What is Development?

Part 1: Medicine

We have all been thinking and talking about the definition of 'Development' especially within the dilemma we find ourselves in, in Papua New Guinea regarding this question. 

There are many controversies and contradictions concerning not only the ideal path we wish to follow, but also our development choices, the advantages of certain choices and also the negative aspects of some of our choices. 

For sure we cannot all be happy about the various development choices we have to make, but one of the crucial considerations of development lies in the nature of the acquisition of collective consent about our national choices, goals and objectives. 

Every society, every country requires a systematic procedure towards arriving at collective consent. Many traditional societies in Papua New Guinea could offer our national governments so many models of seeking, negotiating and acquiring community consent. In our traditional philosophies we even have names for many of these methods. Yet like every other democracy on earth, Papua New Guinea's democracy struggles with acquiring public consent for our national decisions.

We have maybe too often heard the rhetoric about 'development principles' but often the actual principles behind the choices we make as a collective entity, fail to manifest themselves in the form of collective human satisfaction and harmony. 

The effort it takes for any country to arrive at collective consent on any development issue is very difficult to attain. As a result, as we see in Papua New Guinea, and even in the United States of America, the fine art of acquiring collective consent is often avoided altogether. 

Some members of parliament like Moses Maladina, try to invent policy loop holes that can help Parliament to avoid the task of acquiring public consent, but rather seek to bulldoze laws through parliament without public information, debate and collective decision making. Others spend their time in parliament as specialists in filibustering while others, our 'yo-yo' members, spend their time crossing floors and just playing the numbers game. So it happens that we can very easily make a mockery out of our systems of state and thus we also see our country committing a major failure in one of the crucial principles of national development: the achievement of collective consent. 

And let us not forget: the true art and objective of politics and parliamentarianism is to seek to acquire public support for public proposals and programmes - not to just be in government.

Why is it so difficult to acquire collective consent? I may get back to this at a later issue. Today I want to deal with one of the crucial ingredients of collective consent:

The recognition of Common Values. 

In Papua New Guinea Tok Pisin, we call this 'Luksave'.

I will take the example of Health and Medicine for this first installment because this is one of the things our rural people cry out for when they want 'Development'. Rural people all over Papua New Guinea are signing away their rights to their natural livelihood on the land because they want schools, roads and hospitals.

We all want good health. But at what point can we as a country arrive at the common recognition of this value - in a way that we can approach our health development programmes in a systematic manner, without too much argument and fuss along the way, about what our priorities are, what are the standards, what are the best medicines, what is the best medical equipment and technology available on the international market, what kind of facilities to build first and where, how do we maintain our existing facilities, and at the end how do we build a reliable health system in which all our people and cultures may have faith?

My good friend, an Egyptian doctor working in Goroka in 1994, Dr. Adel El Mezin Ibrahim, told me once that: "Medicine is common sense".

So today I look back at our country, floundering with indecision, and sometimes suffering from a seemingly lack of commitment to the perseverance needed for establishing the right health system for Papua New Guinea. And I ask myself how we may, on our own, with our own human, material and financial resources, run, manage and maintain for a long time, a sustainable health system, until the very culture of proper health care and awareness becomes an internalised part and action in the psychology of all our people?

Everywhere I go, I'm always befriending medical doctors, medical researchers, anyone that can give me a clue about the riddle that riddles our people. I have flown from many very rural places in Papua New Guinea accompanying sick people who do not know their way to an urban hospital from the airport, offering to take them there myself - some of them so sick and suffering from things like tropical ulcers that the whole aircraft could smell like there was a very large dead animal on board. My heroes are those pilots who fly those little aeroplanes into the clouds of the various PNG mountains, some of them never to return.

Like many fellow Papua New Guineans, I have seen the look on many people's faces in the last hours before their death, I too have carried the bleeding and I feel that sometimes the blood leaves permanent marks on the back of my shoulders. I still hear the voice of the last person I tried to rescue in Goroka: His last words to me were: "Martin, mi no nap pilim wanpela samting long nek blo mi igo daun long lek. (Martin, I can't feel anything from my neck down to my feet). 

So I can understand our urgency, our strife and our cry for development. But it would be detrimental to consistent development in one were to proceed and to operate in crisis mode. We need to be systematic. We have to use our common sense. But we have to recognise our needs and to act appropriately and accordingly. We have to strive to create an environment of collective comfort and benefit for all our people. Then at one point in the future we may find that we can actually walk together.

Last week I was talking to a medical doctor, Dr. Wagner and his wife in Rottweil, Germany. We were talking about super bugs, and other medical considerations that I get curious about. Eventually, I ventured to ask Dr. Wagner, where we are as humans in our advancement in medicine. And together with his wife, they told me something that I felt was worth reflecting upon and sharing with all our people.

Dr. Wagner: In the last one hundred years, the greatest advance in medicine came in two main areas: 

1. Recognising that we must separate our drinking water from our sewage water. This recognition led humanity to successfully combat Cholera and many other diseases caused by the contamination of drinking water.

2. The second was recognising the fact that we have to separate our rubbish from our living environment. This recognition led to a cleaner living environment, free of infectious diseases that spring from the accumulation of waste.

I was quite surprised and happily shocked by the simplicity of his deduction. So I thought I'd probe further. I asked Dr. Wagner about the medical advances and research into, the identification of various kinds of bacteria and viruses and he agreed, but insisted that these advances cannot overshadow that medical advancement in the two areas he had mentioned.

And so what about penicillin I asked him... 

Dr. Wagner: The industrialised mass production of penicillin was perfected around 1945. Yes penicillin was an important discovery... at this point, Frau Wagner cut in to offer an explanation:

Frau Wagner: Penicillin cannot make a big difference to human health if we do not organise in order to avoid the danger of continuously re-infecting ourselves.

And there it was from Frau Wagner: a reiteration that even the great medical discovery of penicillin could not overshadow those two great steps mankind had taken in the advancement of medical science which her husband had spoken about.

Sixteen years after my conversation with Dr. Ibrahim, Frau Wagner was telling me again that chemical advancement alone, cannot replace common sense in Medical Science. So I was transported back in space to Papua New Guinea and the ample rhetoric we have heard over the years about development and health care, asking myself the same questions we ask over and over again about the state of our health system. 

Back to our dilemma of development and the acquisition of collective consent in development directions, I think it is time that our people stop accepting to be led blind by rhetorical slogans. We should require that our public officials give the public the basic confidence and belief, that we can endeavour, to achieve collective vision and progress. They need to challenge, to prosecute and to continuously debate reflections on the public good, and derive from those reflections, information that they themselves trust, so that they may be clear about what they want to say to the public. We need to be better informed collectively, so that our common sense can inform and facilitate our collective consent. 

Sapos yumi olgeta i kamap long wanpela luksave, em bai yumi hariap tasol, bai yumi wanbel long wanem kain plan yumi laik bihainim.  - The secret to collective consent lies in first achieving common recognition of shared values.