Traveling to Papua New Guinea with QRME has been one of the greatest decision[s] I've made since starting my medical degree. I never thought I'd have the opportunity to practice medicine in a developing nation during my student years.
I went to PNG expecting a few things: 1) to be put outside my comfort zone; 2) to experience a different heath system and gain exposure to tropical diseases; and 3) to learn the culture and traditions of a neighbouring country. I can honestly say that PNG certainly delivered!
In my first few weeks, personally, I found it difficult to be away from family and friends with limited means of communication back home. However, any feeling of homesickness was eased by the company of three other medical students. From a professional perspective, I was challenged with having to work in an unfamiliar setting, making clinical decisions on my own, and assisting in procedures uncommonly performed in Australia (e.g. foot amputation and laparotomies). I must admit, one of the biggest challenges I encountered was having to confront, and eventually accept, the poor health outcomes that occurred despite our best efforts - some things were just out of our control. Without doubt, I feel that these challenges have placed me in a better position for my internship next year.
Whilst at Kiunga District Hospital, I had the opportunity to experience first hand the operations of a hospital with limited resources - with no electronic medical record system, limited supply of medication, restricted access to medical imaging and pathology tests. Nevertheless, the hospital functions very well with what little is available - much to the credit of its administrative staff and health workers. I was further impressed by the variety of tropical diseases and late- presentations of other medical conditions - e.g. Malaria, TB, and HIV.
One of the highlights of this trip was spending time with the locals, learning their customs and traditions. For example, you would greet another person with a simple handshake that involved ending with two clicks of the fingers, symbolizing 'one for me, and, one for you'. There was a strong sense of friendliness and feeling welcomed in community, we would get waves from children from far distances, and greeted more intimately with 'good mornings/afternoons' wherever we went!
Overall, I've had a fantastic international experience, much to the support and credit of QRME and Griffith University. I would highly recommend this once-in-a-lifetime opportunity to students who are unafraid to step outside of their comfort zone, and want a unique and challenging clinical experience.
Kiunga, Papua New Guinea, up until a few months ago was a place I had never heard of. Given its remoteness and size I was prepared for 6 weeks in an isolated town in the Western Province. What I wasn’t expecting was a thriving little metropolis that acted as a hub for many neighbouring villages. Despite its seclusion from the majority of PNG and the outside world, Kiunga served as an important centre for healthcare in the North Fly. As such, the hospital was often inundated with people that had travelled significant distances either by foot or by boat. Given the catchment size and geographical location, the patients brought with them a plethora of medical presentations, ranging from self-limiting viral infections to life-threatening conditions.
Our time in PNG involved the workup and treatment of numerous presentations including; cerebral malaria, black water fever, extrapulmonary tuberculosis, violent trauma, neonatal resuscitation, neonatal seizures, elephantitis, aortic dissection, wild boar attacks, obstructed labour, snake bites, compound fractures, hip dislocations and severe anaemia. Although this list is comprised of the more exciting, rare and confronting presentations, in the interim, more common presentations such as uncomplicated malaria, respiratory infections and gastroenteritis populated the outpatient/emergency department. 6 weeks in PNG gave us the opportunity to experience medicine in a lower resource setting which tested our resolve, creativity and knowledge. Being given the freedom to practice as an important member of the hospital team allowed us to conduct workups and management that we would never experience in a more developed environment.
A day’s work at the hospital was only truly complete after a game of touch footy or soccer on the hospital grounds with a flock of local kids. Throughout our time in Kiunga, the community and healthcare workers were always so welcoming. It was near impossible to walk home from the hospital without hearing your name yelled from a nearby house along with a friendly wave. I would also like to make a special mention to Graeme for looking after us during our time in PNG and for the endless work he does at the hospital!
The PNG selective was undoubtedly one of the most challenging, rewarding and worthwhile clinical placements I have experienced. Thrust into the heart of rural PNG for 6 weeks, we were privileged to learn firsthand the culture and language from the friendly locals around us. We enjoyed afternoon ball games with the kids, trips to outlying villages, and we instantly felt safe and welcome in the beautiful Kiunga.
Clinically, we encountered a diverse range of medical cases we would never get to experience in Australia, and quickly became familiar with malaria and tuberculosis. The staff were incredibly hospitable and keen for us to get hands on with procedures and medical management. The placement undeniably built on our clinical skills, particularly in paediatric, obstetric and surgical fields. It’s not everyday you get to assist in an open laparotomy for a man accused of sourcery with 18cm of knife in his abdomen!
I would recommend the PNG placement for the clinical opportunities, cultural immersion and rewarding experience both in and out of the hospital. It was an eye-opening, enriching 6 weeks that taught me many things both professionally and personally and I would go again in a heart beat. Thank you QRME!
Praneel Kumar"...I feel that the hardest part was not living in Kiunga but leaving it, learning to practice back home, knowing what I had left behind."
As a final year medical student I had the honour of travelling to Kiunga District Hospital in Western Province PNG. This opportunity, supported by QRME, offered much more than a medical experience, as we became integrated into the Kiunga community.
Travelling to Kiunga, we knew we would be faced with challenges that accompany working in a developing nation. But we weren’t prepared for the amazing amount the doctors and health care workers at Kiunga Hospital were able to achieve with the limited resources they can access in this remote area.
As rural medical students it was encouraging to see the similarities with rural and regional medicine in PNG and Australia and that a big differences that can be made with a medical education and a caring doctor (you don’t need the biggest and best equipment to change patients lives!).
Within Kiunga hospital the hard working staff were able to provide a huge range of services to the community they service. Although the doctors, who trained at the highest levels within PNG, Australia and other overseas institutions, are recognised specialists in their fields (one is even a world expert in malaria and tropical disease) – within Kiunga hospital they offered any service they could to the patients that walked (or were carried) into the Hospital.
Between them anything from Obstetrics and Gynaecology, Orthopaedics, Neurology, Gastroenterology, Endocrinology, Infectious Disease, Paediatrics and Mental Health were offered to the patients of Kiunga. The doctors often called specialists to seek advice, and the collegiality and respect with which they corresponded with their colleagues is tribute to the amazing mentorship these doctors provided us while we were in Kiunga. The doctors even sought our advice and assistance, respecting our opinions and ideas on diagnoses, even as medical students.
It was an honour to work with the medical staff at Kiunga and their mentorship taught me a lot about the kind of doctor I would like to be. This rotation is an excellent opportunity, especially for those interested in rural medicine. It consolidates you medical learning so far, but more than that teaches you about yourself as a medical practitioner and your values in medicine.
In 2013 I was privileged to be among the first group of Griffith University Medical Students, supported by QRME, AbtJTA and Oktedi Mining, to undertake a 6 week medical elective at Kiunga, a small community in the Western Province of Papua New Guinea. I honestly can say it was one of the greatest medical and personal experiences I have ever had.
The hospital at Kiunga is back to basics with the doctors, nurses and community health workers doing an incredible job with the limited resources and training available. The scope of medicine and surgery there encompasses what is seen in Australia, along with a vast number of tropical and notable public health diseases thrown into the mix.
In my time at Kiunga I saw colds, diarrhea, sciatica and fractures all common occurrences in any Australian ED or General Practice. However, each alternate patient may present with the diagnostic challenge of leprosy, HIV, malnutrition, malaria, TB or ringworm, to list a few.
I met Messie, a 3 month old girl, and her mother in the outpatient’s department of Kiunga District Hospital after they were referred from an outlying village. She was the first patient I independently managed in PNG and she was the first patient that led to a connection between myself and the local people. She had a fractured femur sustained after her mother slipped over in the mud 2 days prior to her presentation. I was responsible for her cast and care which was a daunting experience given I’d never casted a fractured femur before, let alone one on a baby.
I was lucky enough to see Messie again 4 weeks later for review and removal of her cast. At this point the bone was healing well and no long-term problems were expected, despite the cast being a distant representation of its original form.
My time in PNG taught me more then medicine. It taught me compassion, respect and gratitude. Compassion for the people I saw suffering from illnesses easily treated in Australia. Respect for the staff that work to provide the best medical care with the limited resources and training. Gratitude for the healthcare we are able to access and provide in Australia.
It also taught me that the human body and spirit is strong. I saw a lot of life threatening conditions that would be managed at a tertiary hospital in Australia. However between the patients, their families and the healthcare providers in Kiunga these patients had positive outcomes, despite initial uncertainties they would survive, let alone make a full recovery.
I hope that the continuing link between Kiunga and Griffith University medical students increases the number of these positive outcomes via the provision of resources and sharing of knowledge.
I would strongly recommend anyone, particularly those interested in rural or international health, to undertake an elective in Kiunga. It changed my perception of life and will undoubtedly change yours.
My name is Ashleigh, I graduated from Griffith in 2013 and am currently an intern at Toowoomba Hospital. In my final year of med school I travelled to PNG and spent 6 weeks working in Kiunga Hospital, located in a small rural town in the North Fly region of Western Provence.
When I visited, the hospital had 2 doctors, an emergency physician and a surgeon (those titles are purely arbitrary as their roles in the hospital encompassed everything from paediatrics to obstetrics to orthopaedics and infectious disease). I spent a week in the obstetrics ward where I assisted in the delivery of many babies, included normal deliveries, twins and breech deliveries and emergency caesarean sections in which the neonates required resuscitation.
I spent a week in the emergency department where I saw patients on my own, trying to gather history in broken english with nurses and community health workers trying to interpret for me. I had to work the patients up with limited investigations and decide what treatments they required and whether they could go home that day or if they needed to be admitted to the general ward.
My week in surgery was an interesting and exciting experience. I assisted in many surgeries from debridement of wounds to amputations of limbs as well as tubal ligation and appendicetomies.
My favourite experience was trekking to the remote village of Kungim located near the border of Indonesia. which involved 10 fully-grown adults, and all our luggage, crammed into a troop carrier rocketing along narrow, slippery, winding dirt roads, an amazing trip up the river and hike in the rain!
Our stay in the village was fantastic, we helped out at the little health centre during the day and played football with the local kids in the afternoon. I was very sad to leave Kungim.
Overall PNG was a wonderful and challenging experience. I was recommend it to any student looking for an exciting and adventure filled elective with lots of hands-on, third-world medicine.