Wayne Hawthorne, The Naracoorte News

Training to be a doctor is more than just medicine it seems, at least in Papua New Guinea (PNG) where medicos need to be a Jack of all trades. This is what Naracoorte Men’s Probus found out when Dr David Mills spoke recently. It was a valuable insight into Dr Mills 20-plus years and continuing input in PNG.

Papua New Guinea (PNG) was originally part of Australia. Northern and southern areas fused after World War 2 to become PNG, which then became independent in 1975. Remote areas had miniscule assistance from governments. Independence came, and remote areas had little idea of money, running a country, education etc.

Dr Mills spent his time in Kompiam which is in the Enga Province in PNG. At 5,000 ft in the Central Range, it has a perfect climate. Roads stop there. The town is small, but there is an unknown, large population in the region. Government has left its footprint with a hospital, police, schools, clinic, and an airstrip.

Westerners only arrived in the PNG Highlands in the 1930’s and older villagers still remember their arrival. Dr Mills arrived in 1993, and his first medical experience had a lasting impression. They walked all day to near the Indonesian border to vaccinate villagers. A young baby was suffering badly from malaria. As a fresh medico, they walked all day back to the plane to assist the child, who sadly died in hospital. Its mother then had to reverse track. This first experience impacted Dr Mills approach to medicine in the area. It was typical of health issues in PNG.

Photos were shown of wooden huts and fences carved from huge Casuarina trees. Houses had no windows or chimneys, leading to pneumonia and health issues from smoke, particularly in babies and women who spent most time indoors. The link between house and health is little realised. Sunlight kills TB and parasites and assists moods.

Pigs are currency, and once fenced in by the men, are cared for by the women. There is a lot of walking to be done, and not on pathways as we see here.

The folk in photos looked fit, but this can only happen if they survive the first five years and get to their teens. The tribesmen are short, mainly because of genetics and the lack of protein in their diet. Carbohydrates come from a taro and sweet potato diet. The guys are very strong and can easily carry a 105kg man on a stretcher for hours up a mountain side. The only ambulance is a crude stretcher ride to the plane or doctor.

Vaccines need to be kept cool, so solar refrigerators were used, carried by the tribesmen. Aid posts were built by hand. Over 50 per cent of PNG regions have no doctor, and those that do might have one per 120,000 people. There was no doctor or facilities when Dr Mills arrived in Kompiam. They erected two buildings, one with a crude operating theatre lit by one overhead lamp. There were no labs or X-rays. The generator only operated for three hours a day. Kero fridges and freezers were the norm, with their issues. Eventually gas and solar were adopted. There was no patient privacy, with all around knowing of people’s medical issues and domestic disputes. There was also no loneliness with all knowing one’s business.

When not at the hospital, time was spent on patrol, walking, climbing, wading. This showed how hard it was to access villagers for health care. Medicos had to feel their medicine and understand the difficulties with health care. Melanesian pidgin was mostly spoken. When on patrol, mobile equipment was required. Vaccines were kept in chilly bins that lasted 24 to 36 hours. It was often a one and a half-day walk to get to a village.

Medicos have to make informed practical decisions; hence trainees learn practices like how to build, paint, dig a toilet, fix solar panels, install antennas etc. Only 45 are trained each year to be ‘elite’. They must get their hands dirty to be leaders. Medical student housing has been more recently constructed, and trainees now spend their last 12 months of training in Kompiam. (This system now occurs within Australia, e.g. at Naracoorte). Training is in X-raying, lab work (to cross match blood), Yaws program etc so that they become all-rounders. Initially trainees were Australian or European but are now PNG locals. They progress to become specialists.

One doctor who serves 180 hospital beds is head of the Society for Rural Doctors. This society helps train doctors and provide some fellowship as well as rest and recreation for them.

First attempts at building the hospital in 1993 were ‘comical’ with no experience or guidelines to follow. Workers were pro bono. They did manage somehow. More recently Engineers without Borders and Architects without Frontiers have visited to assist in building and design.

The airstrip at 800m is long by comparison to others of 350-400m, but on a slope (some 12 -14 degrees) so access is one way only, irrespective of the wind direction. Planes are twin otters, real brutes with 1.5t capacity and only 150m required for empty take-off. These were not cheap and run by the mission. There were six strips in the region, and the emergencies from the north ‘drained’ towards Kompiam.

Dr Mills wife Karina is a trained occupational therapist, but became an educator of their own four children and extended family. She soon learned how important education was, so set up an international school, serving from kindergarten to year 12. Education became essential, and the school became part of the hospital.

Young PNG lads were once initiated into the tribe. This has now been resurrected to create bonding while discussing “men’s topics” up in the mountains.

When asked about the financing of such PNG medical ventures, Dr Mills said it was initially from missions and donations. Overseas churches left, so it had to be re-localised. Governments partially contributed – $8,000 to run the hospital and $15,000 for the doctor(s). Hence Dr Mills returned to Australia for six-month stints to assist finances. Mining companies did contribute to buildings. A reputation had to be established, and eventually the Australian government contributed. The current project is to purchase a helicopter to assist in retrieving patients to the hospital.

PNG residents accept the western way and see Australia as the promised land. Australians should see that there is a positive impact in PNG. Fresh water supply comes from highland streams, but lack of fresh water can become an issue in low rainfall coastal areas. Melanomas are not a common complaint.

Security is not so much a problem in the highlands; as is reported in Australia. Disputes are mostly tribal in nature, however it can get violent there with personal disagreements that become brutal. Forearm injuries are prevalent while trying to protect themselves from a machete attack. Alcohol is not a major issue. Betel nut mixed with lime is a stimulant but when mixed with lime tends to cause cancer in the teeth.

Native PNG natives do not wear footwear, and trek barefoot. Their toes are spread as a result, unlike westerner’s feet.

Dr Mills continues to be involved with the training of medical staff in PNG. He conducts training sessions from his home on Fridays, and visits PNG regularly. A great effort that continues after 20 years of working in PNG. He deserves all accolades bestowed upon him.

This article appeared in The Naracoorte News, 30 April 2025.