Innovative delivery mechanisms: Australian aid partnership with churches in Papua New Guinea

The Australian Aid programme is currently valued at AUD5 billion. The majority of this aid flows to the Asia Pacific region with Papua New Guinea and Indonesia being the largest recipients. In addition to traditional delivery mechanisms-bilateral and multilateral-the Australian Government has piloted a small partnership activity with Churches in Papua New Guinea. This paper will consider this model and the benefit it brings. Possible extension of this partnership model to non-Christian religious faiths in other countries, such as Islamic nationwide organisations in Indonesia, is also discussed.

The establishment and development of neurosurgery services in Papua New Guinea

BACKGROUND: Papua New Guinea (PNG) is a developing Pacific Nation of 7.3 million people. Although neurosurgery training was introduced to PNG in the year 2000, it was in 2003 that a neurosurgery service was established. Prior to this time, neurosurgery in PNG was performed by general surgeons, with some assistance from visiting Australian neurosurgeons. Neurosurgical training was introduced to PNG in 2000. The model involved a further 3 years of training for a surgeon who had already completed 4 years of general surgical training. We aim to review the output, outcomes and impact achieved by training the first national neurosurgeon. METHODS: The data on activity (output) and outcomes were collected prospectively from 2003-2012. Ongoing mentoring and continuing professional development were provided through annual neurosurgical visits from Australia. There were serious limitations in the provision of equipment, with a lack of computerized tomographic or MR imaging, and adjuvant oncological services. RESULTS: There were 1618 neurosurgery admissions, 1020 neurosurgical procedures with a 5.74 % overall mortality. Seventy percent of cases presented as emergencies. There were improved outcomes, particularly for head injuries, whilst hydrocephalus was managed with an acceptable morbidity and revision rate. CONCLUSIONS: The training of a neurosurgeon resulted in PNG patients receiving a better range of surgical services, with a lower mortality. The outcomes able to be delivered were limited by late presentations of patients and lack of resources including imaging. These themes are familiar to all low- and middle-income countries (LMICs) and this may serve as a model for other LMIC neurosurgical services to adopt as they consider whether to establish and develop neurosurgical and other sub-specialist surgical services.

Action research in a remote district in Papua New Guinea: final report

This project investigated whether action research could be used to address ‘grassroots’ community problems in a remote district of PNG. The research team introduced, supported and researched the implementation of a pilot action research project from April to November 2015 in Abau, Central Province. The project was funded by the Australian Government and commissioned through the Economic and Public Sector Program (EPSP) managed by Coffey. The action research participants comprised people from throughout Abau with interests in women’s and gender equity issues from community groups and agencies in the district. The action research teams developed evidence-based understandings of the causes and consequences of the problems that they were addressing through their actions. The research team provided each participant with a mobile phone connected to a ‘common user group’ (CUG). This enabled each participant unlimited phone calls and SMS messaging to other participants and to the research team. The research team sent weekly sets of SMS messages to all participants to assist their action research work. The use of mobile phones to support action research in remote communities was an important element of both facilitating the action research and of the research on the pilot project itself. With such knowledge they were strengthened in purpose and intention to help their own community. This suggests that an extension of this work in other remote areas of PNG may be successful.

Genetic diversity of Mycobacterium tuberculosis in Madang, Papua New Guinea

Madang and surroundings, Papua New Guinea (PNG).

Seagrass biofilm communities at a naturally CO2-rich vent at Papua New Guinea

Seagrass meadows are a crucial component of tropical marine reef ecosystems. The seagrass plants are colonized by a multitude of epiphytic organisms that contribute to determining the ecological role of seagrasses. To better understand how environmental changes like ocean acidification might affect epiphytic assemblages, the microbial community composition of the epiphytic biofilm of Enhalus acroides was investigated at a natural CO2 vent in Papua New Guinea using molecular fingerprinting and next generation sequencing of 16S and 18S rRNA genes. Both bacterial and eukaryotic epiphytes formed distinct communities at the CO2-impacted site compared to the control site. This site-related CO2 effect was also visible in the succession pattern of microbial epiphytes. We further found an increased abundance of bacterial types associated with coral diseases at the CO2-impacted site (Fusobacteria, Thalassomonas) whereas eukaryotes such as certain crustose coralline algae commonly related to healthy reefs were less diverse. These trends in the epiphytic community of E. acroides suggest a potential role of seagrasses as vectors of coral pathogens and may support previous predictions of a decrease in reef health and prevalence of diseases under future ocean acidification scenarios.

Sediment biogeochemistry at CO2 vents off Papua-New Guinea (2013, 2014)

Measurement of biogeochemical parameters in coral reef sediments at carbon dioxide vents off Upa-Upasina (Normandy Island, Papua-New Guinea). The data includes in-situ micro/minisensor profiles, sediment characteristics, microbial and meiofauna abundances of vent sediments and reference sites without vent influence.

Molecular fingerprinting and amplicon sequencing of the bacterial biofilm on settlement tiles deployed along natural pH gradients in Papua New Guinea

Bacterial biofilms provide cues for the settlement of marine invertebrates such as coral larvae, and are therefore important for the resilience and recovery of coral reefs. This study aimed to better understand how ocean acidification may affect the community composition and diversity of bacterial biofilms on surfaces under naturally reduced pH conditions. Settlement tiles were deployed at coral reefs in Papua New Guinea along pH gradients created by two CO2 seeps, and upper and lower tiles surfaces were sampled 5 and 13 months after deployment. Automated Ribosomal Intergenic Spacer Analysis were used to characterize more than 200 separate bacterial communities, complemented by amplicon sequencing of the bacterial 16S rRNA gene of 16 samples. The bacterial biofilm consisted predominantly of Alpha-, Gamma- and Deltaproteobacteria, as well as Cyanobacteria, Flavobacteriia and Cytophaga, whereas putative settlement-inducing taxa only accounted for a small fraction of the community. Bacterial biofilm composition was heterogeneous with approximately 25% shared operational taxonomic units between samples. Among the observed environmental parameters, pH only had a weak effect on community composition (R² ~ 1%) and did not affect community richness and evenness. In contrast, there were strong differences between upper and lower surfaces (contrasting in light exposure and grazing intensity). There also appeared to be a strong interaction between bacterial biofilm composition and the macroscopic components of the tile community. Our results suggest that on mature settlement surfaces in situ, pH does not have a strong impact on the composition of bacterial biofilms. Other abiotic and biotic factors such as light exposure and interactions with other organisms may be more important in shaping bacterial biofilms than changes in seawater pH.