According to the World Health Organisation, about 50% of PNG's health service delivery, mostly in the rural areas, is provided through church health services like Enga Baptist Health Services which runs Kompiam Rural Hospital, along with 10 other health centres and aid posts.
Missionary, Dr David Mills, heads up Kompiam Rural Hospital - David shares the challenges of providing healthcare in a remote hospital, which is periodically forced to close its doors due to tribal conflict.
Story by LuAnne Cadd. Photos by LuAnne Cadd and Michael Duncalfe
What brought you to this remote place?
I’m from Australia, whence all good things come! I came as a medical student back in 1993, so that was my first taste of Papua New Guinea, and again in 1997 with my wife [Karina]. In 1999 we came just to relieve a doctor but it was then that we decided to come back to Kompiam and we’ve been here since 2000.
Is this a long-term commitment?
We’ve never had an end date. We just take each year as it comes. We could finish tomorrow or they could bury us here. I don’t know.
Are you raising children here?
Oh yes. Goodness, I’ve lost count. We’ve got four of our own, but we tend to share PNG-style. We have a lot of extras that live in the house with us. I think we’re 11 at the moment.
You do ‘patrols’ where you visit the field health centres and aid posts, combining trekking and flying. How often do you do these?
It depends a lot on how well staffed we are. If we have enough doctors, then one of us should be out every month or two. For MAF flights, we spend what we have and work within our limit. But if we had more funding, our operations would be completely different because MAF would bring in patients all the time, we would patrol whenever we needed it, and bring in an aircraft any time. We have to say no to people continuously.
'In this part of the world, it’s either walking or MAF. So without MAF, basically there’s no way for those women or surgical patients to get help. It’s critical.' Dr David Mills
We’ll take the emergencies we can do. So we’re operating in first gear if you like. If the support was there, we might get to second or third gear. In PNG you’re still just putting the foundations down. You’re not even close to standing the frames up and putting the roof on in terms of a health service. It’s very rudimentary. Aircraft is not the entire answer, but if we had more funding, we’d certainly be able to get a lot further. It’s just the nature of PNG.
How many babies do you deliver at the hospital here?
We deliver about 200 babies here a year. There’s about 1600 deliveries a year in the bush, so you get some idea of the imbalance. Some die. We have no data, but we know they’re out there because when we patrol, we hear the stories of women who have died in childbirth.
You are more than 50 times more likely to die in Childbirth in Papua New Guinea as you are in the UK and 1 in every 20 babies in Papua New Guinea die before their first birthday - 1 in 40 are newborns https://data.unicef.org/country/png/.
What has been your greatest joy in your work?
It’s hard to distil it. The joys and the frustrations happen every day together. But if you can bring someone out of the bush who’s in obstructed labour, or in terrible pain and you can deliver that baby, that’s a very satisfying thing.
Also to be involved with the community, to sort out their issues, like today. We’re going to the back side of the mountain to try and sort out this tribal fighting. To be part of a community in such an intimate way that you’re really involved in the machinations of what makes the community tick, for better or for worse - that’s a very privileged position to be in. There’s a deep satisfaction that this is what we’re meant to be doing.
'They construct a stretcher and carry the person for up to three days in some cases, or they get them to an airstrip, get on the radio and organise a flight.'
What about challenges, hardships?
This is truly an ungoverned area in the sense that there’s no government, no police, no administration of any kind. And you have to work at village level.
If someone decides they want to break in here and steal, no one is going to stop him. So dealing with the community on that level without having any government structure around you was quite a foreign thing for us.
'We are saddened that over 40 young men, along with some women and young ones are not here to see the sun rise again' Dr David Mills
It also gets a bit lonely at times. We have very good friendships with the people here, but to be able to speak your own language, to have that relaxed style of conversation that you would sitting over a coffee with someone – that we miss a bit. The people hold you with such high respect here, there’s not that level of intimacy that comes from having a conversation on the same level as just another human being, rather than one of the bosses. We miss that. That's a level of friendship that’s quite important.
Celebrating the opening of a new clinic in remote Megau - read the story here
How does MAF support your work here?
Right now we’re building accommodation for one of our health workers at Megau. We’ve flown in a kit house – two runs and we’re nearly finished. MAF has flown it all. Materials, everything. Our health centres are spread out all over and they are connected by air. There’s no road network beyond Kompiam so you either fly or walk. To get a patient out they have to construct some sort of stretcher and then carry the person which may take up to three days in some cases, or they get them to an airstrip, get on the radio and organise a flight.
MAF is the only one that does that here. In this part of the world, it’s either walking or MAF. So without MAF, basically there’s no way for those women or surgical patients to get help. It’s critical.
Is the tribal fighting affecting the hospital?
This group here at Kompiam is fighting with the guys on the back of this mountain. So you have a situation where the people who get shot from here can come to the hospital, but the ones over there can’t come because this is enemy territory.
So they start to get frustrated and say it’s not fair. ‘You guys are getting services and we’re not!’ The response to that is they come and destroy the hospital. Then everyone is on the same playing field.
Those types of threats have started to emerge in the last 24 hours or so. We’re going to go there today and say we’ll try to help you guys as much as we can.
Akalianda (pictured right) was shot in a tribal fight in another area and flew with MAF to Kompiam. He is paralysed and will likely not walk again. Despite the prognosis, Akalianda is thankful for the care he has received, 'We and the community are very thankful for the hospital and health service of Kompiam. I would have died and they would have already buried me. This hospital is a good hospital,'
Scars take time to heal
Fighting escalated following the interview with Dr David Mills. A local pastor was attacked and his home was burnt down along with the homes of his sons. Kompiam Hospital had to be evacuated for the safety of patients and staff, although medical supplies were sent out to different clans to treat their wounded and sick where possible. The Mills family stayed in Kompiam to help keep the lines of communication open and broker peace between the warring tribes.
An update from Dr. David Mills on 6th June read that 'after nearly 5 months, we had a very successful set of meetings last week which we expect will bring the fighting to a close. Many of our staff have returned last week and a whole lot more yesterday. We have opened again today and a big clean up is on as I write. The staff are joyful to be back and working again. We will start bringing down patients from Wabag Hospital tomorrow.'
'We are very grateful to God and so grateful to you all for your prayers and support through a very difficult time. We have learned much, and been strengthened in God. But we are saddened that over 40 young men, along with some women and young ones are not here to see the sun rise again. The hospital has been 'burned' and the scars will take time to heal. We are praying that in the aftermath, the hearts of people will now begin to be open again.'
- Pray for a deep spiritual breakthrough to permanently end the conflict. Pray for those who want to keep fighting despite the peace agreements reached between the Tinlapin and Yaowani tribes.
- Pray for the staff of Kompiam Hospital providing health services to 40,000 people in Enga Province. There is a desperate shortage of medical professionals across Papua New Guinea - workers are needed to serve impoverished and isolated communities.
- Pray a special blessing over Dr David Mills and his family and give thanks for their faithful witness in a troubled community. Uphold the community's Christians.
- Lift up the medevac patients that arrive daily on foot and by MAF plane, remembering particularly children and expectant mothers and those who cannot access healthcare.
MAF flies medevac patients to the Kompiam Hospital, as well as medical supplies, staff, and building materials to the region's remotest health posts.
Read more about how - with MAF's help - Dr David Mills built a remote clinic in just 24 hours
Read how MAF flew a medevac flight from Megau to Kompiam Hospital on Good Friday
Despite its location deep in the remote north of Papua New Guinea’s Enga Province, and one of the most disadvantaged areas in PNG, Kompiam Hospital has become a major training centre for overseas medical students and plays a key role in the training for rural doctors in Papua New Guinea. Enga Baptist Health Services is a ministry of the Baptist Union of Papua New Guinea.