Elizabeth Akuire is the Monitoring and Evaluations Manager for the Catholic Church Health Services of PNG. This is her story, but it’s also the story of every rural health worker in Papua New Guinea who wakes up each day to serve their communities, regardless of the obstacles.
"I am blessed to have witnessed their courage and strength, and I am determined to ensure that their voices are heard".
(Preparations before the journey...picture supplied)
On the 3rd of October 2024, I found myself embarking on a journey that would profoundly impact me, both spiritually, physically, and emotionally. As part of my work with the Catholic Church Health Services, I was tasked with conducting a health facility assessment in Alotau, Milne Bay Province. It wasn’t just another work trip; it felt like a calling - an opportunity to witness firsthand the realities of healthcare in some of Papua New Guinea’s most remote areas.
Upon arrival in Alotau, I was warmly welcomed by the local diocesan team, led by the Health Manager, Sr. Nomita Rozario. But while the reception was warm, the challenges ahead were clear and real.
On October 4th, my colleague and I started on a long journey from Alotau town at 2:45 p.m., heading toward East Cape. The road was somewhat rough, and our local driver warned us of the numerous instances of rascal activities and holdups along the highway. Just a day prior, a passenger truck that regularly traverses this route had been held up, and the driver had been slashed by thieves.
Despite the warnings, after nearly two hours of travelling by road, we finally reached the boat stop. The boat, expected at 8:00 p.m., arrived right on schedule, and we boarded for a 10-hour overnight journey to Goodenough Island. As the boat rocked gently through the darkness, I felt a mix of vulnerability and reflective in the vastness of the open sea. By the time we reached Bolubolu at 5:20 a.m., I was physically drained but mentally prepared for the challenges that lay ahead, filled with a renewed sense of purpose for the important work we were set to undertake.
(Journeying through dawn...Picture supplied)
After a short 45-minute boat ride from Bolubolu, we arrived at Wataluma Health Center. The health center staff greeted us with smiles and warmth, despite the isolation and challenges they face daily. I could feel the weight of their responsibilities as we started our assessment.
The next two days were eye-opening. I conducted casual interviews with health workers, spoke to community members, and assessed the facility’s infrastructure and equipment.
What struck me the most was the sheer dedication of these rural health workers. They operate in extreme conditions, often with insufficient resources. Many of them work on patrols, trekking through the mountains and crossing rivers to reach the most remote areas to conduct immunization, nutrition or just to simply give awareness on important health programs. They risk their lives to provide care, sometimes even taking dangerous boat trips to assist nearby health facilities, whether they are run by the church or the government.
I spent time walking in their shoes, sharing their space, and learning what it means to provide healthcare in such a remote place. The isolation was evident, the challenges immense, but the commitment of these workers was continuous. They manage to do so much with so little, always placing the needs of others before their own.
One of the most heartbreaking stories I heard was about a young mother who arrived at Wataluma Health Center suffering from placenta previa, a condition that necessitated immediate medical intervention. Unfortunately, the sea was too rough for a timely transfer to a larger hospital, with waves reaching heights of 2-3 meters. In their desperation to help, the health workers called for a medivac the hands of rescue. Fortunately, the plane arrived just in time to transport the mother and her unborn child to Alotau Provincial Hospital. Despite the doctors' best efforts, they were unable to save the baby's life. While they managed to save the mother, the tragedy served as a bitter reminder of the fragility of life in such remote areas. These losses are not a reflection of medical expertise but rather a grim illustration of the consequences of inadequate access to timely care.
In a place like Wataluma, the unpredictable sea is both a lifeline and a barrier. Many mothers and children die simply because they can’t reach medical services in time.
On October 7th, after completing our assessments, we made our way back to Bolubolu, the boat stop, to wait for the ferry. According to the locals, the ferry only travels to Goodenough Island on Friday, Saturday, and Sunday, and returns to Alotau on Monday. If we missed that ferry, we would have had to wait another week for the next one to arrive. Thankfully, as anticipated, our ferry arrived on time at 3:00 pm, and we were able to board without any issues and we set off for East Cape. But as we crossed the open sea, the waves began to swell, tossing our small boat violently. I remember clinging tightly to my colleague, the only thing I could do was pray. Three times, I thought we would capsize. My heart raced as I silently prayed, “Lord, You sent me here for a reason. If it is Your will, protect us. I have a family waiting for me, but I trust in You.”
In those terrifying moments, I couldn’t help but think of the health workers who risk their lives on these same waters, time and time again. It’s one thing to know about their struggles, but another to experience the fear firsthand. By God’s grace, we made it safely to East Cape in the early hours of Tuesday morning.
This journey will always be one that I remember. Seeing the conditions in which these health workers operate has strengthened my view to advocate for rural healthcare improvements. The government needs to do more. These health workers deserve better housing, reliable transportation, and access to basic medical equipment.
Many of these rural facilities lack essential services like solar-powered lighting, ultrasound machines, and proper ambulance transportation. Medivac services need to be improved, and sea transport should be safer and more consistent. The health workers are doing their best, but they can only do so much with limited resources.
It’s also disheartening to hear complaints about drug supplies sitting unused and expiring in storage, while these very medications should be reaching the rural populations that desperately need them. We often complain of our own illnesses, yet many lack the bus fare to get to a hospital when it is only a 15-20min walk away. In contrast to the ease of city life, people in rural settings may walk for days or endure long boat rides to access even basic healthcare services. This is the harsh reality, and it is both sad and frustrating. However, for healthcare workers, saving a life brings immense rewards and is what motivates them to continue their vital work.
I am proud that CCHS is working to address some of these issues. For instance, plans are already underway to build better staff accommodations at Wataluma Health Center for a doctor that will be based at the health facility, and a Health Extension Officer will soon be stationed there. But we need more support both from the government and from donors to ensure these facilities can provide the quality care their communities deserve.
My experience in Alotau has changed me. It has deepened my respect for the health workers who continue to serve despite the challenges and risks they face. It has also reinforced my commitment to advocating for change in the rural health system. I know that together, we can make a difference.
I am especially grateful to Sr. Jadwiga Faliszek, the National Catholic Church Health Services Secretary, for enabling me to take this trip and experience the rural hardships faced by healthcare workers firsthand. While we enjoy the comforts of city living with easy access to services, the rural areas are in dire need of such support. Our government must redirect its focus toward improving rural health and education services.
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