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Manam Islanders in PNG could have been victims of contaminated water
Posted at 08:15 on 28 June, 2010 UTC
The cause of the deaths of fifteen people on Manam Island off the coast of Papua New Guinea?s Madang Province over the past two weeks remains a mystery.
It?s suspected it?s cholera, which was rampant in parts of Madang late last year.
But with the Manam Island volcano continuing to emit smoke and ash, the Governor, Sir Arnold Amet, says they may have died as a result of consuming contaminated water.
The volcano erupted violently more than five years forcing around ten thousand people into care centres on the mainland.
Sir Arnold says the dead are among hundreds who?d been forced to return to the island following violent clashes with local landowners at the Daigul care centre in rural Madang.
?They are now being allowed to come back onto the mainland to another care centre, Potsdam care centre, where they will be allowed to stay with their other relatives, other Manam Islanders, away from the island.?
FIFTEEN people from Manam Island in Madang have died from a mysterious disease.
However, Sir Peter Barter, who yesterday flew to the island on his helicopter, said last night the disease could be cholera although this was yet to be confirmed.
The deaths were initially confirmed by local councillor Paul Mabora from Bogia yesterday.
He said two children and 13 adults (five women and eight men) had died since June 17.
As Mabora spoke on the phone to The National from Bogia Hospital, the sound of weeping relatives could be heard in the background, as the mystery ailment claimed its latest victim. All victims were from Duguluba village on the volcanic island. Mabora said all victims, some of whom had fronted up at the Bien health centre on Manam and Bogia Hospital on the mainland, had complained of having initial symptoms of a cold sensation which started from the soles of their feet and began to work its way upwards to the upper part of the body. By the time the cold feeling reached the abdomen and stomach of each of the victims, the feeling of hunger then became so intense and, by the time the cold reached the heart, the victim collapsed and was pronounced dead.
Of the 15 fatalities, 10 died in the village, three at Bien health centre and two at Bogia hospital.
Yesterday, a team of specialists from the Madang provincial health office and Modilon Hospital was dispatched by road to Bogia and then by sea over to Manam Island where they will be for the next two days.
Another small team was yesterday flown by Sir Peter on helicopter to the island to determine what the disease might be and how to prevent more deaths.
All the villagers living in Dugulaba were panic-stricken and were making their way to live with relatives in care centres on the mainland.
Dugulaba villagers had been living at Daigul care centre on the mainland until March this year when they were forced out by local landowners.
?We do not know what kind of disease it is. If it is cholera, you have diarrhoea but, with this disease, you have no diarrhoea.
?Your legs go numb and it spreads up to the heart and you die. The victims felt cold in their legs and the feeling spread throughout the body. They then say they feel hungry and then drop dead.?
Life for islanders on Manam is very hard with no water supply, and people drink water from wells which are contaminated with volcanic dust.
Sunday, June 27, 2010Barter suspects ?mystery? Manam disease to be cholera
By MALUM NALU
Former Madang Governor Sir Peter Barter tonight confirmed that 15 people had died on Manam Island from an unconfirmed disease, believed to be cholera.
Dr Sibauk Bieb, the co-ordinator for operations of the cholera taskforce in Madang was flown to Dugalava and Bien on Manam by Sir Peter in his helicopter, where it was confirmed that 15 people had died and several more remained at Bien health centre, which is now downgraded to an aid post.
Dr Sibek Bieb (centre) talking to villagers on Manam Island yesterday.
?Dr Bieb was advised that a family of four had visited Dangale village last week and upon their return to Dugalava No.2, they got sick and within three hours they were dead,? Sir Peter said.
?All those dead are from Dugalava and Dr Bieb feels that those who have become ill have probably contracted cholera as it appears all the people affected are people who may have handled the bodies of the deceased.?
The people in villages on Manam were quite hungry.
Sir Peter was told the gardens were not producing and the only food they had was banana, which the people claimed were very dry.
All the rice given to them had gone complained, a mother of four from Dugalava No. 1.
Sir Peter flew to Bogia to where Dr Bieb advised the staff of Bogia health centre not to send any more bodies back to Manam and arrange to have them buried in Bogia.
?He (Dr Bieb) also advised the staff to practice caution themselves when handling those that were sick and bodies of those who had died,? Sir Peter said.
?Before returning to Madang, further stops were made at Malala High School, Asurumba and Mangem care centres to advise the people from Dangale and Dugalava of the situation and advise that a further medical team was on the way to Bogia and warn them not to take any further bodies back to Manam.
Dr Sibek Bieb (right) meeting with Manam islanders at Asuramba care centre on mainland Madang yesterday.-Picture courtesy of SIR PETER BARTER
?It is expected that Dr Bieb will make a full report to the provincial health office and National Disaster Office so that action be taken to stop any further spread of the sickness that will be most likely diagnosed as cholera.?
The symptomatic description invovling cold spreading up the body in the article in the National newspaper is bizarre to the point where it makes little sense. Perhaps it is villagers' way of expressing the concept of dehydration, but it seems really odd. It is also possible that (especially with the lack of food), the villagers consumed something containing a paralytic toxin (seafood?).
Manam islanders flee village after 15 die from suspected cholera
By ROSALYN EVARA
PAPUA New Guineans have been sternly urged to forego all burial rituals when handling bodies of relatives who have succumbed to cholera.
The warning is from Bogia?s program manager health Camillus Dugumi following the deaths of 15 people, some of whom are understood to have died while mourning over their loved ones who had died from this fast-acting sickness.
Mr Dugumi when contacted yesterday by the Post-Courier could not state how many of the deaths had been as a result of direct contact with the dead but said the deaths had been recorded over a 10-day period ending yesterday.
He said those who had died were all from Dugulava village on Manam Island and that two of them were children. Reports received by the Post-Courier were that the deaths were not related to cholera as some of those who died did not present the usual clinical symptoms of cholera including acute severe watery diarrhoea. Rather, they had complained of feeling cold from the soles of the feet, and the sensation working its way up the legs and to the rest of their body - including the stomach. They also complained of feeling intense hunger and the coldness eventually getting to them before collapsing and dying.
However, Mr Dugumi said an outbreak of this disease had recently been reported on the island, especially in the affected village, where many had just been repatriated following the Tobenam incident on the north coast of Madang, where many Manams fleeing volcanic eruptions were living.
He said health officers had been to the island earlier in the year and had conducted awareness programs and also sprayed the affected villages, but this did not include Dugulava.
?When dealing with people who have died from cholera there is a rule of disposing of bodies. That is that the corpses are sprayed and taken straight to the graves.
?There is to be no mourning over them. The people there have been mourning over their loved ones, resulting in these deaths.
?I would like to reiterate in light of these deaths that the general public abstains from their normal burial rituals and more importantly wash their hands, especially when shaking hands with others,? he said.
In light of these reports, Mr Dugumi has also called on authorities to move quickly to providing the funds in the province for health officials to carry out their jobs and also to purchase water tanks for the people of Dugulava village.
?These people were forced to move back and without any good water supply.
?To control the spread of this sickness they will need access to clean water and on top of that, we in the district will need medical supplies including IV fluids and antibiotics to treat the infected.
?We have run out and are in dire need,? he said.
Paul Mamburau, a village councillor from Dugulava, when contacted yesterday also confirmed reports of the deaths. He said the latest death had been recorded yesterday morning.
He said because of the conflicting reports villagers were receiving on the cause of the deaths, many were now scared and wee fleeing the island. ?Some are here at Bogia station while the others are at Potsdam Care Centre. While I have already informed the district administrator and even asked for money to help feed them, I have been told there is nothing.
?I don?t know what will become of them while they are here on the mainland,? he said. Mr Mamburau also confirmed that since the outbreak had been reported on the island, they had not received any help.
?With the health service virtually non-existent on the island, this has only worsened the situation for us,? he said.
The Post-Courier understands that former Health Minister Sir Peter Barter flew to Manam and to Bogia station yesterday afternoon after receiving these reports.
This paper was not able to reach him for comments. It is understood that the head of operations of the Madang provincial cholera taskforce had gone with Sir Peter.
He too could not be reached for comments.
17 die from mysterious desease in PNG
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Updated June 29, 2010 17:05:00
At least 17 people on Manam Island in PNG's Madang Province are reported to have died so far in less than two weeks from a disease believed to be cholera. National and provincial health authorities are now working to identify and stop the spread of the disease on the volcanic island. Former Governor of Madang Province, Sir Peter Barter who flew to the island by helicopter with a doctor, says some of the victims were from the same family.
Presenter: Peter Jonah
Speaker: Sir Peter Barter, former governor of Madang Province
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PNG task force deals with Manam resettlement plans
Posted at 06:42 on 29 June, 2010 UTC
The Papua New Guinea Government has re-established a national task force to try and permanently relocate islanders displaced by the eruptions of the Manam volcano.
The volcano began erupting more than five years ago, forcing an estimated 10,000 people into care centres on the mainland in Madang Province.
But efforts to permanently rehouse them foundered and recent violence forced several thousand to return to Manam Island.
15 of those people have died in the past two weeks, possibly as a result of water contaminated by ash.
The Madang Governor, Sir Arnold Amet, says it?s more vital than ever that agreement can be reached on sourcing land.
?I would hope by the end of the year that some certainty might be able to be arrived at, as to where, and negotiations for the acquisition of, and the Government making some commitment, together with any international organisations, for the development of the plots of land that might be agreed upon.?
It is far from clear at this point whether this is cholera (and the symptomatic description is false, provided by spooked villagers), or some type of paralytic poisioning (botulism, seafood, cassava, etc.) and the cholera diagnosis and epidemiological clues are incorrect. Of note is that the fatality rate of this illness appears to be close to 100%, as there have been no reports of additional recovered cases.
THE cholera situation on Manam has been described as “more than a medical emergency” and provincial authorities in Madang are calling on the National Disaster and Emergency Office for added assistance. In a brief to the Provincial Administrator Ben Lange, Madang’s director health Marcus Kachau said reports reaching his office were that 17 people had already been confirmed dead while a population of 2000 on the island was at risk of being infected.
He said concerns of the spread of this illness were heightened especially in light of the lack of proper water supply on the island, medical services but more so the myths which had surfaced as a result of the deaths and the increased movements to and from the island and mainland.
He said while the National Government had released K400,000 and the Madang Provincial Government K50,000 to help with the callouts on Long Island and Manam but that access especially to the latter contribution had been slow.
“We are requesting for at least K1.5 million from the national disaster and emergency office and that these funds be deposited to the Modilon Hospital trust account or the Melanesian trust account as it would be easy for us to access funds when needed including after hours,” he said. Mr Kachau in his brief also stated that the Provincial Cholera Task Force was expected to meet this week to put together the Manam cholera response plan.
This he said would include sprayers, volunteers in the communities to do the spraying and awareness and also to support the cholera treatment unit at Bieng Health Centre, beef up the cholera treatment centre and other relevant support.
Mr Kachau said the province had one of the best cholera responses in the country but that officials had not been able to respond well in the Manam and Long Island cases as funding had been a major problem.
In this regard he urged that relevant authorities in the province as well as the NDES ensure the necessary support is given so that they will be able to carry out their jobs effectively.
“NDES must come in and support the people of Manam because they are people who have been displaced not only by the volcanoe but conflicts with the mainland people. “This support should not be mixed up with the repatriation exercise,” he said.
Meanwhile, former Health Minister Sir Peter Barter who assisted in flying in the head of operations of the Provincial Cholera Taskforce Dr Sibauk Bieb said they had visited Dugulava and Bieng Health Centre on Manam Island.
He said it was during the trip that villagers confirmed 15 deaths while several more had been admitted to Bieng Health Center which has since been downgraded to an aid post status.
Re: PNG: Mystery illness kills 15 on Manam Island - cholera suspected
There is an audio clip here that indicates that a rapid test has come back positive for cholera, and that a local doctor has said that the symptomatic description (which replaces coldness with numbness and now includes spasms in the stomach) is a lie, and that the patients are indeed suffering diarrhea.
He also confirms that there is no food in the area, and the water is dirty with volcanic dust.
TWO more people have succumbed to cholera, now bringing the total of deaths from Manam Island to 17, sources from Bogia district have confirmed.
Paul Mamburau, a village councillor from Dugulava told the Post- Courier yesterday that the first of these two victims, a female, had gone to Kayan village on Tuesday to attend the burial ceremony of a dead relative. He said while there, she fell ill and died not long after.
He said her body was brought to Bogia station but later taken back to Kayan for burial. Mr Maburau said another person, this time a man, died yesterday on the island and had since been buried.
Mr Mamburau said the Madang Provincial Taskforce had sent a response team to the area and were now in Bogia not only attending to the sick but also carrying out awareness among the people, especially on the risks involved in mourning over the bodies of those who had died from cholera. The councillor said he had spoken to the director for health Marcus Kachau, who had informed him that a health team from Moresby were in the province and would travel to the island. Mr Mamburau said of the 960 people who had returned to Manam, more than 300 had fled and were now back on the mainland in Bogia at the Potsdam Care Centre. He said this had caused more problems and he was forced to make the trip into town yesterday to seek help from the Provincial Disaster and Emergency office.
Re: PNG: Probable cholera kills 17 on Manam Island
A bit late, but here's the ProMED post. With the above modifications to the symptomatic description, there is no need to blame this on "dry" cholera; diarrhead was really present.
******
[1] Possible cholera - Papua New Guinea (Madang)
Date: Tue 29 Jun 2010
Source: Papua New Guinea Post-Courier [edited]
<http://pidp.eastwestcenter.org/pireport/2010/June/06-29-10.htm>
Papua New Guineans have been sternly urged to forego all burial
rituals when handling bodies of relatives who have succumbed to
cholera. The warning is from Bogia's program manager health Camillus
Dugumi following the deaths of 15 people, some of whom are understood
to have died while mourning over their loved ones who had died from
this fast-acting sickness.
When contacted by the Post-Courier, Mr Dugumi could not state how
many of the deaths had been as a result of direct contact with the
dead but said the deaths had been recorded over a 10-day period
ending yesterday, 28 Jun 2010. He said those who had died were all
from Dugulava village on Manam Island and that 2 of them were
children.
Reports received by the Post-Courier were that the deaths were not
related to cholera as some of those who died did not present the
usual clinical symptoms of cholera including acute severe watery
diarrhea. Rather, they had complained of feeling cold from the soles
of the feet, and the sensation working its way up the legs and to the
rest of their body, including the stomach. They also complained of
feeling intense hunger and the coldness eventually getting to them
before collapsing and dying.
However, Dugumi said an outbreak of this disease [cholera? - Mod.LL]
had recently been reported on the island, especially in the affected
village, where many had just been repatriated following the Tobenam
incident on the north coast of Madang, where many Manams fleeing
volcanic eruptions were living.
[Severe cholera, although relatively rare, can cause rapidly
progressive illness with death even without diarrhea if fluid is
rapidly secreted into the bowel with severe hypovolemia occurring
prior to the onset of diarrhea. This process can be called cholera
sicca or dry cholera. - Mod.LL]
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