Paediatric nurse and health administrator Louise Devereux, RN, says that international volunteer work was always on her list of things to do. A few years ago she spent six months volunteering in Papua New Guinea for Australian Doctors International. This month she’s wrapping up her project at Peter MacCallum Cancer Centre in Melbourne to return for round two.
“In PNG because there is such a shortage of doctors – just one per 17,000 people – that nurses and community health workers operate at a different level to nurses here in Australia,” says Louise. “Limited resources mean that health workers take on considerably more responsibility in the diagnosis and treatment of common conditions using standardised treatment guidelines.”
Louise Devereaux with a mother and baby in Boset.
PNG is Australia’s nearest neighbour, yet has the worst health in the Pacific. Its maternal mortality rate is 733 per 100,000 live births, which is the second-worst MMR in Asia Pacific, topped only by Afghanistan. Communicable diseases account for 62% of deaths, while diseases eradicated elsewhere – notably leprosy and elephantiasis – still prevail.
Louise was based in PNG’s mountainous jungle region of Western Province near the border with West Papua. She frequently travelled by boat, plane and foot to outlying areas, staying in local villages without electricity or running water. Her first job was to facilitate an in-service training seminar for 59 health workers and hospital staff.
“For many, this was the first clinical seminar they had attended since their original training,” she says, listing perinatal care, tuberculosis, HIV/AIDS and snakebite as some of the essential topics covered. “Many had to travel long and difficult distances to attend. Some spent 14 hours in a dinghy, others walked for two days.”
Louise also supported the regional health service provider, Catholic Health Services. She trained staff to better manage their network of eight rural health centres, focusing especially on budget management, funding submissions for health centre upgrades and staff development.
“There are some real challenges in managing a health service that covers such a wide area, especially in an environment where radio is the only form of communication, travel is slow and difficult and the supply of drug and equipment from Port Moresby is unreliable,” she says.
One of the highlights of her assignment was a 10-day doctor patrol to Boset, a remote area afflicted by leprosy and domestic violence. “The villagers were very welcoming and we set up multiple stations for immunisations, antenatal checks, doctor’s clinic and eye and ear testing. It was good to work alongside the local staff and learn from one another.”
There were also distressing moments. “It was heartbreaking – not to mention frustrating – to see patients in an advanced stage of disease and have nothing to offer them, especially when I knew they could be easily treated in Australia,” says Louise, remembering with particular regret a young boy with a bulging eye tumour where nothing could be offered except palliative care.
A young patient with a retinoblastoma.
Upon returning home, Louise was struck by the differences between PNG and Australia. “I couldn’t help but be a little less tolerant of people complaining about the lack of resources here. Also, there’s a high degree of specialisation here. I met nursing staff in PNG who have less training but have wider expectations on what they have to do,” she says.
An accomplished nurse who’s also worked with the Royal Children’s Hospital in Mebourne and the Department of Human Services VIC, Louise can’t wait to return to PNG. Her upcoming four-month assignment is based in the northeast island region of New Ireland Province, better known for tropical beaches and pristine dive sites than poor health.
Louise in remote Boset.
“There’s an enormous amount of work to be done in PNG and there is certainly no shortage of variety: one day immunising children in remote villages and the next participating in health planning meetings with church and government officials,” says Louise, who emphasises the need to be open and flexible about what you’ll find there.
“If you want to use all of the life and professional skills you have – and find a few new ones – then this is an opportunity to grab with both hands.”
Louise’s volunteer assignment runs from February to May 2013.
Australian Doctors International is currently recruiting a Project Health Manager to take over her role. View the job details here.