Year: 1995
Setting: Port Moresby, Papua New Guinea
Position: Chief medical officer for Chevron Oil Co.
I have been in PNG for two years, seen some unusual cases and confronted challenging situations. I am pondering the status of implementing the public health plan that I created for 10,000 villagers in the Kutubu area. I am on my balcony in Port Moresby that sunny, wet Sunday morning when I receive a frantic phone call from the human resources manager: “Doctor, please go to the clinic as soon you can. Two female employees have been gang-raped.”
As I wait for the victims in the office, I gather more information on the dramatic incident. A group of five Australians had gone hiking in a national park near the nation’s capital like many of their friends have done before. Wild nature is particularly spectacular there, with the contrast of lush, green hills and the view of the emerald Coral Sea. Finally, my colleagues reach the clinic. I find that one of the victims is a lesbian, which must have added to the trauma. The group of hikers had been walking for a half-hour when they were surrounded by six armed criminals locally known as rascals. The aggressors tied up the three men in the group, placed them at the edge of a ravine and threatened to push them over if they made any loud noise. Then the members of the posse proceeded to rape the two women while the helpless men were forced to watch.
The human resources manager is pacing the lobby in a state of shock and panic. The nurse does not know quite what to do. I ask my wife to attend to them while I comfort and examine the patients. I then design a treatment plan after screening the women for sexually transmitted diseases. I contact a psychologist in Brisbane, Australia, and arrange for the women to be evacuated there. It will be easier to take care of the patients’ post-traumatic stress disorder in a familiar cultural and human environment.
Lessons for the doctor: Keeping composure while empathizing with patients may become difficult in extreme situations. Focus on the clinical task at hand, which includes psychological support. A holistic medical approach is crucial to a positive outcome.
Yann Meunier, MD, is the health promotion manager for the Stanford Prevention Research Center. He formerly practiced medicine in developed and developing countries throughout Europe, Africa and Asia. Each week, he will share some of his experiences with patients in remote corners of the world.
