by Cate Mackenzie
When it emerged in October 2010 that there was an outbreak of cholera in Haiti, sympathy poured in for those affected; the presence of journalists and international aid workers meant that people across the world were quickly alerted to the situation. But the fact that 16,000 kilometers away, in Papua New Guinea (PNG), cholera had already been claiming victims for 13 months, received practically no media coverage.
Cholera is an acute intestinal infection caused by ingestion of food or water contaminated by a type of bacterium. It has a short incubation period and produces a toxin that causes a copious, painless, watery diarrhea that can quickly lead to severe dehydration and, if treatment is not promptly given, death.
In late August 2009, cholera deaths were recorded in the Morobe province of Papua New Guinea and in the following months, the disease spread to the capital, Port Moresby. It was the first official confirmed outbreak of cholera in PNG since the 1960s, with the WHO, MSF and UNICEF stepping in to fill the shortfall in government capability. There were conflicting reports about the number of dead and infected: In August 2009, the BBC reported around 40 dead and hundreds ill. Soon after, The Age reported 11 dead and 116 suspected infections, whilst UNICEF stated that 100 people had died, with thousands more affected. At the same time, there were also outbreaks of swine flu (H1N1) and dysentry. Such conflicting reports can be attributed in part to PNG’s fragile health system and remoteness of many settlements. Papua New Guinea ranks low on the UN’s 2010 Human Development Index—at 137th, PNG is just eight places above Haiti.
In response to the cholera outbreak, the PNG government committed more than U.S. $4 million to help relief and prevention efforts. But, as IRIN, the news and analysis service of the UN Office for the Coordination of Humanitarian Affairs, noted, by the end of 2009 none of these funds had been released and a hastily prepared government check for U.S. $1 million later bounced. A frustrated aid worker commented that the government would perhaps only take notice if cholera spread to the capital—which it did.
Apart from Australia, which has provided oral rehydration salts, water containers, purification tablets and other supplies through its AusAID program, the international community doesn’t seem too concerned.
In March 2010, after cholera mortality rates dropped, Médecins Sans Frontières handed over all of its cholera units to the Ministry of Health. Within two months, a public health emergency had been declared in Port Moresby. Unfortunately for the population, the government was by that point unable to take action. The Sydney Morning Herald reported that funds to fight the epidemic had dried up, so Australia donated a further U.S. $650,000 on top of the $870,000 it had already provided. This did seem to make some headway into preventing any further spread of cholera; it did not, however, disappear entirely.
Fast forward to late October, a little after the outbreak of cholera in Haiti. Papua New Guinea was experiencing yet another outbreak, on Daru Island in the Western Province. Once more, Australia provided financial and technical assistance, including epidemiologists and a sanitation engineer. This time Australia also went one step further: It closed its border with PNG in the Torres Strait. The restrictions only applied to PNG nationals, though healthcare would be provided to them before their return home.
Complementing the work of AusAID and MSF in helping treat and contain the Daru outbreak is the Church of Jesus Christ of Latter-day Saints. As well as food shipments and medical supplies totaling around U.S. $200,000 the Mormon church also had two doctors providing treatment to the villages in November and offered to pay for doctors from Australia and New Zealand to travel to PNG to help.
The best prevention to stem the spread of cholera is adequate sanitation systems to safely remove human waste from sources used as drinking water, such as the Sepik and Fly rivers. The government of PNG is in no way capable of achieving this, despite the revenues generated by one of the world’s largest copper mines. At an investment conference held at the beginning of December 2010, the managing director of Oil Search (PNG’s largest oil and gas producer) told attendees that the company had paid out U.S. $4.54 billion to the national and provincial governments in oil benefits. The statement may have been intended to highlight financial mismanagement in order to embarrass the PNG government.
The new year hasn’t seen much of an improvement in anything so far:
The cure for cholera is simple: clean water, sugar and salt. The solution to PNG’s complex of problems is, of course, not an easy one. What is clear is that PNG needs to feature on the radar of more than just its Pacific neighbors.
Cate Mackenzie is an editorial intern and Women and Foreign Policy. She is pursuing a master’s in comparative and international studies at ETH Zürich.
