Abstract
Sago haemolytic disease (SHD) is a rare but significant condition presenting in sago starch-eating populations in Western Province, Papua New Guinea. Although rare, case fatality rates are high, and no known antidote is available. The exact cause of the disease is unknown, but it is believed to be secondary to mycotoxins produced by fungi in old sago. In this case report, a 50-year-old female was treated in a low-resource setting in Middle Fly, with fluid resuscitation and transfusion, making a full recovery without complications. The mainstay of treatment for SHD is intravenous fluid resuscitation and strict fluid balance, which can be achieved in even the most remote Western Province aid post. Increased food insecurity, secondary to climate change, may see the incidence of this condition increase. Therefore, all health workers in Western Province should be comfortable with fluid resuscitation and fluid balance practices.