Karawari Caves Mobile Health Clinic for Women

Karawari Caves Mobile Health Clinic for Women

Papua New Guinea
Organization type: 
for profit
$50,000 - $100,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Outfitting a number of rucksacks with medicines for Voluntary Health Workers and trained nurses to conducted patrols amongst the last cave-dwelling nomadic peoples of Papua New Guinea: the Penali peoples of the Upper Arafundi and Upper Karawari Rivers of East Sepik province.

About You
Nancy Sullivan and Associates Ltd
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Section 1: About You
First Name


Last Name



, MD

Section 2: About Your Organization
Is your initiative connected to an established organization?


Organization Name

Nancy Sullivan and Associates Ltd

Organization Phone

675 852 3800

Organization Address

PO Box 404 Madang, Madang Province 511

Organization Country

, MD

How long has this organization been operating?

More than 5 years

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Your idea
Country your work focuses on

, MD

What makes your idea unique?

These women have never had medical services and are dying in childbirth at an alarming rate; while the national and provincial governments have no means to provide for them, they are the critical linchpin of saving an important conservation zone and an extensive cave art system that they inhabit. Our belief is that female volunteers and nurses will be best suited to treat these women who are not only vulnerable to disease and gynecological-obstetric complications, but also subject to rape and abuse at the hands of their own menfolk. The rucksacks themselves are not groundbreaking, but the recognition of these women and their needs certainly is for this part of Papua New Guinea. Rather than build an aid post in a lowland area where they come with difficulty and be attended by [typically] male aid post workers, we strive to bring services to the caves and give them service providers they can trust. The Penali people are semi-nomadic cave dwellers who chose the remain in their remote setting rather than be assimilated with lowland neighbours, and with whom our company has been working for the past 3 years to record the history and stenciled images of their caves (potentially 20,000 years old). Their habitat is under immediate threat from gold miners and timber speculators now roaming their jungle with the unacknowledged permission of the national government, which has provided no services to the region in the 35 years since Independence for PNG.

Do you have a patent for this idea?

Tell us about the social impact of your innovation. Please include both numbers and stories as evidence of this impact

The Karawari Cave Arts Project was begun by Nancy Sullivan and Associates in 1997, when it began to record some mountain caves, their historical stenciled images, and their inhabitants, in a remote part of East Sepik Province. It has since mushroomed into a much more ambitious effort, largely because the caves have been discovered to number almost 300 and are owned by some of the most remote peoples in PNG. The project now aims to produce a book of photos and stories (under consideration by the National Geographic Society); bring archeologists to the field to date some images; train local people to conserve their caves; establish the entire system as National Cultural Property; build scientific research stations; and provide the basic services to the landowners that will allow them to remain as guardians of this cultural patrimony. The most vulnerable population in the project are the semi-nomadic Penali people, a small tribe of people who move seasonally from one set of caves to another. Their health is of critical importance to the sustainability of this project and the conservation of the caves. More importantly, the health of the Penali women is in danger. We have been providing basic needs, including school fees and solar panels, and recently brought a leading PNG doctor to see them, but this is not enough. In the past two months we have been alerted to the social and medical stresses of one Penali community, where most of the young women have already died in childbirth. Barely a month ago a 14 year old girl bled to death from a miscarriage, having been the victim of a brutal gang rape by her own relatives. It is clear to us that the social and medical needs of these women is of paramount importance to their community and our project. We believe training women from neighbouring communities as Volunteer Health Workers (3 selected women are about to begin a midwife and first aid course under the guidance of the Wewak Hospital CEO, Dr Louis Samiak), and outfitting them with rucksacks of meds, will begin to redress this problem.

Problem: Describe the primary problem(s) that your innovation is addressing

We are seeking to address the gynecological-obstetric health of women in an extremely vulnerable population. These cave-dwelling semi-nomadic women have begun making gardens, and improving their diets and health. Along with the relaxation of traditional food taboos, this has allowed them to carry bigger and healthier babies to term. But the consequence is that more women are bleeding out during childbirth. They themselves believe they are suffering a sorcery curse and have become fatalists about their community’s future. Without consistent and culturally sensitive medical attention, the population will soon become unviable and forced to merge with a lowland population. In turn, this will leave their caves and their traditional lands at great risk of encroachment by more dominant highlands people and both logging and mineral developers, many of whom are already illegally surveying their hunting lands.

Actions: Describe the steps that you are taking to make your innovation a success. What might prevent that success?

Our company has been involved in trying to establish National Cultural Property status for the extensive cave art complex (numbering more than 300 decorated caves, possible the largest such complex in the southern hemisphere) of the Penali, Ewa and Alamblak peoples of East Sepik province. We are there to record their histories and provide services that the government has not. These include solar panels, school fees, short-term employment and training. Just recently we brought the CEO of the Wewak Boram Provincial Hospital, Dr, Louis Samiak, to conduct ‘walkabaut’ clinics throughout the area. Our first task is to train and outfit three Volunteer Health Workers, all women already selected from the neighbouring communities, who will begin a course in basic first aid and midwifery under Dr. Samiak’s guidance later this year. We need to provide these women with large medical rucksacks that they can carry up to the cave sites where the vulnerable and semi-nomadic cave owners live.

Mineral and logging speculators have stepped up their surveying in the vast rainforest that embraces these caves, and threaten to enter our project area imminently. These populations have been too long neglected by the government to resist the quick windfalls some developers offer, both legally and illegally. The cave dwellers have told us repeatedly that they wish to remain on their land, but we must bring basic services to these populations to help them make their own choice, freely, and/or fight the threat of their removal by developers.

Results: Describe the expected results of these actions over the next three years. Please address each year separately, if possible

In 2010 we hope to be able to send three women from the villages of Awim, Moinene and Yimas to courses in heath and midwifery in the provincial capital of Wewak. At the same time Dr. Louis Samiak will be helping us outfit rucksacks with basic medical needs for these remote communities. For 2011 and 2012 these volunteer health workers will be establishing patrol schedules for the communities living in and near the caves: the Penali, Ewa and Alamblak peoples. Our company has already been covering the school fees for the children in these three villages, and brought solar panels to three riverside villages where we have established base camps for our project. These panels can eventually run refrigerators for inoculations for all these stakeholder communities. By the end of 2012 we hope to have raised enough money to build a basic aid post in one of these communities, Awim, where a government aid post officer can be placed and help anchor these patrolling volunteers.

How many people will your project serve annually?


What is the average monthly household income in your target community, in US Dollars?

Less than $50

Does your innovation seek to have an impact on public policy?


If your innovation seeks to impact public policy, how?

We hope to establish National Cultural Property status for the caves and their surrounding bush over roughly 60 km of mountainside that includes the headwaters of the Arafundi and Karawari Rivers. This, in turn, will ensure the viability of these populations in their ancestral sites, and attract the government services like health and education to these long-neglected communities. Our mobile clinic initiatives can then be taken over by the Provincial Health Department.

What stage is your project in?

Operating for 1‐5 years

Does your organization have a board of directors or an advisory board?


Does your organization have a non monetary partnerships with NGOs?


Does your organization have a non monetary partnerships with businesses?


Does your organization have a non monetary partnerships with government?


Please tell us more about how partnerships could be critical to the success of your innovation

We have already received discounts for solar panels and other essentials for these communities from businesses in PNG, and we hope to establish a connection between the host communities and Medical Schools at the University of PNG and Divine Word University, whereby students, possibly under the direction of Dr. Louis Samiak, can conduct medical research in the region, using the company’s established base camps. Eventually medical volunteers from overseas would be invited, and scientists from the National Museum, local universities, and overseas institutions can join them.

We would like to learn more about how your initiative is financially supported. Please explain your business plan/revenue model

Our business plan is adapted to the grants received annually, but at its minimum involves profits from our consulting company (Nancy Sullivan and Associates, which is an anthropology consulting company comprised of myself, an American anthropologist, and former PNG University students and fieldworkers) to outfit and pay teams of local villagers and our staff to measure, photograph, and collect stories from each and every one of these 300+ caves. By the end of 2010 we hope to have finished a book on the caves (currently under submission to National Geographic Publications), and delivered sets of solar panels and school fees for three core communities in the region. Each year, the grants we receive allow us to bring in more foreign scientists for dating the cave imagery, conducting biotic surveys of the bush, and training the villagers in data collection and preservation of their caves.

The Story
What was the defining moment that led you to this innovation?

The Karawari Cave Arts Project is a labor of love, begun by Nancy Sullivan and her team as a modest effort to record some caves in a remote part of East Sepik Province. Since 1997 it has mushroomed into a much more ambitious effort, largely because the caves have been discovered to number almost 300 and are owned by some of the most remote peoples in PNG. The project aims to produce a book of photos and stories (under consideration by National Geographic Society); bring archeologists to the field; train local people; establish the caves as National Cultural Property; and provide basic services to the landowners to allow them to remain guardians of this national (and international) cultural patrimony. The mobile clinic initiative is a concept forged by key members of our team. As an alternative to building a conventional aid post (unviable on the mountainside), these trained female volunteers will make regular patrols to the caves carrying basic meds in their rucksacks-- and in so doing guarantee that the women of these tribes, the very linchpin of their survival, have medical care.

Tell us about the person—the social innovator—behind this idea.

Dr. Nancy Sullivan, who runs the larger Karawari Cave Arts Project, is an American anthropologist who has lived and worked in Papua New Guinea for 23 years. She is a mother and grandmother to children from the project area, and has been investigating these remote caves for 20 years. Her company, Nancy Sullivan & Associates, is the first and only indigenous anthropological consulting company based in the country. It provides sociocultural assessments to government and NGO’s, in the belief that accurate research is the key to sustainable and effective development, and a safeguard against the waste of resources, time and local expectations. The company was founded on the principle that bad research can and does actually lead to bad aid projects, exacerbating preexisting inequities on the ground.

Established with a core group of her former PNG university students, the company has come a long way toward replacing some of expensive foreign consultants that drain the budgets of international NGOs.

How did you first hear about Changemakers?

Personal contact at Changemakers

If through another source, please provide the information

Bahiyah Yasmeen Robinson

Does your project address any of the following barriers to women’s technology access and use?

Social norms, Women’s lack of involvement in the technology development process.

If you checked any of the boxes above, please explain how.

Women across Papua New Guinea are constrained by social norms from fully participating in public life of all kinds. Much of this stems from traditional ideas of biology that posit the female as constitutively inferior to the male, and therefore inimitable to masculinity itself. As a result, in the delivery of health services, women are fundamentally disadvantaged, both by a lack of western biomedical information and a belief that they are more ‘feral’ and unsuited to treatment itself. As wild and unsocial beings, they simply need less care. They are also less likely then men to seek care, even when pregnant or nursing small children. Our larger project has brought university educated PNG women into the field as fieldworkers, and now aims to train women to provide medical services to women themselves, as a demonstration of their capacity to perform medical services as well as their value to the community by receiving specialized care.

Does your project involve women in one or more of the following stages of the technology lifecycle? Identification of the problem the technology will solve:

Technology design, Technology introduction, Technology training, Technology supply and distribution, Assessment and evaluation.

If you checked any of the boxes above, please explain how you will ensure women’s involvement in each relevant phase of the technology lifecycle.

Indigenous Papua New Guinean women are involved in our team research, the design, the training for and administration of these mobile clinics, as well as being the primary audience. Because our work is anthropological at its base, we maintain an ethic of gender equality in our fieldwork, to capture data from the full population. This in itself promotes the training of women on the ground who may be interested in working with our teams as indigenous ethnographers. For the mobile clinics, we are specifically seeking local women volunteers to train as health workers and climb back and forth from these remote cave sites to treat the most vulnerable populations.

If women are a focus of your project, how did this focus evolve?

The project developed a focus on women over time..

Which type of women will your project reach directly?


In what ways does your project team/leadership involve women?

It is led by a woman/women from a developing country., The core project team includes women from developing countries..

Has your organization formed any new partnerships in response to this challenge? If so, with what type/s of organization/s?

Non-profit/NGO/community-based organization, For-profit, Government, Women's organization.

Has your project leadership had prior experience with the following?

Working with women, Working to increase women's economic empowerment through technology, Working on innovation.