Auswahl der wissenschaftlichen Literatur zum Thema „Physicians – Papua New Guinea – Biography“

This article commemorates the anniversary of death of Michael Somare, an outstanding politician and absolute leader of the Independent State of Papua New Guinea. The life path of the politician starting from his early years is considered. Important facts from his biography that influenced his formation and popular recognition as the "Father of the Nation" are presented and analyzed.

Paediatric tuberculosis can be challenging to diagnose, and various approaches are used in different settings. A retrospective review was conducted on Papua New Guinea (PNG) children with presumptive TB who presented for health care in the Torres Strait Islands, Australia, between 2016 and 2019. We compared diagnostic algorithms including the modified Keith Edwards TB Score, The Union Desk Guide, and the new World Health Organization (WHO) algorithm, with diagnostic practices used in the remote Torres Strait Islands. Of the 66 children with presumptive TB, 7 had bacteriologically confirmed TB. The majority (52%) were under 5 years (median age 61 months), and 45% were malnourished. There was moderate agreement across the diagnostic methods (K = 0.34; 95% CI 0.23–0.46), with the highest concordance observed between The Union Desk Guide and the WHO’s algorithm (K = 0.61). Local TB physicians might have over-diagnosed presumed lymph node TB while under-diagnosing TB overall. Enhancing the precision and promptness of paediatric TB diagnosis using practical tools is pivotal to decrease TB-related child mortality, notably in isolated regions like the Torres Strait and the Western Province of PNG.

Antimicrobials have been used successfully for over 6 decades, but genes expressing resistance to them have emerged in strains of bacteria and have disseminated through the global ecosystem to reach infecting microorganisms, produce disease, and seriously interfere with therapy, allowing infections to progress and kill despite antibiotic administration. The upsurge in prevalence of such resistance genes in the bacterial population that colonize and infect humans involves two processes, emergence and dissemination, in both of which there have been contributions from the developing world, where resistance is common and increasing. The emergence of pneumococcal isolates noted in Papua New Guinea and later in South Africa that 1 decade later spread to most of the world and the intercontinental spread between the United States and Venezuela of a new gentamicin resistance gene carried on an epidemic plasmid are examples of the ability of bacteria to travel freely, without regard to borders. Complex societal issues such as the misuse of antibiotics by physicians, pharmacists, and the public; the suboptimal quality of the drugs (emergence); and conditions such as crowding, lack of hygiene, poor or nonexistent hospital infection control practices, or insufficient surveillance (dissemination) play a largely unmeasured role that requires study and solutions. In the meantime, we may intervene to delay the emergence of resistance and to limit its spread by promoting the judicious use of antibiotics both at the local level as well as from multinational organized cooperative efforts. Education and improvement of surveillance and socioeconomic conditions are integral parts of any solution strategy.

The most recent estimates, published in 2016, have indicated that around 70% of anaesthesia providers in Papua New Guinea are non-physician anaesthetic providers and that they administer over 90% of anaesthetics, with a significant number unsupervised by a physician anaesthetist. Papua New Guinea has a physician anaesthetist ratio estimated to be 0.25 per 100,000 population, while Australia and New Zealand have a ratio of 19 physician anaesthetists per 100,000, which is 75 times that of Papua New Guinea. To reach a ratio of seven per 100,000, recommended as the minimum acceptable by the Lancet Commission in 2016, there will need to be over 35 practitioners trained per annum until 2030, at a time when the average annual numbers of recent years are less than three physicians and less than five non-physician anaesthetic providers. We review the development of anaesthesia administered by non-physician indigenous staff and the stages of development from heil tultuls, dokta bois, liklik doktas, native medical assistants, aid post orderlies, and Anaesthetic Technical Officers up to the current Anaesthetic Scientific Officers having attained the Diploma in Anaesthetic Science from the University of Papua New Guinea.

Abstract Background The majority of low- and middle-income countries (LMICs) do not have adequate civil registration and vital statistics (CRVS) systems to properly support health policy formulation. Verbal autopsy (VA), long used in research, can provide useful information on the cause of death (COD) in populations where physicians are not available to complete medical certificates of COD. Here, we report on the application of the SmartVA tool for the collection and analysis of data in several countries as part of routine CRVS activities. Methods Data from VA interviews conducted in 4 of 12 countries supported by the Bloomberg Philanthropies Data for Health (D4H) Initiative, and at different stages of health statistical development, were analysed and assessed for plausibility: Myanmar, Papua New Guinea (PNG), Bangladesh and the Philippines. Analyses by age- and cause-specific mortality fractions were compared to the Global Burden of Disease (GBD) study data by country. VA interviews were analysed using SmartVA-Analyze-automated software that was designed for use in CRVS systems. The method in the Philippines differed from the other sites in that the VA output was used as a decision support tool for health officers. Results Country strategies for VA implementation are described in detail. Comparisons between VA data and country GBD estimates by age and cause revealed generally similar patterns and distributions. The main discrepancy was higher infectious disease mortality and lower non-communicable disease mortality at the PNG VA sites, compared to the GBD country models, which critical appraisal suggests may highlight real differences rather than implausible VA results. Conclusion Automated VA is the only feasible method for generating COD data for many populations. The results of implementation in four countries, reported here under the D4H Initiative, confirm that these methods are acceptable for wide-scale implementation and can produce reliable COD information on community deaths for which little was previously known.

IntroductionThe debate about the responsibility of museums to respect Indigenous peoples’ rights (Kelly and Gordon; Butts) has caught our attention on the basis of our previous research experience with regard to the protection of the tangible and intangible heritage of the San (former hunter gatherers) in Southern Africa (Martin and Vermeylen; Vermeylen, Contextualising; Vermeylen, Life Force; Vermeylen et al.; Vermeylen, Land Rights). This paper contributes to the critical debate about curatorial practices and the recovery of Indigenous peoples’ cultural practices and explores how museums can be transformed into cultural centres that “decolonise” their objects while simultaneously providing social agency to marginalised groups such as the San. Indigenous MuseumTraditional methods of displaying Indigenous heritage are now regarded with deep suspicion and resentment by Indigenous peoples (Simpson). A number of related issues such as the appropriation, ownership and repatriation of culture together with the treatment of sensitive and sacred materials and the stereotyping of Indigenous peoples’ identity (Carter; Simpson) have been identified as the main problems in the debate about museum curatorship and Indigenous heritage. The poignant question remains whether the concept of a classical museum—in the sense of how it continues to classify, value and display non-Western artworks—will ever be able to provide agency to Indigenous peoples as long as “their lives are reduced to an abstract set of largely arbitrary material items displayed without much sense of meaning” (Stanley 3). Indeed, as Salvador has argued, no matter how much Indigenous peoples have been involved in the planning and implementation of an exhibition, some issues remain problematic. First, there is the problem of representation: who speaks for the group; who should make decisions and under what circumstances; when is it acceptable for “outsiders” to be involved? Furthermore, Salvador raises another area of contestation and that is the issue of intention. As we agree with Salvador, no matter how good the intention to include Indigenous peoples in the curatorial practices, the fact that Indigenous peoples may have a (political) perspective about the exhibition that differs from the ideological foundation of the museum enterprise, is, indeed, a challenge that must not be overlooked in the discussion of the inclusive museum. This relates to, arguably, one of the most important challenges in respect to the concept of an Indigenous museum: how to present the past and present without creating an essentialising “Other”? As Stanley summarises, the modernising agenda of the museum, including those museums that claim to be Indigenous museums, continues to be heavily embedded in the belief that traditional cultural beliefs, practices and material manifestations must be saved. In other words, exhibitions focusing on Indigenous peoples fail to show them as dynamic, living cultures (Simpson). This raises the issue that museums recreate the past (Sepúlveda dos Santos) while Indigenous peoples’ interests can be best described “in terms of contemporaneity” (Bolton qtd. in Stanley 7). According to Bolton, Indigenous peoples’ interest in museums can be best understood in terms of using these (historical) collections and institutions to address contemporary issues. Or, as Sepúlveda dos Santos argues, in order for museums to be a true place of memory—or indeed a true place of recovery—it is important that the museum makes the link between the past and contemporary issues or to use its objects in such a way that these objects emphasize “the persistence of lived experiences transmitted through generations” (29). Under pressure from Indigenous rights movements, the major aim of some museums is now reconciliation with Indigenous peoples which, ultimately, should result in the return of the cultural objects to the originators of these objects (Kelly and Gordon). Using the Native American Graves Protection and Repatriation Act of 1990 (NAGPRA) as an illustration, we argue that the whole debate of returning or recovering Indigenous peoples’ cultural objects to the original source is still embedded in a discourse that emphasises the mummified aspect of these materials. As Harding argues, NAGPRA is provoking an image of “native Americans as mere passive recipients of their cultural identity, beholden to their ancestors and the museum community for the re-creation of their cultures” (137) when it defines cultural patrimony as objects having ongoing historical, traditional or cultural importance, central to the Native American group or culture itself. According to Harding (2005) NAGPRA’s dominating narrative focuses on the loss, alienation and cultural genocide of the objects as long as these are not returned to their originators. The recovery or the return of the objects to their “original” culture has been applauded as one of the most liberating and emancipatory events in recent years for Indigenous peoples. However, as we have argued elsewhere, the process of recovery needs to do more than just smother the object in its past; recovery can only happen when heritage or tradition is connected to the experience of everyday life. One way of achieving this is to move away from the objectification of Indigenous peoples’ cultures. ObjectificationIn our exploratory enquiry about new museum practices our attention was drawn to a recent debate about ownership and personhood within the context of museology (Busse; Baker; Herle; Bell; Geismar). Busse, in particular, makes the point that in order to reformulate curatorial practices it is important to redefine the concept and meaning of objects. While the above authors do not question the importance of the objects, they all argue that the real importance does not lie in the objects themselves but in the way these objects embody the physical manifestation of social relations. The whole idea that objects matter because they have agency and efficacy, and as such become a kind of person, draws upon recent anthropological theorising by Gell and Strathern. Furthermore, we have not only been inspired by Gell’s and Strathern’s approaches that suggests that objects are social persons, we have also been influenced by Appadurai’s and Kopytoff’s defining of objects as biographical agents and therefore valued because of the associations they have acquired throughout time. We argue that by framing objects in a social network throughout its lifecycle we can avoid the recurrent pitfalls of essentialising objects in terms of their “primitive” or “traditional” (aesthetic) qualities and mystifying the identity of Indigenous peoples as “noble savages.” Focusing more on the social network that surrounds a particular object opens up new avenues of enquiry as to how, and to what extent, museums can become more inclusive vis-à-vis Indigenous peoples. It allows moving beyond the current discourse that approaches the history of the (ethnographic) museum from only one dominant perspective. By tracing an artwork throughout its lifecycle a new metaphor can be discovered; one that shows that Indigenous peoples have not always been victims, but maybe more importantly it allows us to show a more complex narrative of the object itself. It gives us the space to counterweight some of the discourses that have steeped Indigenous artworks in a “postcolonial” framework of sacredness and mythical meaning. This is not to argue that it is not important to be reminded of the dangers of appropriating other cultures’ heritage, but we would argue that it is equally important to show that approaching a story from a one-sided perspective will create a dualism (Bush) and reducing the differences between different cultures to a dualistic opposition fails to recognise the fundamental areas of agency (Morphy). In order for museums to enliven and engage with objects, they must become institutions that emphasise a relational approach towards displaying and curating objects. In the next part of this paper we will explore to what extent an online museum could progressively facilitate the process of providing agency to the social relations that link objects, persons, environments and memories. As Solanilla argues, what has been described as cybermuseology may further transform the museum landscape and provide an opportunity to challenge some of the problems identified above (e.g. essentialising practices). Or to quote the museologist Langlais: “The communication and interaction possibilities offered by the Web to layer information and to allow exploration of multiple meanings are only starting to be exploited. In this context, cybermuseology is known as a practice that is knowledge-driven rather than object-driven, and its main goal is to disseminate knowledge using the interaction possibilities of Information Communication Technologies” (Langlais qtd. in Solanilla 108). One thing which shows promise and merits further exploration is the idea of transforming the act of exhibiting ethnographic objects accompanied by texts and graphics into an act of cyber discourse that allows Indigenous peoples through their own voices and gestures to involve us in their own history. This is particularly the case since Indigenous peoples are using technologies, such as the Internet, as a new medium through which they can recuperate their histories, land rights, knowledge and cultural heritage (Zimmerman et al.). As such, new technology has played a significant role in the contestation and formation of Indigenous peoples’ current identity by creating new social and political spaces through visual and narrative cultural praxis (Ginsburg).Online MuseumsIt has been acknowledged for some time that a presence on the Web might mitigate the effects of what has been described as the “unassailable voice” in the recovery process undertaken by museums (Walsh 77). However, a museum’s online engagement with an Indigenous culture may have significance beyond undercutting the univocal authority of a museum. In the case of the South African National Gallery it was charged with challenging the extent to which it represents entrenched but unacceptable political ideologies. Online museums may provide opportunities in the conservation and dissemination of “life stories” that give an account of an Indigenous culture as it is experienced (Solanilla 105). We argue that in engaging with Indigenous cultural heritage a distinction needs to be drawn between data and the cognitive capacity to learn, “which enables us to extrapolate and learn new knowledge” (Langlois 74). The problem is that access to data about an Indigenous culture does not necessarily lead to an understanding of its knowledge. It has been argued that cybermuseology loses the essential interpersonal element that needs to be present if intangible heritage is understood as “the process of making sense that is generally transmitted orally and through face-to-face experience” (Langlois 78). We agree that the online museum does not enable a reality to be reproduced (Langlois 78).This does not mean that cybermuseology should be dismissed. Instead it provides the opportunity to construct a valuable, but completely new, experience of cultural knowledge (Langlois 78). The technology employed in cybermuseology provides the means by which control over meaning may, at least to some extent, be dispersed (Langlois 78). In this way online museums provide the opportunity for Indigenous peoples to challenge being subjected to manipulation by one authoritative museological voice. One of the ways this may be achieved is through interactivity by enabling the use of social tagging and folksonomy (Solanilla 110; Trant 2). In these processes keywords (tags) are supplied and shared by visitors as a means of accessing museum content. These tags in turn give rise to a classification system (folksonomy). In the context of an online museum engaging with an Indigenous culture we have reservations about the undifferentiated interactivity on the part of all visitors. This issue may be investigated further by examining how interactivity relates to communication. Arguably, an online museum is engaged in communicating Indigenous cultural heritage because it helps to keep it alive and pass it on to others (Langlois 77). However, enabling all visitors to structure online access to that culture may be detrimental to the communication of knowledge that might otherwise occur. The narratives by which Indigenous cultures, rather than visitors, order access to information about their cultures may lead to the communication of important knowledge. An illustration of the potential of this approach is the work Sharon Daniel has been involved with, which enables communities to “produce knowledge and interpret their own experience using media and information technologies” (Daniel, Palabras) partly by means of generating folksonomies. One way in which such issues may be engaged with in the context of online museums is through the argument that database and narrative in such new media objects are opposed to each other (Manovich, New Media 225). A new media work such as an online museum may be understood to be comprised of a database and an interface to that database. A visitor to an online museum may only move through the content of the database by following those paths that have been enabled by those who created the museum (Manovich, New Media 227). In short it is by means of the interface provided to the viewer that the content of the database is structured into a narrative (Manovich, New Media: 226). It is possible to understand online museums as constructions in which narrative and database aspects are emphasized to varying degrees for users. There are a variety of museum projects in which the importance of the interface in creating a narrative interface has been acknowledged. Goldblum et al. describe three examples of websites in which interfaces may be understood as, and explicitly designed for, carrying meaning as well as enabling interactivity: Life after the Holocaust; Ripples of Genocide; and Yearbook 2006.As with these examples, we suggest that it is important there be an explicit engagement with the significance of interface(s) for online museums about Indigenous peoples. The means by which visitors access content is important not only for the way in which visitors interact with material, but also as to what is communicated about, culture. It has been suggested that the curator’s role should be moved away from expertly representing knowledge toward that of assisting people outside the museum to make “authored statements” within it (Bennett 11). In this regard it seems to us that involvement of Indigenous peoples with the construction of the interface(s) to online museums is of considerable significance. Pieterse suggests that ethnographic museums should be guided by a process of self-representation by the “others” portrayed (Pieterse 133). Moreover it should not be forgotten that, because of the separation of content and interface, it is possible to have access to a database of material through more than one interface (Manovich, New Media 226-7). Online museums provide a means by which the artificial homogenization of Indigenous peoples may be challenged.We regard an important potential benefit of an online museum as the replacement of accessing material through the “unassailable voice” with the multiplicity of Indigenous voices. A number of ways to do this are suggested by a variety of new media artworks, including those that employ a database to rearrange information to reveal underlying cultural positions (Paul 100). Paul discusses the work of, amongst others, George Legrady. She describes how it engages with the archive and database as sites that record culture (104-6). Paul specifically discusses Legrady’s work Slippery Traces. This involved viewers navigating through more than 240 postcards. Viewers of work were invited to “first chose one of three quotes appearing on the screen, each of which embodies a different perspective—anthropological, colonialist, or media theory—and thus provides an interpretive angle for the experience of the projects” (104-5). In the same way visitors to an online museum could be provided with a choice of possible Indigenous voices by which its collection might be experienced. We are specifically interested in the implications that such approaches have for the way in which online museums could engage with film. Inspired by Basu’s work on reframing ethnographic film, we see the online museum as providing the possibility of a platform to experiment with new media art in order to expose the meta-narrative(s) about the politics of film making. As Basu argues, in order to provoke a feeling of involvement with the viewer, it is important that the viewer becomes aware “of the plurality of alternative readings/navigations that they might have made” (105). As Weinbren has observed, where a fixed narrative pathway has been constructed by a film, digital technology provides a particularly effective means to challenge it. It would be possible to reveal the way in which dominant political interests regarding Indigenous cultures have been asserted, such as for example in the popular film The Gods Must Be Crazy. New media art once again provides some interesting examples of the way ideology, that might otherwise remain unclear, may be exposed. Paul describes the example of Jennifer and Kevin McCoy’s project How I learned. The work restructures a television series Kung Fu by employing “categories such as ‘how I learned about blocking punches,’ ‘how I learned about exploiting workers,’ or ‘how I learned to love the land’” (Paul 103) to reveal in greater clarity, than otherwise might be possible, the cultural stereotypes used in the visual narratives of the program (Paul 102-4). We suggest that such examples suggest the ways in which online museums could work to reveal and explore the existence not only of meta-narratives expressed by museums as a whole, but also the means by which they are realised within existing items held in museum collections.ConclusionWe argue that the agency for such reflective moments between the San, who have been repeatedly misrepresented or underrepresented in exhibitions and films, and multiple audiences, may be enabled through the generation of multiple narratives within online museums. We would like to make the point that, first and foremost, the theory of representation must be fully understood and acknowledged in order to determine whether, and how, modes of online curating are censorious. As such we see online museums having the potential to play a significant role in illuminating for both the San and multiple audiences the way that any form of representation or displaying restricts the meanings that may be recovered about Indigenous peoples. ReferencesAppadurai, Arjun. The Social Life of Things: Commodities in Cultural Perspective. Cambridge: Harvard UP, 1986. Bal, Mieke. “Exhibition as Film.” Exhibition Experiments. Ed. Sharon Macdonald and Paul Basu. Malden: Blackwell Publishing 2007. 71-93. Basu, Paul. “Reframing Ethnographic Film.” Rethinking Documentary. Eds. Thomas Austin and Wilma de Jong. Maidenhead: Open U P, 2008. 94-106.Barringer, Tim, and Tom Flynn. Colonialism and the Object: Empire, Material Culture and the Museum. London: Routledge, 1998. 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This thesis explores the history of the Papuan Official Collection (POC) from conception, through its acquisition and travel from Papua to Australia, to its storage in Sydney and then in Canberra. It also looks at the ties the Collection has with collections in other institutions. In short, the thesis constructs a biography for a museum collection with a complex history. The primary aim of this thesis is to understand why and how the POC - an ethnographic collection consisting almost entirely of material culture from Papua New Guinea - came to be part of the collections of the National Museum of Australia, Canberra. In order to achieve this aim, the thesis explores the role of objects and collecting during the Australian colonial occupation of the Territory of Papua (now the southern portion of Papua New Guinea) between 1907 and c.1940. It situates the Collection within its historical context in terms of the development of collecting, museum practices, and the establishment of the discipline of anthropology. These three areas of study are important if we are to appreciate the ideologies of the collectors and, in particular, the paradigms that ruled European thinking with regard to Indigenous people which grounded Sir Hubert Murray’s administration of Papua. The thesis is organised around the interweaving of the biographies of the objects in the Collection and events in the life of the Collection as a whole, with those of its primary collectors. Thus, Sir Hubert Murray, his policies and collecting are the focus of the birth and infancy of the Collection. The government anthropologists WM Strong, WE Armstrong and FE Williams and their formal training and informed approaches to their work are the focus of its youth, and the individual and sometimes idiosyncratic collecting preferences of the resident magistrates are the subjects for the directions of its young adulthood. The Australian Museum and Australian Institute of Anatomy form the sites of the Collection’s initiation into adulthood. Institutions overseas and at the Australian Museum, Sydney, are the homes of sibling collections of the POC. This thesis represents the first time that all the available archival and other information about the POC has been brought together in one cogent story. As the Collection has survived mostly intact to the present day, it is not dead, so this is an unfinished biography - there is more of the story to come. The discussion in the final chapters proposes that in directing of the rest of the story, the National Museum of Australia has a choice: Does the story of the Collection become a meaningful feature of the Museum’s own biography, together with that of the story of Australia and Papua New Guinea, or does the Collection begin its senescence in the solitude of museum storage?

Research Doctorate - Doctor of Philosophy (PhD)
This thesis argues that foreign and second language teaching productivity can only reach its proper potential when it is accorded priority, second only to language learner productivity, amongst the many competing productivities which are always asserted by stakeholders in educational institutions. A theoretical foundation for the research is established by examining the historical concept of productivity, and its more recent manifestation as knowledge worker productivity, especially as applied to teachers. The empirical basis of the thesis is sourced from a chronological series of twenty biographical case studies in language teaching venues in Australia, New Zealand, Oceania and East Asia. The biographical case study methodology, although rare in applied linguistics, is justified by reference to its wide and growing application in other fields of qualitative research. The case studies are analysed for common patterns of productivity, as well as teaching productivity inhibition or failure. It was affirmed across all of the case studies without exception that external parties could not control or even reliably predict what individual students might learn, and how well, from instances of instructed language teaching. This was regardless of the power of institutional players, external resources, curriculums or the teacher. Student belief in the immediate value of what was to be learned in a given lesson, and personal confidence in an ability to learn it were the most critical factors. Teaching productivity was found to turn, ultimately, on the teacher's ability to influence the probability of student learning. The teacher could best influence learning probability by enhancing student motivation. The most effective environments for teaching productivity were seen to be those where the teacher was professionally equipped and politically enabled to exercise judgements which maximized opportunities for student language learning productivity. A negotiated pact concerning both curriculum and method often proved effective, especially with mature students, and at times required some deception of institutional authorities. Empirically, the encouragement of reciprocal learning relationships between teacher and students was found to be powerfully enabling for language teaching productivity in the case studies. In many venues a small but effective minority of 'intimate learners' were also able to leverage their language learning productivity by forging more personal relationships with the teacher. The wider cultural paradigm within each of the countries represented in the case studies sanctioned different paths and limitations for both language learners and teachers, and hence was seen to influence teaching productivity in critical ways. It was found that under certain conditions, notably (but not exclusively) those prevailing in many East Asian educational institutions, that certification of foreign language skills had a higher cultural, employment and monetary value than the actual ability to exercise foreign language skills. A negative influence on teacher productivity in many of the case studies was an ignorance about language learning and teaching amongst institutional players. The disregard of language teacher professionalism was fed by a belief that being able to speak a language was all that was necessary to teach it, and reinforced by misinterpreting the meaning of test results. Related to this, an imbalance of power relationships between teachers or students with other institutional interests was consistently found to interfere with teaching and learning productivities. Overall, the model of productivity understood in institutions instanced by the case studies tended to reflect a 19th Century economic paradigm of capital, raw materials (students) and labour (dispensable classroom workers) rather than any more sophisticated grasp of knowledge worker productivity. It was demonstrated in the context of the case studies that productivity, and in particular knowledge worker productivity, is a complex concept whose facets require detailed analysis to arrive at a proper understanding of the role that foreign and second language teachers play in educational institutions.