AS PNG sailed reasonably smoothly into 2010, the dreaded cholera epidemic was floating down Sepik waterways and into the hinterlands threatening many rural communities.
At last report it had emerged in the Murik Lakes, the home of Prime Minister Grand Chief Sir Michael Thomas Somare, presumably having worked its way down from Kambaramba and Angoram where it was last reported.
Unless contained, this contagion will spread further along the north coast into Bogia, Madang province.
The East Sepik provincial cholera response team has reported cholera treatment in Moim, Mareienburg, Biwat and Wewak as well.
Over 300 patients have been treated so far. Eleven deaths have been reported but given the distances involved between health centers and remote villages and the nature of the people to stay away the situation could be far worse.
The cholera epidemic is moving as fast as infected people travel and given that people travel all the time, it will not be long before it emerges in Port Moresby and other population centres of PNG.
Remember that the first reports of this epidemic came from remote Menyamya of Morobe province mid last year.
Within weeks, it was in Lae and then it was reported Goroka and Madang and in remote Kambaramba.
Cholera along with tuberculosis decimated entire communities around the world before proper hygiene and sanitation and treatment for the illnesses basically eradicated the diseases early last century.
Yet both diseases are prevalent in epidemic proportions in PNG as the recent cholera outbreak has shown.
Various strains of tuberculosis exist in PNG and keep emerging.
Cholera and tuberculosis combined with HIV/AIDS are quite a formidable and fatal mix.
It calls for a concerted and sustained effort by the Government and by health authorities to bring cholera and tuberculosis under control early.
Hygiene and sanitation practices in many rural settings are dubious.
Access to clean water in a country with so much water is very limited. These combined make for a quite comfortable setting for epidemics, particularly those bacterium or viruses that are water or air borne such as cholera and tuberculosis.
If cholera must be contained, then people in infected areas need to be told to stay home until the all clear is given by health authorities to travel.
This may mean using the military to ensure quarantined communities observe the travel restrictions.
It will give health teams sufficient time to actually visit all affected communities with medicine and especially to give preventive health care talks to people.
Many people in rural communities just lack basic health and hygiene instructions. Many would normally apply them to the letter once somebody takes the time to tell it to them.
It was also a telling reflection of the way things work so slowly in this country that the Prime Minister has never been kept abreast of the epidemic wrecking havoc in the rural communities of his own province.
When he visited East Sepik last week, he was surprised at the reports that the disease had spread much faster and away from Kambaramba into his own Murik Lakes and other parts of the province, including Wewak town.
This is indicative of the neglect and lack of attention the health authorities have given this epidemic or indeed any other epidemic.
As Prime Minister and also as Regional Member for East Sepik, the Prime Minister ought to be regularly given situation reports by those responsible.
Reports from the cholera response teams in the province should be made available to the Prime Minister on a daily basis if possible.
Because it is not in the news does not mean the disease has somehow petered out somewhere out there.
People out there are dying from illnesses that are so easily preventable but scarce resources are being diverted to other areas.
Resources will be made available if the chief executive is well versed with the situation on the ground.
It is no wonder there has been little support for the provincial response teams. Their efforts, for all it is worth, appear not to have been passed on in order to elicit the kind of support that is needed on the ground.