Why PNG’s only psychiatric hospital can’t get help | By Bethanie Harriman (ABC)

One of the heavy metal doors is opened by a grim face ward attendee to show where violent patients were kept locked up, a claustrophobic room like a prison cell where more than one acute patient slept, fights were common inside.

The cell has been abandoned, but on the white walls are the vivid graffiti patients left behind, you get the feeling they were trying to describe the torture they felt- the place still smells like urine and faeces, despite the effort to clean it up.

The nurse in charge of the acute ward, Dianne Rambe, has brought me into an imposing building; she tells me violent patients couldn’t be kept here anymore.

“We have two acute wards, we are using one right now, this one has been closed, because it’s not right for people to live in,” she said.

The staff at the acute wards tell me there is an on-going water problem, that hasn’t been solved and conditions get very bad in the cells, where up to sixty people use about three showers and three toilets.

Ms Rambe set down with me later in her office, to tell me about her staff missing work, because they were stressed.

I could see too, that there were only three people working at the time, they were all sitting in a small office just before the wards entrance.

When patients came to the hospital, Ms Rambe and her team said they had no other option, but to turn them away after they closed one of the acute wards, despite seeing an increased number of patients.

“When we had that ward open we usually had eighty plus patients everyday, but because we shut the place down, we can only receive enough patients, like thirty,” said Ms Rambe.

She said when families bring their loved ones to get help here the nurses take them in despite the lack of resources to look after them.

“We look after the very acutely ill people, this is the only psychiatric hospital in the country, we receive patients from all over the country, with the very little manpower we have we try to settle this very ill people,” said Ms Rambe.

And it’s not like the hospital’s management didn’t want to look for help, before I went to the acute wards, I met the head of medical services, Dr Ludwig Nanawar in his office, we later walked out to the institutes gazebo, where he told me the facility needs urgent help, but cant ask for it from the Australian government or other donor country’s.

Dr Nanawar said the hospital tried to write to the Australian government and others for assistance, but they simply don’t have the legal status to do so.

“What’s stopping us from accessing this donor funding is having a board in place and a strong management team.”

“At the moment, we cannot have a board, because of the legal status of having a board, unfortunately Laloki hasn’t been given a level, there are seven levels, the lowest being level one, which are the aid posts and the highest level seven are like the General hospitals,” he said.

“We don’t know ours, that’s why we can’t have a governing structure, donor agencies look for that to see how we can handle funding.”

Dr Nanawar said the management of the institution has drawn up a restructure for the PNG Health department to consider.

But, PNG’s Health Secretary Pascoe Kase has responded in local media saying it doesn’t comply with set standards and did not meet the requirements of the law.

For now, the hospital staffs are doing what they can to help patients with what they have. Those who are discharged are released back into the community – continuing to live with their family, if they’re lucky – others are disowned, commit serious crimes or end up on the streets of Port Moresby.

In my time, I’ve travelled many places around Papua New Guinea, but the Laloki Psychiatric facility outside of the capital, Port Moresby is probably one of the most depressing.

I was drawn to do a story on Laloki hospital in January 2014 after reading an article written by PNG veteran journalist Scott Waide about a University graduate suffering from some form of mental disorder and now living on the streets of Port Moresby with his son.

Chris was his name and often he would be discriminated, humiliated and even beaten by his own family members including people on his street.

After all the maltreatment, he was eventually casted out onto the streets of Port Moresby and disowned by his family.

Last year, I finally moved to Port Moresby and this month, I visited Laloki to see for myself, what it was like up there.

I am glad I did, because now I fully understand that the government of Papua New Guinea, my country doesn’t care about the mental health of it’s people, it’s easy to keep objective about this issue, but, so many other Papua New Guineans pay tax to a government that’s supposed to look after its people.

I recognised that the reason PNG has people like Chris living on the streets, is because successive governments of Papua New Guinea have failed to improve social support systems to look after people, when traditional family values vanish, as the country develops and tries to catch up with the rest of the world.

Caption: Outside the condemned acute ward

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