At Port Moresby General Hospital, around 20% of women in labor show symptoms of Covid-19. Of these, about a third (four to five women per day) test positive.
We collect the test results approximately two to three hours after taking the swabs, so often by the time the woman gives birth it is too late to transfer her to the Covid isolation ward for childbirth and staff take care of it. cared for and been exposed to the virus, without being able to put on the appropriate level of PPE and take other precautionary measures to protect himself.
Since mid-February, the increase in Covid cases in PNG has been exponential. Even with our low testing rates, our total numbers fell from 1,000 to 2,300 last month and deaths from 10 to 25 during the same period.
We are now seeing around 10 of our nurses and medical staff becoming Covid-positive every week, and that number is growing along with that of the community. Positive staff are put to work until they are negative a few weeks later. To date, we have lost 30% of the workforce in our maternity ward.
Our midwifery protocols state that a midwife should not have more than four women in labor to care for; However, now we find that sometimes we only have two midwives on duty for our 30 bed labor room – which is usually full at a time. Doctors are now filling in to provide a significant portion of obstetric care, particularly on the night shift, but three of our 20 doctors have also tested positive this month.
I fear that in the near future we will reach a point where we will not have enough staff to keep the doors open. If we get to this point, what will happen to the more than 50 women who present for pregnancy care every day? Some may go home with their severe preeclampsia or potentially fatal bleeding or to give birth, while others may end up dying in the hospital parking lot.
Port Moresby General Hospital (PMGH) is the only hospital in the capital of PNG to provide maternity care to public patients. The service is essentially free, and most of the time we are able to provide basic care to the 20,000 women who come into our service each year at no additional cost to them.
Over the past 50 years, among the 92-93% of women who are booked for pregnancy care at antenatal clinics in our city, we have succeeded in achieving the lowest level of perinatal (baby) mortality of any public maternity hospitals in middle-income worlds (18-19 / 1000) while having perhaps the lowest cesarean rate of any major public maternity hospital in the world (5-6%).
In the rest of PNG, only about 50% of pregnant (mostly rural) women in the country have access to pregnancy and childbirth care. As a result, PNG has some of the highest national maternal and perinatal mortality statistics in the world. Port Moresby General Hospital has a track record to be proud of, but it may all be about to end – because the Covid-19 outbreak has finally reached PNG.
The same scenario takes place in the general part of Port Moresby General Hospital. The Covid isolation room has been full for a week; now we have taken over one of the medical services to become another Covid service. In addition, each part of the hospital has a small isolation area for Covid positive cases who are admitted with other issues and which are then found positive during their admission. All of these are also mostly solid.
When general hospital staff reach levels where the emergency department is unable to maintain service, its doors will also close. Then we will have people who have car accidents, knife wounds, tuberculosis, typhoid, etc. dying in the main parking lot or sent home to their fate.
We urgently need a vaccine, but by the time it reaches us it may be too late to save the Port Moresby health service.