By Stephen Frankel, Gilbert Lewis
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Extra resources for A Continuing Trial of Treatment: Medical Pluralism in Papua New Guinea
The major piece of evidence upon which my argument is based is Scragg's 1977 article in which he shows wildly fluctuating mortality in the coastal villages of Yakamul and Paup, based on mission records. He shows similar patterns for other parts of Papua New Guinea. I believe it can be shown conclusively that diseases which appeared on the coast could and did spread inland rapidly, and therefore the inland patterns of mortality would have been disrupted in a similar manner to those on the coast.
But no documentary evidence has so far been found for dysentery at Aitape until 1932. In that year a "serious outbreak" which moved inland at least as far as Kapoam village was apparently brought under control by a quarantine on all movements inland from July until September. Dysentery appeared again at Aitape in 1935 and spread inland despite a quarantine. In Aitape it is said to have caused no deaths but a geological survey party working in the Palei area reported a 10% death mte in Yapunda village south of the range on the main inland track.
It is not a simple matter of need and efficacy. Firth (1959) pointed out the lack of work analysing people's preferences when faced with foreign introductions. Compare some of the trade items which are so attractive with some medical treatments that have so little appeal. The things introduced as measures to improve health are heterogeneous public health controls were sometimes enforced and belonged to political experience as much as anything. To have sores or bums or wounds dressed might seem to pose less threat than swallowing unknown substances in the form of pills.