Health, institutions and governance in Melanesia

This chapter examines the institutional worlds of public health and biomedicine in Melanesia. It focuses on the health institutions and infrastructures in Papua New Guinea (PNG). The health institutions and infrastructures that were built across Melanesia over the course of the twentieth century were shaped by diverse modes of colonial and post-colonial governance and economic development. PNG is unique in the region, both in terms of the forms that colonialism took, and the challenges that the country’s size and settlement patterns posed for health administration. Biomedical experts, technologies and institutions arrived on Melanesian shores in the boats of nineteenth-century European colonial administrators, missionaries, prospectors, and agricultural industrialists. Ethnographic literature from Melanesia has long noted people’s readiness to adopt biomedical knowledge practices alongside, or through subtle accommodations with, local medicine. The international response to HIV in PNG in the early 2000s is indicative of the technocratic approach that characterises many disease-focused global health interventions.