• By Kate Bradshaw
  • November 12, 2018

Background

In 2009 YWAM Medical Ships Australia & Papua New Guinea (YWAM MSA) first started to engage in Papua New Guinea (PNG), though YWAM first began to have a presence through land-based teams back in 1969. Before YWAM MSA’s operations began, YWAM MSA’s senior leadership team met with the then Secretary for Health for PNG, Dr Clement Malau, to present the idea of a medical ship reaching rural and remote areas of the country with healthcare and training. As a small team pioneering a pilot project with scarce resources, YWAM MSA received an invitation from Dr Malau on behalf of the National Department of Health to bring the first ship, the MV Pacific Link, to the Gulf Province. The MV Pacific Link was gifted to YWAM Australia from New Zealand. The first number of years were very challenging as YWAM MSA started to sail into PNG’s very remote and rural communities, working in partnership with PNG both at a national and grassroots level to bring hope and resources to the villages in great need. It became obvious that the MV Pacific Link (a 37-metre-long Japanese fishing vessel built in 1979) was too limiting for the demands and needs identified on the field. YWAM MSA then began the process of acquiring a much larger ship that would be more suitable for PNG’s remote areas, while increasing YWAM MSA’s capacity to support PNG’s health system. This was a huge undertaking – at the time, YWAM MSA had no funds toward the vessel, but was compelled by seeing the very real needs on the field up close.

After much research, a second-hand ship was found – a small cruise liner built in 1999 by Austral. The asking price was $6.5 million AUD. To acquire this ship took an extreme amount of work; a small dedicated team made of up of volunteer staff named the campaign “Overcoming the Impossible”. The team worked voluntarily and tirelessly, giving their time and personal funds to make the dream a reality. People from all walks of life gave as the vision was presented; communities, churches, school students, companies, governments, charities, and individuals from all over the world, including PNG. Then in December 2014, YWAM MSA officially acquired the vessel and began to work through the details of refitting the vessel into a training and medical ship that would serve hundreds of remote villages each year. The vessel was named the MV YWAM PNG to reflect its intended purpose of dedicated service to the nation. YWAM MSA’s shared desire with national and provincial health authorities is for the vessel to be utilised as a shared innovative tool to deliver services, supplies, and encouragement and support to the dedicated health workers serving on the ground. The vessel is headquartered out of Townsville, Australia and spends 10 months of the year in PNG. YWAM MSA partners with many like-minded organisations, including local YWAM PNG centres and other YWAM ship networks that operate in PNG waters.

Approach

YWAM MSA’s model is centred around the value of the individual and their right to receive healthcare. Over 84% of PNG’s population live in rural areas. The isolation and lack of infrastructure makes delivering healthcare and training very challenging. YWAM MSA teams work in partnership with rural health workers, especially at the district level, to achieve the following right at the doorstep of coastal and inland villages across the Southern

Region and Morobe:

  • Strengthen the capacity of rural facilities to serve year around including
    • Delivery of drug supplies
    • Assistance with vital maintenance and upgrades to equipment
    • Peer support, supervisory visits, in-service updates
  • Boost district patrol capacity through facilitating collaborative patrol activities (explained
  • below) in currently poorly served areas
  • Work with grassroots communities (with a special focus on youth) to empower them to
  • take an increasingly active part in promoting their own wellbeing
  • Advocate to spotlight areas of current under-service, directing attention and resources to
  • improve the situation on the ground
  • PNG’s National Health Plan includes the expectation that rural health facilities will regularly reach
  • out to villages in their catchment on what is called ‘patrol’, with a special focus on preventive
  • maternal-child health services (including offering family planning and immunisation). These
  • regular visits are supported by YWAM MSA’s teams, along with a package of additional support,
  • significantly reducing the marginal cost of each activity delivered to these challenging locations.
  • While there, communities benefit from additional services such as:
  • Optometry services
  • Sight-restoring eye surgeries
  • Health promotion
  • Tuberculosis screening
  • Oral health and dentistry services
  • Facility upgrades for health clinics (solar power, access to clean water, etc.)

As a mother ship, the MV YWAM PNG serves to build capacity in hundreds of villages throughout the Southern Region and Morobe each year. YWAM MSA does not exist to create an independent or parallel health service. YWAM MSA aligns itself with the goals and objectives outlined in the National Department of Health’s National Health Plan.

Facilitating collaborative patrols is implemented in a variety of ways:

  • Patrol supported by MV YWAM PNG at short range (teams deployed less than a two-hour boat ride from the mothership)
  • Patrol supported by MV YWAM PNG at long range deployed via extended-range patrol tenders (boats carried aboard) or
    • On foot / trekking or
    • Via helicopter
  • Patrol conducted by ship-independent, land-based teams

YWAM MSA proudly provides opportunity for many students to participate in patrols. This includes a variety of training programs, such as rural health workers who have requested upskilling, third and fourth year nursing and midwifery students doing their rural placements, and first year primary health care workers. Fifth year medical students from the University of Papua New Guinea (UPNG) also join multiple outreaches a year to fulfil their rural health placements. One of YWAM MSA’s goals is to increase the health workforce in PNG, and training is a vital part of that. We also strongly advocate for rural health. It has been shown that health students who are exposed to the rural setting during their training are more likely to consider a career in rural service. That said, all students work under supervision of qualified medical professionals with the appropriate medical qualifications and registrations for their job. In some cases, these are among some of the foremost professionals in their industry in their nation.

YWAM MSA works by invitation, seeking to work in collaboration and respect with a non-partisan approach at the national, provincial, district, local level government, and village level. YWAM MSA commenced outreaches in the Southern region and Morobe Province after receiving an invitation from each of the provinces. These outreaches are carefully planned with detailed reports submitted after the completion of each outreach and data provided for the national health data system according to guidelines given. Over time, specific districts have requested longer-term assistance and support as they develop their region and in 2019-20, YWAM MSA will pilot a new phase of Healthy Village – Healthy Nation in partnership with several districts.

Maritime Operations

YWAM MSA operates in compliance with Classification Society and Flag State requirements. MV YWAM PNG is classed by Lloyds Register (LR), a member of the International Association of Classification Societies. LR inspects the physical condition of the ship on annual, mid-term and 5- year cycles to maintain the Certificate of Class.

YWAM MSA has a Document of Compliance (DoC) for Safety Management and the MV YWAM PNG has a Safety Management Certificate (SMC). Both are issued and audited by the Flag State. The DoC is renewed annually after external audits of the company’s shoreside safety management system. The SMC is externally audited every five years with an additional mid-term inspection.

MV YWAM PNG is registered (flagged) in the Cook Islands for the exclusive reason of using volunteer international crew. If the ship were registered in PNG or Australia, it would be virtually impossible to engage volunteer crew from around the world, as is the model across YWAM operations. Crew have qualifications required for their positions issued from their home countries and vetted by Maritime Cook Islands according to international standards. Both Lloyds Register and Maritime Cook Islands provide their services to support PNG health through YWAM MSA.

Financial Integrity

YWAM MSA, a non-profit, charitable Christian organisation (ABN: 45 070 160 904) is a separate entity to YWAM Townsville, a registered training organisation (ABN: 14 010 381 738) in Australia. YWAM Townsville’s training campus and associated operations are funded completely separately to YWAM Medical Ships’ work in Papua New Guinea. While the entities are financially and legally autonomous, the relationship between both entities is strong – working together for the benefit of many remote communities in PNG. Audited financial statements for both entities are available from the Australian Charities and Not-for-profit Commission.

YWAM MSA has a wide range of donors from Australia, PNG, and around the world who contribute toward the costs associated with the delivery of the services previously outlined. While many of the donations received are in-kind (such as donated fuel, medical supplies, and volunteer labour), there are still significant cash costs involved in the delivery of these services. These costs include everything from medical supplies (not all are donated), to marine maintenance, to program development. A summary of these expenditures can be found in YWAM MSA’s audited financial statement.

While YWAM MSA raises funds from individuals, churches, and businesses outside of PNG, the leadership team is also committed to sustainability and giving greater joint ownership to PNG. Financial investment from Papua New Guinea’s government departments into the program is very important to YWAM MSA; it is also consistent with the PNG government’s public-private-partnership policy to assist accelerated access to services for rural communities. A small portion of local investment in this way also unlocks significant counter-part funding opportunities, discussed further below.

The stewardship of government contributions has been a catalyst for support from many other donors, corporations, health companies, health professionals and other nations. In fact, it is these contributions from outside the PNG government which are by far the largest contributor to YWAM’s programs, thus increasing the overall resources available toward health in PNG.

It is YWAM MSA’s understanding that the funds invested from the National Government into rural health through this program have come from PNG development funding buckets. Strong advocacy to support and build capacity in Papua New Guinea’s rural health care system has resulted in these development funds being successfully allocated to health. Rather than drawing from health function grants (the pool of funds associated with rural health facilities and supply chain), this allocation on top has added to the overall health budget in Papua New Guinea.

In the big picture, the funding that YWAM MSA does receive equates to a very small portion of all funding spent on health by the National Government. Any funds provided to YWAM MSA go directly toward services that build capacity in PNG, which are delivered in alignment with PNG’s National Health Plan.

It should also be noted that YWAM MSA’s staff, including the Managing Director and senior program managers, are self-funded; they raise their own funds outside of the organisation to support the work they do in PNG. In addition to this, there are a limited number of critical positions which must be remunerated externally at times to maintain operations (i.e engineer and bookkeeper). Every volunteer joins YWAM MSA with an understanding that they give their expertise and goodwill with no remuneration.

Short-term volunteers (mariners, healthcare professionals, and general volunteers) from around the globe also participate in the delivery of the program; approximately 25% of these volunteers are Papua New Guineans.

Using the strength of volunteer labour helps ensure a more cost-effective program. In 2017 alone, YWAM MSA’s volunteers’ donated time and labour had a total estimated value of 10million PGK. To comply with accounting requirements, all inputs (cash and in-kind) are assigned the relevant monetary value and included in audited income and expenditure statements each year.

YWAM MSA values transparency and accountability – integrity and trust must be the foundation and framework that is built upon. YWAM MSA’s finances and financial procedures are audited externally every year and the organisation is a member of the Australian Council for International Development (ACFID), committing to high standards of integrity and accountability. YWAM MSA has anti-fraud, anti-corruption, and anti-terrorism policies in place.

Conclusion

The challenges and access to quality health resources in Papua New Guinea are very real. Indeed, it is said to be one of the most difficult places in the world to deliver health care, and the disparities are confronting. Underpinning any activity in PNG is YWAM MSA’s hope to see sustainable health improvements. YWAM MSA joins with the cry of the people and supports the work of leaders in PNG at every level who will help to make that happen.

To this end, YWAM MSA welcomes open and respectful dialogue centred upon a shared vision: a healthy Papua New Guinea.