When somebody falls ill in Papua New Guinea they are just as likely to look round for a sorcerer as a doctor. Traditional and ‘western’ forms of medicine run in parallel, each tolerates the other, though Government does not officially recognise traditional healers. Every market in PN G sells medicinal herbs.
PNG has a National Health Service which is provided by both government and non-government (mainly Church) sources. Health services are arranged in a pyramidal fashion with aidposts at the base, health sub-centres and health centres in the middle , provincial hospitals near the top and national referral hospitals at the apex. The hospitals receive over 50% of the funding.
With 87% of the population living in rural areas the provision of those services is most important. The Churches operate almost 50% of all rural health services and employ 16% of health workers in PNG. They are a vocal , political and very import ant pressure group in health matters. The Government provided just over K13 million as quarterly grants to Church A genc ies for providing health services. However, to quote from a recent (1995) report, “The Department cannot issue Grants by cheques to Churches if Department of Finance and Planning cannot give us Warrant Authority.” Health has got caught up in a cash-flow crisis.
There are a number of International and Bilateral Agencies who contribute to the Health budget. The World Health Organisation (WHO) provides about K3 million and a deal of technical assistance. UNICEF assists in Child health programmes. AID AB will be contributing tied-aid to certain projects under the PNG-Australia Bilateral Aid Agreement. Japan has been helping with hospital development. The Asian Development Bank ADB has made loans for improving rural services. Nonetheless there is still much concern over the health of the Nation’s people.
Too many women and children continue to die from preventable causes. PNG has the highest child mortality rates in the West Pacific Region. 24 babies die every day in PNG. To the dismay of all who work in the health sector, clinic attendance has declined since 1986. The causes are identified as lack of funds, poor quality of services and law and order problems. Clinics have been vandalised and medicines and equipment stolen. There has been a decline in the number children immunised and a gradual increase in medium level malnutrition especially in urban areas. The minimum urban wage is K26 per week, whereas food prices have risen by 150% in the last 5 years. Some children are simply not getting enough to eat. The Department fears an epidemic of malnutrition if there is a further rapid rise in food prices following the adoption of free market policies.
On the positive side there are good reports of dental health. Every child at school receives oral health treatment. In the last few years leprosy has been on the decline. While the dedicated efforts of health workers must be acknowledged, there is a general despair that ground is being lost. Hospitals, health centres and even aidposts are cash starved and struggling . Diarrhoeal disease, pneumonia and tuberculosis are on the increase. Malaria control had suffered a setback even before 108 people died in Simbu province in the summer of 1995.
The first case of AIDS was diagnosed in PNG in 1987. The spread of HIV/AIDS was slow until 1993 but is now increasing. There is an acute awareness of the problems and an e f fort is made to put forward solutions by the Department of Health. Sweeping reforms may be the only way to avert a crisis. The reformers are asking for more emphasis on preventative medicinee . Concerted efforts are needed to educate the rural populations in health matters, utilising women’s groups and village councils. The establishment of a radio network would link all health facilities with District and Provincial services. All recognise that access to safe water and proper sanitation is a basic health need. Progress is needed in improving management, cutting wastage and making every ‘toea’ count. Nobody wants to slip back to a situation where the sorcerer is the only doctor left to consult.