Preparation Checklist
The following checklist is designed to assist you as you prepare for outreach:
- Initial deposit of 100 USD to confirm place on outreach (due within one week of acceptance)
- Apply for Papua New Guinea (PNG) Entry Permit
- Apply for PNG Medical/Nursing registration (if applicable)
- Book flights
- Purchase additional travel insurance (required)
- Final payment (due four weeks before the start date of outreach) See page 10 for amount
- Seek advice from your doctor or travel medicine specialist with respect to:
- immunisations, anti-malarial medication, and sea-sickness medication
- Collect gifts or donations for the people of PNG
- Flight itinerary
- Completed PNG Entry Permit application
- Completed PNG Medical/Nursing Registration application forms (if applicable)
- Personal travel health insurance
The nation is located 160km north of the tip of Cape York Peninsula, Australia, east of Indonesia, and west of the Solomon Islands.
PNG has a single time zone, the same as Brisbane, Australia (UTC+10).
PNG is considered tropical (warm to hot and humid). Each province experiences a rainy season in the summer months, which can vary from province to province.
With a total land mass of about 473,189 square kilometres, the country encompasses the eastern side of New Guinea Island (which is shared with Indonesia), plus some 600 other islands, atolls, and coral reefs. A central core of mountains run east to west with great rivers below beginning their journey to the seas. Fertile coastal plains and mangrove swamps exist alongside broad sandy beaches, colourful sheltered bays, and dense rainforests.
Port Moresby
7.8 million (2014 estimate)
Melanesian, Papuan, Micronesian, Polynesian
The three official languages are English, Tok Pisin (Pidgen), and Hiri Motu. There are approximately 850 other languages. English is the official language in education, business, and government circles. Outside of the major cities, fluent English is uncommon.
Kina (keena) and toea (toya) are comparable to dollars and cents (100 toea make up one kina) and are comprised of notes and coins.
The traditional colors of PNG are red, black, and yellow. The country’s emblem – the bird of paradise – is a symbol of regional tribal culture, representing the emergence of PNG as a nation.
The Southern Cross, visible in the night sky, symbolizes a connectedness between Australia and multiple other countries within the South Pacific.
Due to the rugged terrain and isolation, most travel within the country is via air and water. There are 21 airports with paved runways and 541 unpaved runways. One third of the roads within PNG are paved. In areas accessed via the Ship, the main source of transport for local people is dug-out canoe.
A Constitutional Parliamentary Democracy and a Commonwealth realm.
PNG is rich with natural resources but utilisation has been hampered by the rugged terrain and high cost of infrastructure. Agriculture – coffee, cocoa, and copra – provides a sustainable livelihood for approximately 85% of the population. Mineral deposits, including LNG, oil, copper, and gold account for the majority of export earnings.
Australia, Singapore, Japan, China, and USA
Gold, copper, silver, natural gas, timber, oil, and fisheries
Machinery and transport equipment, food, and fuels
LNG, gold, petroleum, copper, palm oil, cocoa, coffee, copra, oil, and timber
CULTURAL ORIENTATION
Please familiarize yourself with the culture of PNG. As you walk around the villages, you will discover just how friendly the people are. They love to sit around, tell stories, and find out about your family and home. Take every opportunity to build relationship with locals in the villages.
Hospitality and generosity are two strengths of Papua New Guineans. You will find yourself welcomed into homes, villages, and families. As you are offered food, it is common practice for guests to eat first as the family watch on. They wish to ensure that you get enough food and have the best of what they can give.
Only take what you want, but try and be sensitive by taking a little of most things, especially local food (e.g. sago). Food is a precious gift from these people, and trying local food is the best way you can thank them.
The generosity of PNG locals is amazing. Often people will give their best to you, sometimes resulting in them going without. If you are given a gift, it is respectful to take it graciously.
Consider bringing small things to give away as well. Because of the generosity of these people, care needs to be taken when complimenting them. For example, if you say to someone: “I like your bag”, they may give you their bag right away. Instead, consider complimenting them on their smile, character, or the beauty of their village.
Papua New Guinea’s catch phrase as a nation
is ‘the Land of the Unexpected’.This is very true, so prepare for the unexpected! This could be anything from programs starting late, to the schedule changing multiple times in a day. At times you may find this frustrating, but understand this is a part of PNG culture. Anything can happen, and your stories and experiences will be better for it by the end!
Religion plays a very prominent role in the life of Papua New Guineans. Most villages have at least one church, and attendance is important to the local people.
The further a village is from a city, the more traditional they will be. The best rule of thumb is to follow the lead of a local. Be prepared to remove shoes when entering a home or church.
You will often find in church that men are seated on one side with women on the other. You will not find young men or women socialising together on a one-to-one basis; keep in mind how this may be seen by the locals when working with the opposite sex. Although your actions may be neutral, sometimes they can be incorrectly perceived.
Often there will be many people in the villages who will not speak any of the main languages but only their own tribal dialect. This makes for interesting communication in the clinics.
Having said that, it seems that within every village a few people speak English who can be reliable translators.
English | Tok Pisin |
Hello | Halo |
Thank you | Tenkyu |
Yes | Ya |
My name is… | Nem bilong mi … |
What is your name? | Wanem nem bilong yu? |
How are you? | Yu orait? |
I am good. | Mi orait tasol |
How old are you? | Hamas krismas yu gat? |
PAYMENT TIMELINE
NOTE: FOR MULTIPLE OUTREACH PRICING, OR IF YOU HAVE COMPLETED A YWAM DTS, PLEASE CONTACT US.
All individuals need to enroll / research / purchase their own Travel/International/Outreach Insurance and to please forward us a copy once they have obtained it. For more information, please see page 15 or contactyour registrar.
Deposit is due within one week of acceptance.
Final payment is due no later than four weeks prior to outreach.
If, for whatever reason, you decide not to go on outreach, please notify us as soon as possible as there may be other individuals available to fill in your outreach position.
The final payment is refundable if YWAM Ships Kona is notified of cancellation at least 14 days prior toyour outreach start date.
If unforeseen circumstances arise (e.g. delayed flights, visa issues) and you are unable to arrive on board by the date indicated on page 20, YWAM Ships Kona will not be able to delay the outreach to accommodate for your new arrival date and will not be responsible for any costs associated with your delay (e.g. flight change fees, accommodation).
PAYMENT OPTIONS
If you have any questions or concerns, please contact Placement at YWAM Ships Kona:
+1 (808) 757 9150 or [email protected].
*Please note that all fees for outreach on board the m/v PACIFIC LINK are not tax deductible
Pay online at www.ywamships.net. Cards accepted: Master Card and Visa.
Please note a 2.5% surcharge applies.
American Check
Please make payable to “YWAM Ships Kona” (not to an individual or specific project).
International Bank Draft
Please make payable in U.S. dollars, written to “YWAM Ships Kona” (not to an individual or specificproject).
Overseas Check
Churches & Businesses Only (Non USA)
Please make payable to “YWAM Ships Kona” (not to an individual or specific project).
Please note: personal overseas checks cannot be accepted. Mail to: YWAM Ships Kona, 75-5687 Ali’i Dr., Kailua-Kona, HI, 96740 USA
Also known as direct deposit or international wire transfer, a bank transfer can be arranged through your bank. Please contact [email protected] for details.
Please put your name and address as the transaction reference and send us a copy of the transaction to allow us to identify your payment (email: [email protected]).
VISA INFORMATION
To enter the nation of Papua New Guinea, an entry permit (visa) is required. We recommend that you begin the process to apply for your visa as soon as you are confirmed for an outreach, since it can take at least four weeks for a visa to be granted.
Your passport information is required on your Application for Entry Permit. Therefore, if you do not have a passport, you must apply for it first before applying for your PNG entry permit (visa).
• Your passport must be valid for at least six months from the date of intended travel.
All applications for an entry permit (visa) must be accompanied by the following:
• Passport details
• One passport sized photograph
• Arrival and departure dates (usually the start date and end date of an outreach)
Note: Please do not book flights at the time of application. We will contact you once your application has been accepted and your visa has been approved. It is highly recommended that you book your flight as soon as you hear from us, since your travel to PNG will be limited to the dates entered on your application.
Entry permit application
Please print the Entry Permit Application from the PNG Immigration and Citizenship Service Authority website: www.immigration.gov.pg/home.html
Click on ‘Entry Permit’ under Visa Forms in the right-hand column.
Filling out the Application for Entry Permit for PNG:
Page One
• Check ‘Special Exemption’ and circle ‘Aid Worker/Volunteer’
• Fill in the number of days you will be in PNG, personal details, and passport details.
• Fill in your arrival and departure dates. Contact us for detailed arrival & departure information.
Page Two
• Do not fill out the ‘For entry for the purposes of employment’ section.
• Check ‘Own funds’ in the ‘For all other types of entry’ section.
• Fill in previous name details and other passports, if applicable.
• Under ‘Organizational Sponsor’ please write the following:
o Organizational Name: YWAM Ships Kona
o Agent: Leave blank
o Contact Address Number and Street: 75-5687 Alii Dr.
o Suburb/Town: Kailua-Kona
o State/Province: Hawaii
o Zipcode: 96740
o Country: USA
o Business Telephone: +1 (808) 757 9150
o Fax: +1 (949) 271 4909
• Check if you have, or have not been to PNG before, and fill in the details if yes.
• Complete questions on criminal offence, deportation, and health.
Visa Information
Page Three
• Fill in your residential address and phone number
• For the PNG address simply fill in m/v PACIFIC LINK
• Fill in your emergency contact details
• Complete the declaration (print name, sign name, and date)
• Attach one passport sized photograph
Once you have completed your Application for Entry Permit:
1. Make a copy of the Application for Entry Permit for your own records
2. Send us your completed Application for Entry Permit
- Email: [email protected]
- Fax: +1 (949) 271 4909
YWAM Ships Kona c/o Medical Registrar
75-5687 Alii Dr.
Kailua-Kona, HI
96740
USA
We will submit your Application for Entry Permit to the PNG Immigration and Citizenship Service on your behalf with a letter of sponsorship from YWAM Ships Kona.
Once the PNG Immigration and Citizenship Service has notified us that your Application for Entry Permit has been approved, you must mail the following to the PNG Embassy/Consulate or Australian High Commission in your nation:
1. Passport (actual passport, not copy – we recommend you take a photocopy of your passport before mailing it)
2. A copy of your Entry Permit Application (we will email this to you)
3. Approval letter for the entry permit (we will email this to you)
4. A copy of the letter of sponsorship from YWAM Ships Kona (we will email this to you)
5. Application for Entry Permit fee
6. Return courier pack (self addressed, express, registered envelope)
Entry Permit Fee:
Please contact the PNG Embassy or Consulate in your nation to determine the correct amount to submit in your nation’s currency.
If you are submitting your application to an Australian High Commission in your nation, you will not have to submit a fee. You will be asked to pay 50 PGK upon arrival in Port Moresby.
Please remember that this process usually takes a MINIMUM of four weeks so please be prompt in submitting your paperwork.
Important:
If you are unable to mail your passport to a PNG Embassy/Consulate for any reason (eg. travel) in the weeks prior to your outreach, please let us know as soon as possible.
We highly recommend that you express courier everything by registered post to the PNG Consulate or Embassy to ensure safe arrival of your documents and passport.
Please refer to page 22 of this booklet to find the PNG Embassy or Consulate in your nation. If there is not a PNG Embassy/Consulate in your nation you can apply for an entry permit through the Australian High Commission in your nation.
HEALTH AND IMMUNIZATIONS
YWAM Ships Kona supports the recommendations of The World Health Organization (WHO) and US Centers for Disease Control and Prevention (CDC) with respect to sensible risk management for travellers doing humanitarian work. These bodies advise that medical professionals and volunteers doing humanitarian activity obtain pre-travel health care and advice from a clinician familiar with international travellers’ health. Ideally this visit should take place four to six weeks prior to travel.
In this pre-travel visit, you can discuss:
• Immunizations
• Prophylactic medication (such as anti-malarial drugs)
• Food and water precautions
• Self-treatment for travellers’ diarrhea
• Sea-sickness prevention
• Risk from insect bites
• Injury prevention
• Specific health advice for preventing other illnesses, such as tuberculosis, that you may encounter as a volunteer.
Volunteers with pre-existing medical conditions should carry enough medication for the duration of the outreach and an extra supply, in case the trip is extended for any reason.
Supplies may not be available within PNG or on the Ship. If other medications are needed to manage the exacerbation of an existing medical condition, these should be carried as well.
The clinician managing your existing medical condition should be consulted for the best plan of action.
Volunteers with pre-existing conditions, such as diabetes or severe allergies, should consider wearing a medical alert bracelet.
All medication should be carried in its original packaging with clear labels so that contents are easily identified. For prescription medications, the patient’s name and dose regimen should be on the container. Officials at ports of entry may require identification of medications, so dispensing your medications in smaller containers or daily dose containers is not recommended.
While most travellers are at very low risk for TB, Papua New Guinea has a high prevalence of TB, and the ship travels to high-risk settings (impoverished communities). Volunteers may have close contact with individuals with active TB in the clinic settings.
In accordance with WHO and CDC guidance, YWAM Ships Kona highly recommends all volunteers have baseline TB testing [tuberculin skin test or Single Interferon Release Assay (IGRA)] for comparison with a retest eight to ten weeks after return from travel to the risk area.
Please see Appendix A at the end of this booklet for more information regarding TB.
PNG is a nation that is associated with a high estimated relative risk of malaria infection for travellers. For an area such as PNG where exposure for even short periods of time can resultin transmission, anti-malarial medication and taking personal protective measures are highly recommended by CDC, and YWAM Ships Kona supports this advice. Please talk with your clinician in your pre-travel visit about anti-malarial medication and how to take personal preventative measures.
Please see Appendix B at the end of this booklet for more information regarding malaria.
pre-travel visit. Some require multiple treatments or need to be administered well before intended travel dates; consider making the appointment to review your immunization status eight to ten weeks prior to outreach. Please follow your doctor’s recommendations.
Please see Appendix C at the end of this booklet for more information regarding immunizations.
If you wear corrective lenses, it is wise to carry an extra pair of prescription glasses in aprotective case; or if you wear contact lenses, to bring extra contact lenses and lens cleaner.
YWAM Ships Kona strongly supports the WHO and CDC recommendation for a post-outreach medical consultation, for travellers returning from humanitarian work. This is especially important if you sustain injuries on outreach or become feverish or otherwise ill on return. To ensure a proper evaluation, you should advise your clinician of the nature of your recent travel.
US Centers for Disease Control and Prevention: www.cdc.gov
World Health Organization – International Travel and Health: www.who.int/ith/en/
Australian Government: www.smartraveller.gov.au
Government of Canada: www.travel.gc.ca
U.S. Department of State: www.travel.state.gov
New Zealand Government: www.safetravel.govt.nz
Foreign & Commonwealth Office: www.fco.gov.uk
TRAVEL INSURANCE
All individuals need to enroll / research / purchase their own Travel/International/Outreach Insurance and to please forward us a copy once they have obtained it.
We make no representation with respect to the adequacy of this policy and recommend that each volunteer consider their own insurance requirements to ensure each volunteer’s personal circumstances and requirements are met. The coverage under the group travel policy does not provide cover for loss of income in the case of injury or sickness suffered on outreach.
Travel agents or insurance brokers can be a useful source of advice in arranging/sourcing adequate coverage to meet your personal circumstances/requirements.
http://www.cdc.gov/malaria/about/index.html
YOUR ROLE ON BOARD
Medical and marine professionals will be placed in the team or position relevant to their skills.
General volunteers will receive training and be placed to assist in a clinic team or an onboard ship operations team.
Examples include:
• Primary health care – patient registration, assisting in pharmacy
• Dentistry – patient registration, sterilising equipment, giving oral hygiene education
• Optometry – patient registration, assisting with preliminary eyesight checks
• Community Engagement – community health education, distributing resources
• Ship Operations – assisting in onboard housekeeping or cooking
There may be an opportunity to change teams mid-outreach so that general volunteers can experience more than one area.
As part of community life aboard, volunteers participate in regular work duties on the ship, (e.g. post-meal clean-up).
SCHEDULE
Although outreaches can vary in length, listed below is a useful snapshot.
All volunteers arrive. Brief tour of Ship and free time to unpack and get to know other volunteers.
Comprehensive orientation. General volunteers receive their role allocations and training.
Teams meet together and receive orientation to their designated areas.
0630 – 0715 Breakfast
0800 Combined team meeting to discuss the day
0830 Teams set up for clinics. Dental team usually sets up in our onboard clinic.
Optometry, ophthamology, and PHC teams travel ashore
0900 – 1700 Clinics
Teams have morning and lunch breaks (local foods such as sago and
coconuts are sometimes provided by the village)
1700 All teams conclude clinics and return to Ship
1800 Dinner is served onboard
Most evenings will have an optional social activity onboard for volunteers
Weekends are free days. Some activities may be available on land, such as sports games or village tours. Volunteers will usually have the opportunity to visit a local church – there may also be an opportunity to speak, sing, deliver a drama, or share a story.
All volunteers depart the Ship. Volunteers wishing to stay in PNG for longer are still required to depart the Ship on this day and book alternative accommodation, as the next group of volunteers will be preparing to board!
NOTE: SCHEDULE MAY BE SUBJECT TO CHANGE
PACKING GUIDELINES
Storage space on board is limited. Please pack using a collapsible bag rather than a suitcase.
Each volunteer will have a small space for dedicated personal belongings.
Two YWAM Ships Kona shirts will be provided for each volunteer. These are the clinic uniform and will be worn during any official team activities.
• Casual clothing is appropriate for most occasions
• Pale/light colours and long sleeves are recommended during the evening (mosquitoes are drawn to dark colours)
• Lightweight materials (suitable for the hot and humid weather of PNG)
• A sweater is recommended (air conditioning on board can be quite cool)
Women
Women are asked to dress modestly to maintain cultural sensitivity. Papua New Guineans are fairly conservative (especially in villages and outlying areas). Loose fitting clothing (top and bottoms) that cover the knees and shoulders must be worn. Leggings or tight pants are not culturally appropriate.
Men
Men are asked to wear long shorts or pants, and shirts or t-shirts with sleeves. Rugby style shorts are generally not worn unless playing sport and sleeveless singlets are not worn by many men.
People from many nations volunteer with YWAM Ships Kona so these guidelines are relevant for both off and on board the ship. Thank you for your sensitivity.
Men are to wear shorts. Women must wear long shorts and loose-fitting shirts over their bathers/swimsuit.
Men usually wear buttoned, collared shirts and long pants.
Women usually wear long skirts and loose fitting shirts.
This event formally concludes the outreach. Feel free to bring a smart outfit or dress for the occasion. Women please maintain the dress standards to honour other cultures present.
Provided by YWAM Ships Kona.
Flip-flops are appropriate for the hot weather. As the Ship is often docked in an industrial area at the start and finish of outreach, all volunteers are required to wear a pair of closed-toed shoes upon arrival. Reef/water shoes are recommended for wet landings and walkingthrough mud.
Follow the same clothing guidelines as adults. Please contact YWAM Ships Kona if you wish to order YWAM Ship shirts for children accompanying you.
A pillow and bottom sheet will be provided. Please bring your own blanket or sleeping bag
- Sun hat (wide-brim)
- Sunglasses
- Water bottle
- Towel
- Sunscreen lotion (SPF 30 is recommended)
- Insect repellent (25% DEET for malaria prevention is recommended)
- Rain jacket
- Camera and batteries/charger
- Ear plugs (recommended if you are a light sleeper)
- USB stick (for photo sharing)
- A suitable adaptor for appliances (only 220V Australian power sockets on board)
- Anti-malaria medication
- Sea-sickness medication (supply for two x 24 hour sails)
- Toiletries (small travel bottles are recommended)
- Snacks and drinks (only instant coffee is provided on board)
- Small bag for going ashore
- PNG currency (for souvenirs or snacks in Port Moresby)
- Laptop/iPad etc. (for personal entertainment and photo sharing)
If you wish to bring gifts for locals you meet, here are some suggestions:
• Balloons
• Bubbles
• Soap
• Clothing
• Stickers
• Toys
• Bibles
It can be fun to engage your home community to fundraise prior to outreach. If you wish to fundraise for specific items required by YWAM Ships Kona, please contact our medical office at: [email protected] to request a list of current needs.
If you wish to make further financial contribution towards the work of YWAM Ships Kona, you can do so at www.ywamships.net/donate.
For logisitical reasons, personal laundry is limited to one load per person per week. However, clothes worn during clinics are washed each evening. Laundry powder is available on board.
TRAVELING TO PNG
The following airlines fly to Papua New Guinea:
Qantas, Virgin Australia, Air Niugini, and Airlines PNG.
If unforeseen circumstances arise (e.g. delayed flights, visa issues) and you are unable to arrive on board by the outreach arrival date, YWAM Ships Kona will not be able to delay the outreach to accommodate your new arrival date and will not be responsible for any costs associated with your delay (e.g. flight change fees, accommodation).
Volunteers wishing to stay in PNG prior to, or after outreach, will need to find alternative accommodation on land. Accommodation onboard the Ship is strictly for the dates of outreach only.
Airport pick-up and drop-off is included in the outreach fees. The person picking you up will be wearing a YWAM Ships Kona shirt and holding a YWAM Ships Kona sign.
Please ensure you are wearing closed-toed shoes upon arrival. The Ship is likely to be docked in an industrial area and safety precautions are a necessity.
Note: YWAM Ships Kona reserves the right to update/change this Acceptance Pack at any time.
It is sometimes difficult to exchange money in PNG. Also, ATM use often incurs stiff fees and charges. The Port Moresby airport currency exchange facility is open for limited hours only.
Therefore, consider exchanging money into Papua New Guinea Kina (PGK) prior to coming on outreach.
There is very limited opportunity for shopping while on outreach. Volunteers may have time to stop briefly by a store to purchase snacks for the outreach; 50 PGK is usually sufficient. All items purchased must be stored in your cabin.
A small souvenir shop, which accepts credit cards, is located within the Port Moresby Airport.
Mobile phone reception is available in Port Moresby and some areas of your outreach location. Availability should not be relied upon.
There are two options for mobile phone use within PNG:
• Activate global roaming on your mobile phone prior to leaving your home country.
• Purchase a PNG Digicel or Bmobile (depends on location of outreach) pre-paid SIM card upon arrival for 20 PGK (note: your mobile phone must be unlocked so that it accepts the SIM card). In addition, credit must be purchased. See www.digicelpng.com or www.bmobile.com.pg for more information.
There are desktop computers available on board for volunteers to use. In addition, volunteers may access the internet on personal mobile phones but this can be quite expensive.
Contacting the PACIFIC LINK
In the event of an emergency, family members can reach volunteers by calling our fleet support office in Kona at +1 (808) 757 9150.
For logisitical reasons, personal laundry is limited to one load per person per week. However, clothes worn during clinics are washed each evening. Laundry powder is available on board.
EMBASSIES AND CONSULATES OF PNG
Australia
PNG Consulate – General
Level 3
344 Queen Street
GPO BOX 220
Brisbane, QLD 4000 Australia
Ph: +61 7 3221 8067 Fax: +61 7 3221 7916
Email: [email protected]
PNG Consulate – General
Level 2
222 Clarence Street
Sydney, NSW 2000 Australia
Ph: +61 2 9283 9020/ 9411 2231
Fax: +61 2 9283 5423/ 9411 1489
Email: [email protected]
New Zealand
PNG High Commission
279 Williis Street
P.O. BOX 197
Wellington, New Zealand
Ph: +644 385 2474 Fax: +644 385 2477
Email: [email protected]
United Kingdom
PNG High Commission
14 Waterloo Place
London, United Kingdom
Ph: +44 207 930 0922/4 Fax: +44 207 930 0828
Email: [email protected]
Canada
Australian High Commission
Suite 710-50 O’Connor St.
Ottawa, ON KIP6L2 Canada
Ph: +1 613 236-0841/ 238-1040
Fax: +1 613 238-7621
PNG High Commission
39-41 Forster Crescent
Yarramula ACT 2602
PO Box E432
Kingston, ACT 2604 Australia
Ph: +61 2 6273 3322 Fax: +61 2 6273 3732
Email: [email protected]
USA
PNG Embassy
1779 Massachusetts Avenue
Suite 805
Washington, DC, United States of America
Ph: +1202 745 3680 Fax: +1202 745 3679
Email: [email protected]
Europe
PNG Embassy
Avenue De Tervuren 430
1150 Brussels, Belgium
Ph: +32 779 0609 Fax: +32 772 7088
Email: [email protected]
For a full list of PNG embassies and consulates go to www.immigration.gov.pg/all-locations.html.
If your nation is not listed on the website, contact your nearest Australian High Commission or Australian Diplomatic Mission.
APPENDIX A: TUBERCULOSIS
Tuberculosis: A brief summary. Not to replace the advice of your doctor.
Tuberculosis (TB) is a disease caused by bacteria and spread through the air from person to person. The bacteria are put into the air when a person with active TB of the lungs coughs, sneezes, speaks, or sings. People nearby may breathe in the air containing these TB bacteria and can become infected. TB usually affects the lungs but can also affect other parts of the body.
TB is not spread by:
• Shaking someone’s hand
• Sharing food or drink
• Touching bed linen or toilet seats
• Sharing toothbrushes
• Kissing
Latent TB Infection
The human body is able to fight TB bacteria and stop them from multiplying in most people who breathe them in. The bacteria may then become inactive or dormant, yet they can remain alive in the body and possibly become active at a later time. This is termed latent TB infection.
People who have latent TB infection, have no symptoms, do not feel sick, cannot spread TB to others, and often have a positive skin test reaction or a positive TB blood test.
Most people who have latent TB infection never develop active TB disease, but about 5 to 10% percent may develop the active infection if they do not receive treatment for their latent TB infection. The TB bacteria is most likely to become active when the immune system is weakened because the body is no longer able to control the bacteria.
Active TB disease
If TB bacteria start multiplying in the body, this is termed active TB disease. This can happen at anytime from weeks to years after the initial infection and does not happen to everyone with latent TB.
As explained above, it is people with weak immune systems who are susceptible to active TB.
This includes babies, young children, and elderly people infected with HIV, or with any of the following conditions:
• Cancer
• Severe kidney disease
• Specialised medical treatments (e.g. corticosteroid treatment, anti-rejection medication for transplant recipients, immune modulation for rheumatoid arthritis or Crohn’s disease)
• Very low body weight
• Silicosis
• Diabetes mellitus
• Substance abuse
What is multi-drug resistant tuberculosis?
Multi-drug resistant TB (MDR-TB) is TB that is resistant to at least two of the first-line drugs that are used to treat TB.
What is extensively drug-resistant tuberculosis?
Extensively drug-resistant TB (XDR-TB) is a rare type of MDR-TB. XDR-TB is defined as TB which is resistant to at least four of the core TB treatment drugs. Both MDR-TB and XDRTB are difficult to treat. They take a substantially longer time to treat than ordinary TB and require the use of more expensive second-line TB drugs which have more side effects.
Drug-resistant TB is an increasing concern in PNG. The proportion of MDR-TB is estimated at 3 to 6% of reported TB cases and there have been several cases of XDR-TB reported in PNG.
APPENDIX B: MALARIA
Malaria: A brief summary. Not to replace the advice of your doctor.
Malaria is a serious and sometimes fatal disease caused by a parasite transmitted by mosquitoes to humans. People who get malaria are typically very sick with high fever, chills, and flu like illness.
Although malaria can be a serious disease, illness and death from malaria is preventable. No anti-malaria drug is 100% protective, and must be combined with the use of personal protective measures.
These measures include:
1. The knowledge that malaria-carrying mosquitoes feed between dusk and dawn, which is the time of highest risk.
2. Insect repellent (at least 25% DEET) – apply at times of highest risk and remember to reapply.
3. Wear light coloured, long pants and long-sleeved clothing during high-risk times.
Mosquitoes can also transmit other tropical diseases and itchy bites themselves can become distressing and affect your enjoyment of outreach, so please take seriously the responsibility to protect yourself.
APPENDIX C: IMMUNIZATIONS
Immunizations: A brief summary. Not to replace the advice of your doctor.