Reaching Kira

I first heard of Kira in 2014.

It was mentioned in passing in a meeting with provincial health. I remember that we were discussing where to target our medical efforts for the remaining two weeks of our primary health care school. The District Health Manager for Sohe suggested we go to Kira, but with only two weeks remaining we agreed that it’s be better to try to make it work another time, with a bigger heads and a potential funding.

At the time I liked the idea of going because it was far, it was inland, and they needed help. I was keen to get there by boat and by foot. My good friend and local health worker Philip had done it before.

“Angie, to reach Kira, you take a boat past the border into Morobe, you go into the mouth of the river and travel as far as the dinghy will take you. You might have to get out at times and pull-push the boat. But when you can’t go by river anymore, you’ll have to walk up the mountain. That’ll take you two days, then you’ll reach Kira.”

My brain was thinking… how will I convince the leadership team that it’s a good idea to venture into the unknown with medical gear and food and ride up in rickety dinghies, and then hike up mountains for days!? Not going to happen! Not that way…

In 2016, it got mentioned again, seriously considering this time. Funding was available, we were going to go by helicopter to two different locations in the mountains. One of them was Kira. Eyes wide open and heart full of hope, I did my homework and built up a risk analysis for helicopter patrols. We had an eight weeks outreach on land in the province, surely that would have been enough time to get the logistics organised and the funding released. We work in partnership and want to involve the local health workers and authorities in place to empower them to take ownership, and share in the victories/stories of bringing services to their people. Long story short, it didn’t happen in 2016.

But in 2017… it did! And it happened quick! It was a lot of people rowing together to make it happen. It was part of our collaborative outreach to Oro Province. We had two helicopter patrols that outreach. One to Ioma and one to Kira. I got to go to Kira. So did my friend Philip.

We planned to go for two days and bring immunisations, reading glasses and health teachings. Kira is a health station, but the facilities aren’t open yet and they do not have cold chain. In fact, Philip believed that the last immunisations were given roughly five years ago. According to the Health Centre Facility Map, there should be approximately 500 houses in the area, so we’d be quite busy if people came for services.

Unfortunately, Kira is so remote far inland and without telephone network that they have not heard we were coming. Those that heard the chopper land came to see who we were and what we were doing in their village. Amongst them were village leaders and constables (police officers). Those guys agreed with the officer in charge of the (closed) health centre, to run up the mountains and spread the word in the adjacent wards that a health care team was there and to make their way down to Kira.

The first day we didn’t see too many people. We saw those living at the station. Focused on family planning (Papua New Guinea term for contraception) and education. We also did outpatients consults to see the sick ones. Some ear infections, some musculoskeletal injuries, a man that probably had AIDS, and lots of simple coughs.

It was the end of the first day and I was sitting down with the health workers talking about everything and nothing from health worker training, to life in the village to health care politics, everyone seems to have dreams of a better system! Some village people and kids were still around, it’s not everyday foreigners come, so we become a bit of entertainment in a way…

Mid conversation I heard a sound I knew to be bad. I stopped listening to the ongoing conversation inside and turned my ears outside. There was a little boy roughly 10 years old, coughing his lungs out and then I heard it again! “Whooooop!” Eyes wide opened I stood outside on the porch and watched him cough again, a set of cough followed by a whoop. WHOOPING COUGH!? I had never heard that in real life…! Sure we learn about it in school, I teach my students each year, but had never heard it live.

I brought the boy into the exam room and had a look at him. He had come to the clinic earlier that day for his cough. But he wasn’t coughing like that then. I was actually proud of the local health worker that had diagnosed the boy with simple cough and prescribed “Rest, increase fluids and citrus” as a remedy for his condition. Too often I see antibiotics prescribed where it isn’t needed.

This boy however didn’t have simple cough; he had whooping cough or pertussis! In talking with the local health extension officer, apparently there were many cases of pertussis in the area. Understandably so if the last immunisations were administered in 2012! We decided something needed to be done about it. The local health workers didn’t have much supply of antibiotics and didn’t have the right ones for pertussis.

The next day was market day. Pertussis awareness was done at the market. All were informed to bring children to the clinic. Those showing signs of pertussis were prescribed a course of antibiotic and those not affected yet given a vaccine to protect them. 9 were treated for pertussis and 76 immunised against it over the course of our patrol.

I often think of the timing of things and why we didn’t get to Kira earlier, then I’m reminded that we got there at the right time. I think of what would have happened if I had gone to the house right after clinic rather than sitting there and discussing all these things. And I thank God that I can trust Him to have me at the right place at the right time as He intends for me.

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