VZCZCXRO5565
RR RUEHAST RUEHDH RUEHDT RUEHHM RUEHLN RUEHMA RUEHPOD RUEHSL RUEHTM
RUEHTRO
DE RUEHPB #0225/01 3160602
ZNR UUUUU ZZH
R 120602Z NOV 09
FM AMEMBASSY PORT MORESBY
TO RUEHC/SECSTATE WASHDC 5692
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUCNARF/ASEAN REGIONAL FORUM COLLECTIVE
RUEHSV/AMEMBASSY SUVA 0470
RHMFISS/JOINT STAFF WASHINGTON DC
RHHMUNA/HQ USPACOM HONOLULU HI
RHMFIUU/CDR USPACOM HONOLULU HI
RUEKJCS/SECDEF WASHDC
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE USD FAS WASHINGTON DC
RUEHRC/USDA FAS WASHDC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUCNDT/USMISSION USUN NEW YORK 0054
RUEHGV/USMISSION GENEVA 0017
RUEHBK/AMEMBASSY BANGKOK 0445
RUEHGP/AMEMBASSY SINGAPORE 0085
RUEHJA/AMEMBASSY JAKARTA 0154
RUEHPB/AMEMBASSY PORT MORESBY 3325

UNCLAS SECTION 01 OF 03 PORT MORESBY 000225 
 
SIPDIS 
 
DEPT FOR EAP/ANP DOUG CAREY 
DEPT ALSO FOR OES/IHB 
DEPT ALSO AID/GH/HIDN 
USDA PASS TO APHIS 
HHS PASS TO CDC 
BANGKOK FOR REO AND USAID/RDMA 
SINGAPORE FOR RMO 
JAKARTA FOR RMO 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU AMED ECON PREL SOCI CASC PP
SUBJECT: PAPUA NEW GUINEA DISASTER UPDATE -- DISEASE OUTBREAKS 
DECLINE IN MOROBE, INCREASE IN MADANG 
 
REF: PORT MORESBY 000121 
 
PORT MORES 00000225  001.2 OF 003 
 
 
¶1. Summary:  The Government of Papua New Guinea (PNG) declared a 
State Of Emergency in September to address outbreaks of cholera, 
dysentery and A(H3) seasonal human influenza in Morobe Province. 
 According to the World Health Organization's (WHO) latest 
Situation Report, the number of new cases reported on a weekly 
basis is decreasing slightly.   In Madang Province, however, a 
new outbreak has resulted in 237 clinical cases, seven 
cumulative laboratory confirmed cases and one death.  PNG has 
not requested foreign donor assistance, but other countries and 
international organizations including Australia, the European 
Union, and the International Committee of the Red Cross (ICRC) 
have provided assistance through medical supplies and funding. 
Most foreign assistance is administered through the Department 
of Health in collaboration with WHO and with the assistance of 
Medecins Sans Frontiers/Doctors Without Borders (MSF).  End 
Summary. 
 
 
 
Progress Against Disease Outbreaks In Morobe 
 
 
 
¶2. The Government of Papua New Guinea (PNG) declared a State Of 
Emergency in September to address outbreaks of cholera, 
dysentery and A(H3) seasonal human influenza in Morobe. 
According to the World Health Organization's (WHO) latest 
Situation Report, the number of new cases reported on a weekly 
basis is decreasing slightly. 
 
 
 
¶3.  At the Angau Cholera Treatment Center in Morobe capital Lae, 
PNG's second largest city, admission of patients has declined 
from 10 per day to about 1 per day.  Authorities believe there 
is still a need for awareness-raising activities in the village 
of Situm as many cases of cholera continued to originate from 
there.  As of September 23, WHO reported a total of 296 cholera 
cases with 18 deaths, 1262 dysentery cases with 44 deaths and 
4917 influenza cases with 62 deaths. 
 
 
 
Health Authorities Create New Institutions 
 
 
 
¶4. Morobe's provincial authorities have established a Provincial 
Outbreak Response Committee (PORC) to deal with the outbreaks 
with assistance from the National Department of Health (NDoH)and 
partner agencies.  The PORC is made up of representatives of 
relevant national and provincial authorities and is co-chaired 
by the Provincial Health Advisor and Provincial Health Director. 
 The co-chairs operate a Coordination and Command Center at the 
Lae Provincial Health Office with the support of WHO. To ensure 
a coordinated and efficient response, PORC has grouped work into 
six sectors, case management, surveillance, logistics, water and 
sanitation and environmental activities, communication/outreach 
and coordination. Sector leaders are responsible for 
coordinating and leading the work of their group. 
 
 
 
¶5. The PORC launched a free 511 hotline September 28.  (A 
similar hotline for Madang is pending.)  The hotline received 
149 calls on the first day, exceeding the capacity of three 
 
PORT MORES 00000225  002.2 OF 003 
 
 
operators to answer; the Center needs additional funding to 
increase capacity.  Digicel, a PNG mobile phone company, has 
indicated it can provide more free lines but funds are needed to 
hire additional operators and keep the line open more hours; it 
currently operates from 9:00 am to 5:00 pm. 
 
 
 
¶6. A Cholera Treatment Center with isolation ward operates at 
Angau Hospital with a capacity of 50 patients.  The Center, 
supported by MSF, can treat patients from Lae and surrounding 
areas.  The mortality rate of patients reaching the center is 
low. 
 
 
 
Greatest Challenge Lies In Remote Menyamya 
 
 
 
¶7.  The greatest challenge appears to lie in assisting patients 
in more remote areas. WHO cites continuous problems, compounded 
by communications difficulties, in the village of Menyamya. 
Health workers there require rations and advances, water and 
sanitation at health centers is still a major concern, and there 
is a need for water and sanitation environmental health staff to 
conduct surveys and provide guidance regarding improvements 
needed for health centers.  Menyamya also requires installation 
of pit latrines and communication with the community regarding 
sanitation. 
 
 
 
¶8.  A medical team was dispatched to Menyamya to support the 
response, but faces challenges due to limited facilities and the 
difficulty in bringing supplies to the area.  Stocks of 
cyprofloxin are very limited and are urgently needed to combat 
shigella (dysentery.)  Only 2200 units remain, enough to treat 
220 patients.  Area Medical Store (PNG) is responding to 
requests from health centers.  A WHO survey of water and 
sanitary conditions at Menyamya's health centers highlighted the 
need for significant improvements at health centers. 
 
 
 
Dysentery and Cholera Reach Madang 
 
 
 
¶9. A new outbreak in Madang has resulted in 237 clinical cases, 
seven cumulative laboratory-confirmed cases and one death. 
Madang's Provincial Health Coordinator Markus Katchau declared a 
dysentery and cholera outbreak November 1 and set up a Task 
Force which meets daily.  The concentration of cholera and 
watery diarrhea is greatest in the municipality of Madang's 
Sisiak Settlement, which contains about 500 households. 
 
 
 
¶10.  The WHO Situation Report confirmed that Modilon Hospital 
prepared ten "Cary Blair" sample taking instruments for each 
affected district for outbreak investigation and distribution. 
The tuberculosis program Edna began active surveillance of 
affected areas for data management November 4.  Water and 
sanitary advisors from WHO and NDoH arrived in Madang in early 
November.  World Vision has supplied 200 10 liter (2.6 gallon) 
jerrycans.  WHO has stated that surplus jerrycans and acquatabs 
 
PORT MORES 00000225  003.2 OF 003 
 
 
in Lae will be sent to Madang. 
 
 
 
¶11.  Australia and New Zealand media have devoted a great deal 
of attention to the outbreaks in Madang.  A press conference was 
held for them November 2. 
 
 
 
PNG Receives Donor Assistance Despite Not Asking 
 
 
 
¶12.  PNG has not requested foreign donor assistance. 
Nevertheless, other countries and international organizations 
including Australia, the European Union, and the ICRC have 
provided assistance through medical supplies and funding.  Most 
foreign assistance is administered through the Department of 
Health in collaboration with WHO and with the assistance of 
Medecins Sans Frontiers/Doctors Without Borders (MSF). 
 
 
 
¶13.   A large number of other partners are also contributing to 
the outbreak response, including the PNG Defense Forces (PNGDF), 
international and national NGOs, UN agencies and the private 
sector. WHO and UNICEF have recently submitted funding proposals 
to the European Community's Humanitarian Aid Office (ECHO) for 
250,000 Euros (USD 363,134) and 260,000 Euros (USD 388,059) 
respectively to assist in overcoming the outbreaks. 
 
 
 
Comment 
 
 
 
¶14.  On several occasions, we indicated to Government 
authorities our willingness to look into the possibility of USG 
assistance in dealing with the various disease outbreaks.  We 
can only speculate on why PNG has not yet requested any foreign 
assistance.  Money the Government has already budgeted for these 
outbreaks has not yet been distributed at the local level.  With 
this in mind, some speculate the Government may not wish to 
request foreign assistance since this could encourage Parliament 
members from the Opposition to question why the already budgeted 
monies have not yet been spent. 
TAYLOR