Emergency medicine in PNG : beginning of a specialty in a true area of need

Papua New Guinea is an astonishing place. The Air Niugini flight magazine promotes it as a 'Paradise'. In some ways it is. It depends upon your perspective. The media in Australia would suggest that it is a place of incessant violence and unabated personal danger. They would suggest that the place so recently an Australian dependency is bankrupt of morality as well as funds, and is spiralling into chaos and anarchy. It is strange to see our nearest neighbour so maligned when it would be more constructive to offer support. This paper tells the story of the involvement of specialist emergency physicians in the development of emergency medicine services in PNG, on the background of some history and culture in this extraordinarily needy setting. The Australian Agency for International Development (AusAID) has been providing support in PNG for some years. The Medical Officer, Nurse and Allied Health Project (MONAHP) has played a substantial role in the development of the primary specialties of surgery, general medicine, paediatrics, and obstetrics/gynaecology. Papua New Guinea now has an established programme for surgical training and is making progress towards independence in the other specialties. The need for emergency medicine training was recognized in the mid 1990s, and a Masters of Medicine, Emergency Medicine (M.Med. EM) program was established in 1996. But without leadership there were no candidates. In 2002 MONAHP supported a resident emergency physician and visits by eight others to catalyse development. As a consequence the University of Papua New Guinea has established the position of Senior Lecturer in Emergency Medicine and there are now EM trainees