{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:06:56Z","timestamp":1787018816246,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Anaesth Intensive Care"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>The most recent estimates, published in 2016, have indicated that around 70% of anaesthesia providers in Papua New Guinea are non-physician anaesthetic providers and that they administer over 90% of anaesthetics, with a significant number unsupervised by a physician anaesthetist. Papua New Guinea has a physician anaesthetist ratio estimated to be 0.25 per 100,000 population, while Australia and New Zealand have a ratio of 19 physician anaesthetists per 100,000, which is 75 times that of Papua New Guinea. To reach a ratio of seven per 100,000, recommended as the minimum acceptable by the Lancet Commission in 2016, there will need to be over 35 practitioners trained per annum until 2030, at a time when the average annual numbers of recent years are less than three physicians and less than five non-physician anaesthetic providers. We review the development of anaesthesia administered by non-physician indigenous staff and the stages of development from heil tultuls, dokta bois, liklik doktas, native medical assistants, aid post orderlies, and Anaesthetic Technical Officers up to the current Anaesthetic Scientific Officers having attained the Diploma in Anaesthetic Science from the University of Papua New Guinea.<\/jats:p>","DOI":"10.1177\/0310057x211027872","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T11:56:37Z","timestamp":1632484597000},"page":"29-40","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["History of non-physician anaesthesia providers in Papua New Guinea: from heil tultuls to Anaesthetic Scientific Officers"],"prefix":"10.1177","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7251-8405","authenticated-orcid":false,"given":"Terence E","family":"Loughnan","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Acute Pain Management, Peninsula Health, Frankston, Australia"},{"name":"External examiner in Anaesthesia, University of Papua New Guinea, Port Moresby, Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3992-9998","authenticated-orcid":false,"given":"Michael G","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, The Children's Hospital at Westmead and St George Hospital, Sydney, Australia"},{"name":"Department of Anaesthesiology, University of Papua New Guinea, Port Moresby, Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline B","family":"Wake","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Port Moresby General Hospital, Port Moresby, Papua New Guinea"},{"name":"School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Aigeeleng","sequence":"additional","affiliation":[{"name":"Divine Word University, Madang, Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,9,24]]},"reference":[{"key":"bibr1-0310057X211027872","unstructured":"Gorlinski V.\n                      Papua\n                      . https:\/\/www.britannica.com\/place\/Papua (accessed 27 August 2020)."},{"key":"bibr2-0310057X211027872","unstructured":"World Bank.\n                      Population, total \u2013 Papua New Guinea\n                      . https:\/\/data.worldbank.org\/indicator\/SP.POP.TOTL?locations=PG (accessed 14 September 2020)."},{"key":"bibr3-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X9702500315"},{"key":"bibr4-0310057X211027872","unstructured":"Nelson HB, Bowden T, Findlay H, et\u00a0al. Taim bilong masta: the Australian involvement with Papua New Guinea, 1st ed.  Sydney:  Australian Broadcasting Commission, 1982, pp. 202\u2013204."},{"key":"bibr5-0310057X211027872","unstructured":"Murray H. Papua of to-day: or an Australian Colony in the making.  London:  PS King & Sons Ltd. 1925, p. 110."},{"key":"bibr6-0310057X211027872","unstructured":"Murray H. Papua of to-day: or an Australian Colony in the making.  London:  PS King & Sons Ltd. 1925, p. 227."},{"key":"bibr7-0310057X211027872","unstructured":"Tok Pisin (\n                      New Guinea Pidgin) English Bilingual Dictionary & Encyclopedia of Papua New Guinea\n                      . https:\/\/www.tokpisin.info\/luluai\/ (accessed 26 August 2020)."},{"key":"bibr8-0310057X211027872","first-page":"3961","volume":"17","author":"Pilang CL","year":"2017","journal-title":"Rural Remote Health"},{"key":"bibr9-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.46.534.250"},{"key":"bibr10-0310057X211027872","first-page":"165","volume":"29","author":"Radford AJ","year":"1986","journal-title":"PNG Med J"},{"key":"bibr11-0310057X211027872","unstructured":"MacPherson S. The development of basic health services in Papua New Guinea, with particular reference to the Southern Highlands Province. PhD, University of Nottingham. 1980, p. 185. http:\/\/eprints.nottingham.ac.uk\/id\/eprint\/13992 (accessed 10 June 2020)."},{"key":"bibr12-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1353\/hah.2010.0010"},{"key":"bibr13-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.2000.01808.x"},{"key":"bibr14-0310057X211027872","first-page":"79","volume":"70","author":"Pathik B","year":"1978","journal-title":"Public Health Papers"},{"key":"bibr15-0310057X211027872","first-page":"304","volume":"42","author":"Calov WL.","year":"1955","journal-title":"Med J Australia"},{"key":"bibr16-0310057X211027872","unstructured":"Watters DKA. Stitches in time. Two centuries of surgery in Papua New Guinea, 1st ed.,  Gordon, New South Wales:  XLibris, 2013, p. 802."},{"key":"bibr17-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X20977507"},{"key":"bibr18-0310057X211027872","unstructured":"Johnson L. Obituary Sir John Gunther.\n                      Canberra Times,\n                      30 April 1984, p. 8."},{"key":"bibr19-0310057X211027872","first-page":"137","volume":"10","author":"Foley DJ.","year":"1967","journal-title":"PNG Med J"},{"key":"bibr20-0310057X211027872","unstructured":"Phillips GD.\n                      Unpublished Autobiography.\n                      Archives \u2013 Australian and New Zealand College of Anaesthetists, Melbourne, 2005."},{"key":"bibr21-0310057X211027872","unstructured":"Library Digital Collections, University of San Diego. Phillips GD.\n                      Patrol Reports\n                      . Gulf District, Kikori, 1956\u20131957. National Archives of Papua New Guinea, Accession 496, in Patrol Reports. Gulf District, Kikori, 1957\u20131958. National Archives of Papua New Guinea, Accession 496. 1957, Patrol Reports. Gulf District, Kikori, 1957\u20131958. National Archives of Papua New Guinea, Accession 496: Scanned from microfiche held by UC San Diego Library (MSS 215: Gulf: Kikori: 085: 002\u2013087: 047). Patrol Reports. Gulf District, Kikori, 1957\u20131958. Library Digital Collections, UC San Diego Library (ucsd.edu) (accessed 28 January 2021)."},{"key":"bibr22-0310057X211027872","unstructured":"State Library of South Australia.\n                      Savill Index of \u201cThe Advertiser\u201d funeral notices\n                      1971\u20132019. 2019. Government of South Australia: Adelaide. Savill Index of The Advertiser Funeral Notices: V (slsa.sa.gov.au) (accessed 28 January 2021)."},{"key":"bibr23-0310057X211027872","unstructured":"World Health Organization, Regional Office for the Western Pacific.\n                      Rural health services project, Papua New Guinea: final report of a technical assistance study\n                      . 1981, WHO: Manila: p. 14, p. 144, p. 266. https:\/\/iris.wpro.who.int\/handle\/10665.1\/9856 (accessed 20 December 2020)."},{"key":"bibr24-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X8901700112"},{"key":"bibr25-0310057X211027872","unstructured":"Dobson MB. Anaesthesia at the district hospital, 2nd ed.  Bahrein:  World Health Organization. 2000, p. 143. https:\/\/apps.who.int\/iris\/handle\/10665\/42193 (accessed 20 December 2020)."},{"key":"bibr26-0310057X211027872","volume-title":"Lee's synopsis of anaesthesia","author":"Rushman GB","year":"1999","edition":"12"},{"key":"bibr27-0310057X211027872","first-page":"10","volume":"12","author":"Phillips GD.","year":"2003","journal-title":"ANZCA Bull"},{"key":"bibr28-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1604400318"},{"key":"bibr29-0310057X211027872","volume-title":"World Health Organization, Regional Office for South East Asia. Papua New Guinea Health System Review","author":"Grundy JDP","year":"2019"},{"key":"bibr30-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002258"},{"key":"bibr31-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001988"},{"key":"bibr32-0310057X211027872","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002287"}],"container-title":["Anaesthesia and Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X211027872","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0310057X211027872","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X211027872","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:11:34Z","timestamp":1777367494000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0310057X211027872"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":32,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1177\/0310057X211027872"],"URL":"https:\/\/doi.org\/10.1177\/0310057x211027872","relation":{},"ISSN":["0310-057X","1448-0271"],"issn-type":[{"value":"0310-057X","type":"print"},{"value":"1448-0271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9]]}}}