National services in PNG

A man in a red t-shirt and cap is sitting on a treatment table; he has a right below knee amputation. A lady in a white coat is fitting a liner to his stump, next to him we can see a prosthetic device ready to be fitted, on the floor.

For over 20 years the National Orthotic and Prosthetic Service (NOPS) has improved the function and mobility of many clients through the provision of orthotic, prosthetic, wheelchair and walking aid services to clients with mobility disabilities. With the on-going risk of accident and trauma, and the ever-growing rate of NCD complications such as stroke and amputation, the demand on NOPS Port Moresby continues to grow.

The current ability of NOPS Port Moresby to provide appropriate clinical services is greatly affected by out dated, broken and unsafe facilities and equipment, and a budget shortfall that prevents them from purchasing essential components, materials and devices. As a result, they are currently restricted in the services they can provide. Whilst NOPS has no new components for prosthetic devices, they are able to fabricate new prosthetic sockets and some Ankle foot orthosis, however the polyester resin fibreglass used in this process is a toxic mix that can put personnel and the environment at risk. The lamination is also completed without the use of a vacuum, which results in a less than ideal fit for clients, leading to the increased risk of skin breakdown and reduced functionality.

Going forward NOPS plans to introduce the ICRC Polypropylene technology to replace the use of polyester resin laminations. The polypropylene prosthetic technology made by the International Committee of the Red Cross (ICRC) is the most tried and tested low cost prosthetic components for less resourced settings. The ICRC have been using its’ Polypropylene (PP) limb system all over the developing world since 1993, and control its design and quality. Several countries in the region use PP components already. The PP technology can be used with standard modular components if needed, as well as for a whole range of orthotic devices and even wheelchair components. The use of a standardised material, streamlines equipment and material procurement reducing costs, whilst increasing the range of services available to clients.  The PP technology will also be much safer for NOPS personnel to use.

During this trip MA and NOPS Technical Advisor Almah Kuambu had the opportunity to discuss the need and importance of strengthening NOPS with a range of stakeholders. It was agreed that MA would assist NOPS to draft a ‘special proposal’ outlining the capital improvements and on going budgetary requirements required to allow NOPS to safely and consistently provide priority mobility devices including prosthetics, orthotics, wheelchair and walking aids

The visit also provided the opportunity to strengthen NOPS’ ability to collect and report data through the refinement of new service forms and finalisation of plans to implement the MA Mobility Device Service (MDS) database to track clients and the services provided to them.  The MA database will be an interim measure until the new Department of Health (DoH) eNHIS database can be rolled out. The interim MA MDS database is important to assist NOPS to monitor and report on the new container of wheelchairs donated by the Latter-day Saints Charities (LDSC), which are due to arrive in September. Previous issues with data management of LDSC donations had previously meant that LDSC donations were put on hold, therefore it is important to demonstrate with this new system that NOPS has strengthened the systems around their data collection and reporting.

Initial work was also commenced during this trip to strengthen collaborations between NOPS and clinical services at Port Moresby General Hospital (PMHG). Greater links between NOPS and the Physiotherapy and Surgical teams has the potential to reduce the number of people who are currently being discharged from hospital post amputation, stroke or other disabling health conditions without appropriate mobility devices. NOPS also has the potential to work with clinical services to reduce the number of avoidable amputations by offering essential offloading services to improve healing of diabetic related foot ulcers or prevent their occurrence in the first place.

MA looks forward to continuing their work with NOPS over the coming year and hope we can assist NOPS’ capacity to provide mobility device and diabetic foot care services to the people of PNG.


Thank you once again to the personnel from NOPS, DoH, the Department for Community Development and Religion (DfCDR), and all other stakeholders for taking time to meet with us, and for your ongoing hard work and commitment to building quality, sustainable mobility device services in PNG. Motivation Australia acknowledges the valuable contribution of the Australian Non-Government Organisation Cooperation Program (ANCP)to this project