Ravaging island villages
Pregnant mum’s long trek for malaria shots
George had watched TB kill his wife the same way four years earlier.
“When I contracted TB I knew very well that I was close to my wife and I must have got it from my wife, I was thinking I was going to die”
He lives with his 8-year old daughter at his late wife’s parents’. They share a shack with two rooms separated by a bare frame for a wall.
George is unable to care or provide for his daughter or himself and this has created tension. There is resentment not only at his lack of contribution — he hasn’t been able to work in a year — but also around the stigma attached to his disease.
But all he can do is wait. Until the hospital gets more x-ray film, he simply won’t know if he has TB or is now clear and can start his life over.
“I am . . . being referred back to the private doctor but people like us cannot afford the private doctor.”
At each clinic I visit just one person is assigned to all communicable diseases, with patients all treated in the same ward. This means highly contagious TB sufferers lie alongside new mothers and babies, who have been placed next to accident victims.
Sanitation is non-existent, best demonstrated by the ageing graffiti I see on the back wall of one ward that’s been written with fingers soaked in blood.
They say that one person with TB will infect on average 10-15 people per year through coughing, sneezing, shouting and singing.
Despite all this, one physician I speak to remains confident progress is being made. With 30 years’ experience, Dr Pasion Dakulala, the Deputy Secretary of National Health Services in Papua New Guinea, describes earlier national anti-TB programmes as “chicken without a head”. He claims that through the inclusion of partners and funding “we are on the way to . . . controlling TB”.
While a baby vaccination programme is now in place, it’s hard to share Dakulala’s confidence, when just several sentences later he tells me the country still needs an extra 50-60,000 health workers to be effective.
Rose and Lucy had to spend two months travelling nearly four hours each day so Lucy could receive lifesaving injections as part of a treatment programme that will take 18 months to complete.
Their story may be one milestone on the way to success. She has made huge progress since her legs were so swollen that Rose had to carry her to the clinic each day for injections, an unimaginable task given the steep muddy tracks.
Having seen the results of Lucy’s treatment, Rose has even turned local advocate, telling me she now dispels TB myths in her own community.
We finish our chat with Lucy telling me about looking forward to getting back to school. She should be grade seven this year but had to drop out of school because of her illness and misses her friends a lot.
These final words cause her mum’s eyes to shine too, reflecting her pride and hope for her daughter’s future. The communities of Papua New Guinea and the Solomon Islands are some of the poorest and most vulnerable in the world, without access to the resources they need to withstand increasing challenges to their lives. Over the next three weeks we will bring you their people’s stories and pictures. With your help, we can provide clean water, healthcare, and education to isolated communities. Daphne Norbert is 28 but looks much younger.
Suffering badly from malaria and heavily pregnant, she travelled alone for a full day to get from her village to the Bogia Medical Centre on Papua New Guinea’s northern coast for treatment.
Malaria presents in many ways and symptoms include jaundice and anaemia with patients suffering fevers, aches, tiredness, nausea, vomiting and diarrhoea. If left untreated it can lead to organ failure and death.
Some 60 per cent of Papua New Guinea’s population live in areas where malaria is endemic.
Just four types of parasite worldwide cause it, but PNG has all of them. It’s transmitted mainly via mosquitoes, which infect in the same way as sharing a needle.
Only female mosquitoes bite, sucking in blood and malarial parasites called plasmodium from an infected person, then transmitting these through saliva when biting their next victim.
The injected parasites multiply in the liver before spreading to red blood cells. So if no one in a village has it, it is very difficult to catch.
Papua New Guinea’s multiple failed attempts to eradicate malaria have included using insecticides such as DDT in the 1970s. In the years since, the number of cases has risen and fallen as various methods of control have been tried and then withdrawn, usually through a lack of funding.
In more recent times they’ve had some success with long-lasting insecticidal nets.
On the morning I visit, just a week after her arrival, Daphne has an hours-old baby boy, her fourth child. He has congenital malaria.
“When I get the baby, they said, ‘You are sick and the baby too.’ The I would like to donate $ Credit Card I would like to donate $ Credit Card Card number: Expiry date: Name on card: Signature: Full name: Address: Postcode: Email: baby get sick with the mother.”
The World Health Organisation estimates that 18 per cent of deaths in children under 5 are attributable to malaria. Daphne is lucky that this clinic has some treatment available, although it’s not the officially sanctioned medicine.
Papua New Guinea adopted WHO protocols in 2011 and now only approves and supplies treatment that contains artemether/lumefantrine, which locals call Malawan.
But none of the rural clinics and aid posts I visit has any, with large handwritten notices in waiting rooms advising patients of this.
At one clinic a patient comes forward to tell me the nurses have secret supplies hidden for family members.
True or not, it hints at the desperate nature of the situation.
Daphne has been injected daily since her arrival with a mix of amodiaquine and chloroquine, an older malaria treatment that is no longer approved by the Government after a surge in a drugresistant strain.
But with no Malawan available, despite orders stretching back four months, staff have been forced to resort to what they know can offer relief.
Luckily for Daphne and her baby, her malaria isn’t the drug-resistant strain and she is responding well. For tax receipt purposes please provide: