greeted by the on-duty staff.  John is a Health Extension Officer (PNG equivalent of PA) and is also in charge of the health center.  Sister Lucy looks after the labor ward, and would be helping us for the day.  The health center was much bigger than I expected.  There is one building for immunizations and outpatient visits, another inpatient ward, and also a building for the labor ward.

We set up for our clinic in the maternity building.  The spacious postnatal ward was rather empty.  Apparently there used be some beds in there, but some rascals recently broke in and stole almost everything.  The room was quite a nice place for the women to gather and wait to be seen.  Pauline welcomed them, explained what cervical cancer was and why they needed to have a pap smear.  She also explained what we would be doing, as many of the ladies had never had a pelvic exam.
Sister Lucy and Elijah the nursing student began registering patients.  Pauline and I armed ourselves with head lamps and speculums.  We moved to two smaller rooms, one with a delivery bed and the other with a mattress-less bed frame, where we would do the paps.  Sister Lucy was the first in line–she wanted to be an example for the rest of the women!  Once things got started, we really moved… 76 paps smears in just about 3 hours.  WOW.  I would have never believed it could be done!  Thank the Lord for helping us to go quickly so that everyone could be seen on that one day.  Of all the women that we examined, my second patient of the day was the only one to have an obvious cervical cancer.  The others will follow up in December for their results and referrals.
We concluded our visit with a wonderful lunch provided by the staff of Nondugul health center.  They were so appreciative of our visit, of the service that we provided for the women of their community.  They were ready to recruit more patients and asked when we could return!  HEO John also requested more information so that they could continue to educate patients about cervical cancer.
What an awesome day.
Well, my preliminary assessment is that our pilot project was a cervical cancer smashing success.  In just one morning, we were able to screen as many patients as Pauline sees at Kudjip in one month.  And many of these ladies would have never made the trip to Nazarene Hospital just for a pap smear.  Of course the project will be ongoing.  We will be returning to Nondugul in December to notify the patients of their results, and those with abnormal paps will need to come to the hospital for further care.  But we are on our way in the fight against cervical cancer.
Mr. Gabbie hopes to continue the mobile pap smear clinic as one of the regular PHS services.  Once a month, a team of CHW’s, nurses, and doctors will travel to a different health center to provide cervical cancer education and do pap smears.  Improving access to screening will increase detection, allow for early treatment treatment, and ultimately prevent new cases of cervical cancer.  And most importantly, lives will be saved.
“Jesus went through all the towns and villages, teaching in their synagogues, proclaiming the good news of the kingdom and healing every disease and sickness.  When he saw the crowds, he had compassion on them…”
~ Matthew 9:35-36a
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Giving a chance for kids

According to the National Department of Health in PNG, 7.5% of children do not live to age 5.  (See more PNG statistics on the hospital website).  Sedrick made it that long but it was unclear if he would reach 6 yrs of age.

Sedrick developed a swollen abdomen, jaundice, blood in his urine, fever, and was very ill.  However, unlike many children living in remote areas, Sedrick could get some help.   He lived near Sangape Health Center, and his dad even worked there as a cleaner.  The nurses there stabilized and treated him.  Since he was so sick they got on the radio to Kudjip Nazarene Hospital and talked with Dr. Scott.  He gave some orders to help them get through until the Mission Aviation Fellowship plane could come and medivac him out to Kudjip for treatment.  We are happy to say he is improving.  Another life saved by the services of Sangape Health Centre and all the Nazarene Health Ministries working together.

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High risk OB in remote places

The Rural Health Services division of Nazarene Health Ministries is responsible for staffing, supplying, and supporting two remote health centers in PNG:  Imane and Sangapi.  Now when I say remote, I mean the ends of the earth.  Imane and Sangapi are located in what we call “the big bush.”  There are no roads between these health centers and the outside world.  Medical supplies, staff, and emergency referrals travel in and out by plane.  When there are no flights available, people have to walk several days to get to a road that will take them anywhere.  For example, Imane is located in Morobe Province.  Lae is the nearest big city with medical facilities.  To get to Lae, one must walk 2 days to the main road, and then catch a bus into town.  Imagine doing this if you were sick or injured.  Or pregnant…

Catherine is the wife of the Nazarene pastor at Imane.  She was nearing her 9th month of pregnancy.  She had c-sections for her first and second pregnancy, and needed to have a repeat c-section for her third.  There just happened to be a plane coming to Imane to fly out the coffee harvest.  Well, things got a bit complicated with the plane.  Due to recent heavy rains, the propeller got stuck in the mud.  The pilot radioed his base, and a helicopter was sent to the rescue.  Catherine and her husband Billy decided to hitch a ride.  The helicopter took them as far as Goroka.  They caught a bus and traveled 3 more hours down the horribly bumpy Highlands Highway to Kudjip Nazarene Hospital.  When Catherine arrived, she was evaluated by Dr. Bill in the outpatient department.  An ultrasound was done to confirm she really was 9 months.  But Dr. Bill found something else on the scan–placenta previa.  This medical talk translates to “placenta first”; the placenta was covering her cervix.  If Catherine had gone into labor back at Imane, she would have bled to death before ever reaching a hospital.  Thank the Lord for bringing to Kudjip!  The following day Dr. Jim did a repeat c-section.  She did a little more bleeding than usual and needed a transfusion, but overall did well.  Mama and baby did VERY well considering the alternative scenario.  Ten days after their arrival, Catherine and Billy and their new little bundle of joy were headed back to the big bush.  They didn’t think they would be so lucky to catch a plane ride back home.  Instead they will take public transportation 10 hours over the bumpy road toward Lae.  They are going to visit friends for a few days, and then hike back to Imane.  Being that mom just had major surgery, they plan to take the walk slow and easy.  WOW, what a woman!

Sanguo is a member of Catherine and Billy’s church.  She was also pregnant, only about 7 months.  Her water had broken just around the time that the plane landed at Imane.  Concerned about their church member and her baby, her pastors brought her with them to Kudjip.  Ultrasound showed that Sanguo was only about 31 weeks pregnant (40 weeks was full term).  The baby was too small, and on the edge of survival for PNG.  We started mother on antibiotics and gave her steroids to help the baby’s lungs mature more rapidly.  I also diagnosed her with tuberculosis.  TB medicines will help her live longer and stronger, and also protect the baby from getting sick.  Two days later Sanguo went into labor and delivered her baby.  He weighed just 1800 grams, thankfully bigger than I had estimated on scan.  The baby was admitted to the nursery for oxygen antibiotics and supplement feeds.  Slowly but surely he has been growing.  Last week we celebrated his 2000 gram party!  And soon he and his mama will be on their way home.

“But you will receive power when the Holy Spirit comes on you; and you will be my witnesses in Jerusalem, and in Judea and Samaria, and to the ends of the earth.”

~ Acts 1:8

Article written by Dr. Stephanie Doenges, who is in charge of the Obstetric ward at Kudjip Nazarene Hospital, another division of Nazarene Health Ministries in PNG and a referral hospital for Rural Health Services.    This story appeared on her blog:  http://stephdoenges.multiply.com/

Many thanks to Dr. Stephanie for her excellent care and this story!

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Moving from bush to bush

Markham river crossing

We needed to move out our Officer in Charge, Samuel, from Imane Health Center to go work at Sangape Health Center (both very remote and with no roads).  Unfortunately we could only get one flight to move them out.  So Saumel flew his wife and child and some of his things out with the flight.  Then Samuel walked with 6 other villagers helping- carrying clothes, pots and pans, and other goods.  They walked three days, including a river crossing on foot, to meet Mr. Gabriel, Rural Health Director at the nearest “road”. Mr. Gabriel is thankful to God for his protection for the walkers and his drive.  The car nearly went over a cliff trying to get to the location where he could pick them up. The picture is Mr. Gabriel crossing a river in the Toyota Landcruiser on the “road” to pick them up.

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