How are small Pacific Island countries responding to the threat of COVID-19?

Small Pacific Island countries (PICs) are vulnerable to disease outbreaks. The measles outbreak in Samoa is a grim reminder of this vulnerability. Now another threat is at the door step of the island nations. Their geographical remoteness and isolation from rest of the world may seem to be an advantage and may appear to seclude them from the threat of COVID-19 but the lack of regular interaction with the outside world may be the thing that may decide their fate.

History shows that introduction of a new disease to a group of people that are isolated can wipe their population completely. The reason is that they have not developed immunity to the disease. Also in areas where there is frequent interaction of people there is also regular transmission of infections from people from different areas so the population immunity is primed all the time. Without this regular interaction may result in population immunity being weakened. Pacific island people are at risk because their population immunity (in the general sense) is not regularly primed.

One of the first step that PICs have taken is travel restrictions – from selective travel to complete ban in some countries. It may seem drastic and overreacting but in light of what I described above stopping people from going into their countries may be the cheapest and best strategy. Preventative public health interventions are the main tools at the disposal for PICs because they do not have the resources nor the skilled manpower to contain COVID-19 spread if it hit their shores.

Some small island nations can afford to quarantine inbound passengers because of small population and low volume traffic of inbound passengers. Again the objective of such public health measures are to contain and manage the threat.

Risk communication, public health awareness messages targeted at vulnerable segments of the population (e.g. the elderly, people with co-morbid chronic diseases) also will play an important role. Social distancing is now the key message – avoiding crowds, avoid social gatherings, avoid church services being driven into the community.

Social distancing is a difficult concept for the Pacific Island people because this is what we do – socialise. Telling the population to avoid contact, avoid sharing time and meal together, avoid going to church, asking friends and family members to stay afar from you is difficult to swallow because social distancing is like a big wedge being driven into the “pacific way of life”. It is a challenge that health educators will have to overcome. I think if we can make people see the danger of close interaction during this current pandemic, we will see pacific island people coming together to prevent COVID-19 landing and spreading on their shores.

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Public Awareness, Infection Control and Prevention Strategies Keys To Controlling Spread of COVID-19.

As the numbers of people infected with the new corona virus continue to increase globally, health authorities around the world are working around the clock to find the right treatment and continue to work towards a vaccine. Several clinical trials are underway and several companies have accelerated vaccine development.

Corona viruses are a big family of viruses. Some of the common infections caused by corona viruses include the common cold (flu) and SARS. Many Papua New Guineans would be familiar with the name SARS. COVID-19 stands for Corona Virus Disease 2019. The new virus causing COVID-19 has been named Severe Acute Respiratory Syndrome Corona Virus 2 or SARS-CoV-2, the signs and symptoms of COVID-19 are similar to the SARS outbreak in 2003.

While countries with higher level of healthcare are able to treat severe cases, how can under resourced countries in the Pacific manage the outbreak? Although travel restrictions have been put in place by many countries, the World Health Organization (WHO) does not recommend this measure as the sole strategy to contain and prevent outbreaks. Travel restrictions have far reaching negative economic and social effects.

What we know from current medical evidence is that the spread of COVID-19 follows similar pattern to the spread of common cold. This means being in close contact with someone with the infection, touching contaminated surfaces then touching face (mouth, eyes) with the contaminated hands and being close to someone coughing can result in contracting the infection. Furthermore, current statistics from WHO show that 80% of people with COVID-19 have mild symptoms and recover fully, 15% have moderate symptoms and require hospitalization and recover after prolonged admission and 5% have severe symptoms resulting in death. Also older persons (above the age of 60) who have other underlying chronic medical conditions such as diabetes, asthma or other lung diseases appear to be at a higher risk compared to younger individuals.

Infection control and prevention with cough etiquette is the cheapest and most effective way to prevent the spread of COVID-19. Examples of cough etiquette practices include covering nose/mouth with tissue or handkerchief when coughing or sneezing, using a mask when coughing, discard tissues after coughing or sneezing after use, washing hands if in contact with cough or sneeze droplets, coughing into the elbow (don’t cough into your hands) and coughing into the inside of your clothes (Shirts, etc).

Disinfecting high contact areas (e.g. door knobs, table surfaces, sinks, etc), frequent hand washing before touching your face or eating/drinking and practicing cough etiquette is now being emphasized by WHO and the Center for Disease Control and Prevention (CDC) in USA as a key strategy to contain the COVID-19 outbreak. In resources limited settings like PNG where basic health services remain fragmented, basic hand washing hygiene, cleanliness, and cough etiquette still remain true.

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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.

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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.

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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.

 

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