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# 18th MEDCOM, POMGEN team for first ever PNG Trauma Rotation

By Sgt. 1st Class Timothy Hughes,18th Medical Command

                PORT MORESBY, Papua New Guinea  –              
Machete attacks, tuberculosis, malaria and carjackings are not things commonly associated with laid back island life for members of the 8th Forward Resuscitative and Surgical Detachment.

The 18th Medical Command deployed its 8th FRSD doctors, nurses and medical technicians from the relatively calm Island of Oahu, Hawaii, to work in Port Moresby General Hospital — which is located in the capital city of Papua New Guinea — during the height of its often volatile festive season.

“The mission for our unit is to establish a trauma and surgical ... platform in the Pacific,” U.S. Army Lt. Col. Andrew Galdi, the commander of 8th FRSD said. “The goal of the rotation is to build interoperability by working alongside our Papua New Guinea medical partners to provide both sides with an exchange of medical expertise in very high volume, unpredictable trauma scenarios in a resource constrained environment.”

The U.S. Army's medical team was able to integrate into the hospital due to a recently signed agreement between the U.S. and Papua New Guinea.

“We just signed a defense cooperation agreement, which is the banner of all such agreements,” U.S. Embassy-Port Moresby Chargé d'Affaires, a.i. to Papua New Guinea and Vanuatu Katherine Monahan said. “It really helps us get into these people-to-people relationships, which is why we are here today.”

The increasingly expanding country of more than 10-million citizens faces challenges with its medical infrastructure and resources as it responds to disease and trauma cases.

“The hospital is the largest in the country with a bed capacity of about 1,000 beds,” POMGEN Director of Medical Services Dr. Kone Sobi said. “With the surrounding population, the occupation is usually around 90-95 percent so there is a challenge for us to keep a quick and fast turnaround for our patients we are admitting for various clinical conditions.

“The population of PNG is growing at a rate of 3.1 percent,” the 20 year tenured POMGEN director continued. “It’s like aiding another million of people with the current population of 10.1 million, 3.1 percent translates into ... a million people in just under three years so that’s a huge challenge for Port Moresby in particular being the only large public hospital.”

Sobi said there are other smaller clinics in the country but POMGEN takes on patients outside its higher level of care designation.

“We are meant to deliver highly specialized care but that is not simply possible,” POMGEN Hospital Chief Executive Officer Dr. Paki Molumi said. “We have to see primary and secondary care so it’s a huge challenge for us to deliver a level of best healthcare.”

Sending the 8th FRSD to work alongside the medical administrators and staff at Port of Moresby General Hospital was lauded as a mutually beneficial relationship.

“I think it’s an amazing opportunity,” U.S. Army Sgt. 1st Class Stephanie Grewell, the detachment sergeant for 8th FRSD said. “Offering our trauma surgeons, our nurses, our combat medics, even our ancillary services the ability to work ... in (POMGEN) Hospital — in this region — is something that you can’t replace in the (simulation) lab.

Sobi said, “one of the most heartwarming things is this is the team that came here in May ... to prepare for President (Joseph) Biden’s visit.

“We should be grateful that we have a medical team on the ground that was prepared to look after President Joe Biden and they are here with us working, blending together with our team,” Sobi said.

As formalities were completed and the ink was drying on finalized credentialing paperwork, the 8th FRSD medical teams were being brought up to speed on procedures at their respective wards in the intensive care unit, operating room, and the emergency room.

“The patient population is completely different,” U.S. Army Capt. Brian Cheung, an emergency nurse with 8FRSD. “They presented significant pathologies that are really different from what patients we normally take care of back at home.

“Being here at (POMGEN) Hospital, we are definitely learning a lot from the people that work here,” he said. “They work in a more austere environment than we are acclimated to — working at military treatment facilities. They kind of correlate to our objectives on the forward resuscitative surgical detachment where we are meant to operate within these environments with little or no support at all.

Cheung said the detachment was also learning how to operate with scarce resources while “managing more acute patients with less.”

Medical challenges in the Indo-Pacific stems from multiple-unpredictable factors including natural and manmade disasters.

PNG is located in the “Pacific Ring-of-Fire '', a common term referencing the 40,000 km and up to 500 km wide tectonic belt circumscribing the Pacific Ocean. According to multiple sources, it contains between 750 and 915 volcanoes, which is roughly two-thirds of the world's total. It also hosts nearly 90% of the world’s earthquakes.

Days before 8th FRSD traveled to PNG, a volcano on the northwestern island of New Britain erupted, triggering tsunami scare in nations as far as Japan.

“This mission for the 8th FRSD is really building readiness and capability for providing real-world medical treatment in a foreign country that has varying natural and manmade threats,” said Galdi. “Our world-class medical professionals with varying skillsets are ready to meet the highly demanding challenges in both traditional and austere environments.”

The 8th FRSD is slated to purchase up to $25,000 of medical materiel for POMGEN Hospital to help increase its capacity to treat patients.

“We are really enhancing Papua New Guinea’s medical capacity by making this physical contribution to purchase consumable medical items ... like IV tubing, bandaids, sutures — things that are utilized very highly to help extend their ability to continue to provide medical services to this growing population that is really outpacing the infrastructure and the equipment that this hospital can provide them.

Sobi said POMGEN Hospital is grateful for the donation of equivalently “100,000” Papua New Guinean Kina.

“This will go towards obtaining some much needed consumables, maybe some drugs, depending on what the end users put forward,” he said. “It means a lot -- it’s a huge contribution for us.

“We still have huge gaps to cover but this will be a significant contribution from your team and from the government of the United States,” he said.

Trauma rotations are not new to U.S. Army Medicine. Members of the U.S. team expressed a desire to have a continued civilian-military relationship to build on what was a first-of-its-kind mission for Papua New Guinea.

“Going forward,” Monahan said, “I think we should look at what we’ve done here and how successful it is, and what a difference we’re making in a place where it really matters – and do it again and again.

“The people of Papua New Guinea are the ones who need us the most – and those are the people that are the future and I think we should do it quarterly,” she said.

Multiple members of POMGEN’s administrators and staff echoed similar sentiments and opened its doors to the U.S. doctors and nurses to return as frequently as possible.

“We look forward to (an) ongoing partnership with Andrew (Galdi) and your team,” Sobi said.

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