Kapuna is the only hospital within paddling distance for about 15,000 PNG locals in multiple tribal villages scattered across this region. Accessible only by river, those coming to the hospital have to travel by canoe or dinghy for many hours or days to access health services. (Kikori Hospital is now a part of Gulf Christian Services. In total the two hospitals serve over 30,000 people in the area).
Kapuna is a five-ward hospital, staffed by two doctors and a dedicated staff of seven nurses and 12 community health workers. (To give a bit of perspective, in the UK there would be 93 doctors for the equivalent 30,000 people that the hospital serves.)
Ward A is the maternity suite, with two labour beds and a postnatal ward. Here in PNG maternal health is one of the biggest challenges with pregnancy and childbirth complications still being the biggest killer of women age 15-45. The vast majority of deaths occur in home deliveries. In 2013 over 300 babies were born at Kapuna, a rise of about 30% from the previous year, as more and more women are coming to hospital to give birth. Antenatal clinics, postnatal care, and family planning services are all run from ward A.
Ward B is the children’s ward. All manner of problems are seen here, ranging from simple coughs through to broken bones, along with long-term patients requiring monitoring and rehabilitation. Ward B also manages outpatients from the local villages and immunisations.
Ward C is the adult ward. Again, the full range of medical and surgical problems that may be seen in any hospital in the western world are seen here, with the added challenge of tuberculosis, malaria and other tropical diseases.
Actually, tuberculosis (TB) is such a big problem here, that our fourth ward is a dedicated TB ward. Patients on this ward range from babies to elderly people, with every type of TB imaginable: TB lung, TB heart, TB abdomen, TB meningitis, TB lymph nodes, TB breast, TB of the joints… name a part of the body and we’ll probably have a patient with TB there! It’s a massive challenge. We’re working with the health department ‘Stop TB’ programme to try and reduce TB in PNG, but it’s one of our biggest focuses to try and improve the health in this area and reduce transmission of the disease. Patients need to take TB treatment for a minimum of six months, the first two months of which they stay at the hospital in the TB ward. The local level government has recently granted money for renovations and extension of this ward.
The last ward is the ‘Outpatient’ ward, which has dual purpose. It functions as an ‘Accident and Emergency’ department to manage acutely sick patients and injuries when they first arrive, and also provides daily care and dressings for wounds, sores, burns and skin conditions.
Alongside the four main wards we have a nutrition unit, a minor theatre and a major theatre, an antenatal ward and a very small laboratory.
The antenatal ward functions as a ‘waiting house’ for women from far away villages, who come and stay in the last weeks of their pregnancy so they are at the hospital for when their labour starts.
The laboratory currently only has facilities and resources for testing the sputum of TB patients. A major need at the hospital is equipment and expertise to see this expand, as currently Port Moresby is the closest place where even simple blood tests can be done. It is 200 miles away- not a viable option for our patients!
Gulf Christian Services also is responsible for Kikori Hospital. Kikori is a small town about five hours west of Kapuna if travelling by fast dinghy. Kikori Hospital is a similar size to Kapuna and deals with a very similar range of patients and problems that Kapuna does, but being in a town can be somewhat busier. Kikori hospital is currently staffed by Dr Patrick Kolliwan, Sister Sarah Kaipu, and a team of nurses and CHWs. CHW students from Kapuna also do placements at Kikori Hospital.