Wonenara lies on at ridge at the intersection of 2 canyons 5000 feet up in the Highlands of Papua New Guinea. There is no road connection to the outside world in these parts.  People who cannot afford to fly must walk for days to get out to a road and travel to town.  Unlike most remote communities in PNG, Wonenara does have a functioning government health centre.  The centre is dependent on mission aircraft for medical evacuations and much needed medical supplies.

I taxied into the parking bay and applied the brakes.  As I sat there at idle allowing the temperatures in the turbo charger to equalize and cool, I noticed a young man running up the embankment to meet the airplane.  He stood there bare foot with sleeves rolled up and hands on his hips, panting as the sweat beaded on his brow.  The lines on his face bespoke the anxiety that was upon his mind. 

As I walked over to him he introduced himself as one of the government health workers there.  "We have run out of oxygen," he began. "We have an epidemic of respiratory infection here and several very sick pikininis" (children) he went on.  "Can you fly me in some bottled oxygen?" he asked anxiously.  To emphasize the point he began telling me that a baby boy just a few weeks old was so sick that he could hardly breathe and that he had grave concerns about his survival with the treatment available in this scantly resourced remote clinic.

"Bring the baby and his mother quickly." I replied. We never turned down dying people who needed urgent medical evacuation to hospital whether they could contribute to the cost of the flight or not.  I have had people look at me as if I am a real fool when I tell them that.  Airplanes are expensive to operate.  However I found that when ever I added a medevac flight like this to the budgeted program, God always replaced the resources spent with more than we used and usually within a few days. It is a thrill to be working in partnership with a God like that -who loves people and sent His Son into the world, "That they may have life."

The health worker returned with mother and baby.  The baby was limp and pale and requiring assistance to breathe now.  The health worker was squeezing on the the large ventilation bag connected to the mask.  The mask was too big but it was all he had.
"How I wish I had the suction equipment to clear the air passages and get better air entry." I mused to myself as I recalled that more than half the kids die in a lot of these remote communities before reaching maturity.  I whispered a prayer in my heart, "Not this one Lord, not this innocent little baby, we don't have what we need, yet you are all we need, please help us."

I managed to figure out a way of connecting the Air viva to the aircraft's oxygen bottle. The rapid thready pulse slowed slightly and got a little stronger as we added oxygen to the ventilation bag.  I knew that the babies life was in the balance. My hands would be full flying the aircraft to where help would be waiting.  There wasn't a moment to loose and the only way to save this child was for the health worker to come with us and maintain the airway and ventilate the baby along the way, as best he could with what we had. Soon I had them all aboard. I checked the oxygen connections once more to satisfy myself that they were not likely to come undone on the en route. It was the vital life line this poor little child needed right then.

Soon we were accelerating down the steep grassed incline of this remote airstrip.  My mind had to change gear now.  A strong wind was surging up the canyon to our north and vectoring out from a ridge line off the end of the runway so that the wind swirled over the bottom end of the strip as a gusting crosswind.  The sloping hill on our left, lined with happy waving Papua New Guineans  disappeared behind us.  As we emerged from the hills protection, the full force of the crosswind hit us just as we were entering the lowest,  slowest and most vulnerable phase in our climb out. I was now fighting the wind for directional control while at the same time clawing for height  As I looked ahead I could see into the narrow ravine ahead of me.  The floor of this blind ravine sloped upwards culminating in in a ridge line where I would have to make a low slow 180 degree steep turn to head back out of the ravine.  I tensed as I passed the end of the runway and approached the ravine ahead. The wind was striking the ravine wall on the Southern side providing a tailwind component for my climb into rising terrain.  This has a shallowing effect on the aircraft's ability to climb.  I could feel the furrows blanching on my brow as I saw the terrain looming up in front of us.  However there was a component of the wind that was traveling up the side of the ravine and providing a little lift.  We hugged the side of the ravine as close as was safe to take advantage of that little bit of lift.  It also gave me the opportunity to follow every little indentation in the ravine wall to lengthen the track distance and give me more time to gain height. All too soon the ridge blocking the ravine was  all but filling the windscreen and it was time to carefully make that left turn. 

I will never forget the first time I experienced this climb out procedure with Check Pilot Sid Griffith.  He had come out lightly loaded but in a normally aspirated aircraft with even more limited climb performance at altitude than the turbocharged aircraft that I was carrying this dying baby in.  As Sid leaned into this turn the wings paralleled the steep ridge line blocking the ravine. It seemed that you had to get so close to the grass on the hillside to get the radius of turn needed.  What if you were a bit heavy? What if you had failed to catch all the lift at the mouth of the ravine? This reinforced to me the importance of experience in this sort of operating environment and reinforced the respect one must have for pilots in PNG that have been there longer than you. 

As we rolled out of the turn, I started to ease back on the throttle and accelerated to a climb speed that would allow the engine to cool back to normal climb temperatures.  I glanced back over my shoulder. The health worker looked up from his life saving task and nodded vigorously with a grin on his face.  We were winning so far. 

I now had to make the choice of climbing higher and going direct thus shortening the journey by a couple of minutes or staying low to provide a more positive partial pressure for the oxygen in the babies lungs and going around the high points along the way thus delaying our arrival slightly.  The babies condition seemed to be stable at the at the lower altitude and I elected not to compromise things by going higher. 

My mind started to think ahead now to the logistics of getting the baby to the hospital quickly on arrival at Goroka.  I recalled how ambulances took ages to arrive and had no medically trained people on board and no oxygen or any other sort of life saving equipment.  The baby was so sick it could easily die on the way over to the other side of town where the hospital was.  I radioed ahead to base.  To my relief my wife Lorretta was there with our vehicle. Among Lorretta's many other talents she is a trained nurse and midwife and has some experience resuscitating small babies.  She notified the hospital and was ready to take mother, the health worker and the baby boy over as soon as we arrived.  There was no portable oxygen bottle available so they set off with the air viva working off room air alone once more. 

"Why is there always so much traffic and so many pedestrians when you are in an emergency?" Lorretta mused as she dodged the potholes in the road and traveled as fast as she dared towards the hospital. The babies condition was now deteriorating rapidly. Its poor little system was just running out of what it takes to survive.  As they rounded the corner onto the highlands highway the pedestrian crossing came into view.  There were just crowds of people both sides queuing to cross the road.  None of the other drivers in front of Lorretta seemed to be in any hurry at all.  Lorretta looked back at the baby.  It had all but stopped trying to breath for itself now.  The hospital and the waiting pediatrician were only about a mile away but the crowds were still crossing the road at the crossing.  Had this little baby come so far and come so close to the life saving treatment that he needed so much, only to expire so close to where help was waiting?  Lorretta began to pray.  The traffic at last started moving.  Finally they were beyond the crossing and turning down the rough unsealed road to Goroka Base Hospital.  Just before she turned into the hospital gate the babies heart gave up and stopped beating.  Have you ever tried to do cardio pulmonary resuscitation while trying to carry the person receiving it at the same time?  They hurried in through the door way and to the nursery. 

The two RNs looked up as Lorretta entered the room. "Quick!  the baby has just arrested." she blurted out. Quickly one of the sisters ran for the pediatrician while the other prepared for the resuscitation procedure and helped with the CPR. 

The pediatrician frowned.  Serious brain injury occurs within minutes of a cardiac arrest if effective CPR is not performed. The doctor had to decide if it was worth expending hard to obtain resources to resuscitate this baby or not.  The mother looked on with fear and anxiety in her eyes as Lorretta explained that the baby had only just arrested and had been benefiting from continuous CPR since then. The Drs frown changed to that "well we will give it all we've got" look and he skillfully went to work clearing the air passages, intubating, canulating, infusing the life saving elements and trying to rekindle the fading embers of life in this tiny child. 

  The babies mother looked around her.  She was not used to town and the strange things that go on here.  Standing in this large concrete building, surrounded by strange equipment, seeing all sorts of strange tubes and things going into her baby and hearing the rapid exchange of professional voices as the team worked to save her little boy.  It was all so foreign so unnerving.  So awesome.  Each moment that passed was like an excruciating eternity for that poor bush mother as she helplessly watched and waited.

The doctor listened intently as he gently moved his stethoscope over the tiny bundle before him. No signs of life.  They kept working.  Lorretta kept praying and the mother continued to look on in stunned silence.  Was it all too late?  Had this poor little boy joined the up to 60% of kids in remote areas in PNG who do not make it to adulthood? The Doctor paused again to listen.  The babies mother  did not understand what was happening.  Intently she studied the doctors face.  A drawn look of intense concentration characterized his visage. Suddenly this changed and a smile of joy and satisfaction wreathed his face.  There was a heart beat!!!!  Feint though it was, it was there.  Now hope started to replace the sense of fear and impending loss in the bush mother's mind. She knew something good was happening.

A short while later the little boy started to try to breathe on his own again and began to move slightly.  "Yes yes he is alive!" she thought to herself. "My little boy is going to live!" and he surely did!

As Lorretta filled me in on the story at the hospital when I had completed my flying for the day, I was overwhelmed with a sense of gratitude to God for bringing life to this tiny little child and for giving us the privilege of being a part of His plan to bring life and hope to those in need in this world.

Your prayers and support are really appreciated as we prepare to re start this life saving ministry for the remote people's of PNG.

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