Over the next 9 weeks or so, I'll be chronicling my experiences as a student at Kudjip Nazarene Hospital in the Western Highlands Province of Papua New Guinea (PNG). The original plan was to be traveling there today, but due to some visa hang-ups, my new departure date is in two weeks. On the bright side, that leaves a little more time for me to give you a little bit of background.

I've been looking forward to this trip for over a year now. It all kind of started when I was reading stories about med students/doctors in other countries and all the good they were doing. I guess I just kind of decided that I wanted to give it a try, too. Fortunately for me, my wife of 4 years was up for it as well, and our two-year-old Caleb didn't have much choice but to go along with it! I found Kudjip Hospital on a list being circulated by the Christian Medical Dental Association (CMDA) of mission hospitals that routinely take medical students. To check it out the hospital go to: www.kudjipnazarenehospital.org

The next step for me was finding out more about the place and the people I would be working with. It turns out that PNG is quite an interesting place. There are over 800 native languages there that are still spoken, making it one of the most language-dense places on earth. New species of insects and plants are found in remote valleys every year. Also, infrastructure there is almost non-existent. For example, the capital, Port Moresby, has some of the only paved runway in the country, but is not connected my major roadway to any other city because of the terrain. Apparently, small airplanes is the preferred method of transportation. Over 85% of the population of 5.8 million are still subsistence farmers, and almost all the land there is owned via "customary land title" by the various indigenous tribes, making utilization of the abundant natural resources very difficult. By all accounts, the people are generally warm and friendly, and this I am looking forward to seeing for myself. For all the languages spoken, three are official languages of the state: English, Tok Pisin (Pidgin English, a sort of hodge-podge trade language), and Hiri Motu (apparently a prominent local language). Due to some continued problems with the economy, it was taken off the "Developing Nations" list and demoted to "Least Developed Nations." All this makes for a healthcare system that is not exactly thriving.

That's where the hospital comes in. It is a 100 bed hospital that serves a province of almost half a million people. There are 5 doctors there - a surgeon, a pediatrician, and three family doctors (all from the US). They, along with 35 nurses (PNG nationals) see almost 45,000 outpatients, over 4,600 inpatients, deliver over 1000 babies, and perform over 700 major surgeries per year. All this is accomplished with an annual budget of $750,000. Pretty darn amazing if you ask me. This is definitely not going to be a vacation! One of the things that draws me to international medicine is just how much they do with almost nothing. It is definitely a stark contrast to medicine here in the States.

Well, enough background for now. I'll look forward to writing again, hopefully with something even more interesting!

We had hoped to be in PNG by now getting over our jet lag, but alas, we are still here in the States. Our rather expensive hang up has been obtaining our visas, which finally seems to be getting on track. Unfortunately, that means two less weeks there and some hefty charges to change our tickets. Se la vie.

I just wrote an incredibly boring update on my situation which included some obligatory statistics regarding the country, the people, and the hospital. The only thing worth noting, I think, is the crazy amount of good the people at Kudjip Nazarene Hospital do with what American hospitals would consider chump change. You can check out all the statistics here at their website of how many people they see, babies they deliver, and surgeries they do. Suffice it to say that it is pretty freaking amazing, especially considering they do it all on $750,000 a year.

Coincidentally, that is just under twice the amount it cost for Stephanie and Caleb's stay at the hospital when he was born. Stephanie had preeclampsia, which basically means her blood pressure (as a result of the pregnancy) was so high it was trying to kill her. As a result, Caleb was born at 30 weeks, and spent a month and a half in the NICU. I'm definitely not going to go all utilitarian and say that we shouldn't use expensive treatments/resources to save lives. Far from it! The money spent on both of them was more than worth it, and I don't like to think about what life would be like for me now if we had been in some third world country when it all went down. Selfish... maybe. It is just crazy to think that our one hospital bill could fund an operation that serves a province of half a million people for the better part of a year. I think that speaks to the differences in both the capacity for complex care and the level of resourcefulness in our respective systems. Hopefully I'll be able to pick up on some of that resourcefulness while I'm there.