The highs and lows of working in a tropical hospital

But it did.

Roman was admitted to hospital here in Papua New Guinea in August. Barely conscious, severely malnourished and having multiple seizures, we did not think that Roman would survive. Amazingly he did, but as he began his recovery, it became clear that he had had a stroke, leaving him unable to communicate and with weakness to the whole right side of his body.

Such are the effects of tuberculosis.

It has been a long, hard road, and he still has a long way to go, but five months later, this little boy is a walking, talking miracle, and an absolute delight.

The same day that Roman started to walk again, a canoe arrived at Kapuna Hospital. A young woman in labour was carried in, again semi-conscious, having been fitting on and off for 12 hours. But this was not TB – Maggie had eclampsia and obstructed labour and was unable to deliver her baby.

She had travelled two days by canoe and was fighting for her life. We treated Maggie’s medical problems and she recovered well, but we had no choice but to deliver her baby, who by this time had been dead for a few days. It was probably one of the worst things I have ever had to do as a doctor.

Such are the highs and lows of working in a bush hospital.

Kapuna is a remote hospital in the swamps of Papua New Guinea, and is the only one within paddling distance for 30,000 locals living throughout this part of the jungle.

Transport is by canoe as the rivers provide the only transport system. As one of only two doctors at the hospital, we have to deal with everything that comes through our doors. Tropical diseases and infections are rife, with one in four patients being treated for tuberculosis, and leprosy and HIV causing significant disability.

Being in the jungle, where people have to hunt and work the land to survive, our emergency department deals with a continuous stream of snake bites, machete wounds and crocodile injuries. Aside from the health problems specific to the Tropics, on the wards we have patients with lung and heart disease, stroke, cancer, and all the same problems as people in the UK have to deal with.

There are days when it is incredibly rewarding working here, when I have the absolute privilege of being involved with patients such as Roman and seeing lives changed. But then there are days when I end up discouraged and frustrated as I know I cannot provide the same level of care to my patients as I want to – as I could in the UK.

Today is one of those days. I have a patient with a broken spine, again due to TB, who is in severe pain. The only pain relief I have to offer her is paracetamol, and with only three bottles of that left in the hospital and no idea when our supplies will turn up, even the paracetamol is severely rationed.

We also have a five-monthold baby on the ward with a broken leg. Babies should not break bones, so there is clearly some other problem underlying this, but we have no X-ray and no facilities to do any sort of blood test. To get an X-ray, this family would have to travel about 80 miles and the nearest place for blood tests is the capital Port Moresby – a 200-mile trip, not exactly possible in a canoe.

I knew I was coming to a place with limited resources, so it is a daily challenge to provide the best care possible.

The question I am often asked is: “What made you leave Teesside and move to the jungle?”

It is a long story, but I guess it had been my goal for many years, and last year it eventually became reality.

I wanted to be working in the developing world, teaching and training local health workers to care for their own people. I wanted to try and tackle the health inequalities that affect so many people worldwide.

Naive and idealistic? Probably, but that was the only reason I ever wanted to be a doctor, and that dream only grew when I first visited Papua New Guinea.

I was in my fourth year of medical school and we had been given two months to spend at a hospital anywhere in the world. I took the opportunity to come here, looking to gain some experience in tropical medicine.

Little did I know how much I would fall in love with the people, the country and the culture.

The next four years was a long wait as I finished studying and then worked as a junior doctor in Middlesbrough, before moving back to Papua New Guinea last year.

The health inequalities are still too great and we need to do more for our patients.

Our dream is to acquire an ultrasound machine for Kapuna Hospital to aid us in accurate diagnosis and to guide treatment, and the people back home can help us make this dream a reality.

We need to raise £20,000, but it will make a huge difference.

If you would like to help, visit youcaring.com/kapunaultrasound.

You can also find out more about our hospital online at kapuna.org.