Patanga NWB, Waiting for health care services
People in PNG are dying of illnesses which are preventable.  Many of the illness and health threats to maternal, new born and child health in rural PNG can be prevented or treated easily and cheaply. We already have, in most rural communities, trained lay health workers – known as Village Health Volunteers (VHV) and Village Birth Attendants (VBA).

These trained health workers are already functioning.  They are involved in providing information to individuals and communities (for example – on adequate nutrition, malaria prevention, TB, birth spacing and hygiene) or treating people (for example – diarrhoea and malaria, safe birth delivery, responses to post-partum bleeding etc.) Many women in our villages across the whole country depend on VBA’s for support and help before, during and after the birth of their child. Without this free service many women, would experience complications, serious illness and in some cases death. In a report produced by World Vision PNG in 2011 there it was found that there is evidence which “suggests that up to one third of maternal deaths, over two-thirds of newborn deaths and half of child deaths can be prevented through informed community members, trained VHVs and supported by stronger local health centres and community health posts”. Further, a recent review on impact evaluation done in Karachi, in Pakistan (Lassi Z, Haider B. Bhutta Z) suggests that a 32 percent reduction in maternal mortality could be achieved by care packages which can be delivered by these trained VHV.  The problem here is, how can we expect these volunteers to do their work without much support? These volunteers give their service for free.  They are the unrecognised heroines and heroes in our villages.  They often do this at their own expense as well.  It is time the Department of Health (DoH) took action to recognise and support these volunteers. After all this is a function which normally would be performed by salaried employees who come under the DoH, be they health extension officers, community health workers or whatever.  While the National Health Plan (2011-2020) aims to strengthen rural health services, the retraining of staff and rebuilding rural health infrastructure is likely to take some time. Meanwhile people will continue to have babies and be ill.  The only source of help would be these VHV.  T t.nd mortality and improvings strengthening and to some degree fill gaps in health service access.nd mortality and improvinghus NDoH needs to invest and support these  t.nd mortality and improvings strengthening and to some degree fill gaps in health service access.nd mortality and improving volunteers who can help in rural health systems strengthening and to some degree fill gaps in health service provision.

Volunteers receive basic training in health care but other than that they receive nothing.  They often have to pay, from their own pockets, for transport to see patients, have to feed themselves while on their way to patients, provide their own clothing and other essentials such as gloves, soap, disinfectant etc.  While providing this noble service the volunteers are not engaged income generating activities. Thus this becomes a double whammy and no wonder some give up on being a health volunteer.  This is a great loss to the nation. We need to retain these volunteers. Something must be done, and fast.
I would suggest that either, support to VHV’s be integrated into the LLG plans and budgets, and thus be seen as a part of local health system strengthening,  which would include provision of  regular and on-going supervision, support and replenishment of supplies from the health centres.  Alternatively I would suggest we could, in the short term, introduce a system of volunteer allowances, but in the long term, we could establish a scheme to offer start-up  resources for livelihoods enterprise activities which volunteers could use to generate income.  These two actions do not have to cost much.  The DoH can easily afford this by diverting some of the funds from other sources.  Of course one would expect that structures are put in place to administer the scheme to avoid abuse of the scheme.  It would be easy to involve community based organisations and non-government organisations to administer this e.g. CWA, Tingim Laip, World Vision, Save the Children, VSO.  These organisations are already involved in the training of health volunteers.  The basic structure is in place.

Obviously there may be other interventions to support health volunteers and other ideas would be welcome.  Meanwhile lets us put something to support these volunteers, now and we can have a debate about other options later.

Written by a volunteer working in Papua New Guinea

How are old are you? 17 yrs old

What is your disability? I have Physical disability caused by spina bifida at birth

Are you currently in school? No, I am in home schooling. It is a home based school program , a service provided by the Creative Self Help Inclusive Education Centre for children and young adults with disabilities.

What grade are you in? I am in grade five
What is the biggest challenge to you when you attend school?  Sometimes my home based school teachers do not attend to me to further my education due to the centre lacking staff.

Why is education important to you? Education is important to me because it means knowledge, money and a life to me.

What are the barriers or challenges to attending school? I have an ulcer on my foot which refused to heal for quite a long time that stops me from attending main stream school besides my physical disability.

What are the dreams for your future?  I want to be an IT person, working with computers; repairing and designing programs.

What do you want people to see you as, when they see you?  I want them to see me as a human with good knowledge and skills.