A LESSON LEARNT FROM THE HUMBLEST MEN

Its an experience that I always remember, having walked through some of Papua New Guinea's rugged terrain, all in the name of health services. Let me take this time to share with you some experiences bringing health services to the remote places. I also learnt  valuable lessons from the Tsewi people in the remote part of Menyamya, Morobe Province that shaped my entire life. A life that I promote to be very healthy and practical even now.

It was in 1996, when I worked with Lutheran Health Services (LHS) as a nurse in Menyamya district in Morobe Province. I led a team of health workers, compromising  of a Community Health Worker(CHW) and a Nursing Officer(NO) during a Supplementary Immunization Activity (SIA)  program to Tsewi village( pronounced sewi). Tsewi is a small village located in the midst of Marawaka district, EHP, Markham district in Morobe province and Menyamya. The only government service available is a community school siutated 5 -6 kilometers from the village. Most children walked everyday and some gave up before the school year ends.
We were dropped off by a  chartered light fixed wing NCA plane at Tsewi community school. The headmaster is the only teacher available,while the rest have left to other schools in towns due to its remoteness. The lone head teacher managed to keep the school grounds neat and tidy.  We overnight at the school and before dawn, around 4.30am we  left for Tsewi village. It was still dark and had to navigate through the thick jungles with our bright torches. On our way, we come across snakes and leeds. Even worse,the leeds sucked blood from our feets. This is the first time I saw leeds sucking blood. It was daybreak atfer two and half hours of walking. We had our biscuits and fresh water from the running creek. After the short break, we continued walking until we reached Tsewi at 6:00pm. The welcome reception given by the locals was the best I ever experienced in  my entire life. There were shouts of women,children and men with singsing and kundu beats. We were accorded the 'masters welcome' that one would give to a queen's visit. But more to that, I can see the feeling of joy and peace in their heart from our presence. They seem to be the happiest people I ever met.
The next day we immunized children and treated other  minor health problems. We also conducted a health education and did antenatal examination. We worked all day till 6:00pm and left the next day for Menyamya district.
 I try to figure out what makes them happy and satisfied.  Well, it is very obvious, they lived a very  simple  and humble lifestyle, with basic necessities as the centre of life - food, water, shelter, air  and they have these basic needs in abundance. As long as they have these basic necessities in abundance, they are satisfied.  Furthermore, they lived an independent life and making the best use of what is availabe at their disposal. They build good houses, make more gardens to provide adequate nutrition for their families and also health conscious.Thus, from our examination, their babies are well nourished.  From this perspective, I learnt that having alot of material wealth  like money, clothes, vehicle etc...does not neccessarily make a person happy. As long as there is food, water, shelter,family and air as well as making the BEST use of what you already have - talent, skills, knowledge, will make you the happiest person on earth.

FACTORS THAT AFFECTS HEALTH CARE NEEDS

Accessing and using basic health care is essential for normal physical,mental,social and spiritual growth and development of a person. Health care needs delivered to an individual must be adequate and appropriate. Today, many individuals and families do not have access to appropriate health care. Consequently, PNG has the highest infant and child mortality and maternal mortality rate which the highest in the Pacific region. It is only second highest to Africa in terms of maternal mortality. Many people continue to die from easily preventable diseases like Malaria, Tuberculosis, Pneumonia, Diarrhoea and Pre-natal conditions. The factors affecting health care are varied and far-reaching. As health care around the world is examined, access and use are gaining more attention. If you have health problems -- chronic or acute -- having high-quality, accessible health care is important. Access to health insurance, cultural factors, socioeconomic status, setting, and beliefs about health care, are the most important factors considered when it comes to proper health care.

Many countries in the world have universal health care for their citizens. Access to health care can be determined by the availability of national medical coverage or to that from private health insurance. In 2005, the government of Papua New Guinea made a decision to develop compulsory national health insurance for all citizens. The national health insurance scheme will enable the ordinary people to have easy access to proper health care. Recently,it was discovered that those without insurance were less likely to go to the doctor if they became ill or were injured, compared with people who had easy access to health coverage.
Cultural beliefs about medical care can have a substantial impact on whether or not people seek health care when they become ill or are injured. In some cultures, lack of access to health providers who are of a similar culture or speak the same language can be particularly difficult. This is particularly true in the highlands and some areas of Morobe Province in PNG. Furthermore,income also played an important role for people to access adequate health care. It was discovered that income levels have a significant impact on access to health care. The poor often have little affordable health care. Add to this the expense of pharmaceuticals, and going to the doctor is out of the question for those who do not have universal health care or health insurance.

In PNG majority of the people live in rural areas and urban areas where access to quality health care is a problem.These rural majority and urban disadvantaged lack adequate and appropriate health care needs. The location significantly determine the kind of health care people receive. If you live in a city, you're more likely to be able to access health care than people who live in rural areas. In many cases, doctors choose not to practice in rural settings because of financial constraints or due to lack of resources in rural areas. Often, these areas have deficits in specialists or hospital facilities. As a result, patients may need to drive long distances to attend medical appointments.

Finally, spiritual beliefs have an impact on the use of health care facilities. In many cultural groups, including Native American, Asian and  certain parts of PNG, using modern medical care is in direct conflict with traditional beliefs about the source of health problems and illness. People immersed in these beliefs may turn to more traditional healers and witch doctors for relief of their symptoms.

Whatever it is, on an individual level, in order for a person to access and use adequate and appropriate health care, the factors discussed should be seriously addressed by appropriate government and policy makers.

Heard About It But Set Foot On It

Buka Island looking from the North

I was told that I will be travelling to the trouble island on a teaching tour. I wasnt really interested going to a place I heard so much about fighting,killing,massive destructions and high powered weaponds. And just recently the burning of the Kimbe Queen ships. At first, I was undecided, but after battling my thoughts I finally accepted that I would rather set foot on the island and see for myself the realities of the trouble island.

In fact,it was my first trip to the outer niugini islands region. I board Air Nuigini in Madang at around 8:00am and travelled via Port Moresby and safely landed on Buka island at 200pm. Men, I had a great experience flying at very high altitude. You know what, I felt completely helpless the moment I looked through the window. My entire body was freezing, dead and weak. What if there was a technical fault or something happened to the plane, there was no sight of any surface of the earth, The more I thought of it, the more freightened I became. I  would just die the moment something happened to the plane. Alas, that was the best part of my experience flying high above the clouds.Anyway, upon landing at Buka airport,the passengers mostly locals started for their destinations. I was a bit nervous as I see almost 100 percent dark coloured skin people. There was one particular young man, who later introduced himself as Tony apparently Jiwaka and Buka parentage, was looking strangely at me. That look made me more frightened. We met some minutes later and  he seems so friendly. He knew that I was a first timer there so he wanted to help out if I am lost. We briefly had a chat and offered him some money for making me feel at home.

Like the famous singer olimaya said, "Yu yet kam na lukim", ( come and see for yourself ) Buka island turned out to be different as I set foot on it. People are welcoming and respectful. Its even more safer to walk in town even till late nights. I had an acquainted with a gentlemen who offered to stop a passing PMV bus when I was standing at a bus stop near the airport. Wow, thats unusual in other places. No body cares what you need and strangley I thought if everyone in my place had this type of personality, we would be better off. I conclude that generally Bougainvilleans are educated in their mind. This is clearly reflected in the way they behave. Drunkard youths mind their own business, without intefering the normal lives of others. Women,children and men are moving around freely without fear of violence. Its really encouraging to see that almost 100 percent of the businesses from guest houses to merchandise outlets are owned and operated by locals. The stores itself are all packed to capacity ranging from very small accessories like matches, needles to major accessories like clothes, food, guitars etc. The island is also fortunate to have all the vital government services like bank, post office, hospital, telikom., PNG Power, NBC, New Dawn FM among others. The size of the township is even smaller compared to other centres like Kaintanu and yet they are blessed with abundance of services.

I also had the previledge to tour the New Dawn FM station. Its a community oriented station that inform, educate and entertain community involvement and participation. Its fascinating to discover this talented journalist making headlines at the international arena. The facilties and studio are modern to date and all computerised. As I looked around I saw radio broadcasters busy doing their stuff, some editing news while others broadcasting.
Well, I am running out of words but let me tell you once more that,I really enjoyed my stay at Buka island. So if you are planning for a family holiday, or a business trip, or an employment opportunity, just take the opportunity and dont miss the chance. I have been there and I know what I am saying. Its a beautiful and safe place to live and work as long as you do the right thing.

The Secret of Being An Effective Manager in an Organization

Firstly, a manager is a person with managerial skills and authority. He or she gets things done through other people. Being effective is the result of the manager’s involvement and working relationship and doing the right things. Most of the managers working career will involve working with people. People are the core and vital resources of the organization. The productivity of the organization depends very much on how the manager utilizes its human resources in the organization. Therefore, people working in the organization must be given due care and respect. People either build or destroy the organization. Basically, people here refer to doctors, nurses, carpenters, plumbers, painters, cleaners, etc… in the context of a health institution. I have learnt to work with these people to carry out my plans and discovered to be very effective in my responsibilities as a manager over the last 10 years.

Secondly, people working in the organization must be motivated. Without motivation, workers generally don’t perform to the required standard. Thus, what is motivation? Motivation is the willingness to exert high levels of effort to reach organizational goals conditioned by the efforts ability to satisfy some individual need (Robins, 2009). Therefore, motivation creates tension resulted from an unsatisfied need. This need drives a person to perform an activity in the organization. This performance resulted in achieving the goals of the organization and eventually satisfying the needs of the organization. Therefore, hiring and employing motivated staff in the organization is very vital for growth and productivity. "You should first get the right people on the bus and then figure out where to drive it - not the other way around." Jim Collins

Here are few tips on how to be an effective manager!

1. TREAT STAFF WELL.

Subordinates have to be treated with diligence. The manager has to stay friendly as well as maintain a level of distance with his staff. It’s a tricky ground to tread. The staff looks up on the manager as their leader. They expect maturity, rationality and understanding from their superiors. Further, doing simple things can greatly motivate workers. For example, calling people by their first name, chatting about their families for a while or even a general inquiry about their well-being, brings in a feeling of belongingness. Small gestures of this type help in building up of a cordial relationship.

2. THINK LIKE A WINNER
A manager has to handle two situations, "The Winning" and "The loosing". The crux is to think like a winner even when all the odds seem against you. It is necessary to equip yourself with all the tools of a winner. Always remember that winning and loosing rotate in a cycle. If you have been loosing from a long time you are very near the winning edge. For example, if the operational grant is not released on time and the account is in deficit balance, operate as if you have a million kina in the bank account.

3. RECOGNIZE THE DIFFERENCES
All the employees in the organization vibrate to a different pace. A treatment that motivates one may demotivate the other. Understanding the difference in temperament in between the individuals is important.

4. SET REALISTIC GOALS
Be realistic and simple and set goals you can achieve. Think big and dream of big plans but start at a low profile. Setting too high a task creates a feeling of non-achievement, right from the beginning itself. The goals set should be such which seem feasible to the employees to be achieved. A slightly higher target than expected provides a challenge. Do not make big promises which you can not deliver and lost your integrity. For example, a colleague promised to build five staff houses, a new water supply system and new solar system for the hospital in one year and achieve nothing.

5. PREVENT DEMOTIVATION
A job of the manager is to motivate people. His/her task requires him/her to punish and penalize people. This might create resentment in the mind of the staff members, which may affect the productivity of the workforce. Henceforth, care should be taken, that punishment and penalties are used as a controlling technique and that they do not demotivate

6. JOB-FINANCIAL ENRICHMENT AND SMALL JOB CHANGES ARE HANDY
To make job more effective and to break the monotonous routine, small task additions and minor changes are always welcome. Even small suggestions of the manager seem valuable to the employees. A few challenges in the same job can enrich it. For example, a committed receptionist should be asked to do payroll, asset inventory and other administrative duties instead of just answering phone calls all her working life.

7. NON FINANCIAL REWARDS
Monetary rewards have always had a high motivational capacity. But non-monetary rewards are equally helpful. A thank you note, a letter of appreciation or even few words of praise can help smoothen the creases between the different levels of management.
You have to be very clever to do simple things! And try as much as possible to find out from your staff before they run away!

Lutheran Health Services Roles in the Remote Districts

Papua New Guinea (PNG) is truely the land of the unexpected, with its rugged terrain,fast flowing rivers and  risky geography. Unlike any other countries on this planet earth, PNG is blessed to have two worlds, the urban and the rural world. A land with a total inhabitants of 7 million people and 800 languages with a diversified culture. About 87% of these population lived in the rural districts. Given this geographical context, it makes it almost difficult for the government to deliver adequate essential services to its rural population. As such, the majority of the rural population are denied access to adequate government services like schools, health facilities, roads, clean water supply and sanitation and employment opportunities among others.

No wonder why PNG still has a low literacy rate, high maternal mortality, low living standard,collapse in the health system and low life expectancy comapred to other neighbouring Pacific island countries. None-the-less,the presence of churches and  their work in the districts is a great relief and beneficial to the rural population. The churches delivered vital services in health, education, agriculture and water supply where government services are unreachable. They reach people right into the remotest parts of the country.The Churches Health Services (CHS) is a significant partner with the government to provide basic health services mostly to the rural areas.Further, CHS provides more than 64% of the rural health services. They provide mostly Aidpost, Urban clinics, Health Centres, Health Centres and Rural Hospitals. In addition, CHS also run five General Nursing colleges out of the seven colleges and all the Community Health Workers (CHW) training schools in PNG.



A mother seeking treatment at Braun Memorial Hospital in Finschhafen

Among other churches that provide health services in PNG, Lutheran Health Services (LHS) is one that must be commended for delivering quality health services to the rural majority and the urban disadvantaged. Despite setbacks and challenges with limited resources, the Lutheran Health Services continues to provide high quality health services and is truely a silent achiever. Patients that have gone through their health facilities have experienced and truely saw Jesus Healing Ministry in action. You will find some highly skilled, qualified and dedicated yet humble doctors, nurses, administrators and laboratory technicians in their health facilties. Mind you,these professionals are paid much lower than the government counterparts,but humbly continue to provide quality health services. The Lutheran Health Services are located in  the Highlands, Morobe, Madang, Sepik and Niugini Island. They also provide one General Nursing School and two Community Health Worker training schools.



Transporting medical supplies on a hired PMV to Mindik HC in Finschhafen

Despite poor road access in the districts, LHS strive to provide a health service that is easily accessible, affordable, and appropriate to the rural majority and urban disadvantaged. They do whatever it takes to improve the health status of the rural people. The accessibility to health services in a LHS health facility is very simple in nature. Not so much process and procedures are required when a patient enters their health facility. LHS undoubtedly plays a very significant role by providing the much needed health services in the remote districts. .

University Is Not A place For Clever People

It's a common mentality that university is a place for clever people. Typical people on the street view university as a place for people who are very intelligent and posses unique skills and abilities that enable them to enter a university. This mentality is typical for those that have gone through the formal education system. For instance, one that passess Grade one  through to secondary school and university. To date, many Papua New Guineans(PNG) believe this concept as  a reality.  Rather university is not a place for clever people. Its a place for those who have a high committment and determine to study hard and live a different life. Its also a place for people who have a right attitude and sees ordinary things in an extraordinary way.

There are also many that have gone through the informal education system like College of distance education(CODE),Department of open and distance learning(DODL), Matriculation etc... and are occupying higher places in the social structure in our society.There are many real personal testomonies of people who have gone to universities and graduated with degrees in various discipline despite being termed as a "school leaver" or drop out from the formal education system in PNG. There was one guy I know personally who failed in Grade 8 and went through the informal education system and entered university of PNG and graduated with Bachelor of Medicine and Bachelor of Surgery (MBBS). He is now a practicing medical doctor in PNG. There was also a carpenter who also studied medicine and is a medical doctor. As such, can you say that university is a place for clever people?

I am also a testimony of such commitment and determination to achieve a purpose in life. I droped out of Grade 10 in 1988 and unable to secure a placing in the tertiary institution and university. I was out on the street with the street boys doing what a street boy would do. I indulged in drug, stealing, break and enter and selling ciggarettes to make ends meet. After three (3) years  of been on the street, I realised that I can become a better person only if I made a personal comittment and determined to have a good life.I praise God for the wisdom given to me at that time to started thinking seriously about a better life.

From scratch,I enrolled with CODE and upgraded my marks in 1991. I did extremely well and was accepted a placing at Lutheran School of Nursing in Madang in 1992. I successfully completed my nurse training in 1995 and was employed with the Lutheran Health Services (LHS) and posted to the remote Menyamya district of Morobe province in PNG. While employed, I enrolled with DODL at the University of Technology in Lae and completed my Adult Matriculation(Grade 12 certificate). A year later, I studied Health Management at Divine Word University(DWU) in Madang and graduated with a Bachelor of Health Management in  2010. In the near future, I am looking forward to pursue a Master of Science in International Management and possibly a Ph.D before I retreat from public life.

So there you are.  University is not a place for clever people. I would like to encourage those that are pushed out of the formal education system that its not the end of your life. By all means, you can make it to a university, if you have the right attitude and made a commitment to study hard and is determine to live a different life.

Welcome

Hellow everyone. This is my first post using blogger.
I hope to write things about myself, my work, and my everyday activities.

I hope that you can come and check my bloggs whenever you can.

Thank you