For the past year, Papua New Guinea has been relatively lucky. While it hasn’t escaped the impact of Covid-19, it has managed to avoid a widespread catastrophe – perhaps a function of a warmer climate, closed borders, less urban living and good fortune. But the luck has run out.
Positive cases have doubled every week for the past month. Case numbers are now growing exponentially. Testing is so low that experts on the ground suggest a more accurate picture of positive cases would involve adding a zero to the end of any statistics you see. The virus is now spreading in the west of the country near Indonesia and the Torres Strait, and in the east of the country in Bougainville towards Solomon Islands.
Yet most alarming is in the nation’s capital of Port Moresby. The country’s largest hospital, Port Moresby General, is completely overwhelmed. More than 60 staff have now tested positive, and new patients are being sent away and told to isolate – a difficult proposition for people who live in the city’s crowded squatter settlements. Forty percent of women admitted to the hospital’s labour ward are testing positive for the virus.
The virus has already spread through the country’s elite, with more than a dozen MPs reported to have contracted the virus in recent weeks. Two MPs are currently in intensive care with the virus. Senior civil servants are also contracting the virus – and for some it is fatal. Sadly, those worst affected appear to be people in urban centres, where diabetes and other lifestyle diseases proliferate. Often it is civil servants and health care workers who are most susceptible.
PNG’s health system is already spread precariously thin and deals daily with even worse health issues that are a distant nightmare for most Australians. Dengue, Tuberculosis, Malaria, HIV and diarrhea are a daily threat for Papua New Guineans. Sporadic investment and systemic corruption have hollowed out the healthcare sector.
In utter tragedy, and unrelated to COVID-19, the deputy head of Papua New Guinea's National Pandemic Response to Covid-19 and Acting Head of the Department of Health, Dr Paison Dakulala, died last week. Dr Dakulala is an irreplaceable leader and role model in the PNG health sector, and his loss will be keenly felt at a time when he was most needed.
In this environment, containment and control is no longer a viable option. Rapid rollout of vaccinations is the only option to prevent this from turning into a complete health crisis.
There is some hope on the horizon. The World Health Organisation has been working to ensure cold-chain storage and logistics are in place for a nation-wide vaccine rollout. The plan was to target the healthcare sector over the coming year, in parallel with critical investment in the healthcare system’s capacity. This week the PNG government signed regulatory approval for the WHO-led COVAX facility on vaccines and close to 300,000 Astra Zeneca doses have been fast tracked to arrive in the country as soon as next month.
This is all most welcome, but the program’s timeframes are now too slow.
Port Moresby’s health sector is on the brink of collapse, and unlikely to remain stable in coming weeks as the virus burns its way through the limited number of health workers the country has.
Australia, in partnership with the PNG government, must act immediately to help. Not next month or next week, but right now.
Port Moresby’s hospital is the front line. Australian medical assistance teams (AUSMAT) could help to triage cases there, while testing and tracing can identify and isolate positive cases among healthcare workers to limit the hospital’s role in perpetuating the outbreak.
Concurrently, an immediate rollout of Australia’s vaccine stocks on hand targeting healthcare workers can make sure the country’s frontline workers are as best protected as they can be. Such a rollout could target Port Moresby first, and then be expanded to other covid hotspots – PNG’s Western Province, which borders the Torres Strait, and Bougainville, to protect neighbouring Solomon Islands would seem the highest priorities.
Australians have the luxury of being free of community transmission. PNG’s frontline workers don’t, and cannot be replaced if they fall foul of this disease.
According to Prime Minister James Marape the country only has 500 doctors and fewer than 4,000 nurses. Vaccinating these essential workers would barely put a dent in our domestic vaccine rollout – but could have a dramatic impact in PNG if they were rolled out immediately. A flight to Port Moresby from Sydney would takes three hours. With PNG’s agreement, we could be vaccinating essential health workers at Port Moresby hospital tomorrow.
As critical as availability of the vaccine is rapid distribution. We should muster whatever capacity is available to get the vaccine to where it’s needed as quickly as is humanly possible. If that means the Defence Force, then we should use it. Commercial providers that have been used to stabilise Australia’s covid crises could also be used – the experience at Tasmania’s North West Regional hospital is a model that could be applied.
The true test of friendship is what you do when the chips are down. The shocking scale of PNG’s Covid-19 outbreak means it needs critical help, right now. Through our own management of COVID-19 we have earnt the right to be generous. We have the chance to show genuine leadership at a time when it is most needed.