Anaesthesia in Papua New Guinea: fifty years of challenges and achievements

The history of anaesthesia in Papua New Guinea has evolved from its early administration in 1871 to the development of modern subspecialties, despite constant challenges. Initially, anaesthesia was provided using chloroform and ether, often by expatriate doctors or locally trained 'native medical practitioners'. Development progressed through various non-physician anaesthetic provider programs, such as 'heil tultuls' and Anaesthetic Technical Officers, culminating in the Diploma in Anaesthetic Science. Physician training began with the first specialist in 1968, followed by local Diploma and Master of Medicine programs at the University of Papua New Guinea from 1986 and 1991, respectively. Significant advancements include the establishment of an intensive care unit in Port Moresby in 1967, and the more recent widespread introduction of Lifebox pulse oximeters and capnometry programs. Papua New Guinea anaesthetists have achieved Higher Postgraduate Diplomas in subspecialties such as cardiothoracic, paediatric, and obstetric anaesthesia, and intensive care medicine. Despite this progress, PNG faces substantial challenges, including a severe shortage of physician anaesthetists, and limitations in access to essential equipment, infrastructure and basic supplies, particularly in rural areas. This highlights the need for continuous investment to keep pace with surgical advancement and development to address healthcare pressures.