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EDITORIALS: Leslie Swartz and Judy Dick Managing chronic diseases in less developed countries BMJ 2002; 325: 914-915 [Full text]

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Chronic Illness in Port Moresby

Peter A Sims   (26 October 2002)

Chronic Illness in Port Moresby 26 October 2002
Peter A Sims, Professor of Public health medicine School of Medicine,POBox 5623 Boroko, NCD 111,Papua New Guinea Send response to journal: Re: Chronic Illness in Port Moresby	Sir, This article is timely and important. Papua New Guinea is in the midst of the disease transition. There is still a major burden of acute infectious diseases-Malaria,TB,Measles,Pneumonia and TB and ever increasing rates of Diabetes mellitus and Cardiovascular disease. The AIDS figures and deaths rise remorselessly. In this Capital city the poor live in large insanitary settlements.There is little "community caring" for people have migrated from all over the island, far from the village communities and relatives (wantoks)i.e. the extended family which was the backbone of care in the past. The settlements have limited sanitation, few houses have inside water or lavatories, electricity is unusual, violence is rife. Health professionals are not prepared to go into the settlements to provide a home nursing or palliative care service.They are attacked, murdered and women nurses raped. Dying of AIDS with cryptosporidial diarrhoea and 20 or more bowel actions a day in such surroundings is hell and a long drawn out hell. The first requirement then is protection and law and order, winning communities to police themselves, providing protection for carers and restoring confidence to them. The people do care and want to help. The staff are kind, competent and generous but their safety and well being is vital for a sustainable response to a long term problem.