LKN Scholarship in Action: Training Dedicated Health Workers to Support Lymphoedema Care in PNG

Empowering Grassroots Health Workers

Lymphatic filariasis is a painful, debilitating condition caused by mosquito-transmitted filarial worms that damage the lymphatic system, leading to progressive tissue swelling, fluid accumulation, severe skin changes, and frequent, painful infections. Providing sustainable, accessible, and evidence-based health solutions to remote communities requires targeted expertise, cultural adaptability, and dedicated execution.

Enhanced self-care training in Kokopo, July 2026

Each year, LKN Foundation commits to capacity building among health professionals in Lymphatic Filariasis- and Podoconiosis-endemic countries, covering travel and accommodation costs associated with attending speciality training in lymphoedema management.

Our 2026 scholarship was a collaboration with donors and researchers from the US to deliver an effective self-care training program to Health Workers in East and West New Britain Province in Papua New Guinea during July.

Enhanced-care training workshop in Kokopo.

Access to specialised medical intervention for affected individuals in Papua New Guinea is severely limited, and local health workers are the main source of public and personal health information.

Health Workers learn about WHO-led MMDP

We were invited by Dr Christopher King (Case Western Reserve University) in partnership with the East New Britain Provincial Health Authority, West New Britain health delegation, PNG Institute for Medical Research (PNGIMR), and the Loya Foundation (US), to deliver an Enhanced Self-Care (ESC) program for individuals living with lymphoedema within a project to upskill local health workers and train two dedicated lymphoedema self-care trainers.

Fourteen health workers attended the training program in Kokopo, including two dedicated trainers who will be supported by the US donors to find and assist people affected by lymphoedema across the two provinces.  

Our first day was in the classroom learning key theoretical and clinical skills, including disease staging, tissue stratification, and practical self-care management. The second day was planned to be a visit to an island a short distance away, but as the weather was not suitable for the small banana boats it was deemed unsafe to go.

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  Waiting to know if we can go to the island. (The twin volcanoes are not the island)

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  ready for the trip up the mountain

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  views and valleys in all directions

So we headed for the hills visiting two homes where our dedicated trainers practiced explaining and teaching self-care in a big on-the-job learning curve!

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  washing the foot

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  looking for entry lesions

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  educating the family

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  rinsing away loose dirt

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  looking for wounds

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  washing a leg

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  learning self-massage

Standard self-care

• Meticulous Hygiene and Inspection: Thorough daily washing and drying of limbs, skin folds, and between toes using plain soap and clean water to eliminate fungal/bacterial entry lesions.

• Skin and Wound Care: Applying Vaseline to cover skin cracks and small wounds, using antifungal cream for fungal patches, and protecting open lesions with sterile gauze.

The Enhanced Self-Care protocol

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  Deep breathing video

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  Skin mobilisation

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  Thigh exercises

Moving beyond standard hygiene guidelines to maximise the benefits that can be gained from time and effort invested in performing the self-care activities, the ESC protocol encompasses core daily practices that empower people to manage their condition independently at home:

• Deep Abdominal Breathing ("5-pela win long bel"): Activates the central lymphatic system, acting as an internal pump to draw trapped fluid up toward the heart.

• Active Muscle Exercises: Heel raises, leg movements, and daily walking engage calf and thigh muscle pumps to move fluid out of swollen extremities. These can be done lying down, in a chair, or with the assistance of a family member or caregiver.

• Gentle Lymphatic Massage and Tissue Mobilization: Sweeping, low-pressure strokes on dry skin (or using locally available vegetable oil) to soften hardened fibrotic tissue and clear congested pathways.

• Nighttime Elevation: Raising the foot of sleeping mats or bed platforms to facilitate natural lymphatic drainage overnight.

The Tok Pisin Flip Book: A Culturally Relatable Training Tool

Training healthcare workers in a central workshop is only the first step; ensuring that knowledge filters directly into rural homes and health posts requires accessible, durable, and culturally grounded educational resources.

Following the July workshop, we developed an illustrative Flip Book published in Tok Pisin ("KOMYUNITI-BES HOME-KEA BILONG FILARIASIS-RELATED LYMPHOEDEMA") and English. Each page shows one of the self-care activities with laminated pages for easy cleaning and durability.

The Flip Book serves as an indispensable visual guide for Community Health Workers (CHWs) when inducting patients, family members, and caregivers into daily self-care routines. Every section was carefully designed and translated to resonate with local PNG communities:

• Localised Language: Complex clinical terms were translated into clear Tok Pisin phrases—such as "SEDIUL BILONG OLGETA DE" (Daily Schedule), "Dring wara na kaikai ol nupela kumu" (Drink water and eat fresh vegetables), and "MASAJIM RAUN SKIN BREK" (Massage around small skin breaks).

• Culturally Familiar Imagery: The illustrations depict realistic daily scenarios and accessible items found in PNG villages, such as using wide washing bowls, pouring jugs, clean cloths, local vegetable oil, and elevated sleeping mats.

• Actionable Guidance for Acute Attacks: Clear visual markers warn patients when to pause massage and physical exercises during acute inflammatory flare-ups ("ACUTE ATTACK: NOKEN EKSASAIS, NOGAT MASAJ, CONTINUE WASIM, STAP KOL") while continuing essential hygiene and seeking antibiotic care.

By placing these flip books directly into local health clinics, CHWs can easily demonstrate techniques, verify understanding, and track patient progress over a three-month sticker chart, fostering true community ownership.

Small Donations, Extraordinary Life-Changing Impact

The July mission highlights a profound truth in global health: massive medical transformation does not always require high-tech infrastructure or costly medications. Instead, small, targeted charitable donations yield extraordinary long-term returns when focused on education and simple, scalable self-care tools.

• A basic home self-care kit: Consisting of a washing bowl, clean towels, plain soap, Vaseline, antifungal ointment, and a printed Tok Pisin training guide—costs only a few dollars per patient. Yet, this modest investment dramatically transforms lives:

• Preventing Acute Infection: Meticulous daily hygiene stops painful bacterial "acute attacks" that otherwise leave individuals bedridden for days with high fever and severe pain.

• Reversing Disability: Regular lymphatic massage and tissue mobilization soften hard, fibrotic skin, reduce limb circumference, and restore joint mobility.

• Restoring Dignity and Productivity: Reducing swelling and healing skin lesions allows individuals to walk, work in their plantations, care for their families, and re-engage in community life free from social stigma.

Through pro bono expertise and the strategic deployment of donated funds via the LKN Foundation and Loya Foundation, 14 healthcare leaders were empowered to bring healing, dignity, and independence to communities across East and West New Britain Provinces.