issue no. 13 july - september 2017 support rural health ... toktok issue 13... · issue no. 13 july...

Official newsletter of the PNG Christian Health Services

Issue No. 13 July - September 2017

HE caught this writers attention as the “Text Book doctor” for performing a surgery by reading from a medical text book, but drastic circumstances call for drastic measures and saving lives at the end of the day is what matters most.Dr Hogande Kiafuli who hails from Lufa in the Eastern Highlands Province and who is the resident doctor at Gaubin Rural Hospital on KarKar Island, Madang is a small but humble man who believes that God has called him to be doctor for a reason and a purpose in life.Dr Hogande is currently in his third year of the Rural Doctors Masters in Medicine Program, a joint partnership between Christian Health Services (PNG) and the UPNG School of Medicine and Health Sciences where degree graduates are trained for a further five years to be specialised rural doctors. The program is unique as the recipients in real time can practise what they have learned enhancing their own skills and knowledge.Expertise of health workers in the medical profession in rural and remote areas continues to be a challenge to those in the rural health workforce. “We don’t have a lot of expert staff to do a particular job and so we have to make do with what manpower we have. There were only two medical Officers (MO) and the rest community health workers (CHWs) at Gaubin when I joined so it was a challenge trying to do procedures that needed a specialised person in that field,” said Dr Hogande.Referring patients from rural and remotely located geographical locations is another challenge that continues to be ever present. “When you live in a place like Karkar, you need fuel, an outboard motor and money to pay for your sea fare to transfer patients to a big hospital such as Modilon. Not only that you need an ambulance or other transport to ferry the patients from the mainland to the hospital and this can be very challenging especially when you have a life threatening situation on your hands,” Dr Hogande said.This takes us back to the “text book” story where Dr Hogande had to perform a surgery reading from a text book because he didn’t have the expertise to do the operation.Dr Hogande says in such circumstances, you will do anything to save a life and time is importantIt so happened that a women went into labour on the island and was facing complications. Referrals to Modilon hospital are at 7am and 5pm when

there is an outboard motor on standbye but she was brought to the hospital after 6pm.The woman (name withheld) lived on the Waskia side of the island and went to the Miak Health Centre at 2am on that early morning in 2015 but was seen at 7am by the midwife. She was referred to Modilon at around 4pm but got delayed due to various reasons.Her family brought her to Gaubin Rural Hospital on the Takia side of the island in a bid to save her life.Dr Hogande recalls the woman was in shock and had lost a lot of blood. After doing a general assessment on the patient, his findings were that she had severe abdominal pain due to a ruptured uterus, she was in extreme shock due to blood loss and the baby was lying transverse because of the ruptured uterus, the baby had come out and was lying in the abdominal area causing pain and bleeding.“It was already after 6pm and I could not refer her as there were no boats and she was also in shock,” Dr Hogande said.He made the decision to do the operation a hysterectomy to remove the ruptured uterus. “The first thing I did was to do a blood transfusion. We don’t have a blood bank but the woman’s family and staff at the clinic donated blood. I had to check the blood donations to see that it was compatible with the woman’s blood type so if you see it was like combining skills and part of your body which is the blood to save a life.”After the blood transfusion, the mother was stabilised with intravenous fluids and put on local anaesthetic while Dr Hogande removed the blood

that had clotted in the abdomen which in itself was a challenge as he said there was no electric suction or foot pumps to remove the blood so he had to clean up the blood manually with gauze. This was followed by Dr Hogande locating the source of the bleeding and clamping it and remove the ruptured uterus.He said: “I believe and have faith in God. Before every surgery I pray and it makes the difference. I didn’t know how to do the hysterectomy so I told my MO to hold the open the medical text book while I read what was in the book and applied it. I had no time to feel undecided or worry because two lives were at stake. I read how to do the operation and physically do it at the same time,”The operation was done successfully, with the baby being removed via C-section but as Dr Hogande says with a smile: “After that I was a little worried that she might have difficulties in bladder movements if I had cut the urethra but she did not which meant I had done the operation successfully.” The mother survived and was later taken to Modilon General Hospital for further observation but unfortunately her baby did not survive. Funding support is also another challenge that continues to hinder the work of rural health. Dr Hogande said with the funds coming in by way of grants from the government it has to be used wisely to cater for the needs of the health centre as sometimes funds came in two, three months later. Capacity Building is also another challenge that needs to be addressed to assist the manpower that is currently serving in the rural areas.Dr Hogande also mentioned that the Health Department should focus more on primary health care in the rural settings as this was where the majority of the people were. “The government needs to support the Aidposts and health centres and support Church Health services more. Support CHS, if you don’t support CHS, you don’t support CHS. They represent health services in the rural and remote areas.”“I have a vision, despite all these challenges, I am still there. I would like to acknowledge my wife Goslyn who has always supported me in my work. We believe that God has called us here for a reason and to help others. She tells me people move to other places for greener pastures but we have moved to brown pastures to make it greener.”He added: “ I know what I want and where I want to go. It’s how to get there that is my challenge.Dr Hongande currently lives and works at Gaubin Rural Hospital, Karkar Island, Madang

“Serving with love, dedication, committment & Compassion in humility” QUARTERLY ISSUE NO: 13/20171

Support Rural Health, says doctor

Dr Hogande Kiafuli

From the Desk of the Chief Executive Officer..

Christian Greetings and many good wishes to you all and thank you all for the prayers.It is my pleasure again to greet you all as brothers and sisters in Christ and have this opportunity to updated you all on activities and matters of interest in regards to our core business of serving God through his People.It has been a sad period for many of us and those providing health care services to our people. I am saying this as the National Elections has affected us all. Some of our facilities experienced undeserved humiliation, harassments, damage to properties, closure of facilities hence affecting the provision of services. Furthermore, government priority was to deliver the 2017 National Election and so cash flow was and still a big issue. This is compounded by the decrease in revenue due to the decline in the export earnings resulting from the drop in the market price of our main commodities. Therefore, due to insufficient cashflow, the release of the monthly grants is very slow. We have received and distributed the July grants but are yet to receive August and September grants.I take this time to thank you all for remaining faithful to God despite all the disruptions aimed at undermining our faith to serve Him. Furthermore, the 2018 National Budget is geared towards delivering the 2018 APEC Meeting. This means, we will experience more cuts in the 2018 appropriation. The exact reduction will be confirmed when the 2018 Budget is handed down at the end of this year. This is forward information to keep you informed so that each agency takes appropriate measures so that serve provision continues.CHS has been instructed to get all agency’s staff on strength on the Alesco payroll and Team CHS has been working tirelessly to accomplish this. The communication between CHS and all agencies in this regard has been general good. A specific CHS Officer has been assigned to communicate with each agency in your respective provinces. You will be contacted by that Officer only

when they require more information from you. We are anticipating to get all the staff on strength on payroll by pay number 26 of 2017. We have suspended the mWater rollout to the remaining provinces due to funding constrains. This means for the time being kindly continue sending the monthly National Health Information System (NHIS) reports to the M&E Officer. It is encouraged that you send this report in the excel format and do not send reports in scanned or pdf format. The agencies in Enga, WHP/Jiwaka, Milne Bay, West New Britain are also requested to continue sending your reports however we already have access to you data on a real time manner using the PNG Remote Sensing system. This system is being rolled out by the PNG Remote Sensing Centre and contracted by the National Department of Health.Another responsibility we all share is the acquittal of the Government funding we receive every month. Many agencies are not submitting their monthly acquittal reports. The report includes both the Salary and Operational Grants. A report is incomplete when the NHIS report and the finance reports are submitted. Additionally, submission of incomplete finance reports is unacceptable and it is the responsibility of each agency manager to ensure reports are submitted every month.Irrespective of this, we will still continue the role out of mWater when we source funding. The mWater system will be used to collect data for Health Promotion data (EDEN), Finance Reports, and CHS agencies Human Resource Data.In line with my remarks in the last edition of Health Toktok, CHS is exploring options on how we can work with the Health Standards division of the NDoH in addressing compliance issues within our facility settings. The areas of compliance include infrastructure, clinical services, work force, management competencies including financial management. This is a huge task and your prayers are needed in this regard. The building of new facilities by our

agencies without securing funding for the salary and operational components is becoming an issue. Since 2014, CHS funded staff ceiling has been 3290 with 713 funded health facilities including Catholic Health Services. Anything beyond this is unfunded and we are thinning out in our appropriation. A draft handbook on the procedures of setting up of new health facilities is available. For a copy, request by email and we will send you an e-copy. Partnership at Provincial and district level is encouraged to help you for extra funding support. However, separate agency head agreements are discouraged as it will effectively result in fragmentation and this can weaken our unity. I have the Draft Service Level Agreement template therefore manager a provincial level and district level (hospitals) are encouraged to request.In conclusion, I encourage all agency managers to maintain communication with the CHS Secretariat Office so that we operate within the confines off existing rules of operation. On this note, do remember to request for the e-copy of the CHS Handbook 2005 edition and CHS Act 2007 for your purpose. With this, many good wishes as your continue to serve in His Healing Ministry. God Bless!


Ulch TapiaChief Executive OfficerChristian Health Services PNG

Rural Health and challenges..pg 1From the CEOs desk..p2Highlands Region News..p3Southern Region News..p4Momase News..pg 5Kapuna CHW graduates ..p6The eye and blindness ..pg 7CHS donate to HB appeal..p8Budget talks..pg 9Building & Infrastructure..p10Lifestyle disease training...p11

Inside this Issue...

Dear Readers,

ELECTION related violence in the Western Highlands Province forced the Kotna Health Centre, a facility of the Lutheran Health Services to close for an indefinite period.The health facility was destroyed, staff harassed and beaten and the health centre vehicle had its windows smashed. Staff housing were also destroyed.According to reports, the actual fight were between supporters of two different candidates (names not mentioned) on Thursday July 27th, 2017. Supporters, mainly youth of one candidate ordered all the health workers to shut down the facility and started destroying the building. These young men then proceeded to destroy the guest house and staff VIP latrines and attack people with stones, knives, axes, sling shots and anything they could use. The situation got even more rowdy and community leaders could not step in to solve it. Everyone feared for their lives much less their properties.The youth then went on a rampage destroying the premises of the Lutheran Health Services Highlands Regional Secretary. Food gardens were destroyed, houses burnt and properties damaged.Nursing Officer Sr Wendy Manawe and her daughter were attacked in their house. They stormed the verandah and kicked open the

door but Sr Wendy was blocking the door. As she tried to block them from entering the house, they punched her and kicked her in the face and ran in to attack her daughter but luckily no further harm was done as nearby villagers came in to help them. The attackers left but came back later and burnt down her kitchen (made traditionally) with most of her cooking utensils and beddings.From reports, the situation is tense and community leaders have done nothing much to help.OIC for Kotna John Demok said: “We have no enemies no created any. We provided the best possible health services to the people of the Dei Council only to be kicked and punched and have our properties destroyed and forced to leave.”“Since the lives of the staff have been threatened, we feel insecure to provide health services as we live in fear,” he added.Lutheran Health Manager for the Highlands Region Rev James Koi confirmed the indefinite closure of Kotna Health Centre until the situation could be managed.“I am currently working with the PHA and police to apprehend the youths involved and also with the community leaders to guarantee safety of the health workers,” said Rev Koi.

He added that he did not want to make matters a tribal issue as staff safety was important and ensured that he was working closely with Mt Hagen police, the PHA and community leaders to resolve the matter. As of 2 October, the health centre has been re-opened for the community to use.

Health Department prioritises programs


HighlandsHealth centre destroyed during elections

DHO, Dei District Mr. Rank with CHW Lukas Wamp at the scene (burnt kitchen). The fire destroyed the kitchen and some houses.

NEW program priorities of the health sector have been outlined and these were made known to various health sectors at the 2018 budget coordination meeting in August in Port Moresby.Executive Manager, Strategic Policy Ken Wai in his presentation said updates to the 2011-2020 National Health Plan included:Plans & Visions• Transforming health systems towards the health

vision 2015• Going “back to basics”• Strengthening primary health care for all and

improved service delivery for the rural majority and urban disadvantaged.

• Health is everybody’s businessImplementation Methodologies• The eight (8) Key Result Areas (KRA)• 34 objectives • 135 strategiesAccording to Mr Wai, implementation of these strategies began in 2011 and by 2018 would be eight years of implementation. Findings from the 2015 mid-term review suggest that work progress

has been ‘sluggish’.The reasons identified for these were: work force issues and financing. It was noted that the EPI & TB Programs were not delivering the desired results among others.“The way forward is to strategically prioritise our programs which we have done from 2016-2020,” Mr Wai said.The new strategic priorities include:A.National Level- Effective leadership, governance and partnership- Workforce planning & Management- Medical supplies reforms- Functional health infrastructure & equipment- PHA roll-out reforms- Health financing- Performance monitoringB. Public Hospital Level- Clinical care services- Out Reach/Specialist Visits to districts & Rural Health Facilities-Health Promotion & Awareness

-Infection Control & waste management-Roll-out NHSS to address quality care-Clinical audits in province-Laboratory, imaging and blood bank services-Hospital management informationC. Public Health& Facility Level-Out Reach/Specialist Visits to districts & Rural Health Facilities-Health Promotion & Awareness-Water Sanitation and Climate Change-MCH programs including family planning-TB Prevention & Control-HIV Prevention & Control-Malaria Prevention &Control-Non-Communicable disease control programs-Disease surveillance and epidemic preparednessMr Wai said the way forward was to focus on service delivery, increase partnerships, leverage support from elected members, market health to make it everybody’s business and Health Promotion.

STUDENTS at the Rumginae Community Health Worker training School in Kiunga, Western Province will now benefit from a new student accommodation.Housing for students on practical training at Kiunga District Hospital and the Catholic Health Urban Clinic in Kiunga town was recognised as a priority as students on practical had to live with friends or family in town which posed security risks and financial expenses.“This project was not a one-off funded project so it took almost three years to complete. Catholic Health Services were able to assist students by providing accommodation at their quarters when rooms became available,” said Rumginae CHWTS Principal Mr Amos Kupaloma.He added that this new student accommodation would greatly benefit the students and was added incentive.The building itself has twenty-two rooms: Eighteen standard rooms for two students per room, two air-conditioned room and two self-contained rooms.Technical Advisor Human Resources & Curriculum at the Department of Health Ms Mary Kililo commended the school for having the vision and good partnerships to see the project come to completion.Ms Kililo said Rumginae CHWTS was

meeting the standards set by the health department with such developments and was moving forward in the right direction.Meanwhile, Mr Dume Woo on behalf of the Western Province and District Health emphasised the importance of partnership for development and acknowledged all the sponsors for providing the required funding support to complete the project and other partners who supported in one way or the other. The building was officially opened on June 15th by Ms Kililo and Mr Woo and witnessed by government and church representatives,community leaders and the general public

The student accommodation project was supported by the Western Provincial Government who put up K300, 000 towards the project, The National Department of Health with K80, 000, Telefomin MP Solan Mirism who contributed K20,000, North Fly Health Services & CMCA Health Programs under Ok Tedi Development Fund gave K20,000 and Rumginae CHWTS put up K400,000 with AAPNG Scholarship grants.Mr Kupaloma acknowledged all sponsors for their support and investment into such a project. “This building will benefit Western Province and PNG at large,” he said.


SouthernStudents benefit from building project

RECRUITMENT of health workers will pose a greater challenge for the health sector as the government cannot afford it.This comment was made during a budget meeting before submissions for the 2018 budget appropriation for all health sectors at the National Department of Health in July.Deputy Secretary National Health Services & Corporate Services at NDOH Elva Lionel said with the current cash flow situation in the country, there could not be any more recruitments of health workers so all health sectors had to keep this in mind when compiling their budgets for the 2018 budget.Further cuts to the national health budget

means there will be changes per sector to cater for what funding is allocated.“In the current cash flow for health, it is more labour intensive meaning we need manpower but the government cannot afford to recruit more,” Ms Lionel said.Medical supplies is also one of the biggest challenges the Health Department is facing. Ms Lionel said monitoring of medical supplies was not progressing well thus resulting in shortage of drugs and medicine at health facilities.“These are critical elements of health service delivery that we are trying to manage at our level together with other teams from other government departments,” Ms Lionel said.

Apart from that, infrastructure and new projects will not have any allocations therefore health sectors were encouraged to seek funding and support from other sources such as donor agencies for building projects.Ms Lionel stressed that despite these challenges, the main aim was to keep health services rolling for the majority of the people.Executive Manager Strategic Policy at NDOH Mr Ken Wai encouraged all health sectors to work together with whatever resources they had despite the cuts in funding as health services still needed to reach the people.

Budget woes to affect health service delivery

The new building which will house students from Rumginae CHWTS on practical training


Momase

THE CHS Secretariat has already embarked on the mWater roll out program for CHS Agencies throughout the country.Health Promotion Coordinator Nickson Samblap and M & E Officer Elias Namosha recently visited a couple of provinces conducting awareness and training on the use of mWater for data recording purposes.Eastern Highlands, Morobe, Madang, East Sepik and Sandaun were among the first few provinces scheduled for the mWater training.Most of the required target groups attended the training per province where the EDEN program or Healthy Island Concept was also done.According to Mr Namosha, the mWater system was adopted well by participants and they are confident of using the system for reporting purposes.The CHS Secretariat is receiving reports submitted from respective agencies per province using mWater.“We have learnt some new things and

approaches as far as mWater is concerned as we deliver the training thus improving on our performance too as we go along,” Mr Namosha said.As usual for any new project being tried, there are always challenges that go with it.Some of the challenges Mr Namosha identified were weak or no network coverage for both Digicel and Bmobile mobile networks. This is due to the fact that some health facilities are remotely located where there is no network coverage for instance April River Health Sub Centre (ESP) and Yapsi Health Sub Centre (Sandaun).“ Logistics on the ground such as no transport available for trainings and capacity building for partners and health agency staff for basic computing skills, basic data management, analysis and interpretation are other challenges that need to be looked at,” added Mr Namosha.The CHS Secretariat through the office of monitoring & evaluation, will in the coming weeks work towards correcting,

editing and updating some of the forms used. Presentations on the use of mWater will also be done showing how the data is captured, stored and analysed and the kinds of reports required based on specific need.Mr Namosha said: “We will also be doing quality checks on reports that have been submitted for completeness and accuracy.”The next region for the roll out of mWater will be the New Guinea Islands.The aim of the mWater roll out program is two-fold the first being to introduce the mWater technology to partners and church health agencies as an M&E tool for data management (collection, storage, analysis and reporting) or database management.It is also a form of awareness to church health agencies on the need to prepare themselves the necessary requirements for Alesco Payroll system.The CHS Secretariat hopes to use the mWater tool to mantain collection of data and to generate reports in a timely manner.

Participants from various Church agencies in East Sepik that attened the mWater training

mWater roll out program begins..


CHW graduates ready to join workforce

Kapuna CHW interns going on a trip to Kikori

“They that wait upon the lord shall renew their strength” Isaiah 40:31.This was the key message of reflection at the 14th Annual SSEC Nurses Christian Fellowship in Yakrumbok in the Ambunti/Drekikir district of East Sepik Province.The meeting which was held from the 7-10th September saw nurses from all SSEC health facilities attend as well as families and surrounding communities at the Yakarumbok Health Centre.

The aim of the annual nurses gathering is to fellowship with each other strengthening their spiritual lives, and to share challenges and achievements of their profession. It is also a time where they can all encourage each other.Nickson Samblap, a member of the South Sea Evangelical Church who also attended the meeting said the key message was turning struggles and challenges into your strength.“Regardless of whatever struggles we

face in life, if we focus on God, he can turn those struggles into success,” he said.He said everyone that attended were blessed and had a good time of fellowship and learning from each other’s experiences. Mr Samblap did a presentation on the planning process which was apreciated by all and also a brief update on the CHS Alesco Payroll roll out, EDEN program and mWater and NHIS.

Nurses refreshed after annual meet

Twenty-Seven interns are now ready to join the health work force after graduating from the Kapuna CHW Training School last July. This was after the interns successfully completed a six month practical training after two years of Community Health Worker Training last year. This year’s batch of trainees was the largest number of interns so far but few had dropped along the way in their first and second year. Three left in their third year but most continued to complete their internship.The Kapuna CHW Training School post graduate Practical Nurse Internship program is a six months intensive hospital care course to prepare the graduates to work in hospitals, health centres or aid posts.Candidates for the course also learnt skills such as diagnosis and treatment for sick adults and children based on the Government Standard Care Treatment books, maternity experiences in antenatal clinics, family planning and normal deliveries. They also learnt some skills such as giving vaccines within the clinic and on patrol.

Through their studies, the interns had to improve their competencies in practical procedures such as inserting IV lines, NG tubes and catheters, applying plaster of paris, using urine dip sticks and rapid tests.In addition, the candidates learned the basics of HIV Counselling and testing and were familiar with diagnosing and treating TB and Leprosy. Such skills will be useful in their career.Apart from medical courses, the interns learnt basic computing lessons and leadership courses for church and community related programs. As Community Health Workers they had to learn skills which will be useful in their community relations work.The Graduation was held after three

days of retreat held at the Baimuru - Kapuna base. After the graduation, there

was a meal held to celebrate the event. Invited guests came as far as Kikori to attend

the Graduation and they also had their share of the meal.

Outgoing Principal, Sr Sarah Kaipu urged the interns to go out

serve where they will work as CHW in aid posts, sub health centres and other health work. She encouraged them to continue in their faith wherever they would be located.Dr Valerie Archer commended the interns for their hard work and effort doing the extra work in their studies and assignments. She also presented awards for the students who earned the top marks in the clinical and practical work as well as those completing the SLB books.Other guests at the Interns graduation included retired doctor, Dr Lin Calvert, Matron Kaiki Komal, out-going CHWTS Principal, Sr Sarah Kaipu and her husband, Mr Larry Kaipu, the Administrator of the Kikori District Hospital and nurse, Molly Eddie also from Kikori.


The eye is probably the most amazing and complex structure of the body. The two eyes provide about half the total sensory input from the entire body into the brain. There is, however, one small defect in the visual image produced by the healthy eye, and that is the “blind spot”. This is a small area in our field of vision where we are unable to see. It corresponds to where the optic nerve leaves the eye, and this spot there are no photoreceptors which are sensitive to light. We all have this blind spot even though we are not aware of it. There are certain diseases in which the blind spot may become very large and still the patient may not be aware of any problem. There is unfortunately a very large “blind spot” in world-wide ophthalmology. This is a tragedy of avoidable blindness. Avoidable blindness which could either be treated or prevented cause about three quarters of all the blindness of the world. Just as the “blind spot” is neglected by medical science and technology, and by the caring professionals. Indeed that is the only reason why they are blind.Certainly as far as blindness is concerned,

the whole world is not developing but going backward. The numbers of blind people in the world are actually increasing faster than the world population is increasing. The eye is an external organ and so it is particularly affected by the environment, probably more than any of the other organ in the body. Therefore, poor hygiene as well as the climate, insect vectors and infection with micro-organisms will all significantly affect both the amount and the type of eye disease. Poor nutrition also specifically affects the eye in several ways but particularly as vitamin A deficiency. Also poor medical services and so diseases which are treatable in their early stages are often seen in an advanced or neglected state when it is too late for treatment. This is very true for the developing nations of the world and PNG is no exemption from the scenario. Eye conditions that can cause blindnessREFRACTIVE ERRORThe photos (below) and all other eye conditions not mentioned here can be treated to prevent blindness.

This can be achieved by training more ophthalmic clinicians, ophthalmologists (eye specialists) and provide eye care service with their necessary equipment’s and consumables. CLTC health service has trained one of its staff to provide eye care services and is now doing non-surgical eye care for people with eye conditions.The pictures above are some of the cases seen. “ This is a bonus for CLTC to actually have an eye specialist on board to be able to have a look and treate people with eye conditions.” Wanare said.“ You will be suprised how many people, babies, children, middle aged and elderly people have eye conditions needing treatment.”Wanare added that blindness can be prevented early if eye conditions were diagnosed and treated early and stressed the need for more eye specialists to be trained.There are few others around the nation trained to do that and CHS can do more by training more health workers in the Opthamology (eye) field to providing eye care in the country to prevent blindness and other eye conditions that our people are experiencing and living with.

Information and photos by Wanare Susuke, CLTC, Banz , Jiwaka Province

Bactero-Fungal Keratitis

Rusty metal injury limbus

Bacterial Keratitis

Bilateral Ptosis Blunt Stick Injury

Limberal Mass Bacterial Conjunctivitis

Chronic Keratitis (Bothy Eyes)

Preventing blindness and other eye conditions


CHS Staff recently donated various items, mostly clothing to the victims of the Hanuabada fire which burnt down fifteen houses in August.About 1,500 people lost everything they owned in the fire. They are now homeless and without food, shelter and basic needs. It is unsure how the fire started, but it was widespread and other houses quickly caught on fire. The families affected by the fire have put up make shift tents by the road and an organising committee has been set up to oversee donations.Business houses, individuals, families and companies have donated generously since the incident in cash and kind towards the families and to help rebuild their lives.

Historically, the majority of Port Moresby’s Central Business District (towards the town area) stand on traditionally owned HB land and therefore it was a humbling experience to witness many donations pouring in.The Hanuabada Appeal Committee Coordinator Mea Isaac said they had received many donations from kind hearted people, and organisations.“We have had a good number of contributions towards the appeal and are grateful for those who have given towards this. It shows community spirit and that they have a heart for these people,” she said.She added that all donations in cash and kind would be dived equally amongst the families that had been

affected by the fire and thanked CHS for their donations.Meanwhile, Deputy Executive Officer for CHS Bernard Rutmat thanked CHS staff for their contributions towards HB Appeal.“We never know when we will be in need like this. Let us all help where we can to make the lives of these people more bearable.” “They have a lot of work to to in rebuilding their lives and what they have lost so let us contribute in little ways towards this,” Mr Rutmat said.CHS staff said at the end of the day, they had all felt good as they had been able to help contribute in this small way to those who need it.

CHS give to victims of HB fire

Area where fire burnt down houses.

CHS Staff donating a box and bag full of cloths to the families of the Hanuabada fire

Nickson: “I appreciate the opportunity to have contributed in the 2018 budget exercise. I now can see the number of positions allocated in each facility and province. Having worked down at the field, I have seen that there is a lot of work that goes in to compiling a budget and that we must have accurate data. I have learned a lot of new things from this exercise.”

David: “We were all involved in the budget exercise and I saw that it was good for all of us. I think it is better for a team to be involved in such work instead of just one person. From past experience, it was only the finance person invloved in budget but now i saw that everyone was involved. The team effort was great and I really appreciate it.”

2018 Budget review with CHS


Bernard: “ I think the budget exercise was basically a learning experience for all the CHS staff. We are a small group so team work was essential. The responsibility of the budget is for all of us to master the skills and knowledge in compiling a budget summary.”

Elias: “It was a good learning experience and exposure to budgeting which will be useful for us in other future budget compilations. I enjoyed being part of the team and learning new things. It was also as good way of capacity building.”

Winnie: “The exercise was challenging. I have no experience in accounting or budgeting so it was also a learning experience for me from which I gained a lot of useful knowledge.”

The budget exercise was a learning exercise for everyone. No one had any experience in the actual inputs of the budget and although we had the 2016 & 2017 budget ceilings most of the work we had to do all over again. As far as position distribution per agencey and facility,cadre and categories

per facility per agceny, it was lengthy and time consuming work. It didnt stop there, after compiling everything an e-copy had to be made which was another task that everyone was invloved in. The

entries on IFMS took another week to do as the team from CHS with their willingness to learn and work with our partners from NDOH got it done. We have a good team spirit and we realised that

some staff had the potential and the knowledge to do this work when they thought they could not. It was also a privealge to do a CHS budget presentation to the Treasury Department as it has been

the first time CHS has done this. I wish to acknowledge the efforts all the CHS staff who worked together to compile the 2018 budget for CHS.

Nidra: “It was challenging. I’m not a big fan of the math and numbers game but this exercise taught me a lot. I learned new things especially about cadres of health workers, facilities and facility levels and how they are placed. The team effort was the best and in the end, we did it for all our people who work hard to provide health services for our people. ”

“I have worked at CHS for a number of years but have never had the exposure of being part of a team compiling a budget report. I found it exciting and came to realise that the data we collect is essential for formulating such things as budget. The last two months have given me the fair idea of the budget process, of the data collected, how funds are distributed, staff cadres, doing entries at IFMS and all that. By next year, I will have a fair idea of how to do it better.”

Kanae: “I learned new things even though it was challenging and difficult at times. I saw it as a challenge to teach myself new things”


The Kapuna Community Health Workers Training School (CHWTS) and the Kapuna Rural Hospital has experienced a building boom the last couple of months.Late last year, the CHWTS opened its new computer laboratory, a double storey building and which houses staff offices as well. The computer laboratory and the office are built next to the Library. With the completion of this new building, the School has two double buildings. The other building is a classroom and the other double building houses the Library and the second year classroom.Students and interns also use the Kapuna English Church for some of their lectures and meetings as well as spiritual activities such as devotions and fellowship gatherings.The new office space and the computer laboratory now give more space for the Training School staff. Previously they had been using the next door building of one of the classrooms.While the new computer laboratory and office were completed work also started on the renovation of the kitchen for the male CHWTS students. The renovated kitchen has ample space for the male students to cook and wash their eating utensils. There are two male cooks for the students.As these buildings were being built the carpenters were kept busy trying their best to meet the deadlines. Apart from

the carpenters there were Discipleship students learning on the job as part of their training. Other casual workers also helped the carpenters with the work load.The next building which was completed was the Hospital Laboratory which is yet to be opened. This building is built next to the ward front where the Kapuna community play volley ball and Basket ball. It is also the venue for graduations and church programs such as outreaches and crusades. With the new hospital laboratory, the little old laboratory based in the Outpatient Department will be vacated when the new building is opened for work.The Hospital laboratory was built on land which used to be a river where people paddled with their garden produce to sell at the Kapuna market. After some years there was mud building up and trees started to grow.Another hospital building that was extended was the Kapuna Store. This was originally a small store used by villagers who bartered their garden produce to buy store goods. Later it was extended with two counters serving the staff,students and the community.The extension of the store will help customers more because in the past there was no space to store cargoes. The renovated store gives more space for shoppers and there are enough shelves to display store goods. Work is still progressing with some minor

extension work yet to be completed. Since its inception the Store does not sell lollies, canned and bottled drinks and other unhealthy goods. This is done to promote good health in the community. Apart from serving the Kapuna community and nearby villagers, more customers now come from other distant villages as well.Store owners often come to buy goods at the store and the community section is often filled to capacity as people wait outside to buy their goods.However, there are monthly shopping trips to Baimuru which is an hour travel by dinghy and boat. Staff and students travel on the shopping trips to buy what they cannot find in Kapuna. Shopping can also be difficult when stores in Baimuru and Kikori run out of essential goods.The major problem is when there is no network for staff and students to get cash from the Stores’ EFTPOS machines. It is made worse when the same problem is encountered at the Kikori bank.Other trips can also be made to Kikori which is the only town in the District. Kapuna’s sister hospital, the Kikori District Hospital is also working on the renovation of their Drug Store. Kapuna and Kikori Hospitals are managed by the Gulf Christian Services (GCS). GCS also manages the Community Health Workers Training School.

Building boom to cater for student increase

Gereka housing project soon to be completedTHE Gereka housing project just on the outskirts of NCD will soon be completed.The project began early this year in March with at first one house being constructed. Since then structures have gone up for another two houses to be built. Maslift Construction Ltd has been hired to to do the building and construction of the houses and since then, work on the three houses has been making good progress with the first one (seen in the picture) completed with wirings only to be installed.Once competed, the houses will be available for rent to interested clients. As of October 2nd, 2017, the houses have being completed and are undergoing finishing touches.


A HEALTH improvement training program targeting lifestyle diseases was conducted recently for staff of the East Sepik SDA Health Services.This training, which is the first of its kind in the East Sepik region and was held in Wewak and conducted by the East Sepik SDA Health Services staff from the 02nd of July through to the 16th of July 2017. The name CHIP or “Complete Health Improvement Program” is a series of program sessions presented through video by various lecturers from Avondale College in Australia and the Loma Linda University in the United States of America and is obtained via the internet.The program targets Lifestyle diseases such as High Blood Pressure, Diabetes, Obessity (Over Weight), kidney disease and the many lifestyle issues we face today in our communities.Very interestingly the participants were encouraged to know the status

of their own health before going through the training so they could assess their own progress. This was done by simple blood tests and weight checks to get their weight in the beginning, middle and at the end of the training.During the training, the participants were trained to be knowledgeable about the lifestyle diseases, the food they eat, how much they drink, how much do they move and exercise everyday as these play a very important role in the lifestyle diseases that we all experience and see in the community today as we try to improve our living standards. When the program was first introduced, eighteen people registered themselves to undergo the training and more were keen to join once hearing about it. These participants were mostly over weight, having high blood pressure and high blood sugar and after attending the 12 intensive trainings,

they saw some significant changes in their weight, blood pressure and blood sugar. They felt active and better as never before and felt life had a meaning. “The feeling of drowsiness when reading has gone and I now enjoy reading and even understanding what i am actually reading,” one participant stated.Finally, Non Communicable Disease is of a great challenge to the country and the Department of Health and the SDA church has taken a step forward by inititiating this program to help combat and reduce this rising issue. The program is here to stay therefore the SDA church has plans to run another CHIP training in the month of October 2017.

Particiapnts during the training gained new knowledge about lifestyle diseases. They also had their blood and wegiht checked.

New program targets lifestyle disease

Story by: Ibbis MalaitomHealth Secretary, SDA Health Services, ESP

Dear All,Welcome to the 3rd issue of the Quarterly Newsletter for Christian Health Services for 2017. Much has happened since the publication of the 2nd Quarter Newsletter and as usual Team CHS through its media section tries to bring out these happenings to you all for your perusal and information.At the same time we plead for your contribution to the Newsletter in terms of news items pictures and special cases seen and managed at the facilities. This appeal goes mainly to our own Church Hospitals to contribute to sharing the “special cases” that are seen and managed at the church hospitals. A classic example of what did take place at one of our Rural Hospitals in the country where a Caesarean Section was done to save the life of a mother at Gaubin Rural Hospital in Madang. The story is included in this newsletter.Our Quarterly Newsletter has indeed grown form strength to strength and it goes to show that CHS is indeed placing information sharing and exchange of information also as a priority. Our Newsletter is gaining popularity amongst our stakeholders and since our website was relaunched all issues of the Newsletter have been uploaded as PDF files on to the website to gain international readership.Giving credit where it is due will be at a loss if the work of the Media Officer and the rest of team CHS is not acknowledged at this juncture. From comments we received from those who access our Newsletters are very positive and encouraging and we hope to continue to put out the Newsletter on a regular basis despite the financial situation CHS is faced with.We at CHS have discussed some changes to be made to the newsletter in terms of Newsletter going forward.

We will inform you all of the changes once they are rolled out.Over the last couple of weeks CHS has lost a dedicated health worker a colleague friend and wife of the former CHS Executive and Current Board Member Mr. Wallace Kintak Sr. Regina Kintak passed away at PMGH. She died of a Heart Condition.On behalf of all of us at the CHS secretariat Office (the CEO and Staff) and all our Health Workers in the country, I take this opportunity to belatedly pass our sincere condolences to the family of Mr. Kintak. Your loss is our loss as well and we share with you your grief during the time of your bereavement. We will continue to pray for strength and God’s care to you and family at this time.Work on the Allesco Phase two (2) to include all our Health Workers in the Provinces and Agencies has begun in earnest. Team CHS has completed the Establishment Profiles for all Agencies and is ready to move in to the other face of the process including costing out the establishments and the Budget. We will keep you all posted.Conference 2018: From our level due to the constraining factors placed on us from within and also from without work on the 2018 conference has also begun. COST is the most important consideration we are considering when we focus on the conference. Other considerations include Number of Participants: Number of Conference Days: including others.The conference will still be held from the 23-27th April 2018 as usual. At this point I plead with you all to contribute effectively and meaningfully to the Newsletter. Use this avenue to sow case your Agency and work done at the various level of facilities in the country.Wishing you all Happy Reading!

3rd quarter Updates...


Health Toktok is a quarterly publication of CHS (PNG). All information in this newsletter has been verified before publication. Send any stories from your agency that you would like to see published in this newsletter to the address given. Material published in this newsletter shall not be used in any other publication unless permission is sought from CHS .

Our Contact:CHRISTIAN HEALTH SERVICES PNGP.O. Box 3269 Boroko, NCDPapua New GuineaPh: 325 2362/ 325 33683Email to: [email protected]

Editors:Bernard Rutmat - Deputy Executive OfficerNidra Kewere - Media & Communication

PublicationPrinted and desgined by NAGISOVE Graphics

Bernard Rutmat, Deputy Executive Officer

1. The 2018 conference date : 23-27th April and theme has been approved by the CHS executive Board in its most recent meetings. 2. Regional Meetings: The schedule for the Regional Meetings including dates will also be sent to you all over the next 2 weeks for your preparations. It was agreed at the Board meeting that the Regional Meetings will be held as early as February.3. Due to numerous queries raised by agencies and regions pertaining to the mWater roll out please be formally informed that due to financial constraints the roll out has been shelved indefinitely.4. The Paediatric Society of PNG has put out the latest Standard Treatment Manual (STM) for managing common childhood illnesses. Please check with the PHA or Health Office in your respective Provinces for copies. We were told the STMs were sent to the provinces.5. For our Agencies with Mobile Health Clinics (MHC) please adhere to the email sent out from Digicel Foundation for you to send in your reports prior to the DGF having its Board Meeting. Please treat this as a matter of priority.6. We will confirm with you all later on the August grants and inform you all via other updates in the coming days and weeks.

issue no. 13 july - september 2017 support rural health ... toktok issue 13... · issue no. 13 july...

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