{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:55:13Z","timestamp":1782125713943,"version":"3.54.5"},"reference-count":53,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2002,1,15]],"date-time":"2002-01-15T00:00:00Z","timestamp":1011052800000},"content-version":"vor","delay-in-days":249,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2001,5,11]]},"abstract":"<jats:p> <jats:bold>Background<\/jats:bold>: Papua New Guinea (PNG) is a country of 4.5 million people with an annual health budget of only 96 million Kina (1K = US$0.35). There are 19 hospitals in the country and national surgeons are now staffing most of these hospitals. This review aims to describe the surgical pathology in the year 2000 and the capability of PNG surgeons to manage it.<\/jats:p><jats:p> <jats:bold>Methods<\/jats:bold>: A review of publications, reports and surgical audit data on surgery in PNG was conducted. Surgical audit has been computerized for over 5 years. The review also draws on personal experience and data from MMed theses submitted to the University of Papua New Guinea.<\/jats:p><jats:p> <jats:bold>Results<\/jats:bold>: <jats:italic>Surgical pathology<\/jats:italic> Surgical practice in PNG remains very general. Late presentation and advanced disease are common. Trauma, infection, malignancy and congenital anomalies dominate the surgical scene. The pattern of disease is different from what is found in the West. Western diseases are emerging with the incidence of appendicectomy rising from 5\/100 000 to 75\/100 000 in the past 30 years. The incidence of diabetes and gallstones has also risen. Osteoporosis, Colles\u2019 and neck of femur fractures are rare.<\/jats:p><jats:p> <jats:italic>Surgical capability<\/jats:italic> The standard of surgical care is acceptable with a low wound infection rate for clean and clean\u2010contaminated abdominal surgery of 0.9% and an anastomotic leak rate of 1.6%. Transurethral prostatectomy is also being performed to a satisfactory standard for head injuries admitted with a Glasgow Coma Score of 6\u20138 and a good outcome is achieved in over 70% of cases. Hospital mortality for surgical admissions is 3.7%. Subspecialties in orthopaedics, urology and head and neck surgery have been established. Neurosurgery, paediatric and cardiac surgery are being developed. <jats:italic>Priorities for the next decade<\/jats:italic> Papua New Guinea needs to continue to develop surgical subspecialties, particularly paediatric and neurosurgery, while maintaining a broad competence in general surgery. Services for burns, spinal injuries, rehabilitation and oncology need to be improved. Surgeons need to be more involved in rural health and teaching basic skills to primary health\u2010care workers. Acquisition, maintenance and repair of surgical equipment needs to be improved so that PNG\u2019s well\u2010trained surgeons can have the right tools for their trade.<\/jats:p><jats:p> <jats:bold>Conclusions<\/jats:bold>: Papua New Guinea offers a wide range of surgical pathology. The standard of surgery in PNG is reasonable but there are many areas that need development during the period of the next national health plan, 2001\u20132010. Australasian surgery has many opportunities to assist surgeons in PNG to achieve their objectives.<\/jats:p>","DOI":"10.1046\/j.1440-1622.2001.02101.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T02:46:32Z","timestamp":1047350792000},"page":"274-280","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Surgical capability and surgical pathology in Papua New Guinea in the year 2000"],"prefix":"10.1111","volume":"71","author":[{"given":"D. A. K.","family":"Watters","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. M.","family":"Kapitgau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Kaminiel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Liko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Kevau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Ollapallil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Ponifasio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,1,15]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.2000.01808.x"},{"key":"e_1_2_5_3_2","unstructured":"National Statistical Office.Fourth National Population Census.Port Moresby: National Statistical Office 1992."},{"key":"e_1_2_5_4_2","unstructured":"Ministry of Health.Health Vision 2010. National Health Plan 2001\u20132010 1st edn. Canberra: Ministry of Health August 2000."},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1993.tb138012.x"},{"key":"e_1_2_5_6_2","first-page":"120","article-title":"Quality assurance in surgery: Surgical audit in the developing world.","volume":"36","author":"Watters DAK.","year":"1993","journal-title":"PNG Med. J."},{"key":"e_1_2_5_7_2","first-page":"93","article-title":"Trauma admissions in Port Moresby.","volume":"39","author":"Watters DAK","year":"1996","journal-title":"PNG Med. J."},{"key":"e_1_2_5_8_2","unstructured":"KaminielP.Surgical mortality in Port Moresby 1996\u20131998. MMed. thesis University of Papua New Guinea 2000."},{"key":"e_1_2_5_9_2","unstructured":"KaptigauWM.Trends in abdominal surgery in Port Moresby over 30 years. MMed. thesis University of Papua New Guinea 1999."},{"key":"e_1_2_5_10_2","first-page":"231","article-title":"The perioperative management of diabetic patients undergoing surgery.","volume":"37","author":"Watters DAK","year":"1994","journal-title":"PNG Med. J."},{"key":"e_1_2_5_11_2","unstructured":"KurapaW.Surgical management of diabetic patients at Port Moresby General Hospital 1992\u201396. MMed. thesis University of Papua New Guinea 1996."},{"key":"e_1_2_5_12_2","first-page":"57","article-title":"Post traumatic aneurysm: A frequently missed condition in penetrating injuries.","volume":"38","author":"Golpak V.","year":"1995","journal-title":"PNG Med. J."},{"key":"e_1_2_5_13_2","first-page":"126","article-title":"Management of vascular trauma in a provincial hospital.","volume":"39","author":"Mathew PK","year":"1996","journal-title":"PNG Med. J."},{"key":"e_1_2_5_14_2","first-page":"100","article-title":"Head injuries in Papua New Guinea.","volume":"39","author":"Liko O","year":"1996","journal-title":"PNG Med. J."},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1996.tb00712.x"},{"key":"e_1_2_5_16_2","first-page":"121","article-title":"Trauma review: What do we know and where do we go?","volume":"39","author":"Watters DAK","year":"1996","journal-title":"PNG Med. J."},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.1999.01627.x"},{"key":"e_1_2_5_18_2","first-page":"222","article-title":"A five year review of deaths from trauma.","volume":"22","author":"Sinha S","year":"1981","journal-title":"PNG Med. J."},{"key":"e_1_2_5_19_2","first-page":"100","article-title":"Surgery and anaesthesia at Enga Provincial Hospital.","volume":"25","author":"Lennox CE","year":"1982","journal-title":"PNG Med. J."},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800740219"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199002000-00008"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1995.tb01766.x"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1982.tb05407.x"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1987.tb01419.x"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/clind\/16.3.361"},{"key":"e_1_2_5_26_2","first-page":"33","article-title":"Splenectomy: Follow\u2010up of patients in the Solomon Islands.","volume":"20","author":"St\u2010Yves IFM.","year":"1977","journal-title":"PNG Med. J."},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7015.1273"},{"key":"e_1_2_5_28_2","unstructured":"WattersDAK&KiireCF.Gastroenterology in the Tropics and Subtropics: A Practical Approach.London: MacMillan 1995."},{"key":"e_1_2_5_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1996.tb00822.x"},{"key":"e_1_2_5_30_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1997.02687.x"},{"key":"e_1_2_5_31_2","unstructured":"AcharayaSK&TandonBN.Abdominal tuberculosis. In: Watters DAK Kiire CF (eds).Gastroenterology in the Tropics and Subtropics. London: MacMilllan 1995; Ch. 6."},{"key":"e_1_2_5_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196305)16:5<670::AID-CNCR2820160519>3.0.CO;2-L"},{"key":"e_1_2_5_33_2","unstructured":"MischK AtkinsonL Reay\u2010YoungP.Papua New Guinea. In: Parkin DM (ed.)Cancer Occurrence in Developing Countries. Lyon: IARC Scientific Publications 1986."},{"key":"e_1_2_5_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1990.tb07351.x"},{"key":"e_1_2_5_35_2","first-page":"A38","article-title":"The rising incidence of breast cancer in Papua New Guinea in the 1990s.","volume":"70","author":"Halder A","year":"2000","journal-title":"Aust. N.Z. J. Surg."},{"issue":"1","key":"e_1_2_5_36_2","first-page":"A79","article-title":"Colorectal carcinoma in Papua New Guinea. Annual Scientific Meeting, RACS, 1997, Brisbane (abstract).","volume":"67","author":"Watters DAK.","year":"1997","journal-title":"Aust. N.Z. J. Surg."},{"key":"e_1_2_5_37_2","first-page":"17","article-title":"Ewing\u2019s sarcoma: Fifteen year\u2019s experience at Angau Memorial Hospital.","volume":"33","author":"Kiyingi KS","year":"1990","journal-title":"PNG Med. J."},{"key":"e_1_2_5_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196410)17:10<1289::AID-CNCR2820171011>3.0.CO;2-E"},{"key":"e_1_2_5_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92109-S"},{"key":"e_1_2_5_40_2","unstructured":"Burton\u2010Bradley BG (ed.)A History of Medicine in Papua New Guinea.Kingsgrove NSW: Australian Medical Publishing Co. Ltd 1990."},{"key":"e_1_2_5_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1994.tb02180.x"},{"key":"e_1_2_5_42_2","unstructured":"Papua New Guinea Department of Health.Cancer Standard Treatment Manual 1990.Port Moresby: Papua New Guinea Department of Health 1990."},{"key":"e_1_2_5_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1997.tb04610.x"},{"key":"e_1_2_5_44_2","unstructured":"DewanP HrabovszkyZ McLeeM.Anorectoplasty in Papua New Guinea children.PNG Med. J.in press."},{"key":"e_1_2_5_45_2","unstructured":"DewanP&McLeeM.Paediatric surgery teaching in Papua New Guinea.PNG Med. J.in press."},{"key":"e_1_2_5_46_2","first-page":"263","article-title":"Closed heart surgery in Papua New Guinea.","volume":"17","author":"Berg D.","year":"1974","journal-title":"PNG Med. J."},{"key":"e_1_2_5_47_2","unstructured":"JacobOJ.Surgery for Pericarditis in PNG. In:RACS Annual Scientific Meeting 6\u201312 May 1995 Perth Western Australia. Melbourne: Blackwell Science Asia 1995."},{"key":"e_1_2_5_48_2","unstructured":"PonifasioP.Cardiothoracic surgery by visiting teams in Papua New Guinea.First International Congress of Thoracic Surgery 5\u20137 July 1997 Athens Greece."},{"key":"e_1_2_5_49_2","first-page":"157","article-title":"Operation open heart 1995; lessons learned and thoughts for the future.","volume":"40","author":"Millane T","year":"1997","journal-title":"PNG Med. J."},{"key":"e_1_2_5_50_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1996.tb01116.x"},{"key":"e_1_2_5_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/0967-5868(95)90002-0"},{"key":"e_1_2_5_52_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1994.tb04564.x"},{"key":"e_1_2_5_53_2","first-page":"40","article-title":"Dumbbell schwannoma causing acute spinal cord compression; case report.","volume":"37","author":"Rosenfeld JV","year":"1994","journal-title":"PNG Med. J."},{"key":"e_1_2_5_54_2","unstructured":"RosenfeldJV&WattersDAK.Neurosurgery in the Tropic: A Practical Approach to Common Problems.London: MacMillan 2000."}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1440-1622.2001.02101.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1440-1622.2001.02101.x","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1046\/j.1440-1622.2001.02101.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T20:56:50Z","timestamp":1698785810000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1046\/j.1440-1622.2001.02101.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,5,11]]},"references-count":53,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2001,5,11]]}},"alternative-id":["10.1046\/j.1440-1622.2001.02101.x"],"URL":"https:\/\/doi.org\/10.1046\/j.1440-1622.2001.02101.x","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,5,11]]},"assertion":[{"value":"2002-01-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}