PNG's ER scene

AMID all the problems one can face in Port Moresby, St John Ambulance Service’s emergency responders are hamstringed by an endless tide of prank phone calls.

While the ambulance service is typically not abused in the nation's capital, a lot of people are tying up the "111" toll-free phone line with hoax calls.

"We estimate that one in 100 calls are legit," St John Ambulance PNG commissioner and director Courtney Muller told PNGIndustryNews.net.

"People constantly complain that they can't get through and that is why. I believe we will have to charge for the calls and I can't see any other way."

Despite her job titles, Muller is also one of St John PNG's two paramedics and a key emergency responder for its ambulance services in Port Moresby. She said nearly all of the cases St John attended to were serious.

"In Australia most of my workload was minor injuries and the sick elderly. Here in PNG we see a lot of trauma - gunshot wounds, serious assaults, sexual assault, stabbings and injuries and death from motor vehicle accidents. With the ever-growing population we can't meet the demand of the public."

St John's PNG branch relies on sponsors and donations. Fortunately, the National Gaming Board has provided enough money to bring in two new ambulances in the next two months.

"This will bring our fleet to seven ambulances in Port Moresby and five in Wewak and one in Kupiano," Muller said. "We are also looking at expanding our service to Lae, Wau, Rabaul, and Bougainville. The service is absolutely vital here in PNG. We need some serious support."

She said work was also underway on refurbishing and expanding St John's headquarters in Port Moresby to accommodate its growing service.

"We have been fortunate to have companies like Ferrum Engineering and PNG Forest Products offer in-kind donations in the form of steel works and a kit home/clinic," she said.

"More companies have seen what we are trying to achieve and are coming onboard."

The majority of St John's ambulance officers are technically qualified as advanced first aiders. They are undergoing training this year for a certificate IV in ambulance care, with all staff to be qualified medics in time for the 2015 Pacific Games.

"Our staff are trained here at St John headquarters," Muller said.

"We have a wonderful relationship with St John Queensland which has so kindly assisted us with our training needs. In May this year they sent over one of their amazing trainers - Mr Darryl Rice. He has been paramount in our training and is due back in November to begin the next level of training."

Separately, Queensland ambulance officer Ian Day has also set up a program to fly over St John's PNG ambulance officers to Cairns to observe Queensland Ambulance Service paramedics in action.

Muller said the PNG ambulance officers faced many challenges in their day-to-day operations.

"Most recently we have had two of our ambulance vehicles attacked. One by a mourning family who were so grief stricken they were pounding the glass on the back doors and consequently smashed the window in.

"Another job recently saw a man whose wife on board was about to deliver her baby. He began hurling rocks and beer bottles at the ambulance - causing more damage to the car. This is frustrating as we need to ground the vehicles until repaired. The public then loses a much-needed ambulance."

There are other operational dilemmas caused by lacking public awareness.

"Many people involved in serious car accidents are often removed from the vehicles prior to our arrival," Muller said. "As a result, often poor handling by the relatives can result in more serious injuries and death."

St John wants to deliver free first aid training to key villages and settlements in PNG to help save lives.

"Snake bites for example - learning to properly manage a snake bite can improve the outcome of the patient considerably," Muller said.

In terms of sick children, such courses are expected to yield excellent outcomes for those with treatable illnesses such as dehydration, pneumonia and gastroenteritis.

As for broader nationwide trends, lifestyle illnesses like diabetes, hypertension and cardiac issues are becoming more prolific.

"Most cases are not diagnosed and we see them when they are in bad shape," Muller told PNG Report.

"We are seeing a rise in sexual violence - sexual assault cases are just too common - also domestic violence. It's very shocking at times. The welfare system is not equipped to deal with these issues. Patients can be treated for their physical needs, but there is little to no aftercare, counselling, or support for the victims."

As St John is a charitable organisation, it relies on increased funding to improve outcomes.

"We urgently require new vehicles as most of ours are 20-plus years old," Muller said. "We need uniforms for staff, new equipment - like defibrillators, resuscitation kits and trauma kits. I'm very happy with our progress, though slow.

"We are excited about being a part of the 2015 Pacific Games and plan to have at least 10 ambulances here in Port Moresby, all of which will carry qualified ambulance officers and lifesaving equipment."

While PNG does not have the greatest reputation internationally for medical care, the paramedic had plenty of faith in Port Moresby's services.

"We have great relationships with the hospitals here in Port Moresby, especially with our own St John Hospital located at Gerehu and the Port Moresby General Hospital.

POM Gen has a wonderful emergency department, with dedicated staff. I always feel confident taking patients there."

Published in the October 2013 PNG Report magazine

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