Manalos saving lives in Morobe

By EREBIRI ZURENUOC
MANY women living in remote parts of Morobe province give birth in their family homes, sometimes, with the help of village birth attendants, and other times fellow village women.
In rural areas, the lack of mobile network coverage for clear communication, roads for proper transportation, and accessible aid post and health facilities for adequate health services, are amongst the many reasons why babies and mothers die.
I travelled to Mama Village in ward 23 of Wampar local level government, Huon Gulf District, on Saturday Jan 5. I accompanied the chief executive of Manolos Aviation Jürgen Ruh and his daughter Alexandra to drop off twin babies Nyla and Tahira Mark.
Nyla and Tahira were born around 6pm on Dec 25 last year in the village. Their mother, 21-year-old Rose Simai from Rabaul, did not make it through. She was very young and it was her second pregnancy. She died in the early hours of Dec 26 from loss of blood.
On Dec 26, a medevac operation by Captain Ryan Butler and Sr Rosemary Singidan, between 11.30am and 12.30pm, flew the twins to Angau Memorial General Hospital, where they got all the care they needed.
For Ruh, the twins made a special impact; not only did they lose their mother and were born on Christmas Day, but the fact that they will never know their mother, touched the hearts of many people within PNG and overseas.
The twin’s story on social media caught the attention of an Australian woman who donated $250 (K586) for the twins, which went into the purchase of baby products and K350 cash was given to the babies’ new mother on Friday, Jan 4.
It was a blessing for Molina Mark, 30, who adopted the babies. I had a chat with her before the flight to Mama Village.
“I gave birth in the village seven months ago. My husband and other men built a hut, and that is where I gave birth.
“There is an aid post at Siara Village but we will have to walk two hours to get there. For a pregnant woman, this is impossible, because she will have to cross a river and climb mountains, and during the rainy season, she won’t be able to make it across the river.”
For a hard working mother, taking care of three babies is not impossible. Molina Mark was eager to get back to the village.
The flight took us about 25 minutes to the interior of Wampar. Ruh landed on a small hill, just above the village, where people had cleared a few trees previously and leveled the ground so that a helicopter could land to pick up the twins.
The village is far away from all government services like schools, health facilities and roads. The people use bush tracks to access the village and their food gardens.
I met the twin’s father, Simai Farenuka, 32. He was heartbroken because he not only lost his wife, but made a very brave decision to have the twins adopted.
“The body of the twin’s mother is at Angau Hospital,” he tells me.
“We carried her body on a stretcher to Fanzum Primary School on the night of Dec 26. In the morning of Dec 27, we put her body on the PMV truck and took her to Lae.”
The only road access to all the landlocked villages in this part of Wampar is the pilot track Mama-Bogeba road.
It was constructed in 2014 by MP Ross Seymour. The dirt road continues to the Rumion Piggery road and ends at Fanzum Primary School.
The village magistrate, Mangkot Bafinu, whom I also interviewed, said there were not many options to help mothers.
“We have village birth attendants but they are just first aid people and they do not have the resources to help them do their work. They need help from the haus sik.
“If they are lucky, they can save the mother and the baby but in many cases for this village, the babies die. It is the first time that we have a mother die after giving birth,” he said.
Farenuka said the main problem the village faced was the network coverage and road access.
“If we want to make a call, we have to walk to Fanzum Primary School to get a clear network.
Ruh asked why there is no network coverage.
“We have a tower set up by Digicel, but it was closed. We had a land dispute, and the landowners closed the tower,” Bafinuc said.
Ruh wasn’t happy when he heard that. His reply was: “em i rong bilong yupela tu. Sevis i kam na yupela yet stopim.”
Bafinuc said when there was network coverage many lives were saved because when the villagers called for aid, it arrived quickly.
“We make calls for help before we start carrying patients on stretchers out of the village,” he said.
Ruh was happy to see the twins return. However, the villagers also had another task for him.
The village coordinator, Willie Saiyak informed Ruh of a mother who had a miscarriage. Her husband is from the same village where the twins were dropped off.
“She had complications on Friday (Jan 4) midday,” Saiyak said.
“Pikinini kam aut pinis tasol pipia i stap yet long bel.”
“We carried her on a stretcher to Fanzum Primary School around eight o’clock in the night, hoping that she could catch a PMV to Lae in the morning.
“The thing is, we do not know if they went to Lae already. There is no network coverage to call them and confirm if they have left.”
For Ruh, it was an emergency. We left Mama Village as fast as we could. Saiyak was taken on board with us, to help Ruh navigate to Fanzum Primary School.
The helicopter left Mama Village. In less than five minutes into the flight, we flew above a chain of mountains and crossed the Rumu River. We landed on the sports field of Fanzum Primary School.
We met the ward councilor of Mama-Bogeba area, Ben Fanak, at the school. He was so relieved when he saw the helicopter land.
“The mother needs urgent help,” he said.
“The baby died but is still attached to her womb. She cannot stay like this for long, or travel on the road for more than three hours like that.”
The mother, Selina Samuel, 35, from Raicoast in Madang, was just into her third month of pregnancy. She had three children already, all through village birth.
Ruh waved his hands and four men were already running towards the helicopter with Selina Samuel on the stretcher. As soon as she was removed from the stretcher and put in the helicopter, we quickly left for Lae.
I later called a health worker at Wampar Health Centre who said the Siara Aid Post had been there for more than 10 years, and it was located outside of the network coverage area.
“We have one community health worker working at that aid post right now. It is a two-day walk from Siara to the Wampar Health Centre.”
I asked how they communicated with the CHW when help was needed and the worker said: “The CHW visits the health centre when medical supplies are needed. After that, we do not know how he does his work.”
I asked if there were any visits into the area by health workers. The health worker said: “We usually have quarterly patrols a year into the area, but when there are emergencies like the recent polio outbreak, we visit when scheduled.
“Given the lack of road access into the mountains, the catchment area could not be visited at the same time.”
The worker confirmed that there were health volunteers such as village birth attendants, but there were no records of their work.
The medevac flight from Mama Village was actually not my first. My first was to Tawa in the Nanima-Kariba local government of Menyamya which borders Gulf.
A mother was in a critical condition after she gave birth and was taken to Tawa sub-health centre. I accompanied one of the two flying nurses, Sr Rosemary Singidan and Ruh to evacuate the woman, who was treated at Angau Hospital an hour later.
A lot of help and support is needed in the remote areas. There are a lot of women giving birth, and are facing a lot of complications, the challenges are so many. With birth complications, and when it comes to saving a mother, time is important.
The Mama medevac operation which started in 2009 is literally a lifesaving operation. I had a chance to have a chat with Ruh on Saturday before his very busy schedule.
“The medevacs have been in operation for 10 years,” he tells me.
“I had my first medevac to Lablab station in Siassi in 2009. The baby was deceased for four days. When we delivered the mother to Angau, she did not receive immediate attention and died the following morning. I felt so bad. I told myself I can do better than this.
“For three years, we flew with just pilot and stretcher, and we would lose two mothers a year shortly after delivering to the hospital.
“In 2014, I finally came up with a contract with the Morobe provincial government. I got a nurse to work on board the medevac flights and everything was okay. There were no deaths in flight.”
Ruh has been a pilot for more than 15 years now. He started flying in 2004, and in 2009 he sacrificed his salvage and towing company, which shrunk due to the global financial crisis of 2009.
He has been to nearly all health facilities in remote areas of Morobe. He observed that Morobe was not well-connected in terms of roads and access to government services, and areas such as Finschhafen, Kabwum and Bulolo were very remote.
“For other provinces, I usually land next to a health facility to pick up a patient. Here, many times I land on top of a hill, on footpaths, food gardens, places where it is impossible to shut down the helicopter to get out and help my nurse. The facilities are far away from the people.
He said sometimes he had to turn down requests.
“Last year I had a call to transfer a patient with advanced stage of mouth cancer to Lae. We assessed and a consensus was reached between us and the villages for the patient to remain in the village, due to the lack of cancer facilities in either Lae or Port Moresby.”
“If I bring him here, will he be guaranteed a cure? Or he will be put in a morgue, and the family will spend more money to take him back for burial? Much better to pass on in the village amongst family and loved ones.”
He said an improvement that the company was looking forward to apart from faster dispatch was night flying.
“This is so that we can save women who give birth in the night or early hours of the morning, when it is still dark.
“I have already received a set of night vision goggles, thanks to my only corporate sponsor Trukai Industries. We still need to get another set, and also, modify the aircraft and put different light bulbs so that it will not affect the night vision goggles,” he said.
“There is still a fair bit of work involved before we can even do our first night vision training flight.”
The Manolos medevac operation had done 291 medevacs in 2017 and 177 in 2018.
When medevac nurse Sr Susan Muro was asked why the decrease, she said: “For remote areas where there is clear communication, we manage to get in touch with locals in the village, where we give them instructions and guide them on how to assist patients.
“For such cases, we cut down on the flights that we would have to take.”
Ruh said the good staff and facilities at the Braun Rural Hospital in Finschhafen and Etep Rural Hospital in the Tewai-Siassi were also a contributing factor to the decrease in the medevac transfers.
“When you have good surgeons who can actually do surgery using proper machines, the minute people need help; there is no need to fly them to Angau Hospital.
It is true that most people in remote areas of Morobe, and even PNG, have no access to proper health care services. The need in health care is a challenge, and when dealing with lives of people, time is of the essence.