A recent revelation by the Papua New Guinea Society of Rural and Remote Health that there has been a dramatic drop in the number of doctors attending to the rural masses is a worrying trend.
With a majority of the country’s seven million inhabitants living in villages and the districts, having fewer
medical professionals to turn to for help means the people are at a higher risk of succumbing to diseases and have reduced options for treatment for medical emergencies.
President of the society, Dr David Mills said the problem was that many doctors preferred to work in urban settings and for obvious reasons. The lure of well-paying positions at state or private hospitals is strong, especially when you factor in the advantages of working in a city or town.
Doctors in rural areas tend to work out of a sense of service to the community more than for the perks and privileges. Mills, speaking at the 22nd National Health Conference in Port Moresby last week, indicated that where
previously church-run medical services would cater for the rural needs with the
help of doctors, the trend now was shifting with fewer and fewer medical
professionals willing to work in a remote district. He conceded that although
church operated health centres and clinics were generally well-maintained and
had basic equipment and facilities and drugs to care for the rural communities,
the remoteness and lack of other essential services (communication, banking,
schools, police presence and transport infrastructure) as well as rugged
environment was proving to be deterrent for doctors.
“The majority of districts have no full-time medical staff and curative health services are
provided by the community health worker, nursing officers and some clinical
health extension officers where they are present,” Mills said.
But having a dearth of doctors in rural areas should not be the case because the country’s
only medical school, the University of PNG, through its School of Medicine and
Health Services, entered an agreement with church health services to develop
level specialist level training programme in rural medicine.
Mills admitted that although the programme called the Masters of Medicine (rural) programme was
designed to train individuals to be able to take on the task of working in a
rural environment, it was something few of the graduating classes from the
UPNG’s medical faculty were willing to do.
Mills called for a coordinated effort between the National Department of Health and the provincial health
authorities to see the programme effectively used because there had been little
progress since the programme had come into existence. He said the interest from
doctors was there and they could be attracted to work in district hospitals.
If the number of doctors in rural areas continue to dwindle, the state may
have to make a period of rural medical service compulsory for medical school
graduates or even have public hospital workers have stints in the districts.
The state must make working in the provinces attractive for health
Housing, better remuneration, scheduled breaks, vehicles,
facilities, equipment and adequate staffing can and should be provided.
There is nothing more spirit-sapping for the lone doctor in an isolated or
rural setting and expected to cater for a community’s needs with little
A plan by the Health Ministry some years ago to bring in
doctors from Cuba to prop up the ailing health services sector met with some
resistance from the medical workers union and now the more recent plan to bring
in nurses from the Philippines is another manifestation of the problem – that
more and more local medical professionals are unwilling to go out to the
provinces and the districts to work.
A change in attitude is needed not just
from the Health Department but the doctors themselves.
There is a need in
the rural areas for doctors and other suitable qualified practitioners.
Perhaps Mills statement that “traditionally the church provided health care
in the villages and rural communities of PNG” is inadvertently telling the
government to do more for rural health and not leave it up to the church to do
the unfashionable, unwanted, thankless task of bringing healthcare to the people
of this country.
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