PNG Key Points

This is an excerpt from my PNG Gaire experience. I included it here because it makes several points. On my first day I saw a woman with sarcoidosis. Briefly this is a rheumatologic condition (like lupus or arthritis) that has no cure, gets worse with time, and imparts rather sever disability on those afflicted with it.

This woman was in a wheelchair. She traveled two days from a neighboring village to be seen by us. She had to be pushed along the concrete floor in our clinic so I have no idea how she made it several miles from another village.

Point 1: many patients traveled several days and/or waited in line for many hours to be seen, but not a single one of them complained.

She had her medical record with her. She had been given the correct diagnosis at Port Moresby hospital. I thought she had received the correct treatment with prednisone, but the dermatologist in our group said methotrexate was better. The dermatologist showed me the relevant physical exam findings for this disease and then she took photos of the woman. These were to show the dermatology residents she taught back in the US, most of whom would never see a live patient with this disease in their 8+ years of medical training. The dermatologist did some education for the woman about her disease, left several therapy recommendations in her medical record, and sent her on her way.

Point 2: Many of the people here had a small notebook that had their medical history in it. This aided greatly in helping to get their story right, and (I think) it sometimes helped to move their case forward because we could leave recommendations from our experts for therapies that local doctors could carry out.

So in the end we didn’t do much for this woman except to give her information about her disease and to facilitate her getting the optimal therapy for her terrible illness. She thanked us and left with a smile on her face, ready to set out on her multi-day journey home.

Point 3: The people of PNG were so grateful for whatever we could do for them. No one complained, not even once. And many of them brought gifts which they gave at the end of their encounter to their providers.

--pete