THE WAIT – Healthcare in Vanuatu

A young woman shows off her chest X ray after a visit to the Peace Ark, a Chinese PLA Navy hospital ship. photo: Graham Crumb – imagicity.com

The failures of Vanuatu’s health services are felt by everyone. But these shortcomings are particularly vivid to me today. As I was working on PiPP’s latest multimedia story on the state of health care in Vanuatu, I buried two friends on consecutive days. I have not the slightest doubt that they would both be alive today if they lived in Auckland or Sydney.

Danny Tetiano and Dr John Otto Ondawame were both influential, important people. One was a gifted musician, mentor to a generation of aspiring artists in Vanuatu. The other, of course, was one of the leaders of the West Papuan independence movement. In addition to the loss to society and to the world, both left grieving widows and young children behind.

To put it plainly, Danny and John died of poverty, not disease.

The cost to society is immense. One of the very reasons West Papuans have struggled to organise themselves and become a well-defined locus of international attention is the lack of well-educated, dynamic people, skilled in persuasion and diplomacy. They lack entrepreneurs to improve prosperity, education to create the entrepreneurs, and health services to preserve and protect them.

The lack of basic services is characterised as systemic abuse when Indonesian government policy is concerned. But how should we characterise such neglect in Vanuatu?

Health services in Vanuatu – there is no health system, per se – are rudimentary at best. Post-operative infection rates make even the most run-of-the-mill surgery a cause for concern. One long-time acquaintance died following the amputation of his big toe. A well-intentioned (but unforgivably vague) blog post by the UNDP raises the point that life expectancy in Vanuatu and other Pacific island countries is ten years less than in Australia and New Zealand.

Ten years, and three hours flight away.

The difference is quantum. It’s at once tantalisingly close and achingly distant. But the bitter lesson that I’ve learned this week, and repeatedly in the past, is that the cost of inactivity is not an abstract one. Death impacts directly on a nation’s ability to grow, to gain experience, and ultimately to survive.

Honour is respectable

Vanuatu’s first prime minister Walter Lini famously said, ‘respect is honourable.’ The phrase is often quoted today by people from all walks of life as a means of recalling the best aspects of Vanuatu society: its use of deference and respect as an integral part of community peace-making. Modern influences have transformed kastom in many ways, but respect is still held tightly to the national breast.

We might do well, though, to turn the phrase around.

It must be said that traditional life in Vanuatu is indeed happy… for those men who survive their first five years in comparatively good health. And some women may be content living within the confines of their village roles. But like it or not, that life is no longer available to a growing number of people.

If we include people living in peri-urban areas around Port Vila and Santo, census figures show nearly a 10% change in the urban/rural population ratio between 1999 and the last complete census in 2009. Much of this change is composed of the so-called youth bulge – a growing number of young adults with limited opportunities both in the modern economy and in traditional life.

These are not the only source of discontent. Household dynamics are increasingly complex. Domestic relationships, both formal and informal, are more fluid –and generally more violent– than they were. This is largely a result of the clash between the de facto status of women as chattels, and women’s increased economic independence, and thence mobility, in the modern economy.

Men and women both are no longer subject to the social and geographical confines of village life. Mobility and distance undermine traditions that have sustained Melanesian societies since time immemorial. The coercive or corrective power of community scrutiny recedes once it becomes possible to evade the villagers’ gaze. The village’s role as collective conscience has been eroded and, to date, nothing has arisen to take its place.

At all levels of society, the dwindling power of social pressure leads to behaviour that once might have been unconscionable. Legal and regulatory checks go unheeded and national institutions teeter on the edge of dissolution.

But kastom is a resilient term. It has survived thousands of years of challenge and changing circumstance; it has managed to remain a viable idea throughout even the last two centuries of transformation. There is no reason to believe it won’t survive the changing economic and social conditions of the present day. Continue reading →

Web tricks are not for kids any more

I started writing web apps in 1994. Using CGI.pm in Perl was pretty much state of the art – and the art wasn’t very pretty. ColdFusion appeared shortly thereafter, but only supported basic control structures – no functions or even subroutines at the start. Then came ASP and a disastrous mishmash of security holes, ActiveX objects being called from the only thing worse than PHP for tag soup with spaghetti code for filler. PHP, for our sins, went from being a ‘hey, kids, look – I made a web page!’ app to an actual application platform.

.. and the list goes on.

I’ve lived through the browser standards wars, I’ve seen such sins committed in the name of the Web that I would wake up screaming, ‘Why, Tim Berners Lee?!? WHY???!!’ I’ve lived through <BLINK>, Flash, animated GIFs, <MARQUEE>… and other monstrosities whose names Shall Not Be Spoken.

I’ve used JavaScript since it was a toy.

But this, my child, is the key: It’s not a toy any more. Finally, after two decades of stumbling around blindly, wreaking more chaos and mayhem than a shirtless, drunken Australian on a JetStar weekend in Bali, web development has finally matured. A bit. It’s learned that being cool doesn’t earn you nearly as many friends as being useful. It’s learned that a guy’s gotta eat, fer Chrissakes, and sleep from time to time. It’s learned that popsicle-stick bridges may be neat, but won’t carry the load that a boring old concrete one will.

But, as the scripture says, ‘then I put away my childish things.’ Oh, it’s true that just because we’ve grown up doesn’t mean we’ve learned every lesson ever. It’s true that we Web Developers still get seduced by Teh Shiney. But all in all, we’ve grown; we’ve lost our innocence and our hair. But we sleep at night. And we parallelise. And we scale. We’re grown-ups now. With grown-up tools.

So put down your PHP child. Accept that JavaScript is a language. REST in your Bower and accept that some change is for the better.

The chambers of the heart

You are in the fourth chamber
You are in the fourth chamber and you are pushing    
half impelled          at a doorway

a moving crowd     a crush
like breath held far too long 
and far too deep

lockstep on a pilgrimage of longing 
a pace     another pace inside 
this carapace of gesture and humiliation

s'io credesse       s'io credesse
move me Lord
but let me know I am being moved

Only my first robin

but it was only my first robin

Every day I face the suspicion
that you have had secret springtimes

sunlights that you hid from me
clandestine pussy willows camouflaged
whole choirs of spring peepers
cued by no baton but yours

hidden nations of tulips
daffodils and crocuses
held in boxcars
and run through town at night

without stopping no lights
no whistles

I don’t know which of us to worry for

Song

I’m waiting for the song that writes itself,
A choir of one with hymn sheet white and clear,
Whose even blankness is a kind of wealth.

A coruscating symphony of stealth,
At once a glance to Heaven and a leer—
I’m waiting for the song that writes itself.

A city full of strangers, smug in health,
Devoid of life and liberty and fear,
Whose even blankness is a kind of wealth,

Averse to dying as to life itself:
They will persist, though cities disappear.
I’m waiting for the song that writes itself.

The teacup cracking on the kitchen shelf,
Discarded with a backward-looking tear
(Whose even blankness is a kind of wealth),

The brahmin contemplating loss of self…
Both gravitate toward something too austere.
I’m waiting for the song that writes itself.

I cannot hum it, even to myself,
Nor puzzle out its immanence, this fear
Whose even blankness is a kind of wealth.

Existence has a price that’s far too dear,
But nothingness? A trifle too severe.
I’m waiting for the song that writes itself,
Whose even blankness is a kind of wealth.

Sisters

And Love says
to Death, “That’s the last time
I let you borrow my clothes.
Just look at these wrinkles–
and that stain! My God.
What did you DO?”

(Whacks her over the head
with a hairbrush, and they’re
scrapping all over the room.
Love comes up short one
tooth.)

She screams, but Death,
her eyes are burning like dull coals:
“You just don’t know, do you?
You never never try to understand.
Well it was an accident
but right now I’ve a mind
to accident you.”

(Love is hysterical.)
“You wouldn’t,” she screams.
“You never could!”
(Runs out in tears. Never comes back.)

The birds arrive

The birds arrive at six, begin to feed.
Petulant and raucous, their harangue
stifles the belief they ever sang.
Squirrels make off with all the fallen seed.
The chickadees are orderly in greed;
The jays are not: on suet left to hang
they find a perfect stage for sturm und drang.
Only poets could decry this simple creed.

This is no scene of joy, but satisfaction
flies on stronger wings than love or beauty.
Think good thoughts, but in the end it’s action
(applied with elbows) that defines our duty.
Feed the masses, let the poets rue it.
Their verses nourish less than lumps of suet.

My heart announced

My heart announced today that it will leave.
It kicks in expectation like a child
in the womb, a trapped miner at piled
timbers: long past the urge to grieve,
he gathers up the threads of air that weave
life in darkness, then is reconciled
and only waits. I am no more beguiled
by death than he. Still, my heart will leave.

The unborn child cannot begin to fear
the pain his mother feels, the open wound
that he creates, and when she draws him near
no memory will scar him. All too soon,
I will live this parturition. Pleasure
has no gift to match this last long measure.

THE SCRIPTORVM

Collected essays, columns, etc. by Dan McGarry

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