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Monday, 26 November 2012
Page: 13380


Mr LAMING (Bowman) (20:47): Deputy Speaker, thank you for the opportunity to speak on this incredibly important area of tuberculosis in our region. I think Australians, people living in the Torres Strait and even citizens of Papua New Guinea, will be getting tired of these banal government reports about AusAID's efforts in Papua New Guinea: 'Doing well', 'Could do better', and 'Allow us a little more time.' Time is the one thing that TB patients do not have. A year and a half ago this Prime Minister wrote to then Premier Anna Bligh in response to a request for more financial assistance with the troubles that were being created in TI by the movement of TB infected PNG citizens across that two-kilometre stretch of water. The response from the Prime Minister was simple: 'There is no more money.' I need to make a very clear point to the previous two speakers on this issue of tuberculosis with PNG nationals: the impact of foreign nationals on the Australian health system is the responsibility of the federal government.

Since 1978, we have had a Torres Strait agreement with the Queensland government to compensate that state for the costs of PNG nationals. It is something that every government until this one has proudly compensated Queensland for. As the cost of TB began to escalate, let us remember the previous Premier, Anna Bligh, sought more funding, and it was not forthcoming.

No-one is asking this federal government to solve the issue of tuberculosis in our region. That is what we are talking about. What we are talking about here is asking AusAID at the drop of a hat, within three months, to initiate a tuberculosis program in a part of the world where they have no experience. If you search the website for AusAID, you will see not a single TB program in Papua New Guinea prior to this request. Our only criticism from this side of the chamber is: you should have left more time for the good work that was being done in the Torres Strait to continue until Papua New Guinea picked up its capacity and could stand on its own two feet. I do not care how many WHO reports there are talking about the great work that AusAID has done in a limited period of time. This is a disease that is highly contagious, through spit, through speaking, through coughing, through sneezing or through close proximity with other infected people, particularly in areas where people have low resistance, low autoimmunity and even concomitant HIV. These people are at great risk and they are only two kilometres away from Australia. The surveillance issue has not been raised today, but the presence of qualified physicians at Saibai and Boigu is almost unable to be priced. It is wonderful and important, but it is now gone. To bring those clinics back is the responsibility of the federal government.

It has not been talked about in this place before, but in November last year a nine-year-old Papua New Guinean girl presented for care at Boigu—not once, not twice, but five times. The fourth time she had an extended abdomen and the fifth time she had cerebral TB. At each of those times she was told to go away, for no other reason than that the federal government had decided there was no more federal funding for TB in the Torres Strait. That young girl was evacuated too late to save her life and she died in Cairns. I hope it will be the subject of a coronial inquiry. This was the problem with dropping TI without setting up Papua New Guinea first. We do not ask for Papua New Guinea to solve the problem; we do not expect AusAID to cure the world; we just wanted concomitant care at TI to look after people like that nine-year-old girl.

Where is XDR-TB, multidrug-resistant tuberculosis, right now? There are six cases of it. Nobody has talked about them. Five are in Daru hospital and one is in Cairns hospital right now. One of those cases in Daru is the nurse who was looking after the other XDR patients. There were not enough masks and they were not worn often enough, and the care provider now has multidrug-resistant TB. So do not for a moment think that Papua New Guinea can just pick up the ball and run. There is limited capacity to diagnose this disease and work out appropriate treatments. If people are resistant to rifampicin, isoniazid and the quinolone family, you are left with just amikacin, capreomycin or kanamycin. Doing that in Daru is hard. Doing it in Mabaduan is close on impossible.

I have enormous respect for the people working at AusAID and those they employ, but you cannot expect this to be fixed in months. This is a year-long transition, but the Labor government could not find an extra nickel or dime to continue those clinics, and that has cursed the people of Daru and Western Province to be utterly reliant on an infantile TB program that will not be up and running for years. That is the great tragedy that will not be forgotten by the clinicians in Cairns or the nurses who visit Daru and TI and do the very best that they can with those who cross the Torres Strait.