Papua New Guinea's government is under pressure to strengthen its message about Covid-19 vaccination, and MPs who spread baseless claims about vaccine efficacy have been asked to shut up.
The country is struggling with a third wave of the pandemic which has overwhelmed the country's hospitals at a time when, according to the official leading the Covid response, parasitic external players have also hobbled the health system.
PNG's vaccination rate remains stubbornly low, at less than 2 percent of the population, while "no jab no job" mandates in the workforce have met with political divide.
In a robust parliament debate, the East Sepik Governor Allan Bird defended the government's policy to encourage vaccination. He said implementation of the no-jab-no-job policy was up to employers who needed staff to be vaccinated under workplace safety requirements.
He was addressing a chamber in which numerous influential MPs remain vocal vaccination skeptics whose followers parrot their stand against vaccines and propagate these views from Facebook to the villages.
Bird said given the country's embarassingly low rates of vaccination against measles and chicken pox, MPs who discouraged inoculation were partly responsible for deaths of local children due to such diseases.
"And in this house we have to be more responsible with our words. Be very careful. We have the lowest vaccination rate on earth - 1.7 percent. Papua New Guineans are resistant against all vaccines, not just Covid-19 vaccines."
Listening to science
The Fisheries Minister, Lino Tom, who is a qualified doctor, described the harm being done to PNG's public health by MPs who rubbished science as deep.
Pointing to a pattern where the vast majority of recorded Covid deaths had been among unvaccinated people in PNG, Dr Tom pleaded with MPs not to spread baseless claims about vaccination that he said had sown the seeds of confusion and fear in PNG.
"When good people, people who are supposed to be reputable leaders in this country start politicising the issue of Covid-19, can you for once just leave it, and leave it to the medical fraternity and let them give us the policy advice, and then act on it," the MP said.
A former health minister and the MP for Abau, Sir Puka Temu, said the government should make vaccination mandatory for everyone.
The government insisted vaccination would remain voluntary, but Temu accused Prime Minister James Marape of weak leadership for not pushing harder on vaccination,
"Many of the friends we know have died of Covid, and many will continue to die," he told parliament in an impassioned speech.
"Science says vaccination is the answer. Don't play politics. Politics will not save our citizens. Science will save our citizens."
According to Temu, PNG's low vaccination rate will result in the country becoming isolated.
"Australia right now... 80 percent second dose, going to 90 percent. Soon they won't allow Papua New Guineans to fly over because we don't have a green card. That's the way the world is going now. It's inevitable, the world is moving the science way."
'Let's lead for once'
Opposition MPs attacked the government for employers laying off unvaccinated employees and leaving some families without income earners, although the vaccine is not mandatory.
The former prime minister, Peter O'Neill, said government's confused messaging about Covid management had created anxiety among workers, who deserved a better level of support.
"Government must be clear on this messaging, about 'no jab no job' policy. This is about a fair workplace environment. Many of these are hard working Papua New Guineans. We need to protect them.
All agencies of government had to act in cohesion to enforce the law, O'Neill said.
"Safety is paramount."
His claim that the government had failed to provide a working environment where people could be readily tested for Covid-19 was rebuffed by the prime minister.
"Three weeks ago, the instruction went out, yet people choose not to believe that. The (Pandemic Response) Controller has already issued those instructions... for workplace testing to start," Marape explained.
But O'Neill pushed back on the need for more certainty, saying the government should do more to encourage Papua New Guineans to get vaccinated, adding that while they continued to debate the issue people were being discouraged from vaccination and many were dying of Covid-19.
"Let's lead our people for once. Let's give them the right messaging and we will overcome this pandemic that we are facing," he said.
Health authorities currently report more than 33,000 Covid cases and 436 deaths in PNG. But with limited testing for the virus and a lack of routine reporting of cause of deaths, these numbers probably fall far short of the true figure in PNG.
Outside help
Many healthworkers have become ill during the pandemic in PNG, and a significant number of them remain unvaccinated.
Fear and uncertainy among the health workforce is especially worrying for PNG which this week welcomed a small New Zealand emergency team sent to Bougainville to help the autonomous PNG region as it wrestles with a surge in Covid cases.
One of the team's two doctors, Dr Emma Lawrey, expects to be working in Buka Hospital, supporting staff who have been fearful of dealing with Covid.
"A lot of it will be looking at infection prevention and control, helping staff to keep themselves safe while continuing to work and feel confident that they're safe while working in the environment where Covid is present, things like that.
"We can definitely help them to feel more confident using those mitigation measures every day in the work place," Dr Lawrey said.
As well, medical teams from countries including Australia and the United Kingdom are on the ground providing emergency medical help.
But both the limitations of PNG's health system, and the complications of outside help, have been cast in glaring light by PNG's Pandemic Response Controller, the police commissioner David Manning.
He told a University of Melbourne law webinar this month that he already knew PNG's Health Department was mired in corruption and unable to stop preventable diseases, but that upon taking up the role he was surprised to learn the department was a "shell" run by what he called "a cabal of multilateral agencies and international NGOs".
"They undermined our data systems, they disobeyed my directions to set up parallel systems, and advised a struggling disease surveillance team accordingly, and these systems clearly did not work.
"The country was told we were not having outbreaks and that the caseload was low, when in truth it was ten times as bad."
Manning said PNG was grateful for the financial help forthcoming from international donor partners in the early phases of the pandemic, and mentioned the work of the World Health Organisation and UNICEF in PNG.
Yet according to him, large amounts of funding directed to the health sector for the Covid crisis were being intercepted before it reached its target.
"As a country we've taken responsibility for allowing our health sector to become parasitized by individuals and organisations that do not have our people at heart.
"This crisis cannot be put to waste. We will build back the whole health sector into something the whole country can be proud of."