Transcript

COCHRANE: This woman is heavily pregnant and she has severe pneumonia. She’s having trouble breathing and we’re racing to get her to hospital. 

DR BARRY KIRBY: “As soon as somebody says a mother’s struggling for breath the alarm bells go up”.

COCHRANE: Her life depends on this man, a can-do tradie turned doctor. 

DR BARRY KIRBY: “You’ve got to be a little bit resourceful, not afraid of anything. Women when they’re delivering they can lose a lot of blood in a very, very short time and they can die right in front of you”. 

COCHRANE: Spectacular and wild, these islands speak of a different world, in a distant time. For generations little has changed and contact with the outside world is minimal. We’re here to meet Dr Barry Kirby as he’s about to head out on his island rounds. He first came to the Milne Bay area 30 years ago, to work as a builder after hearing his father talk about his war experiences.

DR BARRY KIRBY: “You know he’d always say, ‘oh Barry if you ever get a chance, you know, go to PNG. It’s a great place, good people.’ I had no idea it was so close to Australia – right on our, right on our doorstep, you know, this is just a completely different world, yeah”.

COCHRANE: At an age when many Australians are considering retirement, Barry is just getting started. 

DR BARRY KIRBY: [loading the boat] “We want somebody down there who’s really nice... packing it nicely okay? We’ve got twice as much gear this time as we had last time. So we may finish up putting some on here and even some on the roof”.

COCHRANE: After starting university in his forties to study medicine, his life now revolves around helping the mothers of Papua New Guinea. 

DR BARRY KIRBY: “Quite often women do not get the respect they deserve and women actually carry this country. I believe that. They’re strong women, they bear the children, they work the garden, ah... humble, not assertive and put up with a hell of a lot”.

COCHRANE: PNG is one of the most dangerous places in the world to be a mother. The lifetime risk of dying in childbirth is about one in thirty, compared with one in ten thousand for Australian women – mostly because the villages here are so isolated. 

DR BARRY KIRBY: “Unfortunately that’s where it all goes wrong. That cultural practice of delivering in the villages I think is at the core of why Papua New Guinea has such a high maternal death rate”.

COCHRANE: Through a simple initiative, Barry has managed to lower the maternal death rate in this area by a staggering 78% and now he wants to pass on what he’s learned to others. Emergency nurse Kila Koupere is making this journey for the first time.

KILA KOUPERE: “Yeah this is going to be very challenging for me. It will be nice to just go, hit the waves and you know, see what people experience”.

DR BARRY KIRBY: “At the end of the day when I can’t do this any longer, it’s people like Kila that are going to take this forward. You know this is a PNG problem and we want to come up with PNG solutions and we want PNG people doing this. You know I’m limited now. I’m sort of almost dinosaur stage and so... women like Kila have got to take over”.

COCHRANE: For the next two weeks the M.V. Losisi will be our home. We leave Alotau off the eastern tip of Papua New Guinea and head for the D’Entrecasteaux Islands. Here in Ulisalolo three nurses look after about 5,000 people. 

It’s these baby baths full of goodies that are making the difference, enticing women down from the mountains and into the clinics. While nappies, soap and baby clothes might seem like basic items, for women who own virtually nothing, they’re a rare luxury. The bundles have doubled the number of women coming to the clinic to give birth.

DR BARRY KIRBY: “So when they have a supervised delivery, when they get into trouble, they’ve got skilled staff there to deal with it, and they’ll save a life. If you have that problem up in the village, you may not survive it and that’s as simple as it is”. 

COCHRANE: It’s already been a long day for Barry and Kila and now 34 year old Vinka has turned up. 

DR BARRY KIRBY: “She’s having her 6th baby but she’s had two previous post-partum haemorrhages so that makes her a very high risk mother. It looks like she’ll probably deliver tonight but we’ll see how we go”. 

[delivers baby] “Congratulations Mamma. Baby girl. Okay rub that up vigorously. Let me just feel for another baby here… I think we’re right. Okay… okay. Mamma can you just hold the baby for me? Can we have 10 units oxytocin please… straight into IV”.

COCHRANE: The team is relieved – there is no bleed. 

DR BARRY KIRBY: “Thank you, can you get that in fast for me”?

[to father, presents bath of goodies] “Here’s something for you… and... all right for you and the baby and mother, okay? Things in there for the baby and for the mother”.

COCHRANE: Things don’t always go so well. 

DR BARRY KIRBY (on beach): And we got the boat in safely, that’s the main thing.

The next day we head to a nearby island where a woman recently died in childbirth. 

DR BARRY KIRBY: “This is what we’ve got to do. I mean sadly every death is going to teach you something and if you don’t investigate it, you may be missing out on something. That’s the way I see it”. 

[meeting the husband] “Pleased to meet you. I’m very sorry that you’ve, you lost your wife two weeks ago, I’m very sorry. We’ve just come to find out what happened, all right? So to see if we can prevent it happening next time okay?”

COCHRANE: The village birth attendant explains what went wrong. 

DR BARRY KIRBY: “This mother was there struggling and she was actually trying to.... moving her legs, I guess trying to move her position around to try and push the placenta out, but.... she was bleeding”. 

COCHRANE: Judith bled to death. Her retained placenta caused a preventable tragedy.

DR BARRY KIRBY: “If she’d been down in the health centre, Judith would still be alive and Peros you would still have a wife”. 

COCHRANE: Judith’s death takes Barry back 25 years to when he was a builder in the highlands with a secret ambition. 

DR BARRY KIRBY: “You think you know it’d be great to be a medico, it’d be great to be a doctor or a nurse and to be in a place like this and have a little clinic and I thought oh, that’s a stupid idea, you know? Forty years of age, I mean you know, come on you know? And I thought, you know, get those crazy thoughts out of your head”.

COCHRANE: Then came a chance encounter that he’s never forgotten.

DR BARRY KIRBY: “I just drove past this... what looked like a sack on the side of the road and moments later I said no hang on, that’s a woman. I said well I’ll take her into the hospital, I put her in the car”.

COCHRANE: The woman had been sick for months and was dumped on the roadside by villagers who thought she was cursed.

DR BARRY KIRBY: “We started to talk as best we could. Obviously she couldn’t talk my language, I couldn’t talk hers and she had the most beautiful smile, lovely, lovely white teeth and I sort of just looked back and I thought wow, what a beautiful lady”.

COCHRANE: Later that night she passed away. 

DR BARRY KIRBY: “Well you know it’s… you know, I think that was the final straw. That was the final straw. You know I was quite comfortable. I’d got rid of all those thoughts of being a doctor and then all of a sudden here it is again, for heaven’s sake. And I thought, well that’s it. Okay you know if a guy needs a message I mean you know, that was it. And I thought well okay, I’ve got to go back, I’ll have to go back... I’ll have to go back and I’ll try and do medicine”. 

COCHRANE: Having grown up in country New South Wales and struggling through high school, Barry spent the next ten years becoming a doctor. 

DR BARRY KIRBY: “If I was going to succeed at this, this is what I had to do. I really worked hard at it. I can’t even believe now how focused I was and I’m sort of still a little bit focused actually, that same drive and passion is there. It’s never gone”. 

COCHRANE: Dio Dio lies on the swell-battered west coast of Goodenough Island, a treacherous stretch of water.

“What makes it so difficult to get to?”

DR BARRY KIRBY: “You’ve got fringing reef and then you’ve got this onshore surf, onto a rocky beach mixed with sand. You know it’s just, it’s a place where you can damage your boat basically and your boat is your lifeline in this place”. 

COCHRANE: It’s a decent walk to the main village, especially hard for Barry with his bung hip. 

DR BARRY KIRBY: Well, I can’t remember it being this far in, but anyway.... I knew it was a fair walk in from the beach.

Barry was the last Dim Dim or white person to visit here. That was about 4 years ago. 

VILLAGE MAN: So the little kids here are very excited. You people are dim dim”. [much laughter]

DR BARRY KIRBY: “What is a dim dim?”

VILLAGE MAN: “Dim dim are white people. Papua New Guineans you see this, brown skin, like black skin. So when you people come we are very excited to see your faces. Thank you for putting me in the camera”. 

COCHRANE: Dio Dio may be remote, but it’s the centre of activity for this corner of the island. Beyond small villages dot the rugged terrain. All depend on Dio Dio and its humble health centre. 

DR BARRY KIRBY: “180 mothers coming? So you must be pretty good”.

COCHRANE: Marolyn is one of the community health workers.

SISTER MAROLYN: “Most of our people are right out behind the mountains, they die due to giving birth. Most of them. So you’re coming here to encourage our mothers to come here and give birth at the health centre”. 

COCHRANE: The whole success of Dr Barry’s operation depends on getting pregnant women down from remote mountain villages into the community health centres where they can have a safe birth. The problem is some of these places are up to a day’s walk away. Normally Sister Marolyn will go out and check on these mothers to be but she hasn’t been able to for a few months because of flooded rivers. Though today though we are going to head out and try to make contact.

Having done this trek before, Barry’s opted to stay behind this time and Kila’s starting to understand why. 

KILA KOUPERE: “Yeah just after crossing the river, it’s kind of reality just set in, having to experience the strength of the current here and this river flowing and how hard it was to cross this river. Stepping on the stones, they’re slippery. The current is flowing against your legs and being a woman, you know it just set me in a place where you know I began to feel how a pregnant woman would feel in having to bear the weight of pregnancy and then come into the nearest health centre”.

COCHRANE: After 5 hours we finally arrive and meet Pristas who’s heavily pregnant with her third child. She’s overwhelmed by our sudden appearance. Twice already she’s had to trek down to the health centre while in labour. 

KILA KOUPERE: “How was that walk with your last pregnancy? Did anyone help you?”

SISTER MAROLYN: [interprets for Pristas] She says that while she was in labour, her mother-in-law and her mother help her all the way down to the labour ward”.

COCHRANE: Local elder Rachel explains that here on Goodenough Island, time is a different concept. The onset of labour is often a surprise.

RACHEL: “They don’t go to school and they don’t know really when they are giving birth. Even though they are pregnant, they are always work in the garden, carrying water, firewood. Sometimes they deliver on the road, sometimes in the house. It’s really hard, hard for them walking down from here to the hospital or aid post, it’s really hard”. 

COCHRANE: Soon Pristas will make the journey once again to Dio Dio. The next day, the staff in Dio Dio get some very realistic training even down to the fake blood. 

DR BARRY KIRBY: “The idea is to try and make it a bit scary for us okay like it normally is. Slip baby Angela in there. By the way we call our model Angela”.

NURSE : “This is mother Angela”.

DR BARRY KIRBY: [mimicking mother] “Hey sister I want to push, I want to push. Sister please help me, help me. What are you going to do now?” 

SISTER: “Since I was here four years nobody came in here to do training and this is the first time in my four years Dr Barry walked in to do this training”.

COCHRANE: “That must feel good”.

SISTER: “Yes and I’m proud about it”. 

VILLAGE WOMAN: “Not too good, not too bad. That’s Goodenough Island”. [laughing]

COCHRANE: “We’re heading for our last port of call, the market village of Wailagi. Here Barry has built these waiting houses for mothers to be. 

DR BARRY KIRBY: “Very few women will deliver on the day you tell them they’re going to deliver, and that’s why we built the waiting houses so they’ve got somewhere to stay”. 

[singing and bringing gifts] “They’re bringing all these gifts for the patients because a lot of them come from a long way away and don’t have enough food or firewood to stay here for more than a few days. So it’s amazing to see it”.

COCHRANE: But there’s no time to relax and enjoy the scenery. We’re soon off again after news comes through of an emergency on a nearby island. 

DR BARRY KIRBY: “We just a call from across, from Kalo Kalo. We were over at Wailagi there, about 20 minutes away across the bay. Pretty rough out there. We’re just racing over here to find out what’s going on”.
[to patient] Hello... sorry...and what’s your name?..

PATIENT: Pastai.... 

DR.BARRY KIRBY: I’m Doctor Barry. Pleased to meet you.

COCHRANE: Heavily pregnant and suffering from pneumonia, Pastai will need to be moved to the only nearby clinic with oxygen. 

DR.BARRY KIRBY: And this is baby number ...?

NURSE: Three.

DR.BARRY KIRBY [on radio]: Okay... look...I have one serious patient here, who needs oxygen.

[patient is carried to boat on stretcher]

COCHRANE: With bad weather setting in, Barry is now desperate to get across the strait before dark. 
On dry land, Pastai is rushed to the clinic and stabilised but Barry thinks she needs more serious help. With no reception, he drives to higher ground to make a call. 

DR BARRY KIRBY: “There is no communication here. I’m out, I’m out on a mountain top here mate! Can we get the chopper over here at first light to pull this woman out? Bolu bolu – good enough, good enough - which is quite bad enough at the moment”. 

[chopper collects sick woman] “For a village woman to sit in a two million dollar chopper and get a ride into Alotau I think that’s going to be like.... you and I flying to the moon”.

COCHRANE: We later learn that Pastai was diagnosed with tuberculosis but gave birth to a healthy girl. 
Back in Wailagi, Kila’s class on resuscitating newborns is already paying off for this new mother, Josephine. 

KILA KOUPERE: “She went into labour around 11 pm, had the baby and the baby was born flat”.

COCHRANE: The baby girl wasn’t breathing. Thanks to the training, community nurse Jerry was able to revive her. 

NURSE JERRY: “When we had last night’s case, we were able to resuscitate the child and we are confident to do that”. 

KILA KOUPERE: It’s amazing because we came here, did the training, and the scenario presented in the night and they were able to apply their skills. It was really timely and..... that what we are doing is actually working”. 

DR BARRY KIRBY: “I always call them the forgotten workforce. I mean they are heroes yeah and they get, sometimes they get very little recognition for that. 
If these people weren’t there, many more people would die. A lot of this is just a lot of basic care, but if they don’t do it, the baby will die. If they don’t treat their infections in the people who are there you know, they go sceptic and they die. So in their context, within their community, the community thinks they’re heroes”. 

NURSE JERRY: “We are all heroes, yeah. Yes we are human beings, we do things, we see things.... we do the right thing for the benefit of our people”. 

DR BARRY KIRBY: “I’m just a real doc really. I mean you know it’s my job to help these mothers out, that’s what I see... see my job as. So you do whatever that takes”.