Only 160km separates the Australian mainland from its closest neighbour Papua New Guinea (PNG), but in many ways the countries are worlds apart.
According to recent estimates, the rate of maternal deaths in PNG is more than five times higher than Australia’s maternal mortality rate from 1964 to 1966. It is more than 35 times greater than Australia’s current maternal mortality rate.
The far north Queensland region of Cairns has a population of about 162,451 people. The main hospital in Cairns has nine birthing rooms, each with an ensuite, 24-hour obstetric support and a special care nursery.
Three of the rooms in the maternity unit have large baths where mothers can relax during labour or have a water birth. Mothers at Cairns Hospital can choose to have mood music, massage oil, aromatherapy burners, heat packs and a fridge in their room.
More than 2,800 people work in nursing roles in Cairns and the surrounding hospitals. Mothers who give birth in Cairns have access to extensive resources to prepare them for birth, as well as healthcare professionals to guide them through the process.There are about 2,700 births at Cairns Hospital each year or about seven a day.
Just an hour away by plane in Port Moresby, the capital of PNG, the conditions could not be more different.
I was born in the small coastal village of Kivori, in Papua New Guinea’s Central Province. With no healthcare centre nearby, my mother gave birth to me at home, with the help of several traditional birth attendants as well as a traditional healer.
Instead of a delivery bed, an empty rice bag was spread on the ground for my mother to use during childbirth, and my umbilical cord would have been cut with a sharpened stick of a sago palm.
With no access to an ambulance and the nearest hospital – and doctor – a four-hour drive to Port Moresby, my mother would have been praying that there were no complications.
More than 30 years later, little has changed for the mothers of Kivori. Globally, and within the Asia-Pacific region, PNG has some of the worst maternal and child health indicators. At least one woman loses her life in childbirth every day. Most of these deaths are preventable.
It was on a visit to Brisbane last year that I was reminded how shocking the conditions are for mothers and their newborns in PNG. We may be Australia’s closest neighbour, with just 400km separating us, but the differences in our healthcare systems are like night and day.
The Royal Brisbane Women’s Hospital has over 400 doctors. This is only one of many hospitals servicing the city of Brisbane. The whole of PNG has fewer than 400 doctors, and my home province of Central Province has just one doctor servicing almost a quarter of a million people.
In fact, the entire healthcare system in PNG is beset by shortages – in doctors, nurses, midwives as well as facilities, medicine and equipment to make childbirth safer.
My village used to have a small aid post, but government funding cuts and a lack of trained staff saw it close in 2013.
So mothers wanting to give birth in a healthcare facility must now walk 10kms to a health sub-centre. Here, they will find a building without electricity or running water, without mattresses for the consulting beds, and a severe shortage of proper medical equipment.
It is not uncommon for the clinic to run out of medicines – even paracetamol. There are only two staff working here – with the same skills as a nursing assistant in Australia – so clinic times are office hours only.
If anything should go wrong, the closest ambulance is a 45-minute drive away and patients must pay 200 Kina (more than a month’s salary) to travel to Port Moresby to go to hospital. If transport can even be found.
This dire lack of professional, accessible healthcare is why so many women from my village will choose to instead give birth at home. In Central Province, four out of five women do not have the support of a skilled birth attendant during childbirth.
And while homebirths are increasing in popularity in Australian, fewer than 1 per cent of Australian women will give birth without the care of qualified health professionals.
The mortality rates underline the terrible impact of this enormous disparity. Mothers in PNG are 35 times more likely to die during pregnancy and their newborns are 10 times more likely to die during the first month of life.
