2017 Korowai
The 2 main aims of the expedition were:
- To administer Albendazole and DEC to the tree house dwelling Korowai as part of the annual WHO funded MDA programme to eradicate Lymphatic Filiarisis.
- To provide a basic primary care service to the same population.
Primary Care Aspects
Clinics
Before we arrived at each village facilities had already been constructed for us. These included a clinic facility and accommodation. The clinic doubled as a dining area.
We ran clinics every day. It was difficult to operate clinic times. The numbers of patients varied depending on patient demand. We tried to operate 2 clinic sessions per day. It was much easier to deliver this when we stayed in a village for a minimum of 2 nights. The villages had prior warning that we were coming but even so would prioritise other business over their medical needs!
Consultations
Patients wishing to be seen would be seen initially by Andreas who would make a list of theirmedical problems. We would then see patients in turn. Because we would often need 2 interpreters to obtain a history we saw patients alternately with one doctor expanding on the history and then deciding on a focused examination whilst the other doctor took brief notes and would dispense medications.
Patients would often present with a number of problems e.g. headache diarrhoea and knee pain. Stabbing arrow pain was a common symptom as was “maybe malaria. ”Establishing timescales and duration of symptoms was difficult. We became more adept at relating history to examination and
trying to obtain a working diagnosis and deciding on a treatment plan and pattern recognition became simpler the longer we were there.
We took easily portable standard items of medical equipment including stethoscope sphygmomanometer auroscope/ophthalmoscope, temperature probe and pulse oximeter. We also took a blood sugar monitor but did not use this.
On this expedition myself and Dr Nielsen were present as members of the medical team and were accompanied by the Trustees of Tribal Survival Mr & Mrs Montanaro who had also travelled from the UK to oversee the work being done by the charity with the Korowai people. The logistics of the expedition had been planned in advance with the help of the team on the ground in Papua & the UK including many of the staff who were familiar with the work of the charity based on the previous year’s efforts. Thanks must again go to Eleanor, Andreas & Fenilon for their hard work in organising the itinerary, recruitment of guides and also roles in clinic triage and translation.
Total number of patients
No Data Found
Presenting complaint
Symptoms by category
No Data Found
Testing
Because we were in an area where malaria is endemic and transmission stable we chose not to use near patient testing kits (as previous expeditions had done) because results are unreliable in this setting. We used clinical acumen and tried to adopt a pragmatic approach to management.
We had no other testing equipment
Conclusions
The general conditions in primary rainforest are challenging. 30 + degree heat and 90% humidity Transport is by foot and by boat. It is a very alien and remote environment. The Korowai are a primitive people essentially living until very recently a stone-age existence (though they now have access to steel axes and machetes). We found them to be very gentle peaceful caring people but conflict with other tribes does occasionally occur. Their belief systems are also primitive and ritual cannibalism still takes place though with decreasing frequency.
We spent less time trekking between villages compared with previous years and this allowed us to feel fresher and more effective when consulting. We flexed the itinerary to allow us to spend the maximum time possible seeing the tribespeople. No 2 days were the same.
