Monday, June 07, 2010

Aid programmes and the real world of Papua New Guinea

BY JOHN FOWKE

DID YOU KNOW that the justly-admired frontline medical corps, Medicins Sans Frontieres, has managed and operated Angau Memorial Hospital's medical and emergency services as best they can under difficult circumstances for the past three years, as an errand of mercy recommended by the World Health Organisation?

And a year or two later, MSF arrived in Tari, the seat of today's burgeoning gas industry . Despite harassment from drunks and criminals there, MSF continues to run this major provincial hospital catering for some 180,000 people of Hela- where for many years there was not one full-time, permanent, practicing resident Papua New Guinea national doctor, let alone the five which are needed, and for whom  aid-funded fully-furnished three-bedroom houses have long been available. Of course Tari's hydro-electric power supply was out of order for many years, needing new parts for its governing mechanism, but MSF managed somehow to get a standby diesel plant operating for the hospital, no thanks to good old Elcom.

With all the fully-justified complaint about the overpaid, often immature and pansy-hands aid-funded consultants being deployed to PNG by AusAid and the multinational aid industry, it would have been a no-brainer, one feels, to have stepped in, MSF-like, with some practical,seasoned, medical and para-medical people to prop up these and many other needy hospitals in PNG. And to send in standby diesel plants and working 'fridges for delicate materials and medicines, plus essential materials and supplies to lost-cause centres like Menyamya and Kikori and Tabibuga and Erave to name only four of many dozens.

However, none of the great brains which fund and design and implement PNG's foreign-aid programs have thought of this. Too busy with REALLY IMPORTANT projects, like telling the coffee industry for the third time in the past  10 years that it needs to re-invent the wheel of on-the-ground marketing practice, a wheel which has regularly been re-invented to no purpose at all by several groups of essentially silly bearded or bilum-wearing white-men apparently  suffering mid-life-crisis or early-onset dementia. Nothing has resulted from all this expensive input, and now yet another team from the vaunted halls of Curtin University is on its way to have yet another go.

All this money would be far and away better utilised if handed to the major, established Church Missions - most of which maintain a majority of honest, idealistic and practical trained workers operating in these essential fields., in well-maintained Church-owned institutions. Whilst I have no religious faith myself I am a strong advocate of the major Christian churches and the programmes both of a spiritual  and a practical, hands-on nature they provide to this society.

I am writing this in Goroka where the district hospital was built and opened in 1967, and for many years remained an excellent institution. Today it is very run-down, facilities for the disposal of general medical and surgical waste, for instance, have deteriorated to where they no longer exist.The nurses quarters appear to have been partly-demolished, with doors and windows stripped from otherwise sturdy concrete-block dormitories. There are nurses present in the hospital, and a pleasant and hard-working lot they are, but one has to wonder where they are forced to sleep nowadays? Supplies and operating funds are always scarce but work goes on even though patients are frequently sent into town to purchase anti-malarial drugs, penicillin, sterile dressings,hypodermic syringes and even humble aspirin and Panadol so that they or their children may be treated appropriately. The politicians of the province pay no heed this, nor to the parlous state of the Goroka sewage-farm which has sat like a great, black, stinking row of Olympic swimming-pools for years  now, growing thick forests of hollow-stemmed pitpit which reaches four and five meters to the sky. A local man, living near this rotting eyesore in what used to be "Beautiful Kolples Goroka" tells me that the pipes were opened long ago and the town's daily contribution of excreta flows, untreated, into the Asaro river. How a community can remain reasonably healthy under these cisrcumstances is a mystery. Goroka, so-far free of cholera, suffers regular epidemics of typhoid. I just wonder about all the villages and coffee-factories situated below the foetid Asaro outflow.

This is just a short list of the wrongs existing within the health system - one could go on and on – and, realistically, like law-and-order, it is a huge social problem in a society which has fallen hard between two steep mountains in its express-ride transition from the Stone Age to the Toyota Age. Nothing will change until the middle-class of PNG realises that it is an entity with the potential to steer this crazy, " wealthy-but-dirt-poor" nation into a clear and open pathway leading to fairness and equal opportunity for all its citizens.The middle-class is made up of the educated and the employed and the entrepreneurial, all of whom hope each day for a better deal for their kids. This will only come when they realise their status, not as "Kerema," or "Sepik", or "Hailans" etc etc, but as citizens of a Commonwealth- the Independent Nation of Papua New Guinea.Once the middle-class understands its real place in modern PNG, once it welds itself into a strong political entity, then this beautiful and loveable country will move towards its right and due place among all the nations of the world.When will this happen? No-one can tell at present for to all intents and purposes this land is still a collection of many mutually-jealous tribes and not a nation at all, in reality. This is a problem that any amount of aid will not solve - PNG society just has to work its way around it. Or not.

Unfortunately there is a shortage of obviously charismatic and ideological proto-leaders lurking in the bush, although we daily look for such to emerge. This will only occur when the middle-class mobilises as such, not as a clamorous mass of jealous, disparate tribes all talking about the same thing . A middle-class which is always missing the point. The point that they are their own solution if only they can stretch their imaginations and act to form a strong, convincing and above all, honest, leadership-block.

A block which also appeals to all the village-based old-timers and all the youngsters now left to waste away in hidden valleys  and dusty settlements with no roads, no opportunities, and and no insight or idea of what the world might be to them if the bonds of lack of opportunity which imprison them were to be  untied.

As for foreign friends, Australia, the EU, the World Bank, the Japanese Government and the ADB to mention the major actors, all these will do well to stop trying to carry out hugely-wasteful "capacity-building" and "re-training" and "niche marketing" nonsense-projects invented and implemented by a generation of spoiled graduate pups who think that by draping a bilum over their shoulder on arrival they have become recognisably assimilated and will be welcomed and valued  and make a contribution to PNG society. The way the ruling-class and the public service has set the system up it is almost impossible even for those elected as Governors to exert influence over the country's administration and fiscal management. Aid-funded advisors are just fiddling around the edges in these circumstances.  A new and differently-aimed set of policies need to be thought about  by the aid-providers. As things stand in PNG what needs to be done is for about 85,000 arses to be kicked and realistically offered the door if not willing to abandon current common practice in the PS and Provincial Administrations. One can't see this happening any time soon and it is with this in mind that donors should seriously re-think their programmes and policy vis-a-vis PNG.

For Australia, lets be sensible and realise that outside of MSF-type medical teams and a limited range of specialist services, the likes of Mal Meninga and his men will do far more for the relationship which Australia wants to maintain with PNG,  and also for PNG  itself, if they or their like are paid to come up and set up and make competitive the PNG League. The National Sports Institute is another target for lots of Australian help and for the formation of links with similar Aussie institutions. And whilst Australia at large is not conscious of the fact,  PNG is, like Australia, one of the few countries which fields an international lawn-bowls team. How about some of the residents of what is now called "Fort Shitscared" in Moresby venturing out on a Saturday afternoon in PoM or Lae or Goroka or Mt Hagen or Madang, to sit with club-members beside the rink and watch nice, sensible, good-mannered midde-class Papua New Guineans enjoy themselves in their spotless whites, accompanied by the odd brown bottle now and then. Here is another place where an imaginative Australia could do so much for both countries. All it takes is a little courage, a little lateral thinking, and a willingness to be a partner rather than a smiling but still heavily-patronising schoolmaster.

How about AusAid funding a tour of a really good Bougainville Bamboo Band around Oz/NZ and the Pacific, ending up at the Edinburgh Festival? This is a magnificent sound, and there are virtuosi available to thrill the rest of the world with it!  This embryo nation needs this sort of confidence-building to make it think and act like a nation, not a collection of several hundred jealous tribes who can't form a bond of common interest largely because under their leadership since independence they have achieved so little as a nation.

From an Australian perspective, lets do lots of a practical nature in the areas of health and education in areas where MSF-style intervention is the only answer to the peoples' needs; lets help develop sport and the arts especially music and dance. Lets get competitive badminton going- this can easily and affordably be played at village level, and its HUGE in Asia. Why not in PNG?

Lets get Australian communities to collect container-loads of books and send them up to nominated communities as demonstrations of good-fellowship and  a desire to help. Lets design and ship prefabricated steel school-library buildings. This list is endless, and with due and careful consideration a much more people-friendly, human and mate-to-mate sort of relationship might be forged between close neighbours than that which exists between us now.We're always going to be neighbours. Always.

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