Pacific Journal of Medical Sciences Continues To Attract Papers From Around The World!

Pacific Journal of Medical Sciences Continues To Attract Papers From Around The World!

Pacific Journal of Medical Sciences continues to attract papers from around the world.

The Pacific Journal of Medical Sciences (Pac J Med Sci) published by the Basic Medical Sciences Division at the University of Papua New Guinea School of Medicine and Health Sciences is slowly growing a reputation within the Asia-Pacific region as a credible peer reviewed multidisciplinary journal. I have been tracking the journal since its inception and I have seen the quality of the articles continue to improve. Another sure sign that the journal is getting a global readership is that the number of papers being submitted by authors within the Asia-Pacific Region is increasing. There have been also an increase in the number of articles from Africa and Middle East. In the last edition of 2019, a letter to the editor from Argentina was published.

What is visibly missing (and disappointing for me) is the lack of authors from Papua New Guinea. For a journal published by University of Papua New Guinea, it is disheartening to note the absence of PNG medical authors.

There are many factors for this but in my opinion I think one of the key factors is that many PNG health professionals do not have the writing skills. Something that I have written about in my blog for many years now. There is clearly a need for training in this area.

I hope that this area of training can be targeted and the Pacific Journal of Medical Sciences can be a good training platform for aspiring PNG medical writers and scholars.

Posted in Health | Tagged

What Happened To The Proposed PNG Occupational Health Bill?

What happened to the proposed occupational health bill (OHS)?

I started writing about the PNG OHS bill around 2014 when the 1st draft was written up in 2012 – OHS Bill 2012. Then if I recall correctly there was a second round of review. The proposed bill was sent to stakeholders – private and public sector parties, but since then no update.

The OHS bill is a vital piece of legislation for the protection of employees, public safety, environmental protection and ensuring private companies in the extractive, construction and other resource sectors in PNG to be compliant to existing safety and public health laws. The bill will also ensure people being hired for high risk jobs are fit for the job. And indirectly the bill will create and encourage the growth of Occupational Health as a speciality branch of medicine in PNG. But I am of the view that lack of such laws allows companies, statutory bodies and government departments in PNG to compromise public and environmental safety.

I hope this proposed bill re-surfaces and becomes a law in PNG soon. Happy to hear from anyone who is involved with the proposed bill. Leave your comments for discussion.

Posted in Health, Mining & Petroleum | Tagged , ,

A Critical Mass of Innovative Thinkers Will Underpin Technological Innovation In The Pacific!

There has been a recent push for innovation in PNG. Mostly this has focused on getting Startups to scale. This November there was a Innovation Convention in PNG’s capital Port Moresby and in December there will be a Start Up convention – called StartupPNG.

I applaud all these ongoing conferences and conventions to get startup businesses going. I have seen that more than 90% of these meetings has been trying to uncover startups that are using ICT and other technological innovation to kick start businesses in PNG. A lot of the media coverage has been on mobile phone app development.

However, what I see not being talked about or addressed is that technological innovators depend on innovative thinking. I think the focus must be on changing mindsets. A shift away from doing what is considered ‘normal’ or ‘routine’ way of doing business in PNG and try new ideas of doing business. Regardless of whether it is a mobile phone app development or a farmer trying to get his/her produce to sell in the larger cities and towns in PNG. The innovative thinking and problem solving involved in overcoming or getting around a challenge to push their business ideas forward is the key.

Another factor that also needs addressing in PNG and perhaps in the Pacific generally is promoting science and technology among young people. Computer science, engineering and coding for software development or mobile phone app developing needs to be promoted and taught in schools, colleges and universities in ways that has never been taught before. Innovation also must involve how science and engineering is presented to young people. This will result in increased number of people with the skills as well as the innovative mindset that is needed for startups to flourish. Without these prerequisites, the push for innovation and encouraging startups in PNG or the Pacific will lag behind Africa or Asia. We need to catch up.

 

Posted in Information communication technology

Major Public Health Journal Dedicates Supplement Issue To TB Operational Research in Papua New Guinea

A major Public Health Journal – The Union, published by the International Union Against Tuberculosis and Lung Disease, dedicated a supplement issue to TB operational research in PNG. The articles published – authored by PNG doctors and scientists working in the TB space, showcases TB operational research around PNG. The articles highlights success stories as well as current challenges.

It was pleasing to read the articles because the issue also show cases the next generation of PNG medical researchers.

I have posted below the summary from The Union website regarding the different articles.

A dedicated supplement drawing attention to the important process of building operational research (OR) capacity in Papua New Guinea (PNG) has been released by the journal Public Health Action (PHA).

PNG is a country where tuberculosis (TB), including drug-resistant TB (DR-TB), is highly prevalent. According to the World Health Organization (WHO), PNG has an estimated annual TB incidence rate of 432 per 100,000 people. In addition, the treatment success rate for new diagnoses registered in 2016 was 62 percent.

In 2017-18, the first OR capacity-building programme for TB was conducted in PNG using the Structured Operational Research Training IniTiative (SORT IT) model. The SORT IT programme offers an intensive course in OR that consists of three six-day modules offered over nine to 12 months, and is a collaboration between The Union, Médicins Sans Frontières and WHO’s Special Programme for Training and Research in Tropical Diseases.

The twelve papers presented in the supplement represent the findings from the research projects undertaken by participants of the SORT-IT course, raising important operational issues for PNG’s TB programme and providing opportunities to inform policy and practice.

The implementation of PNG’s national programmatic response to TB only started in 2008. The supplement’s studies confirm the challenges which is exist in in the country, including: the large number of people with TB who remain undetected, low treatment success rate, high numbers of multidrug-resistant TB (MDR-TB) in concentrated locations, large numbers of children with TB, and high numbers of treatment outcomes reported as ‘lost to follow-up’.

OR is fundamental in providing much-needed baseline data, identifying gaps in provision, and evaluating innovations such as new tools and strategies to increase detection of new cases, improve treatment outcomes and aid prevention.

The 12 studies offer important insight into operational challenges and successes, with the aim of increasing the capacity of the workforce to conduct OR, and ultimately improving health care service provision and patient outcomes for people living in PNG and the wider Pacific region. These include:

  • Drug-resistant tuberculosis diagnosis since Xpert® MTB/RIF introduction in Papua New Guinea, 2012–2017: Xpert® MTB/RIF was introduced in PNG in 2012 for the diagnosis of TB and of rifampicin-resistant TB (RR-TB). The study found that the use of Xpert has increased the detection of RR-TB and MDR-TB in PNG. However, the high frequency of MDR-TB emphasises the need to accelerate the in-country availability of drug susceptibility testing. Ongoing surveillance of DR-TB patterns was also identified as being essential to improve treatment guidelines.
  • Impact of GxAlert on the management of rifampicin-resistant tuberculosis patients, Port Moresby, Papua New Guinea: GxAlert is an automatic electronic notification service that provides immediate Xpert® MTB/RIF testing results. It was implemented for the notification of patients with RR-TB at Port Moresby General Hospital. The study found that considerable improvements have been made in timely RR-TB patient management in Port Moresby, although it was unclear to what extent GxAlert was directly associated with these improved patient outcomes.
  • Implementation of screening and management of household contacts of tuberculosis cases in Daru, Papua New Guinea: Community-based household contact screening and management was successfully implemented, under programme conditions, on Daru Island, which can be described as a low-resource setting with a high burden of TB and DR-TB. Of interest, the study also demonstrated a high level of acceptability of screening among household contacts, and a high level of household crowding on the island, increasing the risk of transmission of TB.
  • Outcomes in children treated for tuberculosis with the new dispersible fixed-dose combinations in Port Moresby: New child-friendly fixed dose combinations were introduced at Port Moresby General Hospital for the first-line treatment of children with TB. Despite the use of child-friendly medicines, a recorded high proportion of loss to follow-up highlighted the need for: promotion of bacteriological confirmation of TB amongst children, better retention in care, increased access to HIV testing, and better links with community TB programmes and nutrition services.
  • Challenges in TB diagnosis and treatment: the Kavieng Provincial Hospital experience, Papua New Guinea: Gaps were identified in diagnosis and treatment in the TB treatment cascade at the Kavieng Basic Management Unit. The study concluded that the TB programme requires strengthening to address: the high proportion of patients with a clinical diagnosis of TB, patients not being tested for HIV, and high levels of loss to follow-up. The challenges are complex and will likely require multiple interventions to improve.”

I have been a strong advocate for PNG nationals to conduct research and publish their findings and it is very encouraging to see the articles published.

Posted in Health, Medical Training, Research & publication | Tagged , ,

A Betel Nut Law Can Help Control Mouth Cancer in Papua New Guinea.

A lot of people reading this article will say – “betel nut chewing is part of our culture. Why do we need a law to control our own culture?” And I agree with all who say this. But the buying and selling of betel nut in our major urban centers is causing a lot of social problems and we have to explore ways how best we can allow people to continue to enjoy their favorite nut without the social problems associated with commercial side of betel nut. The social problems of betel nut chewing appear to be predominantly in the urban centers in PNG with a few exceptions. We already know that betel nut chewing leads directly to mouth cancer. I don’t think there is only one solution to these problems. We should explore other ways to attack the problem from different angles.

I see 3 main factors that are contributing to the social problems associated with betel nut chewing.

  1. Betel nut chewing is a cultural practice in the coastal areas. It was never a cultural practice in the highlands provinces. Introduction of betel nut chewing into the highland provinces has resulted in the habit to flourish outside the context and significance of which betel nut is traditionally chewed. Also it is common belief among some provinces in PNG that betel nut husk and spit can be used by sorcerers to cast spells on the chewer so betel nut chewers in these areas do not throw betel husk nor spit in public places. The same cannot be said of provinces in which betel nut chewing is an introduced practice – the highlands provinces.
  2. The second contributing factor is the commercial aspect of betel nut chewing. Betel nut generates a lot of money for those involved in the business. With the ever increasing cost of goods and services in PNG, more and more people and families will get into the betel nut business, whether it is small scale (e.g. selling betel nut in front of your house) or selling in bulk.
  3. The selling is flourishing because there is a demand for the nut. In other words, the selling will stop or slow down if the demand for betel nut also stop or slow down. It is simple economics – the selling is being driven by the buying.

So these 3 areas need to be targeted to control the habit of betel nut chewing in urban PNG and indirectly reducing mouth cancer rates. This is only my opinion and I welcome comments for discussion.

The Federated States of Micronesia (Pohnpei State), Palau and Marshall Islands are few of the Pacific Island Countries that have a betel nut laws to control the habit of betel nut chewing. Betel nut chewing is now established as a carcinogen by the World Health Organization so like all other cancer causing agents/habits, there should specific laws in countries that this habit is widespread.

So can laws targeted at controlling the habit of betel nut chewing prevent and control the habit? And indirectly control the social problems and unhygienic scenes observed in PNG? Betel nut is widely chewed in Pohnpei (one of the States of FSM) but the streets are clean and there are very few red betel nut stains. Ponhpei introduced the Betel Nut Prohibition Act 2010 to control this habit. The Act prohibits the chewing of betel nut in shops, offices, public areas, parks and spitting of the quid in public places. Offenders are fined or sometimes required to do community service. The Act also mandates shops, private and public institutions to put up notices on the walls or doors to inform the public of the prohibition and the penalty if caught. Betel nut is sold in shops in neatly packed packages. Street hustling to sell betel nut is prohibited. Palau and Marshall Islands also have similar Betel Nut Prohibition Laws. Similar laws ought to be introduced in PNG! Call it Buai Prohibition Act or something similar specific for controlling the sale and buying of betel nut in the urban areas of PNG.

Posted in Health | Tagged , , , ,