Arguments Against the Suva Medical School

Medical Work In The New Papua

IT is easy to think, after reading Nov ember “PIM,” that nothing had been done in the matter of training Papuans to do medical work among their own people, other than sending a few of them to Sydney about 10 years ago. This is not so.

Dr. W. M. Strong pioneered the train ing of Papuans in medicine and he later inaugurated the much criticised scheme of sending natives to Sydney for train ing. The Sydney venture was in the nature of an experiment and as such it was very valuable. It was Dr. Strong’s intention to establish a medical school in Papua, but lack of funds and suitable officers prevented it.

Actually, the “Sydney boys” received far more, and longer, training in Papua than they did in Sydney, both from Dr.

Strong himself and in the Government native hospitals, and it was this train ing that enabled many of them to render very valuable service.

Many of the trainees were failures, and others left the Department to take up work elsewhere. But it was mainlv upon the experience gained by Dr. Strong that organised medical work amongst Papuans was being built. This work was inter rupted by the Japs.

Two years before the arrival of the Japs, a medical school was built in Papua, attached to a large inland native hospital. Many trainees, including those who had previously been in Sydney, completed courses of up to 12 months, and these trainees were distributed throughout Papua. However, the school was in its infancy when the Army took over, and it had not been given much publicity because (a) it was in control of an unqualified man and this was, like “Stomach Ills and Sulfa Drugs” (Nov ember “PIM”) —“unmedical and maybe unethical”; (b) lack of finance.

Both the Administrator, the Hon.

Leonard Murray, and the Chief Medical Officer, Dr. F. J. Williams, were vitally interested in the medical welfare of the Ppauans and the training of Papuans to work among their own people, but this was in the days prior to “Fuzzy Wuzzy” sentimentality and the Army’s discovery of New Guinea, and so these men had to

'THE writer of this article, Mr. E. * J. Wright, is at present com pleting a medical course at Sydney University. Previously he was an officer of the Papuan Medical Department, and in that capacity did many patrols in inland Papua, as well as the outer islands—some of these patrols were continuous treks of 1,500 miles. He is familiar with the medical work on every Government station, mission and plantation east of Port Moresby and, among other things, was tutor and inspector of Native Medical Assistants in Papua for two years.

He is therefore qualified to describe this side of the medical situation in Papua, as it existed before the war. He expresses the hope that, although his article is somewhat critical of the editorial in the November “PIM,” that criticism may be considered constructive.

work within the limits of economic possibility.

HERE are a few reasons why the Suva Medical School —the establishment of which is one of the outstanding achievements in the Pacific—cannot solve the medical problems of Papua even though it sounds an extremely easy way out of the difficulty and responsi

bility. These may be among the '‘rea sons unexplained and unknown” why the Governments of Papua “have held sternly aloof.” (1) New Guinea is the second largest island in the world. Things that apply

elsewhere, particularly in smaller islands, do not always apply here. The Mela

nesians of New Guinea are a different people, in a different stage of develop ment, to most of the other Pacific natives. (2) The greatest problem confronting medical services in Papua is not to pro vide medical services but to get the Papuans to accept Europeanised medical treatment even though it be free and brought to their dying bed (or mat). (3) To the ordinary Papuan, the Suva graduates would be just fellow “Papuan memero,” not singled out for any special respect or co-operation. The NMP would be without the prestige of a “white” Government Officer, and have neither his energy nor ambition and without the backing of an “alma” closer to home they might find that their high task was well beyond them and enough to break the heart of the graduate of any medical school, let alone a native of the happy race that gave to Papua the name of “the land of dohori.”

Under Papuan conditions, and with out an organisation built up in Papua, it is most doubtful if they would perform any more work than the present NMA’s who, with considerable skill, treat pneu monia, colds, venereal diseases, malaria, dysentery, hookworm, yaws, ulcers, and perform simple operations to the patients who chance their way. (4) If Native Medical Practitioners are sent to replace Native Medical Assist ants on Government Stations there is the very delicate question of relationship between the local Magistrate and other Europeans, and the Papuan doctors.

Such local conditions are liable to become acute and, combined with isola tion among unresponsive or enemy people it might prove tq be too much and it will take more than a Fijian Alma Mater to keep some of them on the job. (5) After an absence of years they would have to return to work with an Administration with which they are entirely unfamiliar. (6) Although it might be ridiculously cheap to maintain natives in Fiji it

would not be ridiculously cheap to maintain them when they return. They would have to be paid at least £lO a month plus improved housing, otherwise many of them would accept the tempt ing offers of private firms to act as doc tors, chief clerks, etc. Calculated on pre war standards—and the number of NMA’s was considered entirely inade quate to cover the vast territory—wages alone would run into at least £l,OOO a month: enough to give a headache to any island Treasurer. (7) It is not just a matter of hand picking the natives you want. Under the present system of education in Papua— by missions—the most promising students are likely to be guidqd along channels other than medical. Neither are the most promising Papuans always willing to spend years in training, so that they can spend the rest of their lives doing work among strange people. The call of village life—taking a wife, for instance— often crops up and will not stand post ponement for four or more years. (8) The medical training of large numbers of Papuan natives must go hand in hand with the education of the natives and is inseparable from it. As native education facilities improve, so will medical training. Education and medical training must advance together.

IN my opinion, the new Papua—as far as medical services are concerned should be built on the experience gained in the past by trial and error. A medical school should be set up in Papua in conjunction with an already estab lished hospital, and there suitable Papuans should receive intensive train ing, with the object of becoming, in 18 months or so, Native Medical Assistants.

Native girls should also be trained in nursing, with particular emphasis on midwifery and the care of infants.

Papua should be divided into medical zones, each to be in charge of a Euro pean .medical officer —although not neces sarily a qualified medical practitioner: a general medical course is not always good training for work in Papua. But such men should be properly trained for the work they will undertake.

The co-operation of all missionary bodies should be sought, and short courses in tropical medicine should be readily available to all who work among natives. Medical research should be undertaken on diseases prevalent in the Territory and steps taken, through lec tures, films, education, improved sanita tion and segregation to reduce the inci dence of preventable diseases. Health and hygiene should be taught in the schools and a special emergency staff be available to cope adequately with all epidemics as soon as they break out.

In most of these matters, the assist ance and guidance of the excellent and up-to-date School of Tropical Medicine in Sydney would be readily available. It appears to me that only along these, or similar, lines can the medical services of Papua be built; the main medical prob lems of Panua will have to be solved in Papua—and not in Suva or Sydney.

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WE are grateful to Mr. Wright. He has supplied those interested with the first arguments they ever have heard against the Suva Medical School.

Now they know what it is they have to meet.

It is not only the Territory of Papua which is concerned with < this matter — there is also the very large Territory of New Guinea. It is certain that, in the future, the problem of native health in Australian Pacific Territories will be con sidered in relation to the New Guinea mainland and the Bismarck Archipelago as a whole.

We learn with astonishment of the attempt that was being made to train Papuan Native Medical Assistants at Divinukoiari prior to the evacuation.

Nothing had been said publicly about this “medical school.” It would be inter esting to know something of the scope and results of this plan. With that data, one could more effectively make compari sons with the Suva institution.

MR. WRIGHT’S arguments against the Suva set-up are given out seriatim, and we take the liberty of replying to them seriatim:— (1) Emphatically, the Melanesians of New Guinea are not different from Melanesians elsewhere. The natives of New Guinea are just as capable of being trained as Native Medical Practitioners as are the natives of the Solomons and New Hebrides and Fiji. (2) Mr. Wright apparently is not aware of the success achieved by Melanesian NMP’s in the Solomons and New Heb rides, where the people are just as primi tive and superstitious as the wild people of Papua. (3) Mr. Wright must be arguing with out knowledge of what has been done outside of Papua. In any event, if a native Papuan, with a little special training and a cap, can be sent into a village and can control that village as “village constable,” simply because he has the authority of the Government behind him, surely the same sort of thing can be achieved more effectively by natives who are specially selected, and given four years of intensive training.

There can be scarcely any argument as to whether a Papuan NMA, with 18 months’ training in Papua, would be more valuable to Papua than a Papuan NMP, with four years’ training in Suva. (4) and (5) No trouble of this kind has been experienced in Fiji, or Samoa, or Tonga, or Gilbert and Ellice, or Cook Islands, or New Hebrides, or Solomons.

Why, then, should it happen in Papua?

Mr. Wright overlooks the fact that the Suva Medical School has been function ing successfully for years. (6) Our correspondent condemns the

NMP system because of expense— and then, a little later, proceeds to argue in favour of zones in charge of Europeans —presumably to be assisted by large numbers of NMA’s (with 18 months’ training). Which system, in the end, would be the more expensive—and, more imp9rtant, which would be the more efficient? (7) Experience in the more primitive Territories of Solomons and New Heb rides does not bear out Mr. Wright’s were plenty of suitable young natives available there. Their school record has been excellent. The NMP’s are proud of their school, of their knowledge, and of themselves; and they are not ashamed of their race. In nearly every case, they have gone back gladly to their own people, to the task of helping them and raising their stand ards of living. (8) Precisely. And what better edu cative influence could there be in Papua than the regular arrival among the natives of new groups of specially selected and trained young Papuans?

TliSy may have been away for four years, but the y have been in close association with other young men of the Pacific

races, and have been taught the English language, and have acquired, in addition t 0 medical knowledge, a pride in their school and in themselves which amounts a code of honour to govern their future conduct, 11/fR. WRIGHT’S defence of the isola -ITI tionism of the Papuan native medi cal service—which probably goes for New Guinea as well—only deepens the mystery.

It shows that there definitely is an tagonism on the part of Australian offi cials towards the plan of a central medical school for Pacific Islands natives; but it does not explain that antagonism. Are there white officials somewhere who are afraid of losing their jobs? Or are white officials afraid that the Melanesian natives may be given too much education, and encour aged to think themselves the equals of white men?

The only question that matters is: Can Papuans be trained in Suva as good and efficient NMP’s? The way to find out is to send a few there for training.

If the answer is “Yes,” then the paro chialism of Australia’s petty bureaucracy, which is suspected of having cunningly blocked the Suva plan for years, should be dealt with in the way it deserves.