Thursday, October 15, 2009

Where There Is No 9-1-1: Two Stories of Health in PNG

My first taste of PNG’s health system came just a week into last year’s Panango tour when I found myself catching our malaria-stricken (Or was it even malaria? Results were never conclusive) leader Christa as she collapsed in the waiting room or Karkar’s only hospital, Gaubin. The nurses pricked her for a blood sample to test and stuck her with a serious shot of cloroquine in the bum (leaving an inflamed lump for the rest of the summer) while I divided my time between looking on to insure her attending nurse used a sterile needle and calming a second volunteer who was close to hyperventilating from the appallingly unsanitary conditions, particularly the dog inside the waiting room bating at the flies swarming his grossly infected open sores. Christa recovered, but any faith I might have had in Karkar’s health system never did. I swore I’d never go back to Gaubin if I could help it.

But just weeks from the end of our trip, toting only the bilum I’d packed with a Nalgene, camera, and book for my ‘rounds to visit Kinim Village for a bilum making lesson and Tabel for Steven’s birthday festivities, I found myself back at the hospital preparing to execute an emergency evacuation for a volunteer. I’d learned that afternoon that Yihana had gone to Gaubin for a second check on her eyes, which had developed what she thought was a typical case of conjunctivitis Thursday night. She hadn’t taken her phone with her (Stephen had used up the battery and it was charging), so getting in touch was difficult. Word of mouth told me she’d traveled with the Goodyears, who were on their way to deliver another patient, but Paul Goodyear wasn’t answering his phone. Fortunately, we met Barbara Goodyear on the truck trip back from the birthday party, and she quickly regaled me with an update: Yihana had been given a shot in the eye and was going to be spending the night at the hospital. My worst fear come true, I jumped off the truck and onto the one Barbara arranged to take me to Gaubin.

I found Yihana in the pitch dark of Gaubin’s guesthouse. I flicked the light switch (they have generator power until 10pm) to make my way to the bedroom, but quickly turned it off again as she emerged and painfully winced in the brightness. We would maneuver by the flashlights of our cell phones. It was immediately apparent I would be spending the night.

Admitting a white woman to a bed on a ward clearly wasn’t something the young husband-and-wife team of German doctors were ready to do, so they had set her up in the relatively well-equipped two-bedroom guesthouse. (The house was at the expense of 50 kina/night, which they didn’t expect us to pay, but we paid later anyway. They refused payment for any services or the treatment they gave her, including the last bottle of an antibiotic they had at the clinic, requesting that if at all possible we return what we didn’t use later. I did.)

Walking out to the hospital’s courtyard, the only place in the whole establishment with cell service, we met Dr. Chris, her attending doctor, a surgeon actually. For the next two hours we would play phone tag with insurance, demanding calls back as our prepaid phone minutes dwindled that were then missed as service faltered. By 9 p.m. the insurance rep had spoken to the doctor who described the situation in as dire terms as he could (“She’s in serious danger of losing her vision. Yes, she needs an escort; she can’t see!”), words which, even when cognizant of some probable exaggeration, are harrowing to hear. Insurance wanted an emailed scan of Yihana’s insurance card, which we tried to finagle with the hospital’s theoretical dial-up connection (it didn’t work) and for the doctor to fill out insurance forms, again via email.
While working with insurance was a hassle (we kept the doctors up to 11 p.m., and they had small children to put to bed and rounds to do early the next morning), how fortunate we were to have it! A trip to find more Flex minutes to top up our phone credits took me by six wards packed with moaning residents for whom a trip to the specialist in Madang, let alone an evacuation to Brisbane, would never be an option. Even for the few who do carry some form of medical insurance, they are often left to pay out of pocket for what services they can afford and bet against the odds that insurance reimburses them later. I will shortly illustrate.

But first, our odyssey: Our self-executed evacuation began at 6:30 the next morning when I led a tea towel-blindfolded (to block the light) Yihana down to the beach to catch a speedboat to the mainland. I had only what I was wearing and the contents of my bilum, which fortunately included a bunch of bananas we would eat for breakfast and lunch; Yihana had only the contents of the backpack I had packed hastily for her the day before with important documents and few clothes—including a shirt we discovered the rats had chewed a stain out of the night before. If you’ve never ridden a speedboat blindfolded, I’m told its quite a disconcerting experience; try it sometime.

I had orchestrated a complicated plan to rendezvous with my bag, involving Donald motorbiking to Gial to pick up the bag Mama sent down the hill with Archie and the passport that followed in another sibling’s hands, then delivering the bag to Manus’s boat at Kinim Station, which by no small miracle, met us at Kubugame beach two hours later, bearing the welcome addition to our breakfast of peanut butter and crackers as well as my laptop, change of clothes, med kit, and blessedly, passport.

At Kubugame, the haggle with insurance to guarantee that they would cover flights for both us continued (I finally took the phone from Yihana who was playing down the situation in a perfectly congenial tone, as she is apt to do.) From there, an incredibly generous PMV driver chauffeured us the hour into town, taking us directly to the Air Niugini offices to book plane tickets and then to Modillion Hospital, where we received immediate attention from the eye specialist (whether as a result of a forewarning from the Gaubin doctor or our white skin, I can’t be sure). He described her eye as “geographical”, that is, metaphorically the blue ocean of her iris had a distinctly continental mass of green growing above it, indicating a corneal ulcer.

Our story continues with a trip to the chemist to pick up anti-viral ointment that we would later discover was treatment for herpes, then confusion that resulted in my cell phone being taken back to Karkar (I left it charging at the hospital, an unidentified someone rang, discovered I had left the phone when a nurse answered and thought they were doing me a favor by picking it up and carrying back to the island), a lift from the doctor himself to the airport (this I can only attribute to the color of our skin; he had other patients waiting at the clinic), a flight to Port Moresby, the generous hospitality of our friend Solomon Kantha and his family who opened their house to us that night, a flight to Brisbane the next morning, a taxi to a clinic insurance had given us the address for, the realization that insurance had given us the wrong address and that we needed to report next door to the public hospital’s ER instead, a three hour wait in the ER—we were apparently still plagued by PNG time—and finally an audience with an eye doctor who, as you might imagine, could hardly believe our story.

After doing an ultrasound of her eye and scraping samples of the growth from her lens for the first of many cultures they would do over the coming days, the doctors decided against admitting her to the hospital and sent us off in search of a hostel for the night with the task of putting drops in her eye every hour indefinitely. (That night, we bunked myself on the top and Yihana on the bottom so I could reach over the rail when my alarm went off every hour and administer the drops; the system worked remarkably well.)

Her parents finally returned our many phone calls via email that evening. Fortuitously, they had been sailing off the coast of Australia and had actually accidentally returned to port—and cell service reception—a day earlier than planned. They caught the next flight to Brisbane and picked us up from the koala and kangaroo reserve we visited in our free time the following afternoon. (I had not expected to spoon with kangaroos this summer, but when in Australia…)

After an unnecessary hassle to obtain a visa to get back into PNG, I caught a flight to Moresby Thursday. On the plane back, I rehearsed my story, confident that for once I was guaranteed to have a hit. (Karkar to a koala sanctuary? This isn’t something that happens everyday…) As it turned out, I hadn’t calculated how incomprehensible the premise of the whole story would be. An infection threatening permanent vision damage? Yes, this was all too familiar. But a flight to a foreign hospital for treatment? This was unheard of, or more accurately, something only white people would do.

I admit, the inequality problem didn’t really dawn on me until I was telling the tale to two of my students who were accompanying me on my rounds to say last goodbyes Saturday. Luther, one of my hardest-working grade 8’s, was one of them. He had always sat at the front of the class, presumably to see the board better since his left appeared to have a yellow-grey growth and disfiguration on its lens. I had always assumed his vision was completely impaired in this eye, but I don’t think I had ever really considered how it had gotten to that state—and what might have been done to treat it had he had the access to doctors Yihana had. Now retelling my evacuation tale and showing off the gnarly shot we had of Yihana’s bloodshot eye to him, I was uncomfortably conscious of my medical privilege which had probably saved her eye from the fate Luther had never had a chance to escape: partial blindness.

Throughout out evacuation, I had accepted the preferential treatment we were given with gratitude, conscious of our favored position as white volunteers but doing little to rectify the unequal attention and treatment Yihana was receiving; we needed all the help we could get. We thanked the Gaubin doctors’ for their after-hours attention and free treatment, the Modillion doctor for his carriage to the Air Niugini offices and the airport, and Solomon for taking us in on a moment’s notice. In the process, we took the entirety of Gaubin’s stock of one antibiotic, took a doctor away from waiting patients, and put a 6-year-old out of her bedroom for a night.

I had my taste of PNG’s medical care for its own earlier in the summer when Mama traveled to Lae for a gynecological appointment at one of the few women’s clinics in the country. Mama left Karkar on Friday for a Monday morning appointment; unbeknownst to us at the time, she wouldn’t return for two weeks. I traveled with her on the speedy into Madang, where she had to negotiate a loan from the teacher’s district office before she could take the 6-hour bus trip to Lae the following morning. She was lucky they let her take out the loan; if she hadn’t gotten the K600, she wouldn’t have been able to make the trip—and keep the appointment she had set up months in advance. Her accommodation in Lae? The floor of her daughter’s dorm room.

What doctors’ discovered in the proceeding week would be nothing short of devastating for any woman, but for a woman with limited insurance, the prognosis was terrifying: a cyst had taken root on her uterus and was growing. Her physician recommended a hysterectomy, a surgery for which her relatives apparently scrapped together the bill until she could theoretically get reimbursed from her teacher’s insurance, from which payment may take years, even decades. The morning of, however, she decided against it. I believe fear dealt the determining card and, as she told the school in a testimonial weeks later, she chose to trust in her faith over the answers—and dangers–of modern medicine. Mama was going to be able to afford the operation because she was at a public hospital, and with that came very real problems.

The one that was salient to her decision was something we hear in the US take for granted every day: power. The public hospital had power, sometimes, and when it switched off, there were theoretically a few generators to back it up. But theoretically isn’t good enough when you’re talking about putting patients under for surgery; rumor has it that cuts in power have left some “under” forever. Mama wasn’t willing to take the risk, so she came home. She continues to mull her only other option: surgery at a private hospital to the tune of K7,000 or 8,000, or 8-months salary—money that simply isn’t there. After a frank discussion on the topic a few weeks later, I made her promise to do the follow-up appointments in October, and if it has grown, to somehow get the surgery. If I had had the cash then—or now—I would have insisted on immediate treatment.

Mama wasn’t the only person affected by her prognosis. All the appointments—and their distance—kept her from Karkar, her classes, and her children for two weeks. in which she left her classes in my charge, doubling my load. She left all her classes in my charge, which doubled my load, but had I not been there, the students would have been teacher-less for weeks. Substitutes on Karkar are nowhere to be had. Her children are independent and resourceful, but our dinners were markedly meager in her absence. Listen Congress: inadequate healthcare coverage hurts everybody.

Mama will return for a follow-up appointment this month, when she will undoubtedly miss more school and face what may become a life or death choice to operate. She’s only 46.

Yihana has since returned to the States, consulted a corneal specialist at Johns Hopkins—who never did figure out if the bug was viral, bacterial, or fungal—and resumed life at Stanford. Her eye has healed, mostly, but left a significant scar that continues to severely blur her vision, a defect that may or may not be able to be corrected with Lasic surgery down the road.

My heart goes out to both courageous women.

Saturday, August 22, 2009

When climate comes to call...

Last August, I spent almost every afternoon hiking 45 min. down through coconut groves to reach the beach and the freshwater springs the bubbled up from the rocks to have my bath. It was the height of the drought in what turned out was one of the longest dry seasons in recent memory. While our tank never ran completely dry and I was spared the backbreaking effort of hauling gallons of drinking and cooking water back up the mountain, this wasn’t the case for most of my students and their mothers who lived even further up the mountain. (Of course, many people here don’t have the benefit of a rainwater-collecting tank and make this trek year round to supplement what they catch in buckets.) Classes were canceled after lunch so students could beat the heat at the beach—and have more time to haul precious water.

Anticipating a summer like the last, I left my poncho at home this year. It was a mistake. El Nino has sent us one of the longest wet seasons in recent history. Over a month-and-a-half late, the rains finally gave way to clear skies and a heat wave this week. You are undoubtedly thinking, what a blessing: a cooler clime and a reprieve from afternoon bathing treks! But for locals, and extra months of rain has meant ground too wet for planting the taro that is to be their staple in the coming months. Saturated ground will rot the tubers, so they must be planted after at least a few days dry spell. I’ve heard Mama boast that her initiative to plant her garden during the smattering of sunny days will reward her with a well-provisioned table while others subsist off bananas alone–or steal her taro, which has already begun to happen. Thanks to the almost adolescent mood swings in seasons around here, locals may soon find themselves scouring empty gardens and trees for staples and fruits stunted by the seasonal swings.

Lack of food has never been a problem on Karkar. The bush is wild with bananas, breadfruit, nuts, and in the rainy season, mangos. But then again, the weather hasn’t ever been quite like this either.

Climate change seems to be on everyone’s lips these days, but while in America our lifestyle and geographic position has rendered the issue mostly rhetoric, in PNG and other island nations, it’s no matter for debate: the seasons are changing, and with them, so must the people who measure their lives by the weather. Moreover, the strange currents of global warming have kept the tides rolling in—and climbing the beaches here higher each year.

Tabel Primary School, where Panango volunteers Stephen and Yihana have spent their last two months, is perched on one such tide-encroached shoreline. My Pops spent his childhood on this beach, or rather, the sands now 50 feet off the shore and three feet under water. Waves break over the sandy shoal that marks the historic tide line. Just beyond, the shallows descend over a coral cliff, still home to an abundance of fish and a family of dolphins we watched playing last week. I can’t say how this reef has changed over the years, but just a little further up the coast the host parents of two other volunteers lament the decline in abundance and size of the fish. (Mind you, it can’t be too bad it they’re still dining on octopus at least once a week) No one can say if this is a result of overfishing or climate change, but I imagine it’s a little of both. Still further up the coast, the evidence of environmental degradation caused partly by rising tides is irrefutable.

One of the places I was most keen to revisit this summer was Mater’s coral reef. My day last summer spent floating over the vibrant purple, green, pink and orange corals off Mater’s black sand beach was one of my more memorable on Karkar. I talked up this reef to incoming volunteers and I eagerly led an expedition out there the first week we were on the island.
As we swam along the shore before swimming out to the reef, I took notice of the steep dirt cliff and the trees hanging over it, clinging to soft earth as it crumbled out from under them, but thought nothing of it. (Unfortunately, I also took little notice of the minefield of sea urchins we swam over and would have to swim back over later as the tide receded.) When I finally had gotten out to the point I remembered last year, I was devastated—as was the reef. Large swaths of bleached fingers marked the graves of what were just last year thriving communities of miniature organisms. Some species had managed to hold on, spreading their colonies to new rocks but in so doing, replacing the diversity that had once flourished.

Distressed, I swam into the shore after an hour and immediately began asking, “How?!” The rising temperature of the sea was first proposed. Even fractions of a degree can alter sea life. Someone else said a change in salt concentration made possible by the rising tides mixing with the fresh water that comes out from the underground mountain aquifers at the beach. The harvest of the coral was unfortunately another likely possibility, since grinding coral produces powdered lime, or cambang in Pidgin, the reactive agent favored by betel nut chewers. And with an island of addicts, crushed coral is in high demand.

But when I made it back to the women’s wash area, they had yet another idea and pointed to the cliffs by way of explanation. It was then I took notice of the heavy erosion and the uncountable grains of sand that are finding their way onto the reef, bathing the coral in a much unwelcome sand bath. I’m no expert. I can’t say for sure the erosion is chiefly responsible for the reefs declining health, but I do know that if a 30 foot cliff sifted its soil onto of me, I wouldn’t be happy—and I can’t imagine the coral would be either.

This Wednesday I found myself back in Mater’s bay. I wasn’t intending to take a swim. In fact, I’d spent the day walking to check up on our southern-most volunteers and I wasn’t toting swimming attire (shorts and a t-shirt; swim suits are culturally inappropriate most places here). But there was an unlikely yacht parked off shore, and my volunteers encouraged me to meet its captain.

Chris Bone, yachtsman and founder of the non-profit Oceanswatch, docked in Mater’s waters last week. Returning for his second or third year, he and his crew of three will spend two weeks doing a “reef check,” essentially a survey of the reef’s health, and training three local boys in the process with the intention that they will take over reef checks in the future. Their findings: though the reef was in fact badly damaged, he thinks probably by some storm or violent natural event, there are many small corals growing back. He wouldn’t confirm my hypothesis that the sand’s erosion was responsible for current destruction, but he agreed that erosion could certainly wreck havoc and that rising tide levels could be at fault.

It’s Chris’s hope that with over 150 yachts registered with his non-profit, he will have soon have teams doing similar reef monitoring and community development in seas throughout the Pacific and Caribbean. I’m inspired by his initiative, in part because he appears to have harnessed rich yachtsmen into spending their money to aid conservation and development projects in the third world, but more so because his program trains young locals to take part in the conservation of their own natural resources. This year, he’s taught three young men to scuba dive as well as complete the paperwork for a reef check. And if there is hope for this reef, it’s in the hands of these young men. Yet, while these men work to record and combat the effects of slowly rising waters, on the other side of the island, a much bigger tide has drawn in local attention.

Last year, in addition to our drought, we had the infamous “tsunami” incident. Lost in translation, rumors of a tsunami made its way around the island one afternoon, inciting Christa and Jess to literally sprint up the volcano laden with their full packs much to the amusement of locals, who assured them that they would be safe a mile inland. (They persisted to an elevation of at least 500 feet.) The fabled wave was actually just a high tide on the other side of the island, but even a rise of an extra 5 feet was enough to wash through some of the stilted-houses perched on the shore. No one was hurt, but the retreating waters left their message:

On Karkar, climate change is on the doorstep.

Wednesday, August 5, 2009

Development: Insight From The Next Generation

What does development mean for PNG? I got my most insightful answer yet from of one of Mater Primary School’s eighth graders last week. A recent writing prompt from his Panango teachers, Erica and Olivia, asked, “What do you see in the future?” to which their top student Constantiin (pronounced like the Emperor) wrote the following grim reply (Forgive the grammar errors; I left them in for authenticity):

I see everyone live in the expensive houses, eat only food produces by factories. There is no more PMV’s [public motor vehicles) to transport goods. Our village is changing, each and everyone of us know how to drive. All our forest was cut down, huge factories, towns, and buildings was build there. Also the air is polluted and small children find it difficult to breath[e]. Our traditions was taken away by white people and our country’s features is completely change. Population increase and we [have a] shortage of land. The tribal [wars] takes place, people die, and the fight will keep going.

This dire forecast isn’t what has to be, but sadly a likely prediction. Riding in the back on the PMV into Madang Friday, I took in the state of the town renowned as one of the most beautiful places in the country. Its palm-studded coastline remains idyllic and plumeria still blooms in the trees around the market, yet the steadily crowding roadsides are littered with rubbish and the blood-red sediment of buai (betel nut) spit, the ponds have begun to pool with septic scum from runoff and I believe improperly drained toilets, trash is heaped in the back of a children’s playground, and brightly-painted but corroding warehouses line the pavement where trees undoubtedly once stood. My hosts here visit the market for fresh veg brought hours from the highlands and the grocery stores to buy white bread, sugar, and fatty canned meat that surely must contribute to high incidence of middle-aged heart attacks. Yes, I appreciate the running tap in the kitchen and the ability to buy cheese at the grocery to top a pizza for my hosts—and of course, the wireless internet at Divine Word—but I’ve realized I wouldn’t want to trade Karkar’s greenery for town’s amenities. I’m already missing my garden kumu (greens).

After explaining the American system of food production and consumption to one of my many Karkar “mama’s” last summer, she astutely replied, “Money is your garden.” Unfortunately, some day that may be true for Karkar too. But as much as I worry about the negative physical repercussions of industry and urbanization, I am also aware of positive changes, like an increased value on education, that living in town brings.

“Development must start in the mind,” Christine told me. And I don’t have to look further than Constantiin’s essay to see that that is already happening.

Cocoa and Copra: Karkar's Second Currencies

The first night I arrived on Karkar, now over a year ago, our team leapt down from the back of our transport to meet a welcoming party lead by an old man wearing little more than a thong made of a few leaves, a bit of bark and a bright pink plastic bag—and a sprouted coconut, tied ball-and-chain style to his left ankle.

The cultural roots of the coconut run deep here—if not the roots of the coconuts themselves. The tambuna (origin) story of the sweet-meaty fruit varies with the storyteller, but all draw upon the similar features of a husked coconut’s three “eyes” with the features of a human face. My favorite:

Once two brothers went out to catch fish in their canoe. The canoe overturned and they found themselves surrounded by sharks. The elder brother, fearing that they would both be eaten, directed the younger to cut off his arm and feed it to the sharks as the brothers began to swim to shore. He did this, but the sharks followed and the shore was still far off. The elder brother continued to order the younger to cut and feed his limbs to the shark until finally the younger brother reached the shore, left with just the head of his brother. He planted the head, which grew into the coconut and continues to bear fruit in the likeness of a head to this day.

Dried coconut (copra) is used in almost every recipe, from creamed rice and greens to fish and pumpkin stew and popo (papaya) cake. Fresh green coconut (kulau) is a deliciously-sweet refreshing drink with levels of rehydration salts on par with Gatorade. I (and the rest of Karkar) am addicted to both and reaping the benefits: clear smooth skin, a boost in antioxidants, and lower levels of stress. No kidding! Used as an exfoliant, scrapped coconut meat is a great acne treatment (a trial had remarkable results on the mysterious backne plaguing two in the group) and a compound in the meat is reported to reduce levels of cortisol, the hormone the body produces when stressed. (Finally, a biological answer to the phenomenon of PNG time!)

So integral is the coconut to life here, even my Western-wise friend Christine asked me today where we get our coconuts to cook with if they don’t grow in the US; she was sure we must be importing large quantities of such an important staple.

Plantations (“line coconas” in Pidgin) and the concept of growing coconuts for commerce were, not surprisingly, ideas brought by missionaries and expats. The first profiteers arrived in the 40’s just after the war. Plantations now cover the majority of Karkar’s coastline and large swaths reach up the base of the volcano. The two largest, Biabi and Kulili have made their owners millionaires. The vast majority of the others has much less acreage and is owned privately by individual families. Buai is the official “second currency” of PNG, but at least on Karkar, it’s the price of copra that determines a family’s income for the year.

There are two ways to get paid for the grueling labor of collecting, husking, cracking, desiccating, and pounding the fallen coconuts into their canvas sacks. Working for a large plantation like Biabi or Kulili, a man—or more often, woman—makes a pitiful 60-65 kina a fortnight. Working your own plantation, you get paid by the bags, which must be bought by one of the two plantations on the island that own cargo boats—which double as passenger “ferries”—that provide the only mode of transport off the island. Unfortunately, a 100 kg bag of copra that last year fetched 50 kina is currently going for as little as 30, which is having a devastating impact on many families.

Students join their parents in the plantations during their school holidays to collect the fallen coconuts to raise money for school fees. This year’s deflated price means students are having trouble coming up with the 250 kina for annual tuition. If they can’t pay be the end of the year, most schools will refuse to promote them to the next grade regardless of their class performance.
As Christine pointed out when I asked her for a forecast of Karkar’s development, it seems that one of the first projects villages should invest in is a ferry boat for public use so that small plantation owners could reach a competitive group of buyers/distributors. Not to mention, the island’s tourism would get a real boost from a legit passenger ferry. (Eager to avoid the grueling 5- or 6-hour slow-boat-to-Madang, I’ve opted to take the hour speed boat route directly across the channel to upload these entries. Calm seas made the first two trips absolutely pleasant, but the most recent left me sodden and salty and kept the skipper’s mate scooping water from the boat for the duration of the trip. Thankfully, we threw my bag and computer inside a cooler to keep it dry.)

While the coconuts are the most readily visible cash crop on the island, a second flurishes beneath them. Trees of cocoa, the bean crushed to make chocolate, conveniently thrive between their loft palm neighbors. The beans grow in about 6-in. long and 3-in. wide pods, packed next to each other in a viscous sweet white membrane (well worth a suck and far more appetizing than the dried bean itself). Bond, the operations manager for Biabi’s cocoa production, gave us a tour of the processing facility one afternoon. The beans, pulled from their pods and separated, are thrown into square meter holding boxes to dry. Each day the beans are turned by shoveling them into the next waiting box. At the end of a week, the beans are spread on the hole-punched drying platform where heat from a furnace rises through the holes to roast the beans. The finished product is sorted by machine and then by hand to separate the good from the bad. The first time I tasted a bean, I spit it out, disgusted by the bitter taste and choking from the cloying smell of sweat in the dryer. But trying Bond’s beans this year, I was pleasantly surprised to find them more akin to very dark, dry unsweetened chocolate.

Like copra, the idea for growing cocoa is completely colonialist. In this case to the extent that the plant didn’t even exist on Karkar prior to the 1950’s. To this day no one has tried to incorporate cocoa into the local cuisine, and to my personal dismay, no one has a recipe for chocolate itself. The treat is found on the island only in the form of the imported Milo drink favored by children. Noumea, the German exporter that buys much of Karkar’s chocolate, doesn’t distribute in PNG. (Though I imagine in the heat, it wouldn’t hold up well if they tried.) I’m not sure you can find it outside Germany, actually, and the website doesn’t provide any ordering information.

Yet another crop grows on the ground beneath the copra: vanilla, which was imported and planted after a tsunami devastated Madagascar a decade ago. Unfortunately, when Madagascar recovered, the prices weren’t worth coming back to harvest the vanilla on Karkar. Last year, Christa and I mistakenly thought that given the price American’s pay for sticks of fresh vanilla on US shelves, the wholesale prices must have recovered and we’d hoped to find some fair trade buyers for Karkar’s abundance, but we were sadly mistaken. But the idea of using it to produce boutique soaps or hand crèmes I think might still be worthwhile, if we could a cohort of interested women entrepreneurs and a recipe.

The more likely event however is for another expat to set up shop, as has been the case for every other crop on the island. Such is the nature of colonialism, investment, and free markets, I know. But if I have one wish for Karkar it is that the students we educate today will tomorrow be able to find PNG investors to back their own business schemes. Already microfinance is making this happen on a small scale, but for PNG to assert itself as a player in the global economy, it needs businessmen, or ideally, a business community rather than a single individual, to work and profit from their own resources. But before that can happen we need honest investment from top-level politicians in their own people. And Michael Sumare, accepting Chinese money (or bribes as many call it) to open new mines, industrial parks, and other ventures is not setting a good example. (Rumor here has it that a private business deal with the Kumbukari mine owners will keep the mine opening on track despite a court order to close it.)

I don’t mean to say that outside investment and investors should not be major players in PNG development, but they should not be the only players. And right now, at least on Karkar, few locals have been empowered or funded to sell their products to anyone beside an expat middleman or to found a business of their own. But like the chocolate this island produces (but never consumes), there is sweet potential for a bitter bean with the addition of a few more ingredients.

An Ironic Memorial

We observed PNG Remembrance Day/WWII Memorial Day here last Friday (The actual holiday was Thursday, July 23, but school administrators correctly assumed that if you gave students a Thursday off, they’d take Friday too.) It’s one of three veterans’ days PNG celebrates partly in honor of American troops. On the mainland, I understand the reverence shown to troops since they held the Japanese at bay and supposedly modeled the first racially integrated troops in PNG, but on Karkar, the display of respect is terribly ironic.

The Americans bombed Karkar’s coast relentlessly and indiscriminately in their attempts to route out the Japanese from the caves and bush of the island, killing hundreds, if not thousands. Not that Japanese occupation was better alternative. I can’t even fathom what Karkar Islanders must have thought or how they attempted to explain a sudden bath of bombs and blood on their, by that point, relatively peaceful island. Pop’s has referred me to his uncles who were just boys in 1942 for a more detailed account, but his own tales of bloodied hands hanging in the mango trees at Tabel, a relative tortured on account of suspected spying, a boat of missionaries and Karkar native POWs being bombed at sea are enough to make anyone’s stomach turn. He says you can still see the bullet holes and remains where bombs detonated in coconut trees in the plantation at Kulkul (my family’s home). Rolaine says cousins found the tail fin of and American airplane at the beach once, it’s USA marking still visible.

And a recent addition to local folklore is the well-known story of a prominent Karkar woman’s burial during the war. Villagers had been warned to stay in their houses or the caves many took to hiding in for the duration of the daytime. Only at night would they leave the refuge of the bush to hunt, fish, and cook. But one day the death of a major village figure required them to abandon their stealth to provide the woman a proper burial. As the pall-bearers were carrying the coffin to the grave, fighter plans flew overhead and detecting movement, drops a barrage of bombs on the funeral assembly. All dove for cover, dropping the casket as they ran. When the pall-bearers returned, the casket was no where to be found. The bomb had detonated in the ground next to it and buried the casket completely.

It’s stories like these and others of the terrors of the war that have some on Karkar—or at least my host parents—talking of compensation for their losses. Stories of Japanese war reparation payments for some abused women and widows of the war have filtered through to PNG. Before he died, Pop’s father drew from memory a precise depiction of the boat the Japanese had his maintain and use for their war effort. Pop’s has some hope that some day an appeal (as of yet, theoretical) to the Japanese government to compensate the decedents for their contribution to the war cause will bear a fat paycheck. Given the rate of anything getting done around here, I’m sadly doubtful a suit would ever be filed, and even then it would be little more than a gesture, though an important one. At least as an American, I feel like my history classes completely neglected mention of the sacrifices made by Pacific Islanders during the war.

Today’s respect for America here comes as the repercussion of yet another powerful country: Australia. I’ve heard time an again that the US is willing to give aid to PNG without strings attached (for example, sending a hovercraft marine mission to refurbish Gaubin Hospital here last year) whereas Australia has required the hearts, minds, and labor of PNG in return for its aid (which, for the record, currently accounts for 1/3 of the GDP). Ambassador Leslie Rowe worked tirelessly and successfully to increase American aid and investment here, and I am hopeful that in the future America will better prove to be the ally she is revered to be.

Basketball and other American mythology


Yesterday I lost a club basketball game for the village of Dimer. It is a testament to Melanesian hospitality that they congratulated me on the game afterwards—and only told me later I had fouled four times (and I had to elicit the information myself). If not realizing I carried the ball that many times is not enough testament to my pathetic skills, I don’t know what is.

Today my students gave me a two-hour tutorial on shooting hoops. (Essentially, they played a very kind—but driven—game for two hours, in which time I managed to wear out the soles of my feet since we played shoeless on a court of packed earth and grass. I’m making progress, but I’ve really got a long way to go on my layups if I’m going to play with the Dimer team again in two weeks.

My basketball fiasco is just the latest in my unconscious string of American stereotype-shattering activities. I’ve disappointed students by not knowing a celebrity’s photo in a tear out from a teen magazine and I’ve then astounded them by liking their music and wanting to learning their language. My Karkar family is used to my requests to scrape coconuts for dinner and now anticipates my help with the dishes at 6:15 each morning, but others are astounded when I ask to cook or to other chores and even Mama was still surprised when I lifted a 15kg bag full of rice and potatoes onto my head to carry it up to the school last week (for the record, that much weight pulling on your forehead does put a crimp in your neck). The perception of rich and pampered white Australians and, by extension, Americans runs deep here. Colonialism has a habit of doing that. And if we’ve managed to change anything by our presence here on Karkar, we’ve worked to decrease the “othering” effect Australian elitism had on the PNG psyche and dispelled some myths about Americans—even our alleged basketball skills.

The Education Reform


My little brother Richie is 7, and like all Papua New Guineans, a polyglot. His mother, is from Central Province and was raised speaking Motu—and English in her girl’s grammar school. Richie’s father is from Kulkul on the Waskia side of Karkar, but Pop’s mother was from the Takia side of the island so Pops grew up speaking Takia. Richie’s older siblings spent their early years in their mother’s province, learning Motu in tandem with English and Pidgin before moving to Karkar and picking up a smattering of the island’s two tok ples.

This year Richie started first grade. Because his parents are currently teachers—and subsequently live—on the Waskia side of the island, Richie should be at Taleng taking classes in Waskia tok ples, the local tongue, as mandated by a 2003 reform. The much touted and talked-of reform requires instruction in the local language in grades 1 and 2. Richie has picked up some Waskia from friends, but mind you, Waskia is neither the language of his mother nor father and certainly not the “native tongue” the reform had in mind; Richie grew up speaking Pidgin and English.

Fortunately for Richie, a new “private” (though the school fees are the same as any public school) English grammar school started this year at a village about an hour’s walk from our house. Richie takes his bike down the rock-strewn road each day to get to class. But his parents’ know it’s worth it.

This is not the case for many.

The 2003 reform introduced Outcomes Based Education (OBE) to PNG. The good-intentioned reform aimed to reinforce traditional cultural knowledge by teaching folklore, cooking, agriculture, and traditional language in addition to the three R’s. However, in so doing it eliminated a structured curriculum supported with teacher resources in favor of a series of vague “objectives” to be decoded and taught using teacher-tailored (really, written from scratch) lessons. It also delayed English education to grade three, introducing native tok ples in grades 1 and 2.

This should be a boon for native tok ples, which are suffering considerable losses in evermore Pidgin-speaking PNG. The Takia language, for instance, is in particular jeopardy and is being closely documented by SIL linguists/translators currently. Parents, like Pops, have chosen simply not to teach it to their children. Teaching tok ples in schools is one way to preserve these languages, and many will argue, by extension, cultural ways. After all, cultural knowledge is passed on through language, and as one man explained to me, traditional stories and rituals lose some of their meaning, implication, and expression in translation. Not knowing your tok ples means you also likely are unfamiliar with traditional ceremonies. The reform seeks to insure this is not the case. However, in practice the tok ples is largely ignored in favor of Pidgin in the early grades.

What results is a system that schools children in Pidgin, a trade language with limited vocabulary derived from (and as such, often homonyms to) English words. Imagine learning write about the structure you return home to every night. It’s one thing to learn the name in your native tongue and then later to associate that concept with an entirely new word in English: house. It’s entirely another to learn first in Pidgin that the structure is a haus, pronounced exactly like it’s English counterpart, and then later to have to relearn it’s spelling as house (which, for the record, makes far less phonetic sense). Now imagine learning the entire language like this: welcome to my classroom (or as my students are inclined to write: welcam lo’ clasrum bilong mi).

An additional complication compounds the delayed English learning; that is of course that student’s learning in general is delayed. Ask anyone, even my brilliant college-educated friend Christine, and they will tell you that Papua New Guineans just don’t develop cognitively as fast as the rest of the world. For this reason, most children don’t start grade 1 until age 7, 8, or 9 (and even later in some cases if the child is the last born and Mama wants to keep the “baby” around a little longer or if other children are already in school and the parents can’t pay school fees for an additional child). And maybe in some sense they are right for stating what they’ve observed in villages and schools. Or maybe I’m just on oversubscriber to the nurture side of the nature vs. nurture debate, but it seems to me that if children’s minds would be stimulated (i.e. schooled) at a younger age, they would develop at a younger age.

Many teachers, and in fact, anyone educated under the colonial system, will tell you that English literacy was much better under the old system because students started speaking and hearing English as soon as they got to school. As it turns out, language acquisition research backs this up. Psychology studies have shown that children must be hearing at least 50% of their words in a language by the age of 7 for them to ever gain fluency in that language. In PNG, students are just starting school at age 7—but not starting to speak English until two grades later when they are well past the fluency cutoff. And even in grade 3, its dubious that most students are hearing 50% of their words in English, since the classroom setting is the only place they are exposed and even there the teachers still favor Pidgin. Ultimately, the failure to teach students either their native tok ples or English is what the reform has largely come to stand for. As a result, many teachers on Karkar have sought to ignore it completely, leaving lessons a chaotic mess of Pigdgin, English, and haphazard attempts to use pre-reform materials to meet vague reform objectives. And often the positive aspects of the reform get overlooked in the melee.

One such positive change is the inclusion of objectives for teaching traditional cooking, agriculture practice, cultural histories and tambuna (origin) stories. Last week, I watched third graders giddily chase each other in a dramatized pig hunt as part of this last objective. (The pig eventually succumbed to the spear, but before the hunter could return with friends to drag his kill home, the pig turned into stone. I’ve seen the alleged stone; it sits a top the hill overlooking Taleng. Digicel built the island’s most recent cell tower at this sacred site this year.) Anyway, the other objectives have also proved fruitful, literally: last week we dined on corn grown by the students in a plot at Taleng. The students sell their produce to teachers to raise funds for school projects, but they also practice cooking traditional dishes themselves. (Though I can’t imagine a single one of my students not having learned the PNG culinary arts from their mamas.) Students also study how to build houses using bush materials and just last week completed another teacher’s kitchen roof with woven sago palm leaves.

Certainly, this applied education (or what I like to think of as tech school training) has its benefits, and I’d argue that it needn’t be an either or choice between skills training and English instruction. Many students will find the skills training most beneficial as they go back to live in the villages and work in the copra plantations when they fail the high school matriculation exam. But those who wish to pursue higher education, business, politics, or pretty much any job outside manual labor must master English.

And sadly, this is not happening under the current reform.