‘Let’s say hello to some crocodiles’: The floatplane serving one of the world’s most remote regions
A floatplane taking off from Lake Murray, in Papua New Guinea’s Western Province - Simon Townsley/The Telegraph
Joseph Tua circles low over the islets scattered across the lake, thinking aloud.
The water level has dropped since his last flight in this remote corner of Papua New Guinea, exposing hazards just beneath the surface, while a westerly wind blows at a gentle seven knots. He notes the conditions and makes his final checks. After two laps, he’s ready.
“Let’s say hello to some crocodiles,” he jokes from the cockpit, before aiming the aircraft’s nose directly at the water below.
Moments later, there’s barely a bump as the Cessna 208 Caravan floatplane touches down on the lake and taxis towards a dock near the shoreline. Two recently recovered malaria patients disembark into a waiting boat, while the co-pilot anchors the plane and unpacks the cargo – rice, dried noodles, hardware supplies.
Floatplane pilot Joseph Tua - Simon Townsley/The Telegraph
Wilson Daisi with his wife Simbil, who was rushed to hospital during a medical emergency - Simon Townsley/The Telegraph
For the isolated island communities dotted across Lake Murray in Papua New Guinea’s Western Province, this new floatplane is a gateway for trade, education and health – especially in a medical emergency.
“She would not have made it to hospital if we only had the boat,” says Wilson Daisi, a local fisherman, perched alongside his wife Simbil outside their stilt house. Last August, she encountered life-threatening complications while pregnant with the couple’s fourth child.
“All the time we still think of our baby, who died,” Wilson says. “But I knew at least Simbil would be safe if she made it to the general hospital, and her life is so important. I’m just so happy she’s still here.”
Home to roughly 300,000 people, the Western Province’s low-lying terrain is beautiful but tough, with very few roads crossing its dense jungle and mangrove swamps. It would take Simbil and Wilson two or three days to reach the nearest town, Kiunga, travelling by boat along the winding River Fly. By air, the same journey takes just 30 minutes.
“This is by far the biggest province, but it’s the least connected and least developed,” says Mr Tua, who, at 30, is the first national floatplane pilot for the Mission Aviation Fellowship (MAF) in Papua New Guinea. The daily routes across Lake Murray became fully operational last year, after a trial launched in 2023.
“Up here, some kids don’t know what a car is, but they know what a plane is,” Mr Tua adds, swapping his headset for a wide-brim hat as he jumps out of the cockpit and onto the sun-drenched dock in Boboa, an island close to the Daisi family’s home. “The aircraft is their only lifeline.”
While the regular, subsidised flights are not cheap – with the exception of medical evacuations, it costs 470 kina (£81) each way to book a seat, when the minimum wage is just 5 kina – they have allowed locals to embrace new opportunities.
Pilot Joseph Tua flying across Western Province - Simon Townsley/The Telegraph
Sometimes, passengers are students travelling to boarding school in Kiunga for a better education; often, people send fish and vegetables to be sold in the town’s markets, creating a regular trade and cashflow that never existed here before (Kiunga is one of only two towns with a cash machine in the huge province).
But across the country, where life expectancy is just 65, MAF also helps to plug gaps in the health system.
The Christian organisation operates 11 aircraft using more than 200 traditional airstrips, plus 15 floating docks on Lake Murray. Pilots work with local NGOs to transport health workers and routine medical supplies, facilitate childhood vaccination campaigns, and act as an air ambulance in emergencies.
“In many instances, people wouldn’t make it to a hospital in time [without us],” says Nancy Itake, the bookings and operations manager, sitting in a hangar as the floatplane is serviced at MAF’s headquarters in Mount Hagen – a bustling highlands town in the heart of the country.
Each plane is in the air for an average of 14 hours a week, and just one hour of flying costs 7,140 kina (£1,240). There are concerns among the organisation’s global leadership that the Iran crisis will trigger a steep price hike in MAF programmes across the world, especially in Africa. The region’s operations are already most affected by the sweeping international aid cuts, with some air routes reduced or cancelled.
But although fuel logistics can already be a “nightmare” in Papua New Guinea, the flights are critical in such a disconnected country, says Ms Itake. She runs through medical evacuations in the last few days alone: a man whose leg had to be amputated after an outbreak of tribal fighting; a severely ill seven-year-old; an asthma patient; and three pregnant women.
Nancy Ikate, MAF flight operations manager - Simon Townsley/The Telegraph
After decades of rampant corruption and chronic underfunding, access to healthcare in Papua New Guinea is patchy at best. Across the country there is an average of roughly one doctor per 16,000 people. Only Niger had fewer doctors in 2023, according to the World Bank.
Mismanagement is also common: when the Telegraph visited Enga in the highlands, nurses said even the most basic supplies – antibiotics, paracetamol, surgical masks – were in short supply. The province’s shiny new hospital, the first to be built in the country since independence from Australia 50 years ago, already faces acute funding shortages.
Officially opened by the prime minister last year, the sprawling 300-bed facility cost 700 million kina (roughly £170m) to construct, in partnership with the Chinese bank EXIM. Yet in 2025 and 2026, the national government allocated no money at all for the hospital to operate, according to the chief executive, Dr Grant Muddle.
“Running a hospital in Papua New Guinea […] tests leadership in one of the most complex environments in global healthcare,” he says, noting the unreliable supply chains, funding constraints and “chronic workforce shortages, worsened by fatigue and retention issues”.
But the “real challenge lies in access,” he adds. For many of the 10 million people living across the country, which is twice the size of the UK, reaching even those facilities that are available can be a struggle – whether it’s a provincial hospital or a rural health outpost.
“Geography makes it very, very difficult,” says Dr Betty Koka, the director of public health services in Enga, a region of steep peaks and misty valleys. “So much of the population are living in rural areas three or four days walk from a road, even a week. We have limited health facilities. To access one, you either walk all that way – or you fly, with a service like MAF. ”
The problem is particularly acute during pregnancy, she adds. In 2018, the latest year of data, only 56 per cent of women gave birth under medical supervision, according to Our World in Data. The maternal mortality rate is slowly falling, but at 189 deaths per 100,000 live births, it remains five times higher than the average in the World Health Organization’s Western Pacific region.
“Partly it’s the same issue – the remoteness,” says Dr Koka. “Women often start coming to a health facility when the labour starts. But if there are complications, she could be a day’s walk away, she might be in too much pain to make it. Sometimes we see women give birth on the road – a huge risk for herself and the baby.”
Among the initiatives to mitigate these deaths are ‘waiting houses’. The Enga health department has built two of these units close to health facilities, where women nearing the end of their pregnancy can stay. After a successful pilot, plans are afoot to construct seven more in the province.
A similar approach is underway in the Western Highlands, says Edith Namba, the deputy director of nursing at the Mount Hagen General Hospital, a decades-old facility in the centre of town, some 15 minutes from the airport.
“We encourage women to come to [waiting houses] with their husbands,” Ms Namba says. “We want to give them both a health education, and information about nutrition, gender-based violence and hygiene. But we also talk about the importance of helping a mother or pregnant woman to reduce the risk of a premature death or miscarriage.
“This country is male dominated – they say a child is a woman’s job, sometimes they say no to contraception,” she adds. “We’re using this as an opportunity to change the minds of men.”
Islands on Lake Murray, Western Province - Simon Townsley/The Telegraph
As in Enga, families who go to the waiting houses are given incentives, from sacks of rice to farming tools, in the hope of encouraging the rest of the community to use these facilities.
But even when a woman does make it to a local clinic to give birth, the care they need is not always available.
Shortly before she was due to deliver, Simbil took a 15 minute boat journey to the small health outpost in Boboa, one of 22 communities on the banks of Lake Murray. But the baby was in the wrong position, and she urgently needed an operation that the health workers were not trained to conduct.
After an unnerving night in the clinic, the floatplane rushed Simbil to hospital in Kiunga one Tuesday morning. Doctors there were able to save her life, but not her baby’s.
“I had so much fear,” she says quietly, as children play nearby in the humid heat. “If I had not been able to go to the hospital, if I had remained here, I think I would have lost my life too.”
Junior Tugu, 4, and Elishema Ndamesa, 13, head to school on their first ever flight - Simon Townsley/The Telegraph
While many women have safely given birth in Boboa, Wilson adds that his wife is not the only one whose life was saved by an evacuation flight. There have been other emergencies here, too – after farming accidents, snake bites, and run-ins with wild pigs.
But when the Telegraph joins for the day, it’s business as usual. Back at the floating dock in Boboa, Mr Tua is joking with two young children about to go to school in Kiunga – while they’ve watched the amphibious aircraft from afar, this will be their first time in the air and they’re slightly nervous.
Fishermen in long canoes have also arrived with their latest catch, which is loaded into a cargo hold in the plane’s floats (to avoid a “potent smell” in the main cabin). Later, it will be sold in a market in town.
“People are selling fish and veggies – that trade is enabled because the plane is flying,” Mr Tua says. He adds that the continuous income has spurred the creation of a hardware store in the village – there’s a route to bring in goods, and people now have some money to spend.
Soon, it’s time to leave. As Mr Tua climbs back into the cockpit, his co-pilot Titus Oaeke stands on the floats and unmoors the plane as it begins to glide into the lake. The wake builds as the aircraft picks up speed on the water – then, as suddenly and smoothly as the landing, we’re in the air.
Lake Murray’s lush islets gradually fade into a seemingly endless sea of dense jungle. No roads are visible below, but we follow the shimmering River Fly.
Just half an hour later, we’re back in Kiunga: this route has become routine for Mr Tua, but for many of the passengers it’s a lifeline.
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