Kompiam District Health Service

Kompiam is located within the Enga province of the PNG highlands. It is locally known as the “last place” as it is the end of the road, where the road turns to dense jungle, sharp cliffs and mighty rivers. It has multiple associated outposts which offer primary health care interventions, such as immunisations, and are staffed by health workers (trained with a 1 year university course). Most of these peripheral centres are only able to be reached by foot or by air.

Kompiam Hospital has approximately 70 beds, shared amongst a medical, surgical, paediatric, obstetric and a tuberculosis ward. There are approximately 70 staff employed at the hospital, with a 50/50 split of medical and non-medical.

Medical includes Doctors (of which there are three currently), a health extension officer, a dentist and nursing staff. The non-medical staff includes security, maintenance, drivers, administration and finance people.  

Electricity is sourced from solar panels and is stored in a complicated battery system, which is often sufficient to not only power the Hospital but also the staff housing. There is a diesel generator which can be used to supplement the electricity. Like the electricity, the hospital’s water supply comes from the sky.

There is a medical laboratory which has modern equipment for testing: haemoglobin levels, white cell differential, some electrolytes and LFTs (K+, Na+, ALP, CK, eGFR) as well as a TB gene Xpert (a machine confirming the diagnosis of TB, only accepting sputum and lymph node tissue). We have rapid test strips for the infectious diseases of HIV, Syphilis, Hepatitis B and Malaria. We have the equipment to do blood grouping and cross matching for blood transfusions.

For imaging there is a flash new digital Xray machine and an USS machine.

There is a new operating theatre with 2 suites, 2 anaesthetic machines and two operating tables.

The hospital has been a continually expanding project, changing from an 8 bed hospital in 2000, with a cement ceiling operating theatre, to the 70 bed multi-ward hospital it is now, with more extensions to come. Around 15 years ago, a group of designers from Architects Without Borders came to Kompiam to design the wards and the phases of expansion. First phase was the paediatrics ward, which was newly opened when I first came to Kompiam in the wet season of 2013/2014. The maternity ward was opened in 2016 and the operating theatre was opened in 2019. Since then construction for a new outpatient wing, with an emergency style bay, has begun. On Sunday Feb 16^th the Australian Consulate in PNG pledged $500,000 AUD of AusAid funding a year for the next 5 years.

Another exciting new project in the pipeline is a trial of a Flying Doctors style set up to be based in Kompiam. It will be aimed initially at women in labour within this health region and it is estimated our birth numbers will increase from 200 per year currently to 800. This 3-month trial is due to start in April.

The Hospital is funded through multiple sources. It is set up by Baptist World Aid and co-supported with funding from the PNG government. NGOs, private donations and external government sources such as AusAid also contribute substantially.

The key figure in the whole project is Doctor David Mills. He started working in Kompiam with a young family in 2000. He has grown the hospital from an 8-bed shed to the now 70 bed hospital which locally has a great reputation. David is not only a diligent clinician and a skilled surgeon, he is the electrician for the solar power, the project manager for the building projects, the community advocate to politicians, and always looks at what more the hospital could be doing. He is a loving family man, a terrible cook and a passionate Christian. Karina, David’s wife, runs the local school, which is understaffed and bursting with children. She overcompensates for David’s poor cooking and runs the most welcoming and warm house in the region. They are hosting 4 extra children while still having their youngest two children at home.

The other doctor is Dr Rebecca Williams, a locally trained PNG doctor who came to Kompiam in her residency. She has returned as a Rural and Remote Medicine Trainee and has recently become superintendent of the Hospital. She is humble and softly spoken, but ferociously intelligent and extremely diligent. When she was first in Kompiam with David on Patrol (going out to a village by foot), she was struggling to keep pace under the brutal heat of the sun and the steep incline. David thought that would be the last of Rebecca’s ambition to become a rural GP. However, in keeping with her persistent nature, Rebecca’s only comment was “I am going to have to get better at climbing hills”. She has published a book about Rural Medicine in PNG.

Although not formally a doctor, Tania is treated like one, and rightfully so. She was trained as a Health Extension Officer. Although, I don’t really know what that means she assesses patients, prescribes medicine, does lab work, performs minor surgery and is giving good anaesthetics. She is outgoing, bombastic and efficient. On one occasion we required blood and could not find anyone to donate. Tania just walked down to the local market, got on the soap box and got 6 donors within 5 minutes. She speaks Engan (the local language) and has sensational street smarts.

There are multiple medical students, who come from various parts of the world, who will pop up into these stories. There may be a local PNG resident who comes at some stage, who knows.

My house