Rural doctor decline a worry

 A recent revelation by the Papua New Guinea Society of Rural and Remote Health that there has been a dramatic drop in the number of doctors attending to the rural masses is a worrying trend. 

With a majority of the country’s seven million inhabitants living in villages and the districts, having fe­wer medical professionals to turn to for help means the people are at a higher risk of succumbing to diseases and have reduced options for treatment for medical emergencies. 

President of the society, Dr David Mills said the problem was that many doctors preferred to work in urban settings and for obvious reasons. The lure of well-paying positions at state or private hospitals is strong, especially when you factor in the advantages of working in a city or  town. 

Doctors in rural areas tend to work out of a sense of service to the community more than for the perks and privileges. 

Mills, speaking at the 22nd National Health Conference in Port Moresby last week, indicated that where previously church-run medical services would cater for the rural needs with the help of doctors, the trend now was shifting with fewer and fewer medical professionals willing to work in a remote district. He conceded that although church operated health centres and clinics were generally well-maintained and had basic equipment and facilities and drugs to care for the rural communities, the remoteness and lack of other essential services (communication, banking, schools, police presence and transport infrastructure) as well as rugged environment was proving to be deterrent for doctors. 

“The majority of districts have no full-time medical staff and curative health services are provided by the community health worker, nursing officers and some clinical health extension officers where they are present,” Mills said. 

But having a dearth of doctors in rural areas should not be the case because the country’s only medical school, the University of PNG, through its School of Medicine and Health Services, entered an agreement with church health services to develop level specialist level training programme in rural medicine. 

Mills admitted that although the programme called the Masters of Medicine (rural) programme was designed to train individuals to be able to take on the task of working in a rural environment, it was something few of the graduating classes from the UPNG’s medical faculty were willing to do. 

Mills called for a coordinated effort between the National Department of Health and the provincial health authorities to see the programme effectively used because there had been little progress since the programme had come into existence. He said the interest from doctors was there and they could be attracted to work in district hospitals. 

If the number of doctors in rural areas continue to dwindle, the state may have to make a period of rural medical service compulsory for medical school graduates or even have public hospital workers have stints in the districts. 

The state must make working in the provinces attractive for health professionals. 

Housing, better remuneration, scheduled breaks, vehicles, facilities, equipment and adequate staffing can and should be provided. 

There is nothing more spirit-sapping for the lone doctor in an isolated or rural setting and expected to cater for a community’s needs with little support.  

A plan by the Health Ministry some years ago to bring in doctors from Cuba to prop up the ailing health services sector met with some resistance from the medical workers union and now the more recent plan to bring in nurses from the Philippines is another manifestation of the problem – that more and more local medical professionals are unwilling to go out to the provinces and the districts to work. 

A change in attitude is needed not just from the Health Department but the doctors themselves. 

There is a need in the rural areas for doctors and other suitable qualified practitioners. 

Perhaps Mills statement that “traditionally the church provided health care in the villages and rural communities of PNG” is inadvertently telling the government to do more for rural health and not leave it up to the church to do the unfashionable, unwanted, thankless task of bringing healthcare to the people of this country.