Concerns are growing about the spread of tuberculosis in Papua New Guinea (PNG), where more than one in 250 people are believed to have been infected by the disease.
Providing treatment for the curable bacterial infection that most often affects the lungs, also known as TB, is especially hard in rural PNG, where access and transport to medical facilities is a major issue.
Those infected have to take a personalised heavy cocktail of medicine at set times for several months, which poses a major challenge for those living far from health centres.
“When the patients miss their appointments, I trace them,” Petrina Noonamah, a nurse, told Al Jazeera.
“I go out into the village and I ask them why they did not come in.”
However, a significant number of patients are not able to continue their treatment until the end, which in turn leads to TB developing resistance against medication.
After being morphed into what is called multidrug-resistant TB, the disease becomes much harder and more expensive to treat, with about half of those infected with this version dying.
The country’s government has come under fire for the way it has tried to combat the epidemic – even though the funds to contain it are available.
Critics have pointed to PNG spending millions of dollars on hosting the Asia-Pacific Economic Cooperation (APEC) conference earlier this month as an example of how the government has its priorities out of order
Deputy Prime Minister Charle Able recognises there have been issues with the treatment of patients.
“While money for medicines has been there in quite a large number, it has been the execution of the health services at the front end that has suffered,” Able told Al Jazeera
“Our government has tried to emphasise that some of the funding streams are essential for the delivery of those services.”
As a result of the poor treatment of the disease, PNG is one of the 10 highest tuberculosis-burdened countries globally, according to the World Health Organization (WHO).
Daru, the capital of the Western Province of PNG, has been declared a global hotspot for the disease by the World Bank.
“Overcrowding in Daru’s urban areas have contributed to particularly high transmission rates; not helped by the physical distances many people need to travel to get to the island’s hospital, as well as the fear and stigma associated with the disease,” the World Bank said in a 2016 report.
The WHO estimates that one in 10 TB cases in the area is multidrug resistant, leading to about 500 new cases every year, or about three percent of the city’s population.
Tuberculosis is not the only disease the country struggles with.
In September, PNG started a polio vaccination effort aimed at stopping the spread of the disease after 10 cases were confirmed in the country.