Comments

If we are to use examples to inform decision making in PNG it is important to get the facts right. The article here of the Lesotho privately operated hospital is almost entirely contradicted by John Lister's analysis <a href="http://www.globalhealthcheck.org/?p=481" rel="nofollow">here</a>. Far from being cost neutral the budget for the private hospital in Lesotho constitutes a massive 100% increase in that previously allocated to the public hospital. And all this with an unreasonably low cap on the number of patients to be seen and treated. For example, the contract stipulates a maximum of 20,000 inpatients per year but the average hospitalization rate for Lesotho is approximately 64,000 patients. Each patient over and above the 20,000 has to be paid for on top of the 100% increase in costs already paid for by the government. Does this sound like value for money? This skewing of resources towards tertiary care in the capital is to the extreme detriment of the majority of Lesotho citizens who live in rural areas. And let's also not handpick one apparently successful example (although I am unfamiliar with it so wouldn't be sure of its success) from Spain when the broad base of evidence demonstrates the these private financing and delivery deals lock governments into long term high interest inflexible debts to the benefit of profit-making companies and to the detriment of patients. In many cases these deals are bankrupting health services. The truth is that governments can borrow money at a much lower interest rate themselves rather than borrowing from private companies. In the UK where the government has gone furthest with experimenting with these types of models the evidence is very clear. Private Finance Initiatives have failed and services are being shut down directly as a result of the onerous interest rates charged. I'll leave you with a <a href="http://www.telegraph.co.uk/health/9845691/Lewisham-A-and-E-today-where-tomorrow.html" rel="nofollow">summary </a>quote from the right wing UK newspaper the Telegraph on the ramifications: <blockquote>The blame lies with politicians and the Department of Health who pushed through the ludicrous PFI deals in the first place. It’s the fault of the lawyers and managers who drew up the grossly unfair contracts that saw the pockets of private companies being lined with large wodges of taxpayers’ money for little return. It’s the fault of every myopic MP who voted for PFI and ignored the evidence warning that it would store up problems for the future. The local community, the doctors, the nurses and even the current managers are entirely innocent in all this, and yet it is they who are having to pay. </blockquote>

@Jon Frankel "Lagging perspective", in this context of my comments, means constant rehashing the events of the past and passing it off as current events; analogous to 'old wine in new bottles'. As for your opinion about Fiji's Prime Minister being "starved of legitimacy at home"-unfortunately you have not supported your claims and I stand by my comments that highlighted this fact. "Silence may not mean consent" was probably a poor attempt to explain away the lack of protests in Suva. With regards to who 'knows Fiji better', is basically a moot point and borders on the presumption that someone claims to be the absolute authority on Fiji.

Tom Brady dislikes my 'lagging perspective' (whatever that means!), which he condemns as generated from Canberra or Wellington. Presumably, by this he means that his own views are more authentically Pacific. But they are not, as he indicates immediately by saying that there is no 'crisis of legitimacy' within Fiji and that if there were such a crisis there would be 'Arab-spring type protests erupting in Suva'. Someone who knows Fiji better would be aware of the well-known saying that 'silence is not consent'.

People ( especially those in their 50's upwards) do refer back to the colonial era as being the time when everything was good, corupt free, law and order, " The perfect time" as they say. I was born a few years before independence and saw gradual changes occur over time. I do not hold on to the colonial past where my people were called "kanakas" and the Kiaps and the white minority wielded power. It was a pathetic and a sarcastic past ... No, its wrong to say that we still hold on to that. The colonial past was very degrading and much light has to be shed to fully expose that.

Thanks Grant for that article it was a great read. and yes as a Papua New Guineans we do feel the effect of the name callings and the negetivity of this great land. One of the reasons that is very obvious is the lack of being literate. Hopefully the next generation of Papua New Guineans (those born after Independence) will make that shift. Only time will tell... With the refugees saga, I don't know what the big deal is when we have Irian Jayans strewn all over Kiunga in Western Province and Sandown Provinces. They should also be treated in the same manner as those now being processed... I deeply feel sorry for this setback.

I find the opinions of Jon Frankel to be rehashing a lagging perspective that is laced with half-truths and turgid talking points, as if they were generated from Canberra and Wellington: "While starved of legitimacy at home, Bainimarama enjoys being able to strut on the international stage as the plucky Pacific Islands strong man willing to stand up to the region’s bigger powers. Neighbouring countries like Papua New Guinea, Solomon Islands and Vanuatu have shown sympathy for Bainimarama’s use of the Melanesian Spearhead Group as a platform to criticize Australian heavy-handedness." There is no evidence to support the Frankel's claim of Bainimarama being starved of legitimacy at home -- if there were any there would be Arab-spring like protests erupting in Suva. If Bainimarama's attendance to numerous UN events like chairing the G77 et al. is considered 'strutting the international stage', in Frankel's eyes; then Bainimarama would be guilty as charged. Yes, Bainimarama is standing up to Australia and New Zealand but he is only voicing what Fiji has experienced and what many island nations have been too timid to do. Courage is contagious, as the saying goes, and Fiji's assertiveness is rubbing off with more island countries and their leaders are slowly voicing their dissatisfaction with the neo-colonial type of relationships experienced heretofore, with Australia and New Zealand. Tonga's response to New Zealand withdrawing its Tourism Aid over a new plane donated by China, as <a href="http://www.islandsbusiness.com/2013/8/business-intelligence/stop-interfering-tonga-tells-nz/" rel="nofollow">reported by Islands Business</a>, is a case in point. Other events, like the revelations by Edward Snowden, on Australia and New Zealand's hand in the NSA/Prism wiretapping and internet surveillance have raised some concerning eye brows in the Pacific. Other corroborating sources, have pointed out that, this same NSA surveillance, is being used to spy on the South Pacific island leaders and the activities within the Pacific island Forum nations. There is a looming crisis of confidence in the South Pacific and it was not brought about by actions of Frank Bainimarama, but is the culminated blow-back, a karmic reaction from the very actions of some of our so called, anitpodean 'friends'.

Indeed. So we should stop pretending that such imbalances do not exist and instead do something to manage them. Hence my analogy with the teacher-child relationship. (Though I reckon plenty of NGO folk might see themselves more as a teacher dealing with child-like donor staff ignorant of almost everything outside their embassy bubble.)

Thanks MJ. I agree although I guess I'd add the caveat that it's not totally binary. And some donors are better than others. That said the power imbalance is never 0. Nor could it be I guess. cheers Terence

Thanks Mr. Andrew Anton Mako for your marvelous update. As a PNG Citizen and as an upcoming leader of Papua New Guinea, I declare that what you have posted is all the TRUTH and no one will against this.

Hear hear! Very few partnerships in development are partnerships of equals.A kid being unfairly treated by their teacher (hardly a relationship of equals) has more opportunity for redress than does anyone 'partnering' with a donor.

Technology is a tool, that is true, however what some of the DIFID, USAID and World Bank programs are beginning to recognise is that technology strategies also represent a different approach to solving problems. The web and communications technology have enabled mass participation like never before. The culture within technology communities i.e. Open Source communities is one of collaboration. As such you see a number of these 'technology strategies' focus on 'participatory development' over an above the tool its self. Participatory development recognises that we have a shared problem and that we need to collaborate to solve that problem. For the most part this is the attitude of many technologists and the deep important strategic imperative they bring to the table.

Not only increasingly crowded, but increasingly dysfunctional, it would seem to me.