Kompiam District Hospital was a typical rural health facility in this country with numerous challenges not many aspiring doctors had wanted to be committed to it .
But not anymore, thanks to the work done by an Australian doctor Dr David Mills who has over the past 23 years set the course of this hospital for bigger things, including changing the medical culture in this country: one that was focused on urban large hospitals to those that served the majority of the country’s population who are living in the rural areas such as aid posts, health centres and district hospitals.
Dr Mills and his family came to Kompiam in March 2000.
At the time, it was a two-small building hospital of 25-beds.
It had no x-ray, no laboratory and a basic theatre.
People were using kerosene lamp, its generator had not worked for three months and there was only one staff house.
“At the beginning it was very difficult because we needed more people especially in admin, but had nowhere to stay. The road was only passable to 4WD so building anything new was very difficult. So it was a very, very frustrating few years,’’ he says.
The biggest improvements in the first 10 years were in the administration: It helped greatly when the traditional CEO structure was changed to a management team, taking away pressure on one person as in a village scenario. It paid dividends, although it took awhile to settle as the staff had to get used to it.
He says Enga is an extremely unstable environment due to tribal fights, so gaining community confidence and a sense of neutrality takes a very long time.
Despite its huge challenges, Dr Mills and his wife and four children made their home in Kompiam, on the deep north of Enga and saw the hospital develop to its current status, a modern 55-bed hospital, and soon to increase to 88 when the ward under construction is complete.
It is equipped with two operating theatres, an excellent lab and digital Xray. It also has good speed satellite internet connecting all departments and it is just about to launch its electronic medical record system using fingerprint ID of all patients.
The staff houses have increased from one to 44 and the hospital is entirely solar powered 24 hours and the residences all have solar power 240V for nine hours a day.
Funding is being sought to double the size of the solar system from 100kW to 200kW.
The hospital has recently been upgraded to Level 4 so the staff numbers have increased from 47 ceiling to 202 for the entire health service. Funding is being sought for extra housing as well.
The hospital is also in discussion with the Enga Provincial Government to possibly take over responsibility for some of the more remote aid posts in the region to reduce confusion between the Government and mission arms of the health sector in the area.
Training has long been part of the work at Kompiam District Hospital, but it has not been as more obvious as during Dr Mill’s tenure.
Apart from taking the medical students on practical at the hospital, Dr Mills has gone beyond this by helping start the MMED (Rural) program at the School of Medicine and Health Sciences UPNG. This was in 2008.
He says this program was about changing an entire medical culture.
“One that is currently focused
on urban large hospitals rather than rural facilities such as aidposts, health centres and district
hospitals.
“That culture affects NDOH, PHAs and medical training as well. So changing that culture was never going to occur overnight. It will take lifetimes of sustained work.’’
However, he is optimistic that good progress has been made.
“When we started MMED (Rural) training in 2008, no-one was talking about rural medicine as a career. No one was talking about district hospital. Now, there are Rural SMO’s enshrined in the National Health Plan, PHAs are talking about getting their district hospitals up and going, and they are asking about MMED (Rural) candidates, and most importantly of all, medical students and RMOs are talking about rural medicine. The number of students applying for Rural training is increasing and need the support of the government and NDOH. The PHAs are also behind this.’’
The partnership with SMHS UPNG will be enhanced next year when the hospital opens a Rural Clinical School in July which will see fifth year medical students based at Kompiam for six months and then 12 months for the entire year from 2024.
Having students on training at the hospital ensures a constant stream of doctors at Kompiam Hospital which has health patrols to villages and communities.
The patrols cover part of East Sepk Province as well and used to be done mostly through walking but they now have a weekly flying patrols with the help of MAF.
The patrols give the medical students a good feel for rural PNG and the issues involved in delivering health care in remote areas.
Dr Mills did his training at Flinders University and as part of his training he did come to Kompiam
Hospital for a short time.
So what had motivated him to return? He says, it was not a motivation but a call and it would have been disobedient for him not to go. The suffering he’d seen was also enormous.
“The suffering is enormous – actually it’s really unimaginable to most people. Can you imagine someone with their leg torn off, or in obstructed labour, in screaming agony, and that person has no prospect for being evacuated, of receiving pain relief or medical help of any kind.
“They will just stay where they are and suffer like that until the inevitable transpires. That is not a fiction, but a daily reality in rural PNG. When you come face to face with it, it’s hard not to feel very strongly about the need to change the status quo.’’
The Mills are relocating to Australia to care for Dr Mill’s aging parents, but he will be travelling back and forth to teach his students at SMHS UPNG.
“While my family are relocating to Australia I will be continuing to work for UPNG, especially on the
rural training program, both remotely from Australia and in a FIFO role (month on and month off) for the Uni so I can visit my students,’’ he says.
Dr Mills is happy that the hospital is in good hands Papua New Guinean Dr Rebecca Williams is now the Medical Superintendent of Kompiam Hospital.
“The hospital is in good hands with Dr Williams at the helm and helped by an Australian and another
UK doctor, as well as a steady stream of RMO’s and students,’’ said Dr Mills.
Dr Mills is from Adelaide, Australia.
Source: Papua New Guinea National Department of Health