Ambulance program helps overcome harsh health challenges for PNG women

September 12, 2019

Sammuel Maia’s eldest daughter complained of labour pains when the family sat down for Sunday breakfast. She was in her 3rd trimester and almost reaching the full term of her pregnancy. She had complained of similar pains two days prior. The family rushed her from Vanapa Brown to Port Moresby General Hospital only to find out it was false labour. Vanapa Brown is an LLG in the Kairuku Hiri District of Central Province. Due to the road condition, it takes a little over an hour to get to Port Moresby. The family initially thought it was false labour again that Sunday. But, as the contractions became frequent and the pain unbearable for the first-time mum, the family felt helpless. The spent what little savings they had on the first trip into Port Moresby and the two days spent at the hospital. They had to return to the village because it was expensive in Port Moresby and they had no family with whom she could stay in the city. So, when the real labour occurred, they had no more money to spare and no time to wait if they wanted their daughter to give birth at a hospital safely. The nearest health centre was 15 minutes away by road but not staffed on weekends. Mr Maia said, the District has a community ambulance, but he did not know the number of the driver. That would be the only means of communicating if they needed an ambulance help. But even if he had the driver’s number, he had no phone credits to call. While contemplating what to do, they thought of St John Ambulance. Maia promptly dialled the toll-free St John emergency number 111. The St John Emergency Coordination Centre in Port Moresby received his call for help. An emergency ambulance got dispatched immediately. It took the crew an hour to reach Mr Maia’s residence. The soon to be grandfather was anxiously waiting at the main road, when the ambulance arrived, he was relieved. A month later and Mr Maia says his daughter and granddaughter are doing well. “If St John had not arrived, my daughter would have given birth in the village [unsupervised by a health worker].” It was a Sunday, and only a few PMVs [public bus] were on the road. I had no phone credits. I didn’t know what else we could have done because we were at the point where we had no other options. An open-tray public bus is no place for a woman in labour. “I cannot say thank you enough to St John Ambulance for dispatching the ambulance crew as soon as I called. I knew she was in safe hands When she got on the ambulance. With the highly trained St John ambulance officers on board, I had no doubt in my mind that if she was to give birth along the highway she was in capable hands.” “My daughter has given birth safely at Port Moresby General Hospital thanks to St John. She has returned to the village with a healthy baby girl.” This is one of the many remarkable stories of St John making an impact on maternal survival in rural areas of Papua New Guinea. But this isn’t the case for women who live outside of the areas covered by St John. Statistically, 60% of women in PNG give birth without a health professional present. 61% of women are more than 2 hours away from an obstetric and newborn care facility. Child mortality in rural populations is double that of urban children. Approximately 30% of all rural Aid Posts are closed, and medically facilities have inadequate medical supplies for up to 83% of the year. Outside of NCD, only 51% of health facilities have an ambulance, but these are not part of the coordinated network, and about 74% are out of service due to maintenance. And only about two million people out of a population of 8 million can call 111 for an ambulance. Access challenges are the harsh reality contributing to the sad statistics of 1 in 30 women die in labour. In rural communities, a single ambulance has proven to reduce maternal deaths by 50%. St John has stood-up to be part of the change. To overcome the access challenges and help reduce the statistics and give women and children and the overall population, the quality and timely healthcare they deserve. St John is partnering with the National Government to help train, equip, maintain and coordinate rural health centre ambulances. “Provinces are asking us to give a helping hand to the brave, hardworking rural health workers that for decades have been providing ambulance services in their districts”, said Jean Kekedo CSM OBE OStJ, Chairman of St John. Minister for Health Elias Kapavore said the National Ambulance Network our government is setting-up is to form a network of ambulances to bridge the gap between individuals, communities and safe healthcare”. “The story highlights, how efficient coordination of ambulances will improve maternal care and help women to give birth in the care of health workers”, said Matt Cannon OStJ, St John’s Chief Executive and Advanced Paramedic. The NAS is being managed by St John and funded by the National Government to connect all existing community ambulances to one nation-wide network of ambulances coordinated by the emergency 111 coordination centre in Port Moresby. When the network is fully operational, a person affected by an emergency will be able to dial 111 and know that the nearest ambulances that is available will be sent to them. For the time being, the network is being piloted in East New Britain, Morobe and Central Provinces. The establishment of the service relies on the timely release of funds from the National Government, which has proven difficult in recent times. The ambulances connected to the network will have GPS trackers. The ambulance workers will carry a pager that will notify them of an emergency. Each ambulance will have a mobile data terminal fitted that will guide to the patient’s location. In the second phase of the pilot, ambulances will be formally accredited to a minimum standard prescribed by the National Department of Health. The accreditation will involve giving basic life support training and equipment to health workers that will focus on sustaining life and the emergency management of neonates and post-partum haemorrhage. St John’s mission is to serve humanity by giving quality care to people in sickness and distress and contribute to making Papua New Guinea a healthier, more resilient nation.