By Victoria, Australia 2012. ISBN 9781743240601; 371 pages; RRP $45.. Published by Mosaic Press,
Reviewed by Dr Douglas Shaw
Public health physician, South Australia
In 1978, when the Declaration of Alma Ata was made, Anthony Radford was commencing the third phase of what would become a 50-year experience in Papua New Guinea (PNG).
The first phase of his interaction with this “land of the unexpected” was as a medical student (pikinini dokta) in 1959–60, vividly described in this book from diary notes made at the time. The second phase describes his experiences as a general medical officer and academic from 1963 to 1972. During this time, many of what would later become the documented principles of primary health care in the Declaration of Alma Ata were being learned and applied in rural and remote areas of Papua New Guinea.
Radford and his family lived and worked among rural populations, closely identifying with the local people and being given local names and titles. Community participation in addressing health and other needs was encouraged. Promotive, preventive, curative and – to some extent – rehabilitative services were established. This was complemented by the author's love of teaching rural health workers, medical students and medical graduates from the Papuan Medical College in Port Moresby. Indeed, Radford lists as one of his greatest achievements the establishment of the Department of Rural Practice and rural residency as part of the medical training for students and interns.
The third phase of Radford's experience in PNG commenced in 1978, after which he returned to PNG on many occasions as a consultant with the World Health Organization, UNICEF, AusAID and international non-government organisations, concluding with a moving visit in 2010 to celebrate the 50th Anniversary of the commencement of the Papuan Medical College.
The book weaves together the author's personal, professional and family life with insightful cross-cultural observations in the context of the colonial and post-independence history of PNG. There are anthropological reflections covering cannibalism, sorcery, witchcraft and sex, alongside observations on the role of churches and missionaries.
Not surprisingly, readers will come across references to other, now prominent, Australian and international health professionals; there is even a brief interaction with a young Prince Charles. There are historical vignettes on the aftermath of the volcanic explosion of Mount Lamington in 1951 and the history of the Kokoda Trail.
The reader's experience of the “land of the unexpected” is enhanced by a 31-page collection of colour photographs, most taken by the author, and the frequent use of Pidgin phrases with English translations.
While this is not a public health textbook, it will be enjoyed by public health students and professionals reflecting on the application of primary health care principles in the era leading up to and beyond Alma Ata. Lessons learned in health service delivery, rural health, clinical management and research in tropical diseases, and cross-cultural life, are told with insight, honesty and humour. These lessons from the past are very relevant to the health situation in PNG today, and the author adds his observations on the direction of primary health care in the early 21st Century.
Singsings, Sutures and Sorcery is available from Rainbow Books (Preston, Victoria) or direct from the author at Anthony@radford.id.au.