ISUOG Outreach volunteer Alice Robinson (far right) in Papua New Guinea with one of the trainees (Image courtesy of Nayana Parange)
ISUOG Outreach and the Australasian Society of Ultrasound in Medicine (ASUM) conducted an Outreach mission in Port Morsby, Papua New Guinea in October 2016. As a first time volunteer for ISUOG Outreach and ASUM, Alice Robinson of Australia explains her experience in empowering other practitioners with ultrasound.
Flying into Port Moresby Airport, I found a hive of activity; many of the travellers were expats arriving back to Papua New Guinea (PNG) for a variety of reasons – leading fishing charters, managing a food distribution company, working in a local school, whilst others were visiting PNG for tourism, which extends to bird watching in the highlands and walking the Kokoda track. Brief interactions with these fellow travellers made me think I had underestimated the resources available to this small country, which lies just a hop, skip and jump from the northern tip of my own home country, Australia (150km to be more precise).
Papua New Guinea has a maternal mortality rate of 250 per 100,000, one of the highest in the Western Pacific region, and a high fertility rate of 3.8 births per woman, which is double that of Australia’s fertility rate. The role of ultrasound in the overall care of women and children in PNG needs to be put in the context of these staggering figures, and is certainly vastly different from the role of ultrasound in Australian medical practice.
Spending five days at Port Moresby General Hospital and teaching ultrasound to a dedicated group who had traveled far to attend the course made me realise I had overestimated the resources allocated to maternal health and safety. The doctors, midwives, and supporting healthcare staff who we had the privilege of meeting during the program provide an amazing service to the women of PNG despite limited supplies and challenging circumstances.
With all this in mind, my three colleagues and I (brought together by the Australian Society of Ultrasound in Medicine – ASUM – Outreach Committee), tailored a basic OB/GYN ultrasound course for the nine rural healthcare professionals we trained. Despite the four tutors originating from Australia, we come from different corners of the country and gained our medical, ultrasound, and teaching skills via varied pathways. It was such a pleasure to work with like-minded professionals who brought very different attributes and skills to the course, such as Nayana Parange (PNG Project leader) who’s prior experiences in PNG were particularly beneficial in understanding the local healthcare system and how our course could be most beneficial.
As we took the trainees through tutorials (two or three per day) and practical sessions (three-four hours per day), it became apparent that their enthusiasm and hunger for knowledge was not only due to their impending exams (to achieve a Diploma in Gynecology and Obstetrics), but also due to the direct applicability of new ultrasound skills to each of their clinical practices. The small group practical sessions were a highlight, with two to three trainees per tutor, and a long line of patients from the outpatient clinics and inpatient wards at the hospital. This gave us the opportunity not only to meet some delightful local women, but to see each of the trainees improve individually over the next four days.
The many stories that were told over the course of the program highlighted that ultrasound will be another useful tool at the disposal of these talented doctors. A perfect example is one participant who had recently undertaken carpentry and plumbing training, skills which seemed as vital as any medical technology in keeping his remote health centre running smoothly.
Looking to the future, we hope that this brief training course will give participants the ultrasound skills to save lives and improve management in women’s health. This will require ongoing support and feedback for the trainees, which we are planning to provide with online discussions, and refresher courses during subsequent visits.
I feel privileged to have been involved in the first joint ASUM/ISUOG ultrasound training course in PNG. The involvement of both organisations ensured a structured approach and collaboration between all parties to achieve a common goal. Our glimpse into PNG life was very educational, and I hope we were able to teach the trainees as much about ultrasound as they taught us about overcoming the difficulties of working in the country’s rural areas.
Patients in waiting, Port Morsby – PNG (Image courtesy of Nayana Parange)