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Kapuna Hospital

Papua New Guinea

Overview

This island nation is located just north of Australia. Kapuna Hospital provides the only medical care for some 15,000 people in an area where there are no roads and all traveling is by boat. Infectious diseases are particularly common in this region, including malaria, TB, and HIV complications. The hospital is also known for obstetrics care, and for its malaria and HIV prevention efforts.

Medical students from the Port Moresby Medical School regularly rotate at Kapuna Hospital. INMED learners serving at Kapuna Hospital are supervised by healthcare professionals at this facility. Responsibilities normally include inpatient care, obstetrics, minor surgical procedures, outpatient clinic, and participation in community health work. Students are also invited to go on boat trips to visit the outlying clinics for days at a time. English is the official language of Papua New Guinea and is spoken with varying proficiency.

Location

Kapuna Hospital is located in a remote area on the southwest peninsula of Papua New Guinea (PNG). The region is marked by tropical forest and the Purari River delta. There are no roads and all travel is by boat or on foot. Average temperature is around 30°C, and varies from about 40°C to 22°C with high humidity. The wet season is from June to September. There is a pleasant breeze at times. 

People coming to Kapuna Hospital for care are usually local villagers who subsist on very limited resources. They frequently make a living by canoe carving or fishing. Injuries and infectious diseases are common among these people, while cardiovascular disease and cancer are rarely encountered.

Become more familiar with culture, history and economy of Papua New Guinea by reviewing these resources:

The official language in PNG is English, and most people understand English and speak it with varying proficiency.  The other 2 main languages are Pidgin and Motu.

Kapuna Hospital is associated with Kikori Hospital, and both operated by Gulf Christian Services, whose core values include:

  • Core Value 1

Love the Lord your God with all your heart, mind and strength

Excellence, Fear of God, Creativity, Beauty

  • Core Value 2

Love does no wrong to his neighbour

Honesty, No Wrong, Forgiveness, Hospitality, Boundaries

  • Core Value 3

Servant Leadership

Humility, Integrity, Peace, Build Others Up, Initiative

  • Core Value 4

Be a missionary, not a mercenary

Here for what we can give, not simply for what we can get

  • Core Value 5

The joy of the Lord

Joy filled with an attitude of gratitude

  • Core Value 6

Speaking the truth

Own up, do not cover up; truth spoken in love

  • Core Value 7

Loyalty

Loyal to the vision, and working to build unity

Kapuna Hospital was established by the London Missionary Society in 1949, and today is the only medical facility for about 15,000 people. Kapuna Hospital has five wards, 80 beds total, and an outpatient clinic/emergency department. Also included are facilities for radiology, an operating theatre and a laboratory.

Ward A — Maternity

The maternity ward has with two labor beds and a postnatal ward. Here in PNG maternal health is one of the biggest challenges — pregnancy and childbirth complications remain the biggest killer of women aged 15–45, with the vast majority of deaths occurring in home deliveries. Over 300 babies were born each year at Kapuna, as more and more women come to hospital to give birth. Antenatal clinics, postnatal care, and family planning services are all run from Ward A.

Ward B — Children’s Ward

All manner of problems are seen in the children’s ward, ranging from simple coughs through to broken bones, along with long-term patients requiring monitoring and rehabilitation. Ward B also manages outpatients from the local villages and immunizations.

Ward C — Adult Ward

The full range of adult medical and surgical problems seen in any hospital in the western world are treated here here, with the added challenge of tuberculosis, malaria, and. Malaria, TB, other tropical diseases, HIV complications, and injuries from crocodile attacks and knife wounds.

TB Ward

Tuberculosis is such a significant problem that the fourth ward is dedicated entirely to TB. Patients range from babies to elderly people, with every type of TB imaginable: lung, heart, abdomen, meningitis, lymph nodes, breast, joints. Kapuna Hospital works with the health department ‘Stop TB’ program to reduce transmission. Patients need a minimum of six months of treatment, the first two months of which they stay in the TB ward. The local level government has recently granted money for renovations and extension of this ward.

Antenatal Ward

The antenatal ward functions as a ‘waiting house’ for women from far-away villages, who come and stay in the last weeks of their pregnancy so they are at the hospital when their labor starts.

Outpatients/Emergency Department

The outpatient ward has dual purpose: it functions as an Accident & Emergency department to manage acutely sick patients and injuries when they first arrive, and also provides daily care and dressings for wounds, sores, burns, and skin conditions.

Kapuna Hospital also provides care through 52 village clinics. The Kapuna Hospital community health program is very active, and is led by graduates of the Community Health Worker (CHW) training school started at Kapuna in 1985. This two-year program trains 25 new students per year. Community health activities include the Rotary Against Malaria (RAM) effort to provide mosquito nets and malaria prevention training to villagers, and comprehensive AIDS/HIV awareness and prevention program.

Kapuna Hospital staff includes 2 full time doctors, 8 nursing officers (all PNG nationals), 25 community health workers, 5 laboratory and X-ray staff, and 2 dentists.

Wifi is available

INMED invites all participants to consider raising extra funds to financially support this facility. While such efforts are not required, they provide opportunity for INMED learners to become involved in this important aspect of international healthcare.

https://gcspng.org/

https://www.facebook.com/GulfChristianServices

https://www.youtube.com/watch?v=_Ni0qV1ODXE&t=2s

https://www.youtube.com/watch?v=3qRowsQyngE&t=6s

Travel and Logistics

International visitors initially fly into Jackson Airport in the capital city of Port Moresby. If accommodations are needed for an overnight, these can be arranged by Kapuna Hospital but must be requested at least two months in advance. From Port Moresby, a flight is taken to Baimuru Station on Airlines Papua New Guinea. The final connection from Baimuru Station to Kapuna Hospital, about 20 km, is by boat. As an alternative to Baimuru Station, students can also fly into Kikori Hospital (on Airlines PNG or Hevilift) and take a boat ride (about three hours) to Kapuna Hospital.  Hevilift airline is generally much more reliable than Airlines PNG.  Student discounts are available.

Prospective visitors should visit the PNG Embassy website appropriate for their nationality. An e-visa is available for the nationalities including for citizens of the United States. If a medical student is coming for an elective, state the purpose of the visit as “Student Medical Elective.”

Mosquitoes are common and necessitate sleeping under a mosquito net. Malaria prophylactics are essential, and mefloquine is generally recommended. Vaccination against Japanese Encephalitis, typhoid, hepatitis A & B, measles and tetanus should be current.

Travelers should consult with a personal physician before traveling. All routine vaccinations must be up to date. Refer to the CDC travel website for the most up-to-date health information.

Travelers are advised to refer to the United States State Department website for the most up-to-date general travel information, and to regularly view current travel advisories.

Health profession students and physicians experience considerable supervised hands-on learning opportunities, and often are first on call with the doctor on standby. Medical students from the Port Moresby Medical School also regularly serve at Kapuna Hospital. The daily agenda usually begins at 7:00 with morning rounds. Devotionals with the nursing officers and students occur two days per week and everyone is invited to participate. Lunch time is followed by a rest period, medical work, dinner and evening rounds. Students are also invited to go on boat trips to visit the outlying clinics for days at a time.

Given the prolonged travel necessary to reach Kapuna Hospital, students must schedule at least six weeks on location.

Visitor accommodation is available in most of the staff houses, depending on one’s requirements and tastes. Mosquito net, linen and towels are all provided. Toilets are usually the long drop variety. Electricity is generated for 10 hours each night, mainly for lighting. It is 240 volt and uses the same plug as New Zealand. Depending on the time of year one may need to walk through surface water or mud to get from house to house, and be careful with water consumption because of uncertainty about when the next rain is coming. The houses have running water and the doctor’s house has a washing machine.

A limited range of grocery items are available at the hospital store, including soap, toothpaste, soap powder, batteries, stamps, writing paper rice, cracker biscuits, tinned fish, cordial syrup etc. (but not shampoo, conditioner, tampons, sun screen or insect repellent). More “luxury” items, like soft drinks and sweets, are available at the Baimuru store.

Cool, loose fitting cotton clothing is ideal wear for this climate. Women wear knee length skirts or dresses, especially when attending church. Women can also wear long shorts (Bermudas) and these are very practical, particularly for canoe travel. Short shorts and swimming suits are not accepted in this culture for women. (Women bath in their skirts or dresses). Women’s tops should also be modest covering the midriff and not too tight. Few women wear sleeveless tops in public, but if the top is otherwise modest it shouldn’t be a problem.

Both men and women should bring one long-sleeved shirt or light sweatshirt for cool mornings and early morning canoe travel, and to protect arms from the sun, and long trousers are good for evenings to prevent mosquito bites. A folding umbrella is useful both as a sunshade or when walking between buildings in one of the regular tropical deluges. Also consider bringing a light nylon parka, sun hat, sun glasses. As for shoes, most people at Kapuna go barefooted or wear sandals, flip flops or thongs and it is unlikely one would require any other sort of shoe except perhaps one other pair of good shoes for travel between New Zealand/Australia and Port Moresby.

Explore PNG landmarks at https://www.lonelyplanet.com/destinations/papua-new-guinea

Spare camera film, flashlight, sunscreen lotion, insect repellent, hydrocortisone or Solarcane for insect bites, moisturizing cream, photos of your home and family for everyone will be interested in these, small snacks or sweets, and any food you can’t do without! Medical students should bring their stethoscope and otoscope/ophthalmoscope set.

Learners should bring copies of all healthcare profession licenses, diplomas, or certifications. A carry-on bag should be packed that contains essentials items just in case one’s luggage becomes lost. Bring clothes appropriate for the weather.

To read INMED learner experiences at this site, please visit INMEDblogs.us and search the name of the site. 

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