St Mary's Hospital, Vunapope, East New Britain, Papua New Guinea
St Mary's Hospital is a 200-bed hospital run by the Catholic Church. It is situated in Vunapope, on the outskirts of Kokopo in East New Britain. The hospital is situated in the beautifully-kept grounds of the Catholic Archdiocese, and is quite well equipped. Its main shortfall is a lack of consistent medical staff. The hospital is run by a variety of doctors - mostly local residents, and "health extension officers" (diploma level doctors) and currently one obstetrician. It has medical (including TB), surgical, private, maternity, paediatric wards, as well as outpatients (emergency).
Vunapope is a suburb of Kokopo which is the main town in East New Britain following the volcanic destruction of Rabaul town in 1994. Kokopo has a population of approximately 50,000 most of whom relocated to the area following this natural disaster. The government hospital (regional referral centre) is located closer to Rabaul town (and hence away from the population focus) and is about an hour's drive.
Kokopo is situated on the bay with stunning views of the ever-active volcano, and clean waters with incredible coral reef.
PNG is our nearest neighbour, and continues to have significant Australian involvement despite being independent for more than 30 years. The people are Melanesian, and come from many tribal groups, with over 800 different languages. The official language is Tok Pisin (Pigeon English) which is similar to other Pacific creoles. Their traditions are vibrant and colourful, with ceremonies occurring at every opportunity.
PNG boasts being "the land of the unexpected" which is a great excuse for anything that doesn't go according to plan!! It is a beautiful country with an unfortunate reputation (that is not entirely founded).
As the medical ward doctor, the main cases seen are malaria, tuberculosis (in many forms), as well as general medical conditions- with a predominance of anaemia (often secondary to malaria/tropical splenomegaly syndrome), nephrotic syndrome (also often secondary to malaria), diabetic related conditions, strokes, COPD and various malignancies.
The hospital is in good condition, with reasonable access to resources. It is supplied with electricity (back up generator), spring water (which is tested and drinkable without treatment!) and reasonable. telecommunications.
The hospital has a pathology lab, which does basic biochemistry and haematology, with micro for AFB/Thick and Thin films, but not much else. The test results need to be correlated with the clinical, as they are not always reliable. There is an X-Ray department run by techs, and an ultrasound machine (in maternity) which you can use yourself.
The pharmacy is well stocked with an impressive list of medications- many donated from Rotary, or sourced overseas. Some basic resources are lacking, such as a functional ECG machine or defibrillator. There are no ICU facilities (and the only pulse oximeter lives in theatre).
- Daily handover from 8am until around 9. This includes looking over the X-Ray films from the previous day.
- Ward rounds are done daily, with the TB patient being seen once a week only
- Thursday afternoon from 1.30-4 (or finish) is the medical clinic
- We ran education every Wednesday from 3-4pm, and grand round weekly on Fridays from 11-12 for difficult/interesting cases. (I am not sure if these will be continuing)
- On-call means covering the entire hospital. First on-call (you) sees all new admissions and ward calls, with second on call being contacted for Caesars/Appendix/Trauma only
- (On-call is very unpredictable- often you see 4-5 admissions a night, sometimes more but often less, and occasionally no calls at all!)
8-4 Monday- Friday (+ on-call 1-2 nights/week, 1-2 weekend days/month)
We stayed in a two bedroom unit within the hospital compound; this accommodation is supplied with the job. It was a very comfortable unit (part of a duplex) with floorboards, drinkable water, gas cooking, fly-screens, and even with a solar hot water shower! Electricity, water and gas are supplied by the hospital.
A good variety of food is easily obtained from the local market and supermarket. AVI will provide you with a living allowance (or you will receive a local wage through the hospital) which is more than adequate to cover your needs.
Traditional food is based on the mu-mu (ground oven) and centres around sweet potato, cooking bananas, coconut milk, a large exotic variety of greens (including ferns!!) and pig/fish, if you are lucky!
The hospital will allow you to make an initial call home, and then it is your responsibility to arrange phone access. We applied for a phone line, which took about 2 months to have connected. Phone cards are easily obtained, and able to be used at public phones (of which there is one at the hospital) for reasonable PNG rates (ANY international calls to and from PNG are expensive).
The town has a (slow, expensive and unreliable) internet cafe. The local internet is dial-up and can become quite congested.
You are able to send/receive emails via the hospital account, as long as you limit the time spent on it. (Once you have a phone line, internet access is easily arranged, we found this to be the best option. All internet is slow and frustrating!)
The amount of medical staff is variable. At full staff there are six doctors, and three HEOs. Currently there are only 4 doctors (including one Obstetrician) and two HEOS. The hospital is in desperate need of a surgeon (a resident currently runs the surgical ward) and would benefit from a Physician/GP/Paediatrician as well.
The nursing-staff are of variable training, but are mostly supportive.
While the official clinical language for doctors/nurses/clinical notes is English, many patients only speak Tok Pisin (Pigeon English). It is really easy to learn- I was forced to learn quickly as I often found myself alone on ward rounds, with patients who spoke no/little English.
The town is liveable, though not geared towards tourism. There is a large market daily (except Sundays) where you can purchase all your fresh food needs. There are multiple supermarkets - Tropicana is literally opposite the hospital grounds, and Andersons is an "IGA" with all your imported needs!
There are quite a few resorts around, our favourite being Rapopo Plantation Resort- a five minute drive for an afternoon swim/snorkel.
There are a few restaurants (variable food!) and the odd night club, which are worth experiencing with help of a local chaperone (some of the clubs have bad reputations)!
Flights to and from the assignment are arranged by AVI. Flights from Port Moresby come in at least twice a day, and the hospital is only 15 minutes from the "Rabaul" airport (airport is actually located at Tokua, an hour from Rabaul).
During your placement you may have opportunity to visit some of the regional health posts - highly recommended! These are generally up in the mountains and require trekking in to get there - they are a chance to get a glimpse of "real PNG" life.
Vunapope is situated on the bay, opposite the ever-active Tuvurvur (volcano) and really is a tropical paradise! It is a great spot for SCUBA diving - easy to travel to resorts around the bay/small islands, or go on dive/snorkel day trips with local dive instructors. (Gerry from Rapopo Plantation Resort looks after the volunteers well!)
New Ireland is a short flight away, as is Kimbe (West New Britain)- also great diving locations.
Placements are arranged through AVI. Hospital direct contact is through Ben Mode (Hospital Administrator). He will likely direct you towards to AVI recruitment officer in Melbourne.
If you would like to make contact, please email firstname.lastname@example.org and we will pass your message on.
This placement is highly recommended. The clinical work is stimulating, and fairly high level of responsibility but the work-recreation balance is favourable, making it all worthwhile! This job would be great for a senior resident/registrar/GP with some trop med experience.
There is a large Australian-Chinese business community who are very welcoming and will invite you to play touch football, and have dinner with them: This was an unexpected bonus and we made some great friends!