That journey began in the 1980s with Professor Sir Isi Kevau, Papua New Guinea's first physician, first cardiologist and later Professor of Medicine.

His pioneering work laid the foundation for the country's cardiac services and inspired generations of local ddoctors. Professor Kevau witnessed the early stages of cardiovascular disease becoming a growing health concern in Papua New Guinea. As lifestyles changed and non-communicable diseases increased, so did the need for specialist cardiac care.

His work helped establish the country's first cardiology services which is the Sir Buri Kidu Heart Institute after losing his cousin brother Late Sir Buri Kidu who had died from heart attack in 1994. Thus, creating the platform for today's advanced diagnostic, interventional and surgical heart programs at Port Moresby General Hospital.

And of course the cardiac surgery, which constitutes as part of the operation open heart program for pediatric congenital heart disease, repair of congenital heart disease. And then recently for adults, we started the coronary bypass heart surgery. So that's the cardiac program or cardiac services we are providing at Port Moresby General Hospital.

Once those blockages have been detected, then they move into the stenting procedures. So that basically constitutes the diagnostic services we provide. Not only that, but our team also, with the support of Operation Open Heart Foundation, go out to the provinces to screen for congenital heart disease and other heart diseases as well.

The cardiac services is big because as the population, as the country is modernizing, population is expanding, and lifestyle disease is increasing. So when we look at cardiac services, it's mostly we expect many of our population to come with high blood pressure leading to heart disease, coronary artery diseases. So that will be expected to increase.

So moving forward, we already established the non-invasive, we established the invasive, and then the cardiac surgery. So we want to put all this together into a National Heart Institute with better, those cardiac surgery skills have expanded. Of course, in the cardiac catheterization skills, but the infrastructure is an issue now.

Which we are looking at now is to build appropriate infrastructure to house all the cardiac services under one facility into a cardiac institute. And establish one in each of the regional hospitals for the diagnostic services and of course for some

PNG now has trained Cardiac Surgeons, Cardiac Anaesthesia, cardiac nurses and perfusionists. As a result of this, some types of cardiac surgery take place independently as a result of Operation Open Heart.

Dr. Noah Tapaua, a Cardiothoracic Surgeon who was also trained under the operation open heart program shares his experience on the Operation Open Heart mission has impacted the training of PMGH’s local cardiac specialist team.

Trained at the University Of Papua New Guinea School Of Medicine, Dr. Tapaua first qualified as a general surgeon before returning to Port Moresby, where he has worked as a cardiothoracic surgeon for more than 12 years.

During that time, he has seen Port Moresby General Hospital evolve from an aging institution into one with expanding specialist services and modern facilities.

“There’s a lot of changes in terms of infrastructure,” Dr. Tapaua says, recalling that some of the hospital’s older buildings date back to the 1960s.

Among the major developments has been the establishment of new facilities, including cancer and cardiac services, as well as the cardiac center opened in 2021.

But for Dr. Tapaua, the transformation is not only about buildings. It is also about developing specialist teams capable of providing complex treatment locally.

Dr. Tapaua was part of that transition.

As a former surgical coordinator, he contributed to the establishment of new specialist units, including plastic surgery and orthopedic services.

In cardiac surgery, however, building a capable local team required years of training and collaboration.

A cardiac surgery service depends on much more than surgeons. It requires specialist nurses, theatre staff, anaesthetists, perfusionists, intensive-care personnel and other supporting professionals.

For years, international partners helped provide that expertise.

Dr. Tapaua particularly acknowledges the contribution of Operation Open Heart International teams from Australia and the Singapore National Heart Centre, which supported training and skills development.

In 2015, four doctors and six nurses from Papua New Guinea travelled to Singapore for training. When they returned, they began working together as a core team and gradually expanded the country's capacity to perform cardiac procedures.

The approach was deliberate: international teams would continue to provide support while the local team developed the skills and confidence to take on more responsibility.

That transition can be seen in the size of visiting teams.

In the past, visiting open-heart surgery teams could number as many as 60 specialists, including surgeons, nurses, anaesthetists, perfusionists and intensive-care personnel.

Today, visiting teams can be as small as eight people.

At the same time, the local cardiac team has grown to about 42 members.

For Dr. Tapaua, that is one of the clearest signs of progress.

The team might perform around four cases a month.

Today, that has increased to approximately one or two cases every week, in addition to pacemaker procedures and other cardiothoracic operations involving the lungs and oesophagus.

The growth represents more than an increase in numbers. It reflects the transfer of knowledge and confidence from visiting specialists to Papua New Guinean health professionals.

Procedures that once depended heavily on overseas teams are increasingly being performed by local staff.

The cardiac programme initially focused on what Dr. Tapaua describes as “closed” procedures—operations performed outside the heart without stopping the heart itself.

These include treatment of congenital conditions such as patent ductus arteriosus, or PDA, in which an abnormal connection between major blood vessels needs to be closed.

The service also performs procedures such as pacemaker implantation and a range of general thoracic operations.

The next challenge has been expanding the locally led open-heart surgery programme.

Among the cases were children with congenital heart conditions, including atrial septal defects and coarctation of the aorta.

In one milestone case, the team operated on a six-year-old child from Madang with an atrial septal defect.

The procedure was performed by the local team, with local staff involved throughout the operation, postoperative care and eventual discharge.

Another landmark case involved an eight-year-old boy from the Port Moresby area who had coarctation of the aorta—a congenital narrowing of the body's major artery.

Treating the condition required surgeons to remove the narrowed section and reconnect the vessel.

Because the procedure can interrupt blood flow to the spinal cord, there is a risk of spinal paralysis. To reduce that risk, the team used a left-heart bypass technique.

It was the first time the technique had been performed at Port Moresby General Hospital.

For Dr. Tapaua, it was a major achievement—not only for the patient, but for the entire team.

The progress continued. The local programme subsequently performed coronary artery bypass surgery with support from the Singapore team, before gradually taking on more procedures independently.

The development of cardiac surgery in Papua New Guinea has depended on partnerships that have allowed local doctors and nurses to gain specialist skills and return home to use them.

The model has evolved from one in which large overseas teams performed procedures in Papua New Guinea to one where international specialists increasingly support a growing local workforce.

In 2015, when the trained Papua New Guinean team returned from Singapore, the foundation for that transition was strengthened.

Since then, local staff have continued to build their experience while international partners have reduced the number of personnel they send for each visit.

What once required a team of around 60 visiting specialists can now be supported by a much smaller group.

For Dr. Tapaua, this is evidence that capacity building is working.

Cardiac treatment can be prohibitively expensive for many Papua New Guineans. Travelling overseas for complex cardiac surgery can cost hundreds of thousands of kina for a single patient, according to Dr. Tapaua.

For families, those costs can make treatment inaccessible.

Developing the service locally therefore has the potential to change not only how cardiac surgery is delivered, but who can access it.

“If we look at the cost of only one patient,” Dr. Tapaua explains, “at that same cost, we can treat more patients locally.”

That is why he believes the next stage should be consolidation.

The country has made significant progress in developing the skills, facilities and teams needed for cardiac surgery. The challenge now is to ensure that the service is sustainable and available to more Papua New Guineans.

The programme continues to expand its capacity to identify and treat patients with congenital heart conditions.

While the paediatric cardiac team continues screening patients around the country, the goal is to identify children who can be brought to Port Moresby for treatment as the open-heart programme grows.

For Dr. Tapaua, the journey is far from over.

The achievements of the past decade demonstrate what can happen when local health professionals are given sustained training, institutional support and strong international partnerships.

From large visiting teams to a 42-member local workforce, from a handful of operations each month to weekly procedures, and from relying heavily on overseas expertise to performing complex operations independently, Port Moresby General Hospital’s cardiac service has undergone a profound transformation.

Now, the focus is on making that progress sustainable.

Dr. Tapaua credits the hospital’s management and its partners for helping the programme reach its current stage. His hope is that continued support will allow cardiac surgery to become a fully established service within Papua New Guinea—one that gives patients access to life-saving treatment without having to leave the country.

For a nation where overseas medical treatment can be financially out of reach for most families, which may be the most important achievement of all: bringing advanced heart surgery home.

Cath Lab is specialty area for minimally invasive heart procedures, using thin tubes (catheters) inserted through blood vessels to diagnose and treat conditions like blocked arteries, valve problems, and irregular heartbeats without open-heart surgery, offering faster recovery. Equipped with advanced X-ray imaging, monitors, and intervention tools (stents, pacemakers), a team performs procedures like angioplasty, stenting, and valve repairs to improve blood flow and heart function.

Dr. Wesong Boko is the Interventional Cardiologist and head of CATH Lab at PMGH. In his interview Dr. Boko share his expertise in working in the Cath Lab.

When he began his medical career as a general physician, he did not initially imagine himself specializing in cardiology. But the increasing number of Papua New Guineans arriving at hospitals with heart attacks, high blood pressure, diabetes and other lifestyle-related diseases changed his direction.

Too often, he saw patients with serious heart disease who had few options beyond medication and thrombolysis. For those who could afford it, treatment overseas was possible. For the vast majority, however, travelling to Australia, Singapore or the Philippines for specialized cardiac procedures was beyond their means.

That reality stayed with him.

“I realized that if I don't do it, then nobody will do it,” Boko recalls of his decision to pursue interventional cardiology.

He eventually travelled to Singapore, where he trained in clinical and interventional cardiology between 2013 and 2016. His training was unusual because, unlike many doctors undertaking specialist training, he was returning to a country where interventional cardiology was barely established.

There was no established public interventional cardiology service in Papua New Guinea and no locally trained interventional cardiologist. Boko therefore had to convince his trainers at Singapore's National Heart Centre that his training could help build something that did not yet exist at home.

His case was supported by another Papua New Guinean doctor, Dr. Noah Tapaua, who was undertaking cardiothoracic training at the same time. The two specialists could eventually complement each other's work: Boko could identify patients requiring intervention, while Tapaua could provide surgical treatment for those requiring bypass procedures.

The training became more than professional development. It became the foundation for a new chapter in specialized medical care in Papua New Guinea.

The transformation has been significant.

Port Moresby General Hospital has traditionally been one of the country's major referral hospitals, dealing with everything from primary conditions to complex cases requiring specialist attention. But over the years, Boko has watched the hospital's specialist services expand.

Cardiology has been one of the most notable examples.

Procedures that once required Papua New Guineans to travel overseas can now be performed in Port Moresby. The cardiac team can carry out coronary angiograms and stenting, as well as procedures to close certain congenital heart defects.

For patients and their families, the difference is profound.

Instead of leaving the country for treatment, they can receive increasingly sophisticated cardiac care at home.

Boko says the development has also been mirrored in other areas of Port Moresby General Hospital, including renal medicine, neurology and surgery.

He believes the hospital is moving beyond its traditional role as a general referral facility towards a center capable of providing increasingly specialized services.

“In the next five, 10 years, we will see more specialized services provided here,” he says.

Patients with coronary artery disease can undergo angiography and stenting. Those with congenital defects such as atrial septal defects and patent ductus arteriosus can receive catheter-based treatment.

Patients with heart rhythm problems may also receive pacemakers.

The service has expanded beyond the heart itself.

Boko describes the team's involvement in stroke treatment as another major milestone. In selected cases, patients who arrive within a critical window can undergo a procedure to remove a blood clot from the brain.

He recalls the team's first such case shortly before Independence celebrations, describing it as a pioneering moment in the country's medical history.

The same interventional expertise can also be used to assist surgeons treating certain cancers, including procedures designed to reduce the blood supply to a tumor before surgery.

For Boko, these developments demonstrate what is possible when specialized expertise, equipment and institutional support come together.

Overseas treatment can cost many times more than receiving comparable treatment in Papua New Guinea. Boko points to the cost of a coronary stent as an example: a procedure that might cost around K11, 000 locally could cost K150, 000 or more overseas.

For a country where access to specialist healthcare is already constrained, those differences can determine whether a patient receives treatment at all.

Yet maintaining these services comes with its own challenge: funding.

Boko says funding and continued institutional support remain among the biggest obstacles to providing specialized services at their fullest capacity.

He credits Port Moresby General Hospital's leadership, the board, Kumul Petroleum and the Government of Papua New Guinea for supporting the development of specialized services.

But he stresses that continued investment will be essential.

The equipment, expertise and infrastructure required for modern interventional medicine are expensive. Without sustained funding, even services that have already been established can struggle to grow.

The cardiac team provides diagnostic services including ECGs and echocardiograms, allowing patients to be assessed and referred for further treatment when necessary.

He encourages people not to assume that advanced cardiac treatment is available only overseas.

“What you can actually see in Australia or in Singapore, Philippines, we can do here,” he says.

For him, the development of cardiac services is ultimately about giving people another chance.

He remembers the patients who once arrived at hospital after heart attacks with little more than conservative treatment available to them. Many eventually developed heart failure and died.

Today, some of those patients have access to interventions that can restore blood flow and potentially change the course of their lives.

That is what makes the Cath lab more than a room filled with sophisticated equipment. To Boko, it represents the possibility that a heart attack, a congenital heart defect, a dangerous rhythm problem or even certain forms of stroke does not necessarily have to become a death sentence.

He initially chose cardiology because of the disease patterns he saw around him: rising blood pressure, diabetes, heart attacks and other non-communicable diseases.

But as the service developed, he came to see his journey as a calling.

“I realized that maybe it was not personal, but it was God's call,” he says.

The journey has not been easy. Establishing a highly specialized service in a resource-constrained environment requires persistence, training, equipment and financial support.

But the results are increasingly visible.

For patients who previously had to travel thousands of kilometers for specialized treatment, the ability to receive care in Port Moresby can mean the difference between financial ruin and manageable treatment costs—or, in some cases, between life and death.

Boko's vision is therefore not simply about building a Cath lab. It is about ensuring that Papua New Guineans have access to advanced medical care without having to leave their country to find it.

And his invitation to those facing heart disease is simple: come and get assessed.

There is now a growing range of specialized treatment available at home.

For many patients, that may be the beginning of a second chance at life

The center serves as a specialized cardiac diagnostic clinic for patients suspected of having heart disease. Patients are referred to the center from within Port Moresby as well as from other parts of Papua New Guinea for proper diagnosis and appropriate cardiac treatment.

Following diagnosis, patients who require further intervention can receive treatment through cardiac surgery or Cath Lab services. The center has therefore become an important part of Papua New Guinea's healthcare system, providing access to specialized heart care and helping patients receive timely diagnosis and treatment.

The center was fully funding support from the Kumul Petroleum Holdings Limited through the National Government.

Sister Wangi began her nursing career at PMG around 2009/2010. She spent the early years of her career working as a critical care nurse in the intensive care unit and high-dependency unit, where she developed the skills and experience that would later become the foundation of her work in cardiac care.

Her interest in cardiac nursing grew through her involvement in the hospital’s annual open-heart surgery programme, led by cardiothoracic surgeon Dr. Noah Tapaua. While working in Ward 7 and the ICU, Sister Wangi cared for many cardiac patients, particularly children who came to the hospital for open-heart procedures.

Those experiences inspired her to specialize further.

“I wanted to join the cardiac service and specialize in cardiac nursing,” she recalls.

Between approximately 2009 and 2019, she became one of the team leaders involved in the open-heart surgery programme. Her role included leading other nurses and coordinating the care of cardiac patients during the programme. She also had opportunities to work alongside the cardiac team and care for patients in the cardiac ICU.

Her background in critical care provided an important foundation. Sister Wangi undertook intensive care nursing studies at the University of Papua New Guinea, gaining specialized training that qualified her to work as a specialist ICU nurse.

By 2022, her experience in critical care and cardiac nursing had positioned her for a new responsibility as the hospital expanded its cardiac services.

In March 2022, Sister Wangi was asked to take responsibility for the cardiac clinic. Although initially brought in as a team leader, she quickly found herself playing a managerial role, helping establish and organize the new service.

“We set up the place within one month,” she says.

The work was carried out in preparation for the opening of the Kumul Petroleum National Heart Centre. On 12 April 2022, the center was officially opened, marking an important milestone in the development of specialized cardiac services in Papua New Guinea.

For Sister Wangi, the opening represented more than the establishment of a new facility. It was the culmination of years of nursing experience, from caring for critically ill patients in ICU to leading teams during open-heart surgery programmes and ultimately helping establish a dedicated cardiac service.

Her journey reflects the evolving role of specialist nurses in cardiac care—combining clinical expertise, leadership and a commitment to improving care for patients with heart conditions.

From the ICU to cardiac services, Sister Wangi’s career has followed the needs of her patients and the growth of cardiac care at PMG. What began as an interest developed through caring for children undergoing open-heart surgery eventually became a specialized career and a leadership role at one of the country’s important cardiac care facilities.