The Raihu Health Centre (RHC)
The Raihu Health Centre (RHC), named after the Raihu river that runs along the perimeter of its grounds, was founded in 1955 as a leprosarium. Over the years more buildings were added and additional medical services offered, which slowly changed the nature of the centre into a general Health Centre (HC). Given the comprehensive array of services being provided over the last few years, the RHC can at present be characterised as a rural hospital. Raihu Health Centre is operated by the Catholic Diocese of Aitape, being an agent for the government in supplying health care. The official agreement with the Sandaun provincial authorities expired in 1994. Although progress has been made in the negotiations, a new contract is still to be signed. In the mean time the health service functions in the spirit of the former contract.
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Other health facilities in the area
The health care in the province should be provided through one provincial hospital, 10 health centres, 19 health sub-centres, 2 urban clinics and 140 aidposts. Unfortunately, not all facilities are open or have sufficient staff.
The provincial hospital is located at Vanimo, the capital of Sandaun Province. During 1998 two general doctors were available to run the services. Since there is no road between Aitape and Vanimo, almost no referrals to Vanimo take place from the health (sub) centres in the Aitape / Lumi and Nuku districts. When patients need SMO care, they are referred to Wewak in East Sepik Province instead, where a paediatrician, a gynaecologist and a surgeon were available during 1998. Referral is not always possible due to lack of funds for transport or the wish of the patient. Infrequent visits of SMO's to Raihu Health Centre have occured, a more regular program is desirable.
The Diocese of Aitape also runs 10 Health Sub Centres (SC) in the Aitape / Lumi & Nuku districts. Besides the Catholic church-run HSC also two government-run health centres operate in Nuku and Lumi and one CBC-church HC in Angugunak with a few HSC. In Lumi HC a Memisa medical officer was present from August 1995 until August 1998, but was withdrawn. All HC's and HSC's have a close working relationship with the Raihu health Centre, being their referral and supervising hospital. 22 Aid posts are situated within the Aitape District itself, in only 12 of these aid posts and Aid Post Orderly (APO) is working. These aid posts are officially run by the government but a close working relationship exists between the community health workers at the aid posts and the staff at the Raihu Health Centre. For the populous eastern half of Sandaun Province (approximately 80.000 - 90.000 people), Raihu Health Centre in Aitape is the main referral centre.
The Father Antonine Services
The former structure was started by Br. Stan as Leprosarium in 1954. In 1959, there were more than 400 in-patients. By 1961, 1200 lepers had been cured, 147 remained and the Leprosarium began to take patients with tuberculosis. In 1973, the lepers and patients could continue to take their medications from their Sub Health Centres and Aid Posts.
It was at this time that Fr. Antonine, who had been working in the Leprosarium with Br. Stan, felt compassion for some lepers that still needed attention, especially because some of them no longer had homes or relatives in their villages. For this reason, he established a Lepro village here, that took the name of "Father Antonine Centre" (FAC) and he did everything he could to help the remaining lepers.
When Fr. Antonine died in 1976, the Bishop nominated Fr. Leo to take his place. For 22 years, Fr. Leo contiued as parish priest of Pes and visited the village three times a week. It was in 1995 that Fr. Leo left the parish of Pes and took his place in the village of Fr. Antonine.
During the last years, many things have happened:
We counted 410 lepro people in the Sandaun Province, some of whom are still taking medication but none of whom are contagious.
The lepro village changed its denominations in "Father Antonine Services" (FAS).
The Service became affiliated with the National Board of Disabled Persons.
With the help of National Orthotic and Prosthetic Services of Angau Memorial Hospital in Lae, we started a workshop to make artificial limbs.
We began working with Callan Services.
We began the C.B.R. or Community Based Rehabilitation.
We sent a person to France for a course in C.B.R. with the United Nations and we sent another person to Italy to the Amici di Raoul Follereau with the same purpose.
The tsunami disaster occurred on July 17, 1998. The villages involved were Sissano, Warapu, Arop, Malol andAitape.
The Fr. Antonine Service was selected to help the amputees.
Charities of PNG and Australia have promised to upgrade the Fr. Antonine Service to basic standards for disabled people.
Fr. Leo visited the new village of Warapu, now renamed Barapu and decided to help them build a new primary school. The school will be dedicated to the memory of Mariele Ventre, the lady who established the Zecchino d'Oro, a children's television transmission from the Franciscan Friary.
With the help of Callan Services we have provided the necessary exercises to all the amputees and with the help of National Orthotic Prosthetic Services we made the artificial legs to all the amputees and we sent them back to their families.
A team of experts in eyes and ears of Callan Services have also visited all the survivors in their Care Centres and have treated them or recommended them to surgery or treatment in the hospital.
A physiotherapist from Holland arrived and helped us with the setup and implementation of the Community Based Rehabilitation Program.
We sent some personnel to special courses in Lae and Wewak in order to learn some new techniques to teach the disable to be more confident about their possibilities and to make them as much as possible indidendent.
At the moment we are organizing a team of persons to patrol the Aitape Diocese bush to discover eventual new lepers and take them to the Raihu Hospital where they will have all the appropriate treatments.
Co-ordinations among health structures
Communication between the Health (Sub) Centres and the staff at the Raihu Health Centre is conducted via the short-wave mission radio network. As almost all HSC's are located near the local parish priest, daily communication and consultation between nursing staff, medical offiecers and the health secretary is possible. The radio is situated in the secretary's office, communication between especially HSC's and the RHC is possible the whole day during working hours. Through regular communication we hope to improve the working relationship with our Health Sub Centre staff members. They are encouraged to discuss difficulties with patients and potential referral cases on the radio. In this way we hope to increase the level of health care provided in the HSC's and to prevent unnecessary and expensive referrals.
In 1997 actual contact was established between the Raihu Health Centre, the Father Antonine Services (FAS) for Lepers and Disabled and Callan Services. The purpose was to discuss possibilities of transforming the existing facilities for leprosy and disabled patients into a centre which provides more service in the general field of rehabilitation. Rehabilitation services will be provided on three levels:
In the RHC: patients who need rehabilitation while still on medication are visited and trained by people from the FAS. As soon as they do not need specific medical care any more, which can only be provided in the RHC, patients are discharged to the FAS.
In the FAS: patients will get further training to improve their skills; if necessary specific adjustments will be made in the workshop (crutches, special shoes etc.), considering the need of the patient who will have to live under the specific circumstance of the village. Apart from this the patient and his family will be trained according to Community Based Rehabilitation (CBR) principles. Patient and family will be taught how to live and handle their disability in their community.
In the village: the rehabilitation team from the FAS will do follow-up care on the patient in the village. Apart from this they will give health talks to the community to create awareness on how people can live with disabilities and also information will be given on how to prevent disabilities. The FAS can combine these patrols with the MCH team from the RHC, who go for patrols two to three times a week all through the year. Thgis will bring down the cost for both centres.
A constitution was made and a mangement structure has been designed and implemented. Because specific knowledge on the physiotherapy / CBR is required, we have recruited a physiotherapist with the necessary skills. Support and guidance with financial and management problems will be provided through people who already work for the Diocese of Aitape.
