Never have so many gained from so little


SECOND year Bachelor of Medicine and Bachelor of Surgery (MBBS) students of Divine Word University are planning weekend rural visits to remote villages in Madang.
During each visit the MBBS students are accompanied by a doctor, who is also a lecturer from the Department of Medicine within the Faculty of Medicine and Health Sciences.
The most recent rural visit was to Ariangon, in Bogia, making it the third after a visit to Mogil, in Bogia, and Brahman, in Usino-Bundi. This time, five students went with Professor Jerzy Kuzma, PhD, the Head of Medicine.
The trip started with a three-and-half-hour drive to Bogia on the afternoon of Friday August 4. Early the next morning, we drove for another hour inland from Bogia station to Ariangon on a muddy road.
The poor road condition, which in the wet season is not passable, makes it difficult for the people to access services from an area that is under-developed. This area is affected by poverty stemming from a lack of income, education, access to clean water and sanitation facilities and very poor access to health services. These conditions have contributed to the high incidents of ill–health in this area.
There were more than 400 patients waiting for us, and they said that “it was the first time in 30 years for such a health team with a doctor to visit”.
The health centre staff members were all present and began by selecting patients who would benefit most from seeing the doctor.
The students worked under the lecturer’s supervision with a short break for lunch which the local people prepared for us. All in all, we examined and treated more than 120 patients. Some patients were referred to the provincial hospital in Madang, even though many said it would be hard for them to get there.
We experienced the challenges of trying to deliver clinical services to remote and rural populations. We also learnt the advantage of rural clinical visits that exposed medical students to practical opportunities and diagnostic challenges, especially when laboratory tests and imaging were not available on site.
We took the opportunity to develop  our clinical skills and exercise clinical thinking in a real low-resource environment. The people came with so many diseases; common were tuberculosis, pneumonia and sexually transmitted diseases.
The visit also gave us the opportunity to refine our examination techniques.
One female student said: “I learned the different respiratory sounds and what they mean and the possible diagnosis that is accompanied with each. What I noticed there was a need for a pathology laboratory where specimens for TB and other diseases like STIs can be checked for diagnosis.
“Moreover, I also saw a need for things like hospital beds, water tanks, medicine and other equipment in the village health centre.”
Another female student said: “There were what seem to be hundreds of people gathering at the local health centre when we first arrived. When I saw this, I pity those unfortunate people. A majority of those people couldn’t make it to Modilon General Hospital in Madang town because of the road distance and lack of money. They told me the PMV fare was K60 which most of them cannot afford.
“As the saying goes: seeing is believing. You will not feel the pain these people face every day unless you actually see what they are going through. With that, my mind is fixed – I am willing to serve the rural majority wholeheartedly in years to come.”
Another medical student also shared his experience of the visit to Brahman health centre in the remote part of Usino-Bundi: “What inspired me the most in our visit to Brahman was seeing the hope that the people had when they heard that a doctor was coming to see them.
“Because such rural places hardly have doctors, many people from very far away villages walked to the station upon hearing the news.
“We attended to more than 60 patients, and unfortunately, there were still more when we left because of insufficient time. Also, many couldn’t be helped due to insufficient basic medical resources.
“However, I do believe that some patients got healed one way or another that day because they believed that doctors were there for them and just by listening and attending to them attentively made all the difference.”
These rural visits are helping medical students appreciate what the needs and challenges are in the rural and remote areas of our country where the majority of the population live.
We feel that by going to the rural and remote areas constantly and seeing the people, we can identify the gaps in existing health delivery and we can contribute meaningfully in addressing these gaps in our primary health care system and save lives in our country.

  • The writers are second year medical students at Divine Word University.