GOLD COAST – PNG’s prime minister Peter O’Neill was recently quoted as saying that “preventing death and sickness as a result of inadequate sanitation is a personal quest of mine to improve health and hygiene.”
He continued: “I have lost several friends and relatives to preventable sicknesses caused by poor hygiene conditions such as the use of filthy toilets and a lack of health facilities. We must do all we can to improve hygiene.”
During the 18th and 19th centuries the skill of grinding glass lenses led to the construction of microscopes.
Scientists and the medical fraternity then became aware of the existence of bacteria and ultimately of viruses. Today we refer to these life forms under the general heading, ‘germs’.
Since the dawn of human history, human disease and illness were thought to be the result of many origins, from the disfavour of the gods through to various natural phenomena.
People’s imaginations conjured up reasons why people fell ill and died - or recovered.
Medieval Europeans ate near their animals which sought food scraps and bones around the table. Food dropped on to the floor was snatched up by the eater and, after a hopeful prayer to ward off evil spirits, popped into the mouth.
The possibility of people becoming ill was accepted on the basis that divine intervention might prevent it happening.
Many human diseases originated in birds and animals kept in or near houses and subsequently leapt the ‘species barrier’. Influenza in humans for example, is believed to have originated in birds.
New forms of disease constantly do this today with one of the most recent being Middle Eastern Respiratory Syndrome (MERS) that is believed to have originated in camels but is now able to be transferred between humans.
Where a disease has been prevalent in a human community for some time, a certain amount of natural immunity starts to build up in that group to help resist the disease, however when there is no natural immunity in a community, the effects of a newly introduced disease can be devastating.
The so called ‘Spanish flu’ at the end of World War I killed more people than died in that terrible ‘war to end all wars’.
The old expression ‘seeing is believing’ was a benchmark used for understanding infection that led to illness. Until microscopes were invented, the inexplicable, which could not be seen, was attributed to the unprovable.
Even today faith healers or sorcerers are consulted by people when modern medicine is either not available, affordable or simply unable to cure an illness.
Prior to the arrival of modern medicine, Papua New Guineans were no different to people in other societies where illness was attributed to witchcraft, magic, divine or ancestor intervention, or the breaking of customary laws.
The beginning of government services in PNG’s rural areas usually started with a government patrol led by a kiap who was often accompanied by a medical assistant.
The miracles of modern medicines such as penicillin on devastating diseases such as yaws and tropical ulcers were often considered ‘white man’s magic’. It took a leap of faith to understand that disease and infection were due to something not able to be seen with the unassisted human eye.
Even the existence of infections like hookworm were doubted as no one had actually seen the ‘worms’.
In light of this, it was not surprising that, when the building of pit latrines was demanded, there was a reluctance to conform. Free roaming pigs were expected to perform the work of faeces removal in the village and no one knew anything about the life cycle of parasitic worms.
Physically debilitating illnesses like anaemia were attributed to various other causes.
When an explanation about disease was ignored by villagers, coercion was used as a means to pursue public health concerns. Local government by-laws about constructing pig pens and pit latrines were introduced. Gradually, these ideas began to be accepted.
Yet this was only a first, tentative step in combating infection and disease.
In a rural village environment with low population density and readily available fresh water, village hygiene could be maintained at acceptable levels. With the inevitable urban drift, the impact of population pressures has stretched public facilities often to breaking point.
Fortunately, there are some useful road maps from other societies available for PNG to follow.
A visitor to India may be startled by the number of males seen publically urinating against walls, fences and in the open. It has been said there are more mobile telephones in India than there are toilets and the Indian prime minister is promoting a campaign to drastically increase their number.
In most rural areas of PNG, clean, fresh water was always available from nearby streams. As people started to move to towns and cities and urban squatter settlements grew, the lack of clean water became a major problem.
Many people now queue for hours to fill plastic containers from a single communal water tap and carry the water back to their homes. Lack of clean water for washing and hygiene can be a serious problem.
In India, clean water for drinking, washing and cooking is in short supply and public wells and hand pumps are a frequent sight. Clean drinking water in public places like railway stations and food markets are mobbed by people in the tropical heat desperately seeking clean water to drink.
The incidence of water borne disease in India is now so prevalent that people constantly infected by organisms in their youth end up with digestive systems that cannot provide sufficient nutrition to live a healthy life.
Where organic matter builds up in Indian drains and waterways to rot or be washed away by the next monsoon and plastic now stops drains from working, increasing health issues affect many Indians and the message to PNG is that this situation should be avoided at all costs, although it is certainly already problematic in Port Moresby.
Concerns about untreated raw sewage have been previously raised in PNG. Where water sources are so contaminated, public infection rates soar.
It has been suggested that the introduction of composting toilets could help improve public health as these facilities can effectively sterilise human waste and turn it into useable fertilizer. This requires an understanding of the process and the necessary skills to effectively manage these toilets.
PNG’s problems of buai rubbish in the cities pale into insignificance when mountains of plastic rubbish are seen almost everywhere in India. Any gap in a fence or wall invites the disposal of rubbish. Even where there are public bins with the words ‘Use Me’ on them, people don’t seem to care where they throw their rubbish.
It seems that when rubbish is thrown away it becomes someone else’s problem. The inside of a private house or shop may be fastidiously clean but as soon as any rubbish or dirt is swept a metre away from the front door - someone else’s problem.
Eating meat is a thorny issue in India where many people are vegetarians. While a Papua New Guinean might wish for better nutrition than a lamb flap, freely roaming Indian cattle held to be holy by the Hindus add to the general pollution and constantly spread potential disease.
Hand crafted cow patties are dried in the sun to be stacked and used as cooking fuel or fertilizer in. Holy cows are often seen eating cardboard boxes and even plastic to assuage their hunger where no other food or greenery exists. Cow pats and urine are everywhere.
PNG doesn’t have the problem of free roaming cattle but it does have similar problems of a fast growing population together with a perceived lack of freely available fresh water in urban areas.
Non-treatment of raw sewage and lack of toilet discipline are affecting people’s health, especially in times of drought.
So, before PNG goes further along the route of environmental degradation and health threat, maybe it’s time to learn its mistakes and start to address the problems head on.