A group representing doctors in Papua New Guinea says there is a critical shortage of doctors in rural areas and the situation is becoming dire.

The Papua New Guinea Society of Rural and Remote Health president, David Mills, said there is no hard data on the total number of doctors working in PNG, which complicates matters.

“We know roughly the numbers of doctors that are in the country. But we don’t have all the information, unfortunately the medical board itself has struggled over recent years so we don’t even have good centralised data on the total number of doctors.

“But let’s say we work with the data that is available so we can get a rough idea as to the number of doctors in PNG and from there we just go from district to district and work out how much of the population basically doesn’t actually have access to basic services.

“So we know that the situation is fairly dire but we don’t have very accurate hard data on the total numbers.

Mills said the majority of districts don’t have a doctor.

“The vast majority. I mean, it is 89 districts in PNG and those districts range in the populace that they contain of course but it can be anywhere from 30,000 in a small district up to 80 or even 100,000 – and the vast majority of those have no resident medical doctors present.”

He said that means that some people are not getting the treatment that they might need.

“For those of us who live here in PNG it is unfortunately common knowledge that the vast bulk of the population doesn’t have access to meaningful health services.

“And that can mean even the most basic medicine – antimalarials, or antibiotics – there are just no health workers present in the rural places and for a place like PNG, where 80 per cent of the population live in these truly remote areas, that is truly a disaster – it is not just an inconvenience.

He said its difficult to get doctors to serve in remote areas.

“The jobs are there but there are a whole string of reasons as to why they don’t go. But generally speaking it is a case of actually attracting doctors to work in these places.

“It is not just a question of pay. In fact, pay is probably one of the smaller issues. It is the whole gamut of, for example, what sort of hospital will they find?

“When they go to this area is there going to be power? Is there going to a laboratory or an X-ray facility. Is there going to be an operating theatre where they can actually do some of the things they have been trained to do?

“And then there are also considerations like road conditions. Another very big issue is whether there is going to be schooling for their children and so it is a bit of a systematic problem rather than just simply no doctor.

“Having said that, I think the issues are a bit deeper than that.

“Those of us who work in the field would say that it is more to do with a cultural issue, by that I mean a medical cultural issue.

“PNG trains 45 doctors a year, so that in itself is a problem because we have nearly eight million people now and 45 doctors a year is clearly nowhere near enough compared to say like New Zealand or Australia where you’d have one doctor for every 800 people.

“Here we are looking at tens of thousands of people without doctors so there needs to be a very large increase in the number of doctors that are trained.

“However, when those doctors do graduate the vast majority of them unfortunately are wanting to pursue careers in specialist urban practice to become surgeons, or gynecologists, or pediatricians and ply their trade in town

“What we really need to be training is generalists, rural generalists, who have the skills to be able to manage district hospitals.

“Unfortunately what has happened in PNG over the past two or three decades is that the medical culture has moved more towards training specialists and away from generalists and we are paying the price for that.”

However Mills says he is optimistic about the situation as there are some very committed young Papua New Guinean doctors who are working in rural parts of the country and making a difference.