Wednesday, July 23, 2014

Haus Sik

When I came here a year and a half ago, I did not expect to function as an ambulance driver, but many times I kind of have, running sick students to the local health centre and back.

From my perspective, there are three layers to our health care system. First, here at the seminary we have a small “clinic” by which we mean an air-conditioned closet with some bandages and medicines in it. Secondly, there is a nearby Catholic health station at Sek/Alexishafen. It is not quite a hospital, but is a fairly large operation by PNG standards. And then lastly, there is Modilon Hospital, the provincial hospital in Madang town. I have only occasionally filled in at our “clinic”, when staff with more medical savoir were away. I have spent a significant amount of time waiting in lines at the Sek haus sik and the provincial hospital.

I have many observations.

At proper medical facilities, medicines and treatment are heavily subsidized, but you are not guaranteed that there will be either medicine or medical personnel at any given health facility. Recently the main provincial hospital was out of Panadol (painkiller/fever reducer) for about a month. At Sek, it costs three kina (about a dollar) to have a nurse look at you. Pregnant mothers can come on Tuesday for check-ups that only cost one kina.

Many people here rely on health clinics for diagnosis of ailments that many Americans self-diagnose and medicate with over the counter drugs. It is still treated as some sort of medical consultation when someone has a basic painkiller prescribed for a headache.

People also want to take Amoxicillin (an antibiotic) for almost every conceivable ailment. I was once told that infection, and not malaria, is the biggest killer in PNG, and that sounds believable. The health center at Sek certainly hands out a lot of Amoxicillin, and I’m sure there are good reasons for that. People also sell extra pills of it in the market, though, and this is one medicine which many people gladly use to self-medicate. I was surprised once when a student who had had a boil on his hand came to me and said that he had gotten three Amoxicillin from another student, and had taken them all at once, but even that hadn’t been enough to get rid of the boil.

I have begun to suspect that for many people including some of my students, modern medicine is still little different from magic. When we had a student in the hospital for a more extended period of time (for a mysterious ailment related to seizures), I was shocked by how little information the medical staff gave us. If we didn’t ask, we wouldn’t be told anything. Most people have no real source of actual medical information, and in many cases they don’t walk out of the hospital any more informed or educated than when they walked in.

My point in describing that is to say that really people can’t be blamed for regarding medicine as magic. I haven’t thought about this too deeply, but wouldn’t the distinction be that for medicine we know how it works physically through means that are repeatable, testable, and observable, whereas magic relies on the supernatural and therefore is not necessarily observable, testable, and repeatable. But if one is altogether ignorant of how medicines work (and thinks that magic is also repeatable), then the difference becomes quite a subtle one. And in that case, if a sickness is not easily identifiable by the doctors, then it kind of makes sense to suggest that it is likely caused by sorcery or “poison.”

In the wards, people come through twice a day and assess how patients are doing. In the common way of speaking about it, there are three things they can do. They can give 1) marasin (medicine), 2) sut (injection), or 3) drip (intravenous injection). In explanations, there is no distinction made between different kinds of injections and medicine, other than their “strength”. I believe this is one reason why people will buy antibiotics from each other for malaria and take malaria medicine for an infection.

It can be astounding, too, to see medical advice passed around that is blatantly false. For example, I have heard at least one student claim with an air of authority that since this is a hot climate (the highlanders still aren’t used to how hot and humid it is down here on the coast), one should drink less water. If you drink less, you will sweat less. And I guess it is true enough, but from my knowledge, itself limited, I think this theory may also explain a fair amount of our headaches.

I sometimes don’t know what I should feel about all of this.

I believe there is something spiritual, though, about spending time in a hospital ward here, even if it is deeply discomforting. There is an expression in pidgin: bun nating (nothing but bones). It was rare for me to see people who are truly bun nating in the States, but in the hospital here one can see it all aronud you. And then to remember in the midst of all the emotions that come when one is confronted with human suffering and radical inequality: these are the people God loves. These are the little ones that the whole Bible says God loves most. This is who Jesus identifies with. This is the sickness and disease that Jesus took on Himself.

To end on a little bit of a positive note, one uplifting thing that one observes in the health centres here is the absolute reliance of sick people on their relatives. The health care workers are there to occasionally look at you and give you marasin, drip, or sut, and to respond if you seem to be dying. They are not there to take care of you. If you need to be fanned, bathed, or say…drink water or eat, then you need to have someone from outside come to take care of you. So the wards are full of all sorts of other people there watching their sick loved ones. It can be truly beautiful to realize that for most Papua New Guineans relationships are everything. Everyone has someone watching them, and none of the caretakers seem to begrudge the time that they’re giving just hanging out in a ward with their loved one and dozens of other sick people for days on end.

And I believe that that is an important part of what a pro-life culture looks like. The more we begin to see people as people whose lives are sacred and of intrinsic and not merely utilitarian value, the more we move towards a a culture of life.