The National newspaper 25th of July 2012.
Trained Health Staff Needed.
By SALLY TIWARI
TRAINING and increasing the number of health workers in rural areas is the way forward to bringing health services closer to the people, an expert says. Australian Doctors international (ADI) marketing and communications manager Leah Boonthanom said volunteer doctors who carried out patrols in the remote areas were mainly focused on promoting clinical care. She said training of local community health workers would ensure that health services were carried on after the volunteers left.“The best approach to health care in PNG would be working as part of an integrated team that incorporates capacity building as a major goal,” she said. This meant strengthening skills, competencies and abilities of people and communities so they could overcome the causes of their exclusion and suffering.ADI has been in PNG since 2000, previously in Western province and later in New Ireland.“We consider our work in New Ireland a success because of the great support we received from the provincial government, Namatanai LLG and Newcrest Mining,” Boonthanom said. She said with more support, they were able to take a bigger team, including specialists such as an eye nurse, TB expert and Pap smear nurse, into the remote region. She said many of the locals in the outer islands of New Ireland were unable to seek medical help because of high transportation costs.“If the services don’t go to them, than it’s difficult for them to access these services,” she said.“Some of them even say health service is the only service reaching them through ADI.” ADI currently has two volunteer doctors in the province – Dr Romany Topsfield at Namatanai district hospital, and Dr Rosemary Lee, who would be carrying out monthly patrols with a team of specialists, into rural New Ireland.
I used to hold onto the strong view that capacity building of rural health workers in PNG is the way to deliver rural health services. However, after spending 2 years working at the Immanuel Lutheran Rural Hospital in the Enga Province, and conducting numerous rural health centre visits and clinics, I came to the conclusion that capacity building is only a part of the solution. Not THE way.
My experience is that attracting health workers to a rural post with incentives either be financial or training will attract many but keeping them there for long periods of time to make a real impact takes more. Major issues that need to be addressed are (according to my analysis):
- Road infrastructure – can not over emphasis this. This has to be improved. Roads need to be sealed with regular maintenance. I drove through very rough terrains to go to conduct health centre clinics.
- Communication infrastructure – this is vital not just for hospital administration but for the health workers to communicate with peers, specialists, friends, relatives etc. Mobile phone is good but I had problems when trying to send or received faxes, or email a colleague to get an opinion on a patient or a chest x-ray. It also allows health workers to get continuing medical education either by correspondence or online.
- Banking services – health workers must be able to access banking services at the district level. Otherwise they will travel to major centres to access cash from an ATM or send money for relatives. This will mean the health worker will be absent from work.
- Better education services – health workers in rural health centres want a better education for their children. My experience has been that when their children are old enough to attend school, health workers will leave a rural post and move to a major centre so that their children can get a good education. The perception among health workers now is that rural schools offer a poor quality education because the infrastructure and the curriculum is not supported and better resourced by the government to improve its quality.
- Good accommodation – this is addressed in some areas now. But this needs be sustained.
I think when these areas above a addressed as a priority and at the same time build the capacity of the rural health workers, PNG will begin to see real change in the health status of our people. Delivery of health service to rural PNG is a developmental issue therefore needs to addressed as a whole part of development. A piecemeal approach is not the way to go.