Health in Papua New Guinea: a Decline in Development

Abstract

Papua New Guinea has experienced the start of an epidemiological transition in health status from infectious towards non-communicable diseases, though the latter were absent until the post-war years. This transition is particularly marked in urban and coastal areas, where life expectancies are higher and mortality rates lower. Tropical diseases remain significant, malaria has worsened and new mobility has increased the severity of epidemics of influenza and measles. Indigenous medical systems have increasingly given way to modern medical systems, though disease aetiology is usually perceived through traditional cognitive models. Modern medical systems were mainly developed in the 1960s and 1970s, on either side of independence, but despite an official focus on primary health care, have had much reduced effectiveness since the 1980s. Rural health centres have been poorly maintained and serviced, and health workers have limited skills and access to resources. The health budget has been increasingly concentrated in urban areas, though the bulk of the population and of the health problems are in rural areas, resulting in a worsening 'inverse care law', that is particularly significant for women. Overall health status has declined in the past decade despite overseas advocacy of new policies and the prospects for improvement are poor.

Elephants in the Pacific? Pacific urbanisation and its discontents

“…An epidemiological transition towards ‘lifestyle diseases of modernisation’ (NCDs), has been exacerbated by urbanisation: a more sedentary life, lack of recreational facilities, combined with increased alcohol, soft drink and tobacco consumption and poor nutrition, in contexts of inadequate education and housing, lack of access to clean water and sanitation, overcrowding and poverty (e.g. Calvert‐Faamoe et al ., 1997; Connell, 1997b). Some of the greatest health problems are experienced in urban settlements, especially in Port Moresby and on atolls.…”

Sik Bilong Ples: an Exploration of Meanings of Illness and Well‐Being Amongst the Wosera Abelam of Papua New Guinea

“…In rural Papua New Guinea (PNG) the introduced modern medical system consisting of a network of aid posts, maternal and child health (MCH) clinics 1 and district hospitals exists alongside indigenous medical practices. Although the latter have not been formally linked with the modern system, there does seem, as Connell (1997) notes, to be a 'syncretism and synthesis' between the two whereby attempts are made to combine treatments from both regimes. Introduced western beliefs and practices have been incorporated into indigenous systems, and illness is usually treated within the modern health care system, though disease aetiology is usually understood in terms of traditional knowledge systems.…”

The Changing Health Care Behaviour of the Hmong Refugee Population in Sydney

“…Fifth, the continued use of Hmong medicine has benefited the health status of the Sydney refugee community in several ways, beyond that of health alone. The older Hmong were able to maintain a more active and respected role within the community through their knowledge and dispensing of traditional Hmong herbs, while other community members were willing to accept the advice of the older Hmong as part of their health care regime, thus practising a form of syncretism of the two health care systems (Connell, 1997; Koczberski and Curry, 1999). The use of traditional medicine may have also assisted with their generally positive resettlement, providing the community with an important link to their history and culture.…”