The National

PORT MORESBY, Papua New Guinea (April 20, 2009) – Health and HIV/AIDS Minister Sasa Zibe unwittingly gave the answer to the country’s losing fight against vandalism, threats and harassment last Friday at the Port Moresby suburb of Morata.

He said people must take ownership and responsibility to look after their own health care centres in order to have health services closer to their communities.

Mr.Zibe needed to take his own advice one step further and develop it into Government policy.

He is right to urge ownership and responsibility. Now he must apportion ownership as he did last Friday so that the responsibility for looking after a facility did not just fall on a community of unnamed individuals but to named parties. In this instance, Zibe said the Morata health centre would now come under the management of the Catholic archdiocese of Port Moresby. It will be jointly funded by NCDC and the Health Department.

And such must be the way forward in health for the future, the new modus operandi – a health policy as it were.

Despite coming from a cultural background of communal ownership such as in land, modern Papua New Guineans had repeatedly shown themselves to be incapable of such ownership.

Time and again we have seen schools, health centres, sporting facilities and roads and bridges fall victim to vandalism, looting, theft or to terror and destruction in tribal conflicts. Often the school or health centre becomes the common battlefield, precisely because it is communal-owned and nobody could lay direct claim to it.

Zibe said a large number of PNG’s 600 health centres and more than 3,000 aid posts had been closed for years, many as a result of vandalism. This had deprived most Papua New Guineans of access to proper medical facilities. As a result, a staggering number of deaths are recorded each year throughout the country from easily preventable diseases or conditions.

It is also well known that since 2006, 60% of urban clinics in NCD had closed as a result of staff refusing to work due to continuous harassment and threats and damages to properties.

The statistics are equally staggering in the education sector where countless numbers of school-age children are deprived of primary education because schools are razed or vandalised or teachers are harassed and chased away.

Churches are an excellent choice for provision of health and education services.

While church properties also fall victims to vandalism and theft, the churches have demonstrated more responsibility in guarding and protecting their properties than does the Government comparatively.

Church followers are also more zealous in protecting church-owned assets.

In the end, if the churches were willing, the Government should offload all responsibility for community-based health and education facilities, such as aid posts and health centres from elementary to secondary schools, into the hands of church- or other privately-run organisations.

This will mean all budget allocation for these functions will have to be shifted to the agencies responsible.

Churches have had a bad experience, particularly with the education subsidies, so it is highly likely this suggestion would be met with stiff resistance.

Still it is do-able. All the Government has to do is to improve its own systems and processes so that all allocations to church agencies are done when they are due and in the correct amounts.

The ownership strategy will also need to be developed further to include those individuals and entities that show interest and have the ability and capacity to operate health and education facilities.

An urban clinic in Port Moresby, for instance, could quite easily be operated by a medical practitioner, or a group of them operating under a public-private partnership.

A public-private partnership would involve a doctor or group of doctors to be given responsibility to look after a clinic or health centre professionally, but their fees and medicine would be heavily subsidised by the Government so that services would be offered at today’s rates; only the services would be better.

And since ownership is clear, the facility would be protected.

Professional educators could be banded together to offer primary and secondary education on such a basis.

This would, of course, require a complete change of approach in management at the departments of Health and Education.

The National:

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