Madang Province has a population of an estimated 450,000 people most of whom live in remote regions without access to roads. 70,000 live on the outlying islands of Boisa, Manam, Kar Kar, Bagabag & Long Island and rely solely on banana boats powered by outboard motors for transport which are not suitable for medivacs and they themselves are dangerous in open water during inclimate weather.
Although there are some operational air strips in Saidor, Tapen, Teptep, Bambu, Meibu, Wangeto, Gusap, Bundi, Aiome, Simbai, Sangapi, Mamuse, Yilu, Chingribu, Kar Kar, Long Island, Josephstaal, Nahu most of the other airstrips have closed due to lack of maintenance.