Some background information for travellers, field workers and visitors to New Ireland (Papua New Guinea)
PNG Online is a very useful site, with links to PNG newspapers, statistics, government departments, embassies and more.
Link to my main page: http://www.ling.su.se/staff/evali
Headings on this page:
People sometimes write to me asking for information about much everything to do with travelling and living in PNG, such as food, security, transport, suitable gifts, diseases and so forth. On this page I have basically put together bits that I have written to various people, hoping that it might provide some answers to others.
Disclaimer: Please note that everything here represents my own impressions and experiences in the places I visited (which is mainly New Ireland where I’ve spent about 20 months) and may not be valid for another person, or in another place. Nor am I going to take any responsibility for factual content, so forget about suing me if you get malaria going by my information below!
Lots of things vary from region to region, perhaps in particular security issues and climate. Security and transport fluctuate a fair bit over time in the same place, so you need to track down someone who's been there recently and ask them. The Australian Department of Foreign Affairs and Trade have a regularly updated page about PNG which is worth checking. As far as I can make out, the safest urban centres are Kavieng (New Ireland) and Madang. You can still go to the other places (and you tend to have to go to Port Moresby), you just need to be careful, not display wealth and stay in at night unless you are with someone who knows where to go and what to do. If there are resident whites around, you could look what they do, but not all whites in PNG are terrific role models to be sure. Best advice: use some sense. And most people you'll meet (talking locals now) are wonderfully friendly, generous and hospitable. You can start practicing big smiles now, you'll need them.
There are frequent roadblocks on some of the roads connecting urban centres on New Guinea island and sometimes in the Rabaul area in East New Britain, but other than that, the countryside tends to be fine. If you look like you are going to spend a long time in a place (for instance doing fieldwork, actually living in the community), you usually get associated with a particular group and they will look after you.
It’s a good idea too to inform people that you are dumber than a newborn babe when it comes to their environment, so can they please tell you if you are about to step into a snake hole or swim in a croc-infested river. People are very accommodating and assume that you’re doing what you want and why should they interfere, so they may not say anything (this is also a manifestation of respect).
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There is also extension of kinship terms. Your mother’s sisters are also mothers, your father’s brothers also fathers. You therefore call your sister’s children your children etc. So if you are trying to figure out how people are related, you may end up asking a lot of questions like ‘mama tru bilong en?’, i.e. ‘his/her real mother?’. (You need a whole group of people to take down a genealogy because of the name taboos.)
In New Ireland, kinship is matrilineal, that is, you belong to the same clan as your mother, while your father is of a different clan. (Most of New Guinea Island is patrilineal, i.e. the opposite.) In most of New Ireland, further, the clans are grouped into two moieties, one associated with the eagle and one with the fish hawk; the moieties are called bik pisin (big bird) and liklik pisin (little bird) in Tok Pisin. Each is traditionally exogamous, so that a person of the bik pisin must find a spouse from the liklik pisin. Marrying or having sexual relations within the same moiety was considered incest. Marrying a cross-cousin (i.e. child of mother’s brother or father’s sister) was also banned. Many of these taboos are weakening but are still saliently present in social interaction in many different ways, and also reflected in kinship terminology.
Naturally, kinship is not the only thing that determines interactions between people. It provides the guidelines; apart from that people like or don’t like each other and form their friendships on a personal basis. But knowing about the overall system is useful, and it also explains why someone’s behaviour can change rather drastically; for instance my sister in the village was very subdued when some people were around, very direct and open to me (=sister), totally surprisingly rude in a joking way to our female cross-cousin. Because she was my sister, I could “copy” her relations, they would be the same as mine. The problem of course is that you don’t know with others, i.e. if someone makes crude jokes with X, it doesn’t always mean you can do it. None of this will be of great importance on a short visit. And like I said, people are generally very accommodating, so all of this is mainly to explain a bit about the system, and give you some hints about what to look for if you want to try and slot in, in case you are staying for a longer time in a particular place. The logic of it takes some getting used to.
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FoodI liked the food! The staple in my area was sweet potato, and there are dozens of different kinds. It was usually boiled in coconut milk, or baked in the mumu (stone oven). Taro used to be the big crop but it is much more labour intense with a lower yield, and the traditional varieties were pretty much wiped out by disease around the 1940’s, so although it is still considered “real food”, not many people can be bothered growing it. Yams and cassava also appear on the menu a fair bit. Rice, which is bought in the store, is also common. Sago is used in my area mainly when there is a shortage of other foods (and then it was mixed with coconut milk and roasted rather than boiled with water into the glue one hears about from areas of New Guinea Island).
For proteins, tinned fish and bully beef are depressingly common, and unfortunately people seem to have the impression that this is what white people eat, so sometimes you have to say that you want ‘kaikai bilong ples’, village food. I mean, what’s the point of going all that way only to eat rice and mackerel? My village is on the coast so we often had fresh reef fish - yum! - usually grilled or boiled in coconut milk, or smoked and then boiled in coconut milk. Chickens are slaughtered for minor feasts and pigs for major feasts, but neither is everyday food, except if someone kills a bush pig on a hunt. Eggs aren’t eaten much for some reason. Some snakes, and birds, possums and fruit bats also used to be eaten regularly but not anymore where I was.
For vegetables there is a variety of indigenous and introduced leaves, my favourite was a ferny thing called ‘kumu gras’ in Tok Pisin. Beans are also grown, and sometimes pumpkin (mostly for the shoots, a really nice vegetable when cooked in coconut milk) and other cucumber-like things. Vegies are always cooked, but fruit is eaten fresh: bananas of lots of kinds, pineapples, pawpaw (papaya), guava, mango (when in season) and pomelo, and there is also sugar cane.
Yeah, well, so is it safe? you are wondering. I say yes: I have never been ill from food while in the village. These people have survived in that environment for some 35,000 years so they seem to have got it figured. I think village food is safer than town food, because people are preparing things they know in ways they know (boiling has been introduced, there never used to be saucepans or clay pots in New Ireland, but other than that). Everything is cooked and then eaten straight away, and if not eaten within about 12 hours is either recooked (e.g. meat left over from a feast) or given to the pigs and dogs.
It might be a good idea to carry some salt, we lose a lot of salt sweating when not used to the climate, and they tend to use less than we do anyway. A salt deficiency can be quite dangerous.
Depending on where you go, you may also want to carry something to purify the water. I never needed to do this, as it came straight out of the mountain side, fresh and cool, but some places might be a bit dodgier. And if you have the slightest suspicion that there are pigs upstream that might pollute the water, take care. Pig shit is very bad news. Tea etc. is fine of course, since the water has been boiled. I never liked to use things like water purifiers openly, because it could make people feel bad if you have to put stuff into their water before you can drink it, so if you have a big bottle for water (which you should anyway) you can treat your drinking water a bit discretely. (This could just be me, but imagine someone coming in and having to apply treatment everywhere to be able to cope with where these people live their lives: against the sun, against the mosquitoes, to drink the water, and taking pills all the time. But maybe it’s just hypocritical to do it on the sly instead, as I tried to.)
Another note to do with tea. “Tea” stands for hot water with a lot of sugar and a very tiny bit of something brown (tea, coffee, or Milo). The brown stuff can be hard to identify due to all the sugar, and no one bothers distinguishing the different kinds of brown, it’s all just “tea” (though I hear that for instance in Milne Bay Province they make a proper cup of tea). If you have a severe caffeine addiction (like me), work out a plan (like caffeine tablets, or carrying instant coffee – but for the latter you might be required to share...).
Food as giftFrom you: Food is a good thing to bring. If you are going out to a village, especially if you are staying over, bringing some food is a good way of paying your way (money is not unless it’s an official guesthouse). You can buy kilo packs of rice in town, and the aforementioned tins of meat or fish, also onions (which are liked but don’t grow near the coast), and bread (which is liked but not a staple and usually not made in the villages, so it’s a bit of a treat). Obviously, if you know the place and the people, you can scout around the cooking house before you go to town and see what’s missing, e.g. cooking oil, "black sauce", salt, sugar, tea, coffee, Milo (a disgusting chocolate drink), instant noodles, sweet or savoury biscuits etc. All of these of course are fine even if you haven’t established a need for them beforehand. Often, a woman will take the things and go away and cook for you, so you may want to make it clear that you brought them for them, and that you’d like to eat whatever they were having. Forget about magnanimous gestures though, see below about gifts.
To you: If you are staying for more than two days or so, people are likely to come and give you plates of food or large quantities of fruit, often conveyed by a child. First find out who sent it, so you can send something back if you think of something. Now you start worrying about what to do with it all. You have just eaten a mountain of sweet potato, and you’ve already got seven bananas and a huge pawpaw. The answer is give them on to others! Gifts don’t operate the same there, you are not expected to keep everything for yourself (likewise, things you give will often circulate in the community). As far as I could make out, it is always appropriate to give food to a child, so you call the nearest child and give it to them and they’ll work something out if they’re not hungry either. If you are already equipped with a sister you can ask her if she’d like some. Send some of the bananas to whoever gave you the plate of food, etc., this is how you build and maintain relations.
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Gifts (other than food)Going to villages and staying with people is a great experience, and eminently possible at least in New Ireland. A man can stay in the men’s house in many places (not all villages still have them), and there will always be some way of making space for you in a house. But you’ll want to pay your way. Giving money just doesn’t work very well. People in this area are very concerned to keep a good reputation for hospitality, and are very genuinely hospitable and welcoming. You just can’t pay for that, and they can’t take money, it just gets strange (a bit like if a colleague comes for dinner and then tries to pay you for it). So you have to work out something else.
If you just stay one or two nights, bringing some food would normally be enough (see about food gifts above). But if someone really puts something on for you, you will want to give something more; perhaps they take you out fishing, or organise a big picnic on the beach or take you to the gardens (if you say you want to go, not everyone realises this could be interesting for a white person). If you stay for longer, you might want to give something special to your host family. After the following list of possible gifts, there are some notes on sizing gifts, and other stuff to do with the social consequences of giving, which I think you should read too.
So here is a list of gifts that might be appreciated in a village in New Ireland, and probably other places in PNG. The first lot are "expensive", big gesture gifts, the second lot are more medium sized to small gifts. Most are available in towns in PNG, you can work out for yourself which ones could be fun to bring from home:
There is very little money in a village (and spending $1 a day looks like you’re made of it). Work and time as such carry no monetary value (although there is a social value attached to village work), and therefore it is totally over the top to give an expensive torch when someone has given you dinner. People give travellers food when they come through their village, that’s normal. A traveller in turn brings some food, or helps out a bit around the place (not an option for us whites who hardly know one end of a bush knife from the other). If someone does take you out on a fishing trip, a laplap (about US$4) could be right, or maybe the torch (about US$25) if you really really enjoyed it and want to make the person happy.
What you have to know is that there was traditionally no word for “thank you” in this part of the world. Don’t expect a big thank you display. Still today, people often take the gift and just say “OK, that’s good”. I think this is because people give to people with whom they have giving relationships; either because their kin relationship specifies that they can’t refuse anything to a particular person, or because of reciprocity requirements. If you give a gift that is too big to someone, it makes them uncomfortable, as they don’t know how to reciprocate. You have given them a debt that they can’t repay. Reciprocity is a very important social value in this area, and not repaying a gift makes a person very bad. For this reason, don’t try and impress people with your gifts! Try to make your gifts insignificant, that is, don’t stand there and beam and expect them to fall on the ground in gratitude (“Look, I’m giving you a PEN!!!”). The way to go is to belittle your own gift (‘liklik samting tasol’), that shows people that you don’t mean to “own” them or put them in debt. Sometimes, if you feel awkward about giving something to someone, you might opt for sending it with a child, but I don’t actually know if this is the done thing or not. Generosity is highly valued, and people will appreciate getting things (especially as we come across as very moneyed compared to them), you just need to figure out how to give without causing embarrassment to yourself or your hosts.
Another thing to be aware of is that people often give your presents to someone else within hours. The trick is not to be upset about that. It brings them capital with that person, and there are lots of relatives that they simply may not refuse if asked for something. Never expect them to have it the next day, however much they like or need it. Besides, watching a thing move in the community can be an interesting way of tracing the network!
Don’t give too much to people who just step up and ask for things, without checking in some discreet fashion with the people who are your hosts. It does happen that you get some individuals just “testing”, which could be very impolite on their side, and you don’t want them getting in the habit :-) This usually applies to young men. Well, I think it’s never wrong to give things, but in my experience it’s more normal and culturally accepted that someone with a request asks very politely, and my village sister was chasing the lads away at some point, wanting to know what they meant by asking me for cigarettes all the time without ever bringing me a fresh coconut to drink in the daytime.
If you are staying a long-ish time in a place, your contacts and relations develop of course. Some things that can be useful at least for women are: big safety pins to hold nappies, elastic, rubber bands and ordinary plastic bags, sewing needles, buttons, thread etc – you get asked for these things so it’s useful to have a little supply, and they are the right level for maintaining lots of relationships with other women; you can’t be giving laplaps and so on every day. Smokers can always give out cigarettes of course (where I was, in principle only men smoke). If you get into chewing betel nut it can be very interesting to observe the giving structures; some people will pass by and give you some, others will ask you for some, and the next day they swap – betel nuts don’t collect any dust.
It gets a little different if there is a ceremony. If you have been in a place for several weeks, it could be that they put on a goodbye ceremony before you go. These are somewhat embarrassing events if you are not comfortable with limelights, but there you are. They probably differ from one place to another, but where I was it goes like this. The village or the families concerned with you spend one or two days preparing food, while you are trying to figure out if you’re supposed to help or not and if it’s OK to take pictures. On the evening, you sit on a chair at a table, perhaps with the pastor and other bigmen and dignitaries next to you. Songs are sung, food is eaten (others sit on the ground, eating from breadfruit or banana leaves). At some point, everybody lines up for ‘sekhan’ (shake hand) and each person, including little children, shakes your hand and drops 20 toea or so in a bowl next to you. This can’t be avoided, it’s what they do, though it does feel strange to receive money from them when you have so much more of it. Other gifts, like baskets and mats, may appear if they have worked out that you like them. You are supposed to cry, which is easy, and others cry too. One or more people hold speeches (“this person has come to our community and taken part in our life and our ways and has always been generous and helpful, and now he/she will leave us, maybe never to return again”). Then you are invited to make a speech (in which you praise the hospitality etc. of the community), and this is when you may give money, to the church or the local language preschool or the women’s fellowship. K20 or 50 is a lot of money. After my second long stay in the village, when I thought I might be leaving for good, the women’s fellowship gave me K50, and I gave them K80. The interesting thing here is that it doesn’t work out to me giving them K30. Each gift is a separate item, a different event or gesture, and there is no balancing out. At some point the sum of the money given to you during sekhan is announced – they start counting while it’s still being dropped into the bowl. I also exchanged gifts of money at separate times with particular families that had been close to me when I was about to leave for the (maybe) last time. Anyway, this is a time when giving money can be appropriate.
Instead of giftsI went through a 100 plasters (band-aids) in my first week; I became the local aid post. So take a good supply of rubbing alcohol, etc., you can get it all in town. I also got some antibiotic ointment and cotton buds to apply it – avoid touching sores if you can without seeming like you’re afraid of black skin, aids is really a severe problem in PNG today, and the sores are yucky anyway. But never treat anything but superficial wounds and headaches unless you are a qualified medical person. It’s illegal for one thing, and if the person then gets seriously ill or even dies (from whatever illness), you may be in serious trouble.
People will love it if you bring pics of your family, and also of flora and fauna from you country; maybe you can find some book or a stack of postcards. You don’t need to give these away, they’re just to show people. It also provides something to look at and talk about when they come to see you, it can be a bit awkward sometimes (I’m not a village person, so I don’t have much to say about piglets etc...). I also had another really neat thing: a beach ball globe. It was really good, easy to take when travelling, and much better than any number of 2-dimensional maps for explaining where your country is and so on, or even explaining about seasons and days and nights if you get caught in one of those discussions (though I’m not sure anybody really got a grasp of that, it’s pretty abstract if you’ve never experienced seasons).
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ClothesGenerally women wear something that goes down to their knees – if it’s shorts it’s wide ones; showing the shape of your thighs is not on in many areas. Sleeves should cover the shoulders except for very informal times, though some elderly local ladies (probably more when I wasn’t looking) take their tops off altogether in the gardens. I took to wearing a sleeveless top around the village. As for skirt length, too long was too hot where I was and long skirts also collect horrible itchy grass seeds that take for ever to get out. Kneelength was about right. My area was a meri blouse one (that’s a kind of dress the missionaries introduced; it’s called ‘klos’ in Tok Pisin), and women also wear T-shirts. Long and a couple of sizes too big is the normal thing, nice and airy.
Men wear laplaps, shorts or trousers. Young lads even wear those tiny shiny sports shorts, but looking a little more proper than that might be good (depending on what you are trying to achieve during your stay). Long trousers is over the top though, just regular shorts is fine. For tops: T-shirts, singlets (considered not very proper but OK), short-sleeved shirts.
On Sundays you might feel that you want to go to church (in Seventh Day Adventist areas the Sabbath is celebrated on Saturdays). I never feel that normally (not being a religious person), but I had been told that people in PNG, can have trouble coping with the idea of a white person who is not Christian, so I went along with that from the start. Don’t know if it’s necessary, but that’s what I did. For church you have to be clean and tidy, and preferably wear light colours where I was. Klos was the only permissible thing for women in that area, but any kind of neat dress or whatever will probably be fine. Men wear laplaps or long trousers if they have any, and preferably long-sleeved shirts and even neck-ties. This is if you want to pass yourself off as someone who really cares about church, otherwise anything will do as long as it’s neat and clean.
You also have to wash and change in the morning on Sundays, otherwise you wash every afternoon, then change, sleep in those clothes, wear them the next day until wash time, etc. You can wash and change in between too if you want to or get dirty, but that’s the general pattern. Washing yourself usually happens rather publicly, like in the river, and is done wearing the clothes you wore that day, or minimally a laplap (or shorts for men). Women go with women and men with men (married couples sometimes go together), and usually there are different places for each sex to wash. Washing while wearing a laplap takes a bit of practice, but is possible – it works out as a portable partial shower cabin. Depending on the particular river and other circumstances (degree of daylight etc.) some daring people take their clothes off under the water, mainly so that they can wash the clothes too while they are at it, if they didn’t bring change. Otherwise you then wash your clothes, wearing your towel or another laplap you brought or so. Take a towel which is thin so it dries well, and, if you are female, one that is wide enough to cover you from your armpits to your knees when you wrap it around you. A clothes washing soap is useful (Omo etc, you can buy them there.)
For swimming in the sea, wearing a T-shirt is recommended because of the tropical sun. The locals swim in T-shirt and laplap, but I found it difficult to make the laplap stay on in the water! Shorts is better (wide and longish for women as usual). If you’re in a village, tipping up in a bikini is not recommended for other reasons, but at a resort things are different of course. Some nasty corals and other stuff live in the sea, so sandals are a good idea, or just tying your thongs on – I eventually developed the technique to swim with thongs, it’s actually not that difficult as long as you’re doing breaststrokes, since the thongs float.
It doesn’t often get very cool on the coast, sleeping under a single or double sheet was enough (but it can get quite cool at night in the highlands; I slept under 1 blanket in Goroka, and 3 in Ukarumpa). If transport is on the back of a truck and you run in the night it gets very cold even if it’s 24°C. On the coast, getting things to dry was a problem when it rained, it would go mouldy straight away, so for skirts and shorts etc. a minimum of elastics with bunching material is good; laplaps are a lot better for that.
FootwearThongs for the village. Where I was you take your shoes off going into/up on a house (on stilts) so it’s a hassle if you have sandals or shoes that have to be undone, and the sand that gets in doesn’t get out. Thongs are perfect most of the time – in fact I only wore shoes about once the whole time and got terrible blisters on leaving.
Something else for the bush probably; thongs get slippery when wet, and you also don’t want to get too many scratches as anything can develop into tropical ulcers (happened to my dad when he visited). Gardens are away in the bush and you’d probably want to go if you get a chance (I have a photo and some text about gardens here). Walking boots if you have them, even gum boots will do. I had sand shoes (canvas shoes) and socks. On my first trip I had basketball boots, that worked too, and I just gave them away when I left (they are useful too because they dry out reasonably well and don’t get as mouldy as leather often does). Best protection as usual: tell people to tell you what to look out for.
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MalariaI’ll put in another disclaimer here: Everything said here represents my understanding of these things. I am not a medical person, and could well be misinformed in various respects. What I present here are bits of information that I have collected while trying to understand this disease during the years since 1997 when I first started going to PNG to do fieldwork. Since I have found it quite difficult to get consistent and reliable information about malaria, and think that I’m beginning to approach some kind of picture that seems about right, I tell you here what I know about it, with no guarantees as to accuracy. Maybe it gives you inspiration for some questions you would like to ask of your doctor.
The first things you need to know about malaria are:
Science moves fast when it comes to malaria, so check for information about the disease and various drugs on this page and other pages linked from it: Malaria Foundation International.
Malaria is less of a problem on high altitudes. (I think this is because the mosquitoes that spread it don’t breed well there.)
You can get malaria when a mosquito bites someone who has it and then bites you. That person doesn’t necessarily have it in a visible way, the malaria parasite has a cycle of developmental stages and at some point it is around in the blood to be picked up by a mozzie. This means that you should be particularly careful with your mosquito repellent when sitting around with lots of people at night. Conversely, if you should find yourself alone on a mountain top being bitten, you don’t need to worry about malaria (just about not scratching the bites so they can become sores which can become infested... antihistamines are useful, they come as pills and as ointment to apply straight to the bite to stop it itching).
About the different kinds of malaria: vivax is the most common one, and falciparum is the dangerous one. Falciparum can turn up like “normal malaria” or go on the brain, and that’s when it can be very deadly, causing unconsciousness and sometimes death. In adults, it usually shows up as normal malaria first, and turns cerebral only as a complication if improperly treated, but in children it can sometimes go straight to the brain. I seem to have had falciparum sometimes but only in the ordinary form.
The falciparum type does not go and sit in the liver. That means that if you do get it and you treat it properly, it’s gone. Vivax, ovale and malariae, on the other hand, often do go and “hibernate” in the liver, and can then pop up whenever your resistance is down. Therefore, if you get sick a couple of months after getting home, you probably have one of those, and if it’s three months after getting home you can be sure it is. They can be treated with a two-week course of primoquine (usually following a course of chloroquine). This is done after you leave the malarial area.
Falciparum is the reason why doctors want you to take heavy drugs like mefloquine (Lariam). Doctors seem to really love this drug, but very many people have had very severe problems when taking it. I know someone who had psychological imbalances (like total indecision and inability to work, anxiety etc.) lasting for years after taking Lariam for something like six months, someone else who got a very bad attack of anxiety and paranoia after just some weeks of taking it, and various other people have had various other problems. That’s on prophylaxis doses; treatment doses have a higher concentration and tend to cause more side effects, but it also depends on the length of time you’re taking it as prophylaxis. The scary thing with mefloquine is that it’s cumulative, so if you keep taking it it builds up in the brain and is very difficult to get out again if it starts giving you trouble. I took it for a few months without any trouble, and you might be lucky, but if you want to take it you should know about these possible side effects and carry an alternative drug so that you can drop Lariam immediately if you start having weird dreams or noticing feeling strange in some other way.
The other thing to know about mefloquine (Lariam) is that it doesn’t necessarily protect you against vivax and the other kinds of malaria. These are less of a threat to life, so that’s OK maybe, but no one tells you and untreated malaria is bad for you even if it’s the “nicer” kind of malaria.
Many antimalarial drugs are quite poisonous, perhaps especially those ending in -quine. That means you have to be very careful to follow instructions about dosage. (In treating a malaria attack with chloroquine, you actually take a potentially deadly dose of it, but over 3 days.) It also means that you should never treat an attack with the same drug that you take as prophylaxis, nor preferably with another one ending in -quine as they are related, at least not if it is less than a week since you took your last prophylactic pill. Go through this stuff with your doctor, i.e., make sure that you take some entirely different kind of drug for prophylaxis than for treatment. If you just go for a few weeks it shouldn’t be necessary to take a treatment drug as you are unlikely to develop malaria symptoms in that short a time while on prophylaxis, but you should still be on the lookout for symptoms when you get home.
Another drug often prescribed as a prophylactic against falciparum is doxycycline (also known as vibramycin, or doxy for short). It’s a mild antibiotic, and can be combined with chloroquine (which seems to be more effective against vivax, even in areas where vivax is supposed to be largely resistant to chloroquine). The problem with doxy is that it lasts exactly 24 hours and has to be taken with food, so you have to make sure to eat very regularly or you are unprotected for some hours. It causes some people to get burnt by the sun more easily (‘photosensitivity’), and you can get fungal troubles. It can be useful in giving you some protection against other infections too of course, but you might not want to be taking antibiotics for months on end, and people who are allergic to antibiotics will of course have to look for something else.
In the last few years, a drug has appeared that is all the vogue in malaria treatment (not normally used as a prophylaxis). It has various names to do with Artemisia, Qing Hao, Sweet Annie, Sweet Wormwood. These are names for the herb from which the drug is made, a relative of wormwood. The active substance is artemisinin. It is part of the drug Riamet (Coartem) which is coming on the market in the west but is not being prescribed a lot yet. Artemisinin-based anti-malarials can be bought in pharmacies in PNG (there are at least five different Chinese brands of it). Many people swear by it, and it’s supposed to treat both vivax (etc.) and falciparum, it’s cheap, and it’s supposed not to have side effects (though I’ve heard that some people get rashes during treatment). I used it but found it not very effective, that is, I would get well, but then have another attack within 3 to 6 weeks. But it can be combined with a lower-than-normal dose of one of the traditional drugs for higher efficiency, which worked (in my case Fansidar). Doctors in the west follow these things and can probably tell you what to combine it with, otherwise the PNG pharmacist often knows.
Chloroquine is the classic drug used as prophylaxis and treatment. Malaria in many parts of the world is resistant to it, but it is still what the locals in New Ireland are given as treatment when they go to the doctor with malaria, or as prophylaxis when pregnant. It seems to be fairly effective against vivax in this area but has little or no effect on falciparum. It is well proven and has hardly any side effects (except it can kill you if you overdose and you also have to eat a lot before taking treatment doses), so if you don’t have falciparum, take chloroquine first, it mostly helps.
People who have had problems with various other drugs have found Malarone useful. It’s very expensive (but so is Lariam), and I have used it as treatment too without trouble. There are other drugs that I have no experience with, like maloprim and proguanil (Paludrine), you’ll just have to find out about them from somewhere else (try for instance the Travel Doctor or MASTA; it’s good to be prepared when you go to see the doctor at the travel medicine centre).
So how do you know you have malaria at all? It has a very typical fever curve: suddenly you are freezing and shivering with cold (which means your temperature is going up); a few hours later you are sweating (your temperature is going down). The frequency of the fever tops are supposed to tell you what kind of malaria you have (the fever matches the breeding cycle of the parasite). Information on malaria that I have been able to find e.g. in Sweden tells you that vivax typically gives you fevers every second day, while every second day you are fine. That is true, if you’re in Sweden, or anywhere else with a cold climate. But note that it behaves very differently in the tropics! When I have had malaria in Sweden or cold areas of Australia (contracted in PNG), I have had sore joints, headaches, stomach aches etc. for 5 days to a week before the fevers set in; then fevers every second day. When I’ve had malaria in PNG, it has been about 2 hours from the first symptoms to the fevers, which have then peaked several times in each 24-hour period for a few days until the treatment takes effect.
If you already have a cold or something, the alternating chills and sweats is a giveaway that you have also got malaria. Pay attention to it, it is really typical that you get malaria when sick with something else. Have yourself tested if you’re anywhere near a hospital – but you need to be tested while the attack is ongoing. They make a blood slide (i.e. put a drop of blood between two pieces of glass) and look through a microscope, and can then tell what kind of malaria it is. But it takes a lot of practice to tell, and right at the beginning of the attack the parasites aren’t always easy to spot, so you should know that a negative test does not prove that you do not have malaria. Get tested again the next day.
I’ve always given priority to taking pain killers to reduce the temperature over timing the fever peaks – too high a temperature I think is the worst danger with vivax &Co in the short run. Even if it’s the last thing you want to do when your teeth are clattering, a cold shower or short cool bath is a very effective way of bringing down the temperature (not the least for children who may refuse to swallow tablets).
Right, so how do you know what sort of malaria you’ve got if you are far from a hospital? There is a selftest kit which is available from some travel medicine centres in Australia, and can be ordered from the Australian MASTA site as you find out when you write to them; you can’t tell from the web page (maybe from the main site in the UK too, I don't know). I hear you can also buy them at travel medicine centres in Australia. The kits are small and easy to carry. You prick your finger for a drop of blood, and do the stuff with reagent A and it tells you if you have falciparum (take scary drugs) or vivax (have a go with chloroquine and see how you go). It doesn’t tell you if you have the less common ovale or malariae, but if you think you have malaria these are treated as vivax so you should go ahead with that. Again, a negative test result is inconclusive, and you should try again at the next fever peak.
I tend not to think very straight when I have malaria, especially before I take something to reduce the temperature, so it’s useful if you are travelling in a group or pair to keep an eye on each other, not the least when reading the instructions for the malaria test or dosages for drugs! It’s a good idea to note down all pills you take, and your temperature at various times – what with being so fuzzy-headed I would have popped far too many Panadols etc., but when my sister was there she took notes and kept an eye on things. Another good reason for taking fever-reducing medicines is that it makes it easier to eat, and eating is a very good idea before taking antimalarial drugs. Always take a thermometre!
What about not taking prophylactics at all? I dropped prophylaxis for most of one of my longer stays, and the short version of the story is that I can’t really recommend it, but I will give the reasoning here. This issue ties in with several things, primarily perhaps the length of your stay and your tolerance for the various drugs. If you spend 9 months in the tropics it’s quite a different matter from a few weeks’ holidays, in terms of what pills you would be willing to take for that entire time + 1 month after you get home. So in the end I decided not to take prophylaxis and just treat myself whenever I got malaria. This is what many people do who live in the tropics. I had been on things like Lariam but ended up treating myself with good old chloroquine when I got malaria, and it just didn’t seem to make sense; this was false logic, as I have later come to understand: Lariam protected me against falciparum but I still got vivax which I could then treat with chloroquine. I thought of taking chloroquine as prophylaxis, because being on anything at all lessens the likelyhood and severity of the attacks (I wasn’t aware at that point of the fact that chloroquine is not very effective against falciparum!). But I found out that as soon as people are using a particular drug as prophylaxis in an area, this increases the risk of the parasites getting resistant. Since chloroquine is the first drug given to the locals as treatment, and to pregnant mothers as prophylaxis, I felt I didn’t want to contribute to making the parasites resistant to it. Later, I have realised that this line of reasoning too makes very little sense, since my contribution to parasite resistance is going to be negligible given the number of local people who only take half the treatment course they are given and give the rest to their cousin. In sum: do take prophylaxis if your body can tolerate it.
You might have worked it out by now, but the reason why you get malaria months after coming home from a trip is that the prophylaxis suppresses the symptoms. You keep taking it for about a month after getting back, and then, some time in the month(s) after you quit, you have a resistance low, and wham, there you go. It happened to two of my visitors (one was on Lariam and got vivax, the other was on doxy and got ovale), and it has happened to me after each of my three stays (in all cases vivax). I’m not kidding, about 10 people in Sweden die from malaria every year (I am told, or maybe it was 10 during the last few years) because they fail to work out that they have malaria, and don’t tell the docs that they have been in the tropics – 8 or 10 weeks after your vacation when the tan is gone and you’re back at work, you don’t think you could have a tropical disease. Well, now you know.
Creepy crawliesMice: are common, I’m afraid. You actually get used to them. If you have some wire, hang food from the roof beams, they can’t climb wire (but they can climb string). For some reason they eat soap too, so hang it up or put it outside or in a container.
Ants: are even more common. Airtight containers are good, but not all actually withstand ants. Standing the container in shallow water (in a plate or bowl) stops them.
There are of course lots of kinds of bugs, you can’t kill them all. But you can avoid inviting them to your bed by never eating there – the smallest crumb will cause a big parade of bugs very quickly.
New Ireland is really good though, there isn’t much that can kill you according to most reports (like no snakes that will kill an adult etc). By most reports I mean that I have never seen one that says there are deadly things, just that most reports aren’t 100% sure, as probably not enough zoologists have surveyed the area to make guarantees. It’s a bit worse in the sea, what with sharks and stonefish and seasonal box jelly fish and all that stuff, and crocs in some areas. Ask the locals. And do go for a snorkle, it’s one of the top places on earth for snorkling and diving, don’t miss it!
MapsMostly you have to stop in Port Moresby (PoM) on the way. Walking around there without knowing what you’re doing is not recommended, but if you are interested in detailed maps of the areas you are going to, try to get someone to take you to the Mapping Bureau (Melanesian Way, Waigani, at least that’s where it used to be; phone 327 6465, fax 327 6460). They have quite good maps of most of PNG, in the scales 1:250.000 and 1:100.000. I think most of them are from before 1975 but all the same.
CompanyPrepare yourself for not being alone for any of the time that you are out in the villages. You might find some moments away, but houses are flimsy and privacy isn’t much of a notion all in all. This can be incredibly stressful if you are not used to it, especially in a foreign culture if you’re constantly worrying about doing something wrong. Only crazy people spend time alone in PNG. I don’t know if there is any way of preparing for that mentally, but at least you are forewarned. One trick is to go and lie on the beach or wherever and sleep or pretend to sleep. People do this a fair bit, especially pregnant women or others who didn’t go to the gardens or elsewhere that day.
PhotosIn my experience, people are quite happy to have their picture taken and even say thank you (‘tengyu’), but as usual it’s best to ask first (‘inap mi snepim yu/yupela?’). Always use the flash when taking pictures of black people or you won’t be able to see them! Take an extra battery, using the flash runs it flat and the humid climate doesn’t help either. Think about taking an underwater camera (you can often get disposables in airports); you’ll want it when you go snorkling.
PricesThe prices at hotels and in stores in PNG are not cheap, at least not compared to neighbouring Indonesia and probably other countries in the region. There is little domestic production, and many items are imported from China, Indonesia or Australia. Exchange rates vary a lot, so it’s not really useful to give hotel prices here, but several hotels have webpages where you can check. In Port Moresby you may want to stay in “a good hotel” because of security (including the courtesy bus from and to the airport). In a place like Kavieng it is probably easier to follow the demands of your wallet, but even the cheapest room (fan but no aircon, mozzies in the room, baking hot in daytime) is not dirt cheap. I’m just saying this so you’re prepared. As you have probably gathered from other stuff above, it’s totally different as soon as you get out of town and hit the villages, you can live on a lot less then.
TransportThe main term for personal transport is ‘PMV’. A PMV can be a bus, or a flat bed truck for copra transport where you sit on the flat bed. They come from the villages into town in the morning and go back in the afternoon. That works OK and is cheap, but try to make sure that your driver is sober. Also pack sensitive stuff in waterproof bags in case of rain. Watch out with boats, they sometimes have very insufficient emergency equipment, and have been known to drift into the big blue nowhere that is the Pacific Ocean. As with everything, it all works pretty well most of the time, but it makes sense to be a little careful in some respects.
Always allow an extra day or two for transport!! This saves you from having fits, getting angry and jumping up and down, when you could spend the time walking along the beach. Everything is doable, but it sometimes takes a little time, and it’s just not worth it to be stressed out – try and organise it so that you don’t get yourself into that, you’ll only be a nuisance to yourself and others.
Guide bookThe Australian travel book publisher Lonely Planet makes fantastic books for many parts of the world. Therefore, I am sad to have to report that in the latest edition of the PNG book (1998), the New Ireland section wasn’t updated, and therefore is incorrect in many respects (not the least regarding prices). I don’t know about the other sections. But it’s still a book that could give you a good idea about the country, and it also has a good introductory section with history and stuff. Lonely Planet also has a whole site about PNG on the web!
Visas and permitsHolders of passports from most countries usually get a 60-day tourist visa on arrival (Air Niugini has some information on this), but sometimes the lines are long and you may want to arrange your permit in advance via one of the overseas consulates. Note that this can take a few months and tends to involve posting your passport off to a remote city.
If you are planning on doing any research or collect any kind of samples, you should have a research permit (research visa) read more about this on the pages of the National Research Institute. You could probably get away with doing it without a special permit, but there are several good reasons why you shouldn’t. One is that it’s illegal, and if found out you will be banned from returning for years. It is also un-ethical and respectless. Another reason is the fact that there are universities and researchers in PNG who have very limited resources for investigating the wealth of nature and culture around them, and for whom it is not very much fun to see international researchers zooming in and out and never sharing a thing. With a research permit you are affiliated with a PNG institution which you are expected to visit and normally to give a talk. In that way you can give back a little to the under-funded colleagues in the country about which you are about to go away and write papers to further your career.
Last commentMaybe I should add that I’m not an incredibly adventurous sort of person, and have never been attracted by ideas like climbing Mount Everest or sailing around the world in a small boat – that all just seems like madness to me. But I like to see how people live in other places so going to New Ireland was a fantastic opportunity. The point is that you don’t have to be some special kind of person to go there and enjoy it. I had a number of visitors when I was there, all people who have travelled quite a lot but mainly in more organized places. They all said that New Ireland was the best ever (and I’m not getting paid by the tourist agency to say this! It’s the truth!).
If you found all the stuff about malaria etc scary, well yes, it can be, but if you know something about it you can protect yourself, and I would tell you to go all the same! I had a fantastic time there, it’s a beautiful beautiful place with wonderful wonderful people, and I cried for weeks when I had to leave...
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Link to my main page (with pics and stuff!): http://www.ling.su.se/staff/evali
You may be able to find more PNG-related pages at the PNG Ring
Page created January 2001, last updated September 2004