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Kikori Hospital

Papua New Guinea

Overview

Kikori Hospital is located on the southwest peninsula of Papua New Guinea (PNG), near the capital city of Port Moresby. The setting is extremely rural, with few roads. Travel is frequently by boat. Most people make a living by logging or subsistence farming. Infectious diseases are particularly common in this region, including typhoid, malaria, TB, and HIV complications, as are traumatic injuries from logging, snakes and crocodiles.

INMED learners serving at Kikori Hospital are supervised by healthcare professionals at this facility. Responsibilities are tailored to the ability of the learners, and may include inpatient care, obstetrics, surgical procedures, and outpatient clinic. The official language in PNG is English, and most people speak it proficiently.

Location

Kikori Hospital is located on the southwest peninsula of Papua New Guinea (PNG), near the capital city of Port Moresby. The region is marked by tropical forest, and the hospital is on the banks of the Purari River. There are few roads, and most travel is by boat or by air. 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 Kikori Hospital for care are usually grassroots villagers who subsist by farming. Some are employed by the oil and logging companies. Injuries and infectious diseases are common among these people, while cardiovascular disease and cancer are less commonly 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.

Kikori Hospital is associated with Kapuna 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

Kikori Hospital has four wards, outpatient clinic, and emergency department. Also included are facilities for radiology, an operating theatre and a basic laboratory.

Medical Ward (General Ward)

This unit caters for both adult and pediatric patients, including 12 beds in each wing. The most common reasons for admission are respiratory disease (e.g. pneumonia, tuberculosis), followed by gastrointestinal disease (e.g. amoebic dysentery, gastroenteritis). Acute cases including newly admitted TB patients are stabilised here before transfer to the TB ward. Approximately six staff working in this ward on any given day.

Adult Wing / TB Wing

One quarter of this wing is specifically used for tuberculosis sputum-positive patients (4 beds). There are a total of 10 beds available for extra-pulmonary tuberculosis patients and patients with other medical conditions (up to 14 beds total).

Paediatrics Wing

Reserved for paediatric patients (10 beds), though adults may be moved here when the adult wing capacity is exceeded.

Surgical Ward

This unit caters for all trauma cases — fractures, wounds, and other injuries — as well as skin diseases and snake bites. It serves both adult and paediatric patients. Unfortunately, many trauma cases are due to domestic violence under the influence of alcohol. The ward consists of two wings: 10 paediatric beds and 14 adult beds.

Tuberculosis (TB) Ward

The TB ward admits all types of TB cases, both adult and paediatric. Newly admitted TB patients remain in-house for the first two months of their treatment, after which they are discharged with their medication. TB follow-up remains a challenge due to limited staff and funding.

Obstetrics & Gynaecology Ward

This ward caters for antenatal and postnatal mothers, and women with general gynaecological problems. Approximately 300–500 supervised deliveries are attended annually. The acute wing has seven beds; the postnatal wing has six cubicles. Admit are women in labour, women with a birth before arrival, gynaecological problems, high-risk antenatal cases, antenatal women at term without nearby wantoks, and neonates under 4 weeks with any neonatal issues. Cases involving violence and rape are also admitted for security and counselling. A nursing officer or midwife is in charge, with a maximum of four staff at any time.

Family Health Services Clinic

The family health service clinic provides daily weekday services at the extended far end of the obstetric ward. Attended are family and reproductive health issues and a baby clinic for infant and child immunisations. The aims are to reduce outbreaks of treatable disease in children through immunisation; for antenatal women to attend at least 4 visits for early detection of high-risk pregnancies; to provide appropriate and patient-specific family planning; to provide friendly and welcoming services for this important population.

Weekly Schedule: Monday: Immunisations and well-baby clinic. Tuesday: Antenatal enrolment for new antenatal women. Wednesday: Family and reproductive health. Thursday: Antenatal clinic for re-attendance. Friday: All of the above.

Outpatients & Accident and Emergency

The outpatient clinic is busy, with about 38,000 consultations per year. It is subdivided into the Outpatient Department (OPD) and Accident & Emergency. Other services are coordinated here including doctor’s consultation clinic, dental clinic, and pre-employment medical evaluations. The OPD provides curative and preventive health services for adults and paediatrics. A&E provides immediate care in acute circumstances, with triage performed on all patients based on severity. Typhoid, malaria, TB, HIV complications, and injuries from logging, crocodile and snakebites are common, with about 1,000 admissions per year. Together these units deliver services 24 hours per day.

Kikori Hospital actively trained community health workers, and also invests into primary school education, and community development projects.

Kikori Hospital staff includes 2 doctors, 1 Health Extension Officer, 14 nursing officers (PNG nationals), 29 community health workers, 1 medical lab assistant, 1 radiography assistant.

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 Kikori Hospital but must be requested at least two months in advance. From Port Moresby, a commercial flight is taken to the Marsden Matting Airport, which is located right beside Kikori hospital. Those at Kapuna Hospital can travel to Kikori Hospital by boat, which takes about four hours.

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

The Kikori Hospital facilities include dorms for men and for women, and staff houses. Visitor accommodation will be arranged among these options.

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 brining a light nylon parka, sun hat, sunglasses. Many people at Kikori 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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