By ANTHONY SIL
I AM conscious of having chosen such a presumptuous title for this article, and my subsequent textual onslaught.
Some readers may find it rather discourteous, or ridiculously unreasonable if you will. However, I am vehemently calm.
The time has come to assess the achievements and failures of the 2005-2010 Medium Term Development Strategy (MTDS).
Its broad objectives include rural development, poverty reduction, human resource development, export-driven economic growth and primary health care.
In the absence of any recognised independent report, the anecdotal perception is that, the MTDS has experienced both successes and failures.
The failures turn out to be expensive lessons that need to be learnt.
Conceivably, there are three subtle undercurrents that militate against the MTDS.
First, some development issues are too cumbersome for the infrastructural and resource capacities of the responsible state departments.
Second, there is a general indecision, or rather a “traditionalist-complacency” displayed by some ministers and department secretaries against the demanding needs to outsource research proposals that offer innovative solutions to complex and overlapping development issues.
Third, corruption is so entrenched that development funds have dwindled through the funnel between politicians and public servants.
The practice of “give-and-take” is so systemic that the public service machinery has fallen into grave disrepute.
In these contexts, health governance has faltered into abysmal disarray.
People living in the rural areas are besieged by endemic diseases.
These diseases and other medical problems are curable but unfortunately, the health system does not have the capacity to deliver quality, efficient, accessible and wide range of medical services.
In the last two decades, independent reports have depicted PNG as a country with enduring poor health indicators compared to other developing countries.
This reflects lack of proper planning and management by the Health Department.
The fault does not lie with local doctors and other health workers.
They are well trained and have displayed admirable resilience under difficult working environment.
The fault lies with the Government, which has done so little and so poorly.
Many provincial hospitals are grotesquely under-resourced and utterly neglected.
Broken windows, dirty sinks and toilets, dusty floors, leaking sewerage pipes, leaking roofs, exposed electrical wires, shortage of health specialists and medical equipments and drugs are normal features.
The mortuary at the Port Moresby General Hospital (POMGH) has become a fermentation tank due to overcrowded bodies, and an unreliable freezer.
Most patients die mostly from curable medical problems due to resource deficiencies.
Maternity wards are also overcrowded where it is not uncommon for pregnant women to sleep on bed sheets spread over hard floors.
At the POMGH, first-time would-be mothers have the privilege over limited beds while the experienced often fend for themselves.
Women in remote areas are more disadvantaged.
They continue to face the terrible experience of giving birth the old-fashioned way in their village houses.
Some of them die with their babies due to delivery complications.
Emergency wards have become death rows due to queues of patients moving at snail’s pace to see a doctor.
In such situations, a person’s life oscillates precariously between the ticking clock and the discretion of the on-call doctor.
The scanning and radiology equipment at the POMGH cannot adequately serve the country.
Doctors in other provinces are handicapped and forced to improvise.
The 2005 MTDS recognises primary health care as one of its priority sectors.
To achieve the policy objectives, the Health Department embarked on a so-called “Health Vision” that entailed priority health programmes.
However, meeting the goals of such health programmes seems a daunting, if not impossible, task. Most of the goals for year 2010 have not been met.
The Health Department is enmeshed in a vicious cycle of wound-licking and band-aid dressing.
It needs to graft the bleeding ulcers, and reconstruct the cancerous bones of its system.
The perpetual miscarriage of the department to deliver results within a given timeframe demands not only a change in the management, but also a restructure of the health system.
If there is any comfort, the health funds have proven to have an inherent inclination towards the “Consolidated” Trust Funds.
At least the Health Secretary did provide that benefit without a blush.
The Department of National Planning & Monitoring will soon launch a Long Term Development Strategy (LTDS) to complement the MTDS.
The ideological underpinning it is noble. It will advance the stages of national development and harness the policy capability of the State.
The successes of various sectors in meeting the objectives of the MTDS become the precondition for LTDS to advance from. But the prospects of the health sector look utterly bleak.
Inevitably, the Health Department will jump on the LTDS bandwagon with its bag of failures to grapple with.
Public confidence in the department going back to its vomit is hopelessly high.
To address the cumulative problems, it requires significant funding.
It will need a new Health Secretary who has the alacrity for an eclectic approach to solving complex and overlapping issues.
Members of Parliament also need to channel their electoral development funds more meaningfully.
A more consolidated funding mechanism and coordinated whole-of-government approach is needed for “seed-funds” to be effectively propped with “counter-sector” funding.
Like termites on wood, the health system is decaying to the point of collapse against the demands from an increasing population.
Never are the health problems more ominous and pandemic elsewhere in the Pacific than in PNG.
The State as the constitutional arbiter is systematically denying its citizens the right to live.
The Government as the vehicle of statehood, having the legitimacy and prerogative to preside on matters of national interest, must now address the health system.
The public can no longer endure the misgivings. They certainly cannot continue to despairingly talk of having to face the same after the next election.
The Government has blood on its hands.
* The writer is a lecturer in International Relations and Diplomatic Practices and Procedures; Political Science Strand at the University of Papua New Guinea