Papua New Guinea’s first woman neurosurgeon has graduated from the national university.

Dr Esther Apuahe graduated with a higher post-diploma in neurosurgery during the University of Papua New Guinea’s 67th graduation ceremony yesterday.

“She is the first female neurosurgeon in Papua New Guinea,” said the dean of UPNG’s Medical Faculty, Professor Nakapi Tefuarani.

Dr Apuahe, 43, originally from Morobe and married with three children, was also the first Papua New Guinean woman surgeon to finish in 2012.

“Surgery for almost 30 years had no female graduate since 1979 when the first male graduated. And, it has been a male-dominated field,” she said.

“In 2008 I started doing my masters in surgery at UPNG. I became the first female to finish in surgery.

“I finished in 2012 and I went out as a general surgeon at Vanimo General Hospital and I was called back here to take up neurosurgery.

New field for PNG
“It is a new field, basically to do with surgery of any brain pathology, head injuries and any brain tumour.

“Surgery, in the field of medicine, has been a male-dominated field.”

Dr Apuahe wanted to do something more than general surgery and, therefore, took up study in neurosurgery.

“After that, working outside, I felt that I needed to do more, maybe going further into surgery in some specialising,” she said.

Her study, which started in 2015, took a little longer than expected due to the pandemic as well as the unavailability of mentors.

“Neurosurgery is such a hard field. At that time, there were only two male neurosurgeons,” Dr Apuahe said.

“Because there was no one to cover in Port Moresby, I was called to come back here, so I’ve been here since 2015.

Not an easy journey
“The journey is not easy, it has been hard trying to manage patients and training with no medical supervision, just supervision externally, from Australia.

“It probably took a long time from 2015. I started, not officially, on training just getting some hands-on experience and I started towards the end of 2016, commencing neurosurgery.

“I had an attachment in Townsville (Australia) in 2019, but just as I was completing that, covid-19 came and so I was unfortunate enough to go before the pandemic and I came back and I sat for my exam last July.

“I thank the Royal Australian College for being there, supporting the training of neurosurgery and also to the academics at UPNG such as Professor Isi Kevau who pushed us through to make sure that I succeeded.

“After I graduated, there are now about eight female surgeons.”

Phoebe Gwangilo is a PNG Post-Courier reporter. Republished with permission.

Article by AsiaPacificReport.nz

It seems not a day goes by without learning someone in our inner circle of family, friends and colleagues has covid. When we ask how unwell our acquaintance is, the responses vary from “they’re really crook” to “you wouldn’t even know they had it”.

This is in line with studies that report moderate to severe illness in a minority of people (usually older with other risk factors) and that up to one in three positive people exhibit no symptoms.

Given the ubiquitous presence of this highly infectious coronavirus in our community and the high rate of asymptomatic illness, those who have not been diagnosed with covid might wonder, “how would I know if I had been infected?”

And, “does it matter if I have?”.

How covid is diagnosed
Most people know they’ve had covid because they had a fever or upper respiratory tract symptoms and/or were exposed to an infected person AND had a swab test (PCR or rapid antigen) that detected the covid virus (SARS-CoV-2) in the upper airway.

At the beginning of 2022, many people with consistent symptoms or high-risk exposures were not able to access PCRs or RATs to confirm their diagnosis, but instead presumed themselves positive and quarantined.

It is possible to diagnose past infection in those who never tested positive. A blood test can look for SARS-CoV-2 antibodies (also known as immunoglobulins). When we are infected with SARS-CoV-2, our immune system launches a precision counter strike by producing antibodies against viral targets, specifically the Spike (S) and Nucleocapsid (N) proteins.

Covid vaccination induces a similar immune response against the S protein only. The S antibody “neutralises” the invader by preventing the virus from attaching to human cells.

These antibodies can be detected within one to three weeks after infection and persist for at least six months — potentially much longer. A blood test that shows antibodies to S and N proteins indicates someone has been previously infected. Detection of antibodies to the S protein only indicates vaccination (but not infection).

The problem with antibody tests
Before you rush off to get a covid antibody test, there are a few notes of caution. There is still much to learn about the characteristics of the immune response to covid infection.

Not everyone mounts a detectable antibody response following infection and levels can decline to undetectable levels after several months in some people.

Because there are other circulating seasonal coronaviruses (such as those that cause the common cold), tests may also pick up antibodies to non-SARS-CoV-2 strains, leading to “false positive” results.

Commercial and public hospital pathology labs can perform SARS-CoV-2 antibody testing, but the interpretation of results should be undertaken carefully.

So, antibody testing should really only be done when there’s a good reason to: say, when confirming past infection or effectiveness of vaccination is important for the current care of an individual.

Diagnosing a post-infectious complication or eligibility for a specific treatment, for example. It could also be useful for contact tracing or for assessing the background population rate of infection.

Antibody testing a population
“Seroprevalence studies” test for the presence of SARS-CoV-2 antibodies in repositories of stored blood that are representative of the general population, such as from a blood bank. This data helps to understand the true extent of covid infection and vaccination status in the community (and informs our assessment of population susceptibility to future infection and reinfection). It’s more useful than daily reported case numbers, which are skewed towards symptomatic individuals and those with access to swab testing.

New research from the World Health Organisation, which is yet to be reviewed by other scientists, reported the results of a meta-analysis of over 800 seroprevalence studies performed around the world since 2020. They estimated that by July 2021, 45.2 percent of the global population had SARS-CoV-2 antibodies due to past infection or vaccination, eight times the estimate (5.5 percent) from a year earlier.

There are plans to conduct fresh seroprevalence studies in Australia in the coming year, which will update local data and help us understand to what extent the omicron wave has washed through the population.

Even after ‘mild’ cases, a new study by this @CurtinUni expert finds “long COVID” symptoms may persist. This includes “brain fog”, fatigue, and problems with concentration and memory. https://t.co/4lckYrks0Y

— The Conversation (@ConversationEDU) March 7, 2022

Does it matter if I have had covid and didn’t know?
For most people, knowing your covid infection status is unlikely to be more than a topic of dinnertime conversation.

While some studies have pointed to a less robust and durable antibody response following mild or asymptomatic infection compared with severe illness, it is not known how this influences protection from reinfection. Certainly, the knowledge we have antibodies from past infection should not deter us from being fully up-to-date with covid vaccination, which remains the best protection against severe illness.

There are reports of people with mild or asymptomatic covid infection developing ‘long covid’ — persistent or relapsing symptoms that last several months after initial infection. Symptoms can include shortness of breath, physical and mental fatigue, exercise intolerance, headaches, and muscle and joint pain.

However, the likelihood of developing this condition appears higher in those who suffer a heavier initial bout of covid illness. This might be linked with higher viral load at that time.

Bottom line
As we enter the third year of the covid pandemic and given that up to one in three infections may be asymptomatic, it is likely many of us have been infected without knowing it.

If you are experiencing lingering fatigue, brain fog or other symptoms that could be long covid, you should talk to your GP. Otherwise, knowing our covid infection status is unlikely to be of much practical benefit. Antibody testing should be reserved for specific medical or public health indications.

Being up-to-date with covid vaccination is still our best defence against severe illness moving forward.

Dr Ashwin Swaminathan is a senior lecturer at the Australian National University in Canberra. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Article by AsiaPacificReport.nz

Papua New Guinea’s biggest hospital is straining to provide medical services to the growing population of the capital Port Moresby – with an estimated growth rate of 3 percent annually, a medical executive says.

Port Moresby General Hospital chief executive officer Dr Paki Molumi said overcrowding, especially in the emergency department, was a big concern.

“The population increases at 3 percent a year yet services remain the same,” Dr Molumi said.

“There is a discrepancy between demand and supply which is reflected by the overcrowding.”

He said sometimes patients died while waiting to be attended to because of the long queue.

“The hospital serves over a million people in Port Moresby, Central and Gulf,” he said.

“Limited staff are struggling to meet the demand which reduces the quality of care given to a sick person.

Specialised care needed
“As a specialist hospital, it should be concentrating on delivering specialised care so that our people do not need to go overseas for that.

“Instead, we are taking on primary and secondary care as we do not have a separate hospital for the growing population in the city.”

The city has an estimated population of 385,000.

Dr Molumi was responding to a complaint on social media about a woman being admitted at the emergency ward on Saturday but was not attended to until Monday night.

“There is no hospital for Central and the Gulf Hospital cannot offer adequate services,” he said.

“Hence, all come to the Port Moresby General Hospital.

“The overcrowding at the emergency department and outpatients is a reflection of a defective health service we are offering to our people.”

Dr Molumi sees a separate hospital for the National Capital District Health Authority and Central to look after primary and secondary healthcare, leaving Port Moresby General Hospital to concentrate on referrals as the best solution to the overcrowding.

Right now, he said, the hospital was dealing with “everything” which was putting a strain on existing resources.

Lulu Mark is a reporter for The National. Asia Pacific Report republishes The National articles with permission.

Article by AsiaPacificReport.nz

The world was ablaze with hope following the announcement last week that a vaccine developed by Pfizer and BioNTech may be more than 90% effective in preventing COVID-19.

New Zealand politicians were quick to point out 1.5 million doses had already been pre-purchased through a legally binding agreement signed in late September to buy any vaccine to emerge from the multilateral COVAX facility.

Within the week, a second potentially effective vaccine emerged from US biotech firm Moderna. Health Minister Chris Hipkins would not say if New Zealand had negotiated for this option.

But assuming an approved vaccine is coming, attention then turns to logistics. Funding, procurement, storage and distribution all raise significant questions about values, decision-making and ethics.

We know there are multiple candidates for a covid-19 vaccine, but there will be few “winners”, as many countries have already pre-contracted substantial amounts based on calculated risk assessments of which will emerge first. Even then, the challenges will be immense.

For example, assuming the Pfizer vaccine does become available as a safe option, it must be held in “ultra-cold storage” at -70 degrees Celsius. As has been observed already, “Distributing an effective COVID-19 vaccine to the global population will likely be the greatest logistical challenge since World War II.”

UPDATE: We are proud to announce, along with @BioNTech_Group, that our mRNA-based #vaccine candidate has, at an interim analysis, demonstrated initial evidence of efficacy against #COVID19 in participants without prior evidence of SARS-CoV-2 infection.

— Pfizer Inc. (@pfizer) November 9, 2020

Who gets a vaccine first?
For New Zealand, as with all countries, the questions raised are complex: do we now spend a large amount of money to scale up a logistics, distribution and storage system for the Pfizer drug? Or should we wait for an alternative that is more effective, easier to transport and store, and possibly cheaper?

After all, the first available vaccine might not achieve the outcomes we want. But would it be fair (or feasible) to make the country wait?

Furthermore, because enough doses to treat everyone will not be available immediately, it will be necessary to prioritise recipients. What are the country’s obligations here? Do we offer the vaccination first to the oldest, or the youngest, or the most vulnerable?

National health systems will have some idea about how to go about this, but wealthy countries have never faced an immediate requirement on this scale.
An ethical framework
Answering these questions means calling simultaneously on a number of different ethical perspectives:

• an ethic of justice to assess the fairness of a decision
• an ethic of consequentialism to look at outcomes
• the ethics of obligations to see who we may have made commitments to
• an ethic of care to look at individual cases, rather than relying on abstract logic.

Only when we combine these perspectives can we begin to make sense of priorities.

The vaccine marketplace is a kind of oligopoly, with a few extremely large firms deciding which vaccines get made, when and at what price. Pharmaceutical companies are reluctant to invest in producing new vaccines for the developing world because they have little prospect of earning an attractive return.

While global organisations such as vaccine alliance GAVI have been instrumental in getting vaccines to developing countries, given the geopolitics of procurement it could be a long time before an effective COVID-19 option reaches the poorest populations.

We just announced that mRNA-1273, our COVID-19 vaccine candidate, has met its primary efficacy endpoint in the first interim analysis of the Phase 3 COVE study.
Read more: https://t.co/vYWEy8CKCv pic.twitter.com/YuLubU1tlx

— Moderna (@moderna_tx) November 16, 2020

The moral dimension
All this points to the deeper ethical issue of inequality. Many agencies, including the World Health Organisation (WHO), have demonstrated that health outcomes are related to socio-economic, ethnic and gender inequalities. COVID-19 has only made these inequalities worse.

Only last week, for example, a UK study showed 57.7 more people per 100,000 have died in the poorest areas of northern England than in the rest of the country.

This matches other research showing how the pandemic has disproportionately affected poorer families, including their being less likely to be able to work from home or adapt to home-schooling.

Limited or selective availability of a vaccine could exacerbate these problems. And while New Zealand may be in a relatively privileged position, this doesn’t mean there won’t be negative consequences for other countries.

This adds an international dimension to our national dilemma: we have a duty to protect our own citizens, but is there a way we can minimise harm to others at the same time?

Dr Barbara Allen is senior lecturer in public management, Te Herenga Waka — Victoria University of Wellington, and Dr Michael Macaulay is professor of public administration, Te Herenga Waka — Victoria University of Wellington. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Article by AsiaPacificReport.nz

We cannot even get National Agriculture and Quarantine Inspection Authority (NAQIA) accredited laboratories up and running around Papua New Guinea for various lab testing our requirements.

These labs are used for testing water supply samples and processed food samples for public safety. But we want to leap frog over all the other things this country needs and do drug research.

Wow!

The National Institute of Standards and Industrial Technology (NISIT) is failing and cannot handle the local calibration of weights, thermometers and other standard measurement equipment so it needs to be outsourced or referred to the private sector.

It seems we have forgotten about the necessity of this associated enabling environment and are considering paying a start up entity for drug research.

Shocking!

Let’s say goodbye to our tax money! I mean, the government has just restructured an existing loan with the Bank of the South Pacific (BSP) and given us some breathing space so that K10.2 million is possibly just loose change that fell out of the Prfime Minister’s pocket while he was listening to their spiel.

I wonder if the EMTV news item, about Niugini Biomed justifying themselves, is reminiscent of how they presented to Prime Minister Marape?

Imagine if they were rambling like that in front of the PM too? Would he still buy it, hook line and sinker, with that poor presentation?

Right thinking Papua New Guineans would say NO to the Biomed proposal in its current form and at this time.

We have other pressing priorities!

Article by AsiaPacificReport.nz

Papua New Guinea’s Auditor-General has questioned who approved a US-based international auditing firm to audit the awarding of contracts by the Health Department to pharmaceutical companies.

Acting Auditor-General Gordon Kega said his office should “sanction” the involvement of any private firm in the auditing of public funds.

“Under the Audit Act, we are supposed to sanction private auditors to audit public funds,” he said.

Kega said his office was not consulted when the Forensic Technologies International (FTI), a business advisory firm from the United States, was called in to carry out the audit after concerns were raised about the way AusAid funding was being used by the department to procure pharmaceutical supplies.

The Public Accounts Committee (PAC) of Parliament also conducted a commission of inquiry into the AusAid funding complaint.

Kega said the FTI audited the Health Department “without our authorisation”.

“And that report has been given to the police to carry out investigations,” Kega said.

Police have own jurisduction
“But then the police have their own jurisdiction to investigate any information they [receive] from complainants.

“We are available to clarify our position [with police] on the sanctioning of private auditors such as the FTI.”

He distanced the office of the Auditor-General from the auditing of Ausaid funding to procure pharmaceutical supplies.

The police said the work of the FTI had been approved by the government and funded by AusAid.

Chief Inspector Joel Simatab said the police had already received the FTI report and were awaiting the one from PAC chairman Sir John Pundari.

“The FTI report was sanctioned by the Department of Prime Minister and National Executive Council while the PAC report was sanctioned by Parliament,” he said.

The FTI and PAC conducted their enquiries in August last year.

“We received the FTI report first.

Both inquiries ‘similar’
“Both enquires are similar but PAC has statutory powers to summon people, seize confidential documents from the banks, companies, service providers and government departments,” he said.

He said the FTI “has no statutory power and so their report is not really in detail”.

“What they did was look into the tender of contracts, procurement, delivery of medical drugs and the lack of consultation between service providers and the provincial health authorities,” he said.

“PAC has the authority to go into detail.”

He said they had the same aim of finding out the processes of procuring medicines for the people of PNG.

“So while we are investigating the FTI report, we are mindful of the PAC report.

“Once we receive it from PAC, we will cross-check both recommendations [before we] conduct criminal investigations.”

The Pacific Media Centre publishes The National news reports with permission.

Article by AsiaPacificReport.nz

By Rebecca Kuku in Port Moresby

Flaws in Papua New Guinea’s public health system and the medicine supply chain are because of poor management in the Health Department, with some officers “living extravagant lifestyles far beyond their salary”, according to a new report.

Public Accounts Committee chairman Sir John Pundari yesterday tabled in Parliament the report of an inquiry which began in August last year into the supply, procurement and distribution of medicines but is timely with a rising rate of covid-19 infections.

Sir John said the responsibility “rests primarily on the management” of the department “who are custodians of our medicine supply chain and our people’s health”.

“Our medical supply and distribution systems have been compromised because the (Health Department) allowed this to happen by either complacency, incompetence, design and or greed,” Sir John said.

He said “numerous reports had been received of senior officers of the department directly involved in the procurement of medicines, affording to living extravagant lifestyles, far beyond that which is expected from a normal public servant salary”.

Sir John said the inquiry was about establishing the truth.

“It was about understanding the reasons for the failing procurement, supply and distribution of medicines and medical kits throughout the country,” he said.

‘Deeply saddened by betrayal’
“The committee was deeply saddened that our very own politicians, bureaucrats and senior civil servants in positions of trust and authority have betrayed our own people in allowing greed and corruption to flourish in the procurement, supply and distribution of drugs and medical kits in our country that have resulted in avoidable deaths from curable diseases.

“If ever there was a sector which should be safeguarded by political leaders to ensure that services are provided in an effective and efficient manner, free from exploitation, it is public health.”

He related an “unforgettable and heart-wrenching” picture the committee came across of a rural aid post with a grave next to it.

“[Locals] told us that they carried [the sick man] for miles to the aid post,” he said.

“There was no hope to begin with. But he was their brother. Their father. Their husband. So they carried him anyway.

“Finally at the doors of the aid post, they were told that there was no health worker there anymore.

“Medicines [had] stopped arriving a few months back, so the aid post had been abandoned. [The sick man] looked at their tired and troubled faces and as he lay [dying] he asked them to bury him there so they would not have to carry his body back home.

‘They buried him alone’
“They buried him there alone, away from his land, his village and his family.”

He said the story depicted the truth about the failing health system.

“It needed to come from patients and health workers who regularly see men, women and children dying in front of them while they are helpless to save their lives.

“They tell us the truth.”

The Pacific Media Centre republishes The National articles with permission.

Article by AsiaPacificReport.nz

Pacific Media Centre

Off-label drugs may now be used in clinical trials in the Philippines to test possible cures for the coronavirus, pandemic, the Department of Health (DOH) has announced.

During the department’s regular afternoon briefing yesterday, Health Undersecretary Maria Rosario Vergeire said the DOH is coordinating with the World Health Organisation (WHO) for the arrival and storage of medication that are part of the global solidarity trial which aims to find a treatment for covid-19, reports Rappler.

These off-label drugs, explained Vergeire, are used to treat other diseases, but will be tested by hospitals and doctors on patients in the solidarity trial to see if they can help against the coronavirus.

READ MORE: Al Jazeera coronavirus live updates – Spanish daily death toll lowest in weeks

Vergeire noted, however, that these clinical trials should be conducted with the proper guidance of a licensed doctor.

“Habang hinihintay po ang pagdating ng shipment, maaari po nating gamitin ang mga gamot na available na mula sa HIV at malaria control programs ng DOH…ayon sa tamang gabay ng lisensyadong doktor,” said Vergeire.

(While waiting for the arrival of the shipment [of these drugs], we may now use the drugs that are available from the HIV and malaria control programmes of the DOH…with the proper guidance of a licensed doctor.)

Vergeire mentioned litonavir, ritonavir, chloroquine, and hydroxychloroquine as among the drugs that will be used in the solidarity trial. In an interview with DZMM on Sunday, Vergeire also listed remdesivir, lopinavir combined with ritonavir, and the last two drugs plus interferon beta.

21 hospitals in ‘solidarity’ trial
In a Facebook post on Sunday, the DOH said 21 hospitals would take part in the solidarity trial. Participating patients will also be made to sign consent forms.

The Health Undersecretary was also asked in Sunday’s DOH briefing about the United States Food and Drug Administration’s warning on hydroxychloroquine and its adverse effects on the heart and other body parts.

In response, Vergeire said patients will first go through screening procedures, and qualified patients will then be monitored by investigators and doctors to make sure that the treatments like hydroxychloroquine would not be harmful.

As of Sunday, at least 7579 coronavirus cases have been confirmed in the Philippines. Among them, 501 have died and 862 have recovered.

Article by AsiaPacificReport.nz

COMMENTARY: By Scott Waide

In Lae City, Papua New Guinea’s second-largest city, there are seven urban clinics, each serving between 100 and 150 patients a day.  They get their medical supplies form the Government Area Medical Store (AMS) in Lae.

The AMS  in Lae also supplies the Highlands and the rest of Momase.

For the last six years, staff at the clinics have  been battling  medicine shortages.  You can see,  first hand,  how the medicine shortage affects people in Lae.

READ MORE: PNG faces ‘catastrophe’ if no crisis action taken

At Buimo Clinic on Friday,  a mother and baby came in  for treatment.  She  was  told that the last bottles of Amoxicillin suspensions would be given for her child  and that she  would have to go to a pharmacy to complete the treatment course.

The woman’s name is Merut Kilamu.  She lives with her family at Bundi Camp in Lae.  She is not just a statistic.  She is a real person who is bearing the brunt of the ongoing medicine shortages.

-Partners-

“Sometimes, we are able to buy the medicine,” she says. “Other times,  when we don’t have the money, we can’t buy what we need.”

Patients go from the clinics to  Angau Hospital in the hope that they will get  the medicines  they need. But Angau can’t handle the numbers.  Hospital staff have even  posted on Facebook saying they too need the basic supplies of antibiotics, antimalarial drugs and consumables like gauze, gloves and syringes.

Hospitals and clinics have become little more than prescription factories channeling their patients to pharmacies who charge the patients upwards of K40 (about NZ$18) for medicines. Pharmacies are profiting from the desperation and ill health of the Papua New Guineans.

Prices increased
In 2017, when clinics ran out of antimalarial drugs, pharmacies increased the prices.

In some instances, officers in charge of clinics felt the need to negotiate with pharmacies to keep their prices within an affordable range.  It is difficult for staff in smaller clinics to send away patients knowing they can’t afford  to pay for medicines.

“Sometimes, we can’t send them away. Staff have to fork out the money to help them pay,” says Miriam Key, nurse manager at Buimo  clinic.

This is a nationwide medicine shortage!

As much as  the politicians dislike it, social media gives a pretty accurate dashboard view of the health system from the end user.  Charles Lee posted on Facebook about how the medicine shortage was affecting his family in Mt Hagen.

“Relatives in Hagen have flown to POM to seek medical treatment because of a shortage of drugs in Hagen.”

His post drew more than 20 comments.

Gloria Willie  said from Mt Hagen:

“They just discharged a relative from ICU and we are taking her to Kundjip (Jiwaka Province)  today and if they are not allowed to receive  medical attention then, we are also planning to bring her to port Moresby. It is really frustrating.  But because of our loved ones, we are trying any possible way to have them treated.”

‘Stay at home’
Melissa Pela responded saying:

“Same here in Kavieng. Patients told to buy Panadol and keep at home. If you feel something like fever/running nose etc.. just take it. They say treat it before it becomes serious because there is simply no medicine.”

The officer in charge of Barevaturu clinic in Oro Province, Nigel Tahima,  said by phone,  the  they are seeing an increase in the number of patients  because other clinics just don’t have  medicine.

The reports are flooding in from all over the country. There are too many to mention in one blog post.

If urban clinics are a gauge to measure the flow of medicines from the AMS to the patient, you can imagine what rural clinics are going through.

They are too far from the AMSs and too far to adequately monitor. The only way to get an understanding of their problems is when staff make contact or when you go there.

Scott Waide’s blog columns are frequently published by Asia Pacific Report with permission. He is also EMTV deputy news editor based in Lae.

Article by AsiaPacificReport.nz

The latest life expectancy world rankings show Fiji has the highest death rate from diabetes in the world with 188 of 100,000 fatalities being attributed to the disease.

The head of Diabetes Fiji says the ranking highlights the magnitude of the problem and the need for a more proactive approach.

Jenny Meyer reports:

LISTEN TO DATELINE

Transcript
Project manager Viliame Qio says people are shying away from medical attention and treatment out of denial and so when they do come forward they have more severe complications from their illness.

He says there needs to be more community education about diabetes and many people turn to traditional healers for help first, which also delays effective treatment.

“We have three amputations that take place in a day in the major hospitals and the main reason is the people are presenting late, they come very late, they are not coming early. So we want to get people to be educated that they have to seek medical attention first before they resort to other traditional methods or herbal methods.”

Viliame Qio says diabetes is the leading cause of disability in Fiji and people need to heed the public health messages about poor eating habits and sedentary lifestyles.

Dr Jone Hawera is a Fijian surgeon and says the diabetes crisis is becoming more widespread now affecting people in rural areas and at younger ages.

‘Bottom of the cliff’
“Just last week we amputated half a foot of a 30-year-old i-Taukei female. It’s not only the rate that’s increasing it’s also the age group that’s involved with the amputations. And that means we have a big disabled and non productive population. The economic impacts that’s going to make for us is huge.”

Dr Hawera says he is part of a group of frustrated, demoralised, under-resourced health personnel working at the bottom of the cliff trying to deal with the ongoing diabetes crisis.

He says there are many factors affecting the rate of diabetes including issues like food security and climate change and policy makers must do more to turn the crisis around.

He says diabetes is a physical manifestation of social issues and preventative policies need to address these.

“It’s preventable and that’s the hope that we continue to have, we know that it’s preventable. A lot of these deaths are preventable. A lot of these complications like amputations are preventable. We are trying to improve our education and our awareness, making people really understand what diabetes is and what causes it and the many ways they can prevent complications once they have it.”

Dr Hawera says he would like to see diabetes education get to a point in Fiji where people are prevented from getting the disease in the first place.

Early detection vital
Viliame Qio says both education and early detection are vital to dealing with the crisis.

“The very important thing is that you get screened and secondly that you adopt a healthy lifestyle. Especially the eating habits.

“Our diet has been transitioning from healthy food to very fast food and with this fast food comes a sedentary lifestyle. We need people to be very health cautious, to be mindful of what they eat and be physically active.”

Fiji’s Ministry of Health says one in three Fijians has diabetes and there is a higher incidence in Fijians of Indian descent.

It encourages regular health checkups and says symptoms include frequent urination, feeling thirsty and hungry, fatigue, blurry vision and pain in the hands and feet.

This RNZ Pacific item is part of the content sharing arrangement with the Pacific Media Centre.

Article by AsiaPacificReport.nz

By Scott Waide, EMTV journalist and blogger

Survivors in Papua New Guinea’s earthquake in the Highlands face tough challenges. And so do the relief agencies and government authorities trying to deliver support to them.

Many of the worst affected areas in Hela and the Southern Highlands provinces are in isolated spots.

The people don’t live in large villages that you see on the coast. They live in small hamlets of 5-10 houses spread out over a plateaus or valleys.

They have no road access.

Many have to walk for hours to get within line of site of a mobile telecommunications tower in order to send a text message. Data signals are too weak and problematic.

For other locations, it takes more than a day.

Some of the villages are relatively close to the LNG site. But it looks deceptively close on a map.

Difficult to reach
What you’re dealing with on the ground are terrains that are extremely difficult to reach – even within a day’s walk. That is precisely why helicopters are vital in this disaster.

In some villages, people have had to build helipads on mountainsides to allow for medical teams to land safely.

Chopper pilot Eric Aliawi, who took an EMTV crew to one of the locations, had to land on three logs that had been placed on a spot dug out on a mountain side because the helipad had not been completed.

Even after landing, the crew and the doctors had to walk for about half an hour to get to the village.

A few commentators have said that the people affected are subsistence farmers and that they still have food to eat because they plant crops.

The reality is that their gardens have been destroyed and it is dangerous for them to go into the foothills and the valleys, or mountainsides, because of the ongoing aftershocks.

Trauma of death
They are also dealing with the trauma of the death and destruction that happened in their villages. They will have to adjust to normal life as time goes by.

Their houses have been destroyed and they have moved from the locations of their hamlets to central locations like schools, airstrips and mission stations to seek help.

Congregating in large numbers in one location is unusual for them. Losing their independence and relying on someone to give them food is also not something they are accustomed to.

They need is help to get back on their feet and resume their way of life.

They need the following:
Good quality tarpaulins for shelter – They live in a high rainfall area. The temperature drops rapidly at night and without shelter, young children and older people will get sick.

Food – With limited access to their gardens, food is a priority for them.

Water – Their water sources have been polluted. They need large water containers, tanks and clean water (as an immediate need).

Cooking pots – This is important if they are to boil drinking water.

Warm clothes + blankets – Sweaters, hoodies and simple blankets will help a lot to ease their burden. It is not as important as the others mentioned, but it will help.

Children’s clothing – also not an immediate priority but it will help a lot.

6 to 15cm nails and tools – in order to rebuild their houses, they need nails and tools like bush knives, axes and hammers. It is very difficult to obtain items like this where they are.

Disposable delivery trays, disposable suture trays – during the earthquake, sterilisation equipment at the Tari Hospital was damaged. The doctors need this to send to aid posts so that health workers can handle deliveries and other treatment.

The government contacts are:

Thomas Eluh – PA for Southern Highlands

Joseph Bando – PA Hela Province

Dr Tana Kiak – Tari Hospital

Inbox Scott Waide on Facebook for contact details, or text him on +675 70300459. Or email scott.waide@gmail.com for information. This article was first posted on Scott Waide’s blog, My Land, My Country.

• More PNG earthquake reports

Article by AsiaPacificReport.nz