Papua New Guinea Disaster Update — Disease Outbreaks Decline In Morobe, Increase In Madang

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¶1. Summary: The Government of Papua New Guinea (PNG) declared a
State Of Emergency in September to address outbreaks of cholera,
dysentery and A(H3) seasonal human influenza in Morobe Province.
According to the World Health Organization’s (WHO) latest
Situation Report, the number of new cases reported on a weekly
basis is decreasing slightly. In Madang Province, however, a
new outbreak has resulted in 237 clinical cases, seven
cumulative laboratory confirmed cases and one death. PNG has
not requested foreign donor assistance, but other countries and
international organizations including Australia, the European
Union, and the International Committee of the Red Cross (ICRC)
have provided assistance through medical supplies and funding.
Most foreign assistance is administered through the Department
of Health in collaboration with WHO and with the assistance of
Medecins Sans Frontiers/Doctors Without Borders (MSF). End
Summary.

Progress Against Disease Outbreaks In Morobe

¶2. The Government of Papua New Guinea (PNG) declared a State Of
Emergency in September to address outbreaks of cholera,
dysentery and A(H3) seasonal human influenza in Morobe.
According to the World Health Organization’s (WHO) latest
Situation Report, the number of new cases reported on a weekly
basis is decreasing slightly.

¶3. At the Angau Cholera Treatment Center in Morobe capital Lae,
PNG’s second largest city, admission of patients has declined
from 10 per day to about 1 per day. Authorities believe there
is still a need for awareness-raising activities in the village
of Situm as many cases of cholera continued to originate from
there. As of September 23, WHO reported a total of 296 cholera
cases with 18 deaths, 1262 dysentery cases with 44 deaths and
4917 influenza cases with 62 deaths.

Health Authorities Create New Institutions

¶4. Morobe’s provincial authorities have established a Provincial
Outbreak Response Committee (PORC) to deal with the outbreaks
with assistance from the National Department of Health (NDoH)and
partner agencies. The PORC is made up of representatives of
relevant national and provincial authorities and is co-chaired
by the Provincial Health Advisor and Provincial Health Director.
The co-chairs operate a Coordination and Command Center at the
Lae Provincial Health Office with the support of WHO. To ensure
a coordinated and efficient response, PORC has grouped work into
six sectors, case management, surveillance, logistics, water and
sanitation and environmental activities, communication/outreach
and coordination. Sector leaders are responsible for
coordinating and leading the work of their group.

¶5. The PORC launched a free 511 hotline September 28. (A
similar hotline for Madang is pending.) The hotline received
149 calls on the first day, exceeding the capacity of three

PORT MORES 00000225 002.2 OF 003

operators to answer; the Center needs additional funding to
increase capacity. Digicel, a PNG mobile phone company, has
indicated it can provide more free lines but funds are needed to
hire additional operators and keep the line open more hours; it
currently operates from 9:00 am to 5:00 pm.

¶6. A Cholera Treatment Center with isolation ward operates at
Angau Hospital with a capacity of 50 patients. The Center,
supported by MSF, can treat patients from Lae and surrounding
areas. The mortality rate of patients reaching the center is
low.

Greatest Challenge Lies In Remote Menyamya

¶7. The greatest challenge appears to lie in assisting patients
in more remote areas. WHO cites continuous problems, compounded
by communications difficulties, in the village of Menyamya.
Health workers there require rations and advances, water and
sanitation at health centers is still a major concern, and there
is a need for water and sanitation environmental health staff to
conduct surveys and provide guidance regarding improvements
needed for health centers. Menyamya also requires installation
of pit latrines and communication with the community regarding
sanitation.

¶8. A medical team was dispatched to Menyamya to support the
response, but faces challenges due to limited facilities and the
difficulty in bringing supplies to the area. Stocks of
cyprofloxin are very limited and are urgently needed to combat
shigella (dysentery.) Only 2200 units remain, enough to treat
220 patients. Area Medical Store (PNG) is responding to
requests from health centers. A WHO survey of water and
sanitary conditions at Menyamya’s health centers highlighted the
need for significant improvements at health centers.

Dysentery and Cholera Reach Madang

¶9. A new outbreak in Madang has resulted in 237 clinical cases,
seven cumulative laboratory-confirmed cases and one death.
Madang’s Provincial Health Coordinator Markus Katchau declared a
dysentery and cholera outbreak November 1 and set up a Task
Force which meets daily. The concentration of cholera and
watery diarrhea is greatest in the municipality of Madang’s
Sisiak Settlement, which contains about 500 households.

¶10. The WHO Situation Report confirmed that Modilon Hospital
prepared ten “Cary Blair” sample taking instruments for each
affected district for outbreak investigation and distribution.
The tuberculosis program Edna began active surveillance of
affected areas for data management November 4. Water and
sanitary advisors from WHO and NDoH arrived in Madang in early
November. World Vision has supplied 200 10 liter (2.6 gallon)
jerrycans. WHO has stated that surplus jerrycans and acquatabs

PORT MORES 00000225 003.2 OF 003

in Lae will be sent to Madang.

¶11. Australia and New Zealand media have devoted a great deal
of attention to the outbreaks in Madang. A press conference was
held for them November 2.

PNG Receives Donor Assistance Despite Not Asking

¶12. PNG has not requested foreign donor assistance.
Nevertheless, other countries and international organizations
including Australia, the European Union, and the ICRC have
provided assistance through medical supplies and funding. Most
foreign assistance is administered through the Department of
Health in collaboration with WHO and with the assistance of
Medecins Sans Frontiers/Doctors Without Borders (MSF).

¶13. A large number of other partners are also contributing to
the outbreak response, including the PNG Defense Forces (PNGDF),
international and national NGOs, UN agencies and the private
sector. WHO and UNICEF have recently submitted funding proposals
to the European Community’s Humanitarian Aid Office (ECHO) for
250,000 Euros (USD 363,134) and 260,000 Euros (USD 388,059)
respectively to assist in overcoming the outbreaks.

Comment

¶14. On several occasions, we indicated to Government
authorities our willingness to look into the possibility of USG
assistance in dealing with the various disease outbreaks. We
can only speculate on why PNG has not yet requested any foreign
assistance. Money the Government has already budgeted for these
outbreaks has not yet been distributed at the local level. With
this in mind, some speculate the Government may not wish to
request foreign assistance since this could encourage Parliament
members from the Opposition to question why the already budgeted
monies have not yet been spent.
TAYLOR