- Jon i putim vanis long tebol bilong em.
John is varnishing his table.
FYI: Vaccine-preventable Diseases in Papua New Guinea
Papua New Guinea was certified as a country free of poliomyelitis by the Regional Commission for Certification of Poliomyelitis Eradication in 2000. It made the switch from OPV (oral polio vaccine) to the IPV (inactivated polio vaccine) on 18 April 2016 and was validated on 2 May 2016.
Vaccine coverage has declined over the past 5 years and continues to fall below targets across all antigens. Against the third dose of diphtheria–tetanus–pertussis (DTP3) national coverage target of 72%, the official estimate is 61% (2016), down from 68% in 2013. WHO/UNICEF estimates are higher at 72% coverage (GAVI, 2017). Estimated coverage with measles-containing vaccine (MCV) continues to stagnate at 70% since 2013 and stayed at 70% in 2016 (GAVI, 2017).
Pneumococcal conjugate vaccine (PCV) was introduced formally in November 2013, but only in some provinces. Roll-out continued in 2014, though impacted significantly by delayed training and a major measles outbreak (described below), and without formal coverage estimates. The national roll-out in late 2015 was consistent with the official estimated coverage of 20%. IPV was introduced nationally with PCV in November 2015 but coverage estimates are not available for IPV, or for second-dose MCV2 (introduced in early 2016).
There was a large-scale measles outbreak from September 2013, with the last case reported in September 2015. In total, 2649 confirmed cases and no deaths were officially reported to WHO through the national surveillance system. However, the National Verification Committee report notes that there were more than 75 000 suspected cases during this period. The sensitivity of the surveillance system is not adequate, as measured by performance on standard surveillance indicators (the rate of reporting of suspected cases with fever and rash that tested negative for measles and rubella). In 2016, the annualized national reporting rate of non-measles/non-rubella suspected cases was 0.5/100 000 population (target >2/100 000 total population at the national level) and only 10% (target >80%) of provinces are achieving this recommended reporting rate.
More positively, there was an improvement in the drop-out rates between pentavalent (penta)-1 and (penta)-3 vaccinations from 29% in 2014 to 25% in 2015, though this was still significantly worse than the target of 16%. Provincial and district penta-3 coverage levels vary widely across Papua New Guinea, from 20% to 97%, though there are concerns with both the numerator and especially the denominator, with the number of eligible children based on a 2011 national Census adjusted for annual population growth.
In terms of equity of vaccine coverage, just 18% of the 89 districts have penta-3 coverage above 80%, down from 20% in 2014. Although a signatory to Maternal and Neonatal Tetanus Elimination, routine administrative coverage of tetanus toxoid 2+ dose (TT2+) decreased from 60% in 2008 to 50% in 2014. Papua New Guinea faces serious challenges in improving TT coverage even where ANC attendance rates are higher than the TT+ coverage rates, and reflects the serious and complex problems in the system, including vaccine availability. No data were reported on the number of cases of neonatal tetanus in 2014, impeding the Expanded Programme on Immunization (EPI)’s ability to design and plan effective and evidence-based interventions (GAVI, 2016).
VD, venereal disease (also STI).
One of the great experiences of travelling in PNG is taking the opportunity to stay in a village. Village accommodation comes in all manner of guises. It might be a basic hut in a highland village; a tiny thatched stilt house in the Trobriand Islands; or one of the simple village guesthouses on the Huon Gulf coast, or around Tufi, Milne Bay, the Sepik or New Ireland. It might not be a village house at all, but a spare room in a school, space in a police station, in a church house or just about any building you see. Just ask.
Village accommodation can be pretty rough but it’s the cheapest way to see the country, and in most villages you’ll find a local who’ll put you up. You must pay; K30 to K50 is a fair amount to offer a family providing you a roof and kai (food). But ask locals before you head out of town what might be appropriate compensation – a live kakaruk (chicken) could be the go. But a live kakaruk can be a hassle to lug around, so maybe a sack of rice, or some bully beef, salt, tea or sugar might be better. In some instances a carton of beer is good currency, but alcohol can be a very sensitive issue in some communities, so proceed with caution.
In some villages couples might be asked to sleep in separate buildings to observe local custom. Most rural villages have a men’s house and these spaces often function as domiciles for elderly or widowed men and young male initiates, as resthouses for male guests and as places where men practise ‘the arts’. Men’s houses are tambu (forbidden) to women – female travellers will be enthusiastically ‘adopted’ by the village women and quickly engaged with the womanly affairs of the community. In some villages there’s a haus kiap – a village house set aside for travellers to stay in. These were originally erected for accommodating visiting kiaps (government patrol officers) and some remain today. You might be asked to stay in one of these, but it’s more enjoyable to stay with a family in a traditional house than sleeping by yourself.
voice (also nek)