Talking with Mike (missionary in charge of construction and maintenance) and Steve (a visiting surgeon from WA) last night, we talk about how the local PNG natives seemed to ignore planning for the future at all. And it's not just one or two, but they seemed to notice it as a cultural thing.
Mike talked about how when they would take the trip to Mt Hagen (~60 minutes away) to buy parts, a local would only by one (or however many were needed) and no spares. Similarly, the hospital runs on a well, but they only have one pump for it for the longest time. Recently, he made them get a spare. Even with that, they don't clean the pump regularly. Rather, they wait until it breaks and swap them. Mike has been trying to get them to swap the pumps at the first of the month and clean the just removed one.
They have 4 suction machines for surgery. Rather than tell Mike when one of the breaks, they will just get the next one and only call Mike when all four are broken and they are about to start a surgery where it will be needed. (And even then, they don't leave them on for fear of burning the motors out, Steve says. Rather, there's a nursing student at the switch to turn them on and off as needed.) However, Mike was relating a story about how all four were broken at one point and they were urgently needed for a surgery. He gets a couple of them back to the maintenance building and opens it up. It just needed cleaned, as the filters were clogged. He had it cleaned and it worked.
Steve was talking about how in a surgery they often have to "clamp-clamp-cut-tie", that is they use 2 forceps to clamp either side of something, scissors to cut, and then they tie the ends. Yet, no matter how many times they do this, the surgical tech does not seem to either be paying attention or doesn't think ahead and offer the second forceps, scissors, or ties until asked for. Steve says it drives Jim, the resident surgeon, nuts.
Steve also related how they will send someone out of a surgery to get some suture or some other instrument. Rather than get two, as they might need more than just one, they get just the one they're asked to get and return. Steve was saying this is very different than the US where it's drilled in to be prepared and have extras.
This seems to be something cultural. Currently, the hospital is working on building an entirely new building. Mike is trying to educate the PNGs about how many of what personnel they will need to run the hospital. Or more precisely, how many maintenance, cleaning, and other such they'll need. He relates that it seems to be a foreign concept to them.
Looking at the cultural history, this seems to be from their tribal history. Here, there is always food. There is no cycle of plenty and scarcity that more temperate climes might have. Since gardens are always producing food, there was no cultural reason to find ways to store foods. Rather, in times of plenty they shared it. (And thus earned respect and debts from those they shared with.) Then, should they run into need, they could call on those debts to fill in their shortfalls.
This cultural view seems to have permeated their lives here, even when they are trying to live in more Western environs. There seems to be little maintenance or cleaning done, even in the hospital. Nykki and the other doctors complain about the lack of places to wash their hands (and even a lack of soap in the hospital!) or even hand sanitizer.
I'm not sure if this is changing as the country adopts more Western culture. I suspect so fatr it's not, but I'm not sure if the younger generations might pick up on the idea of maintaining what is built, rather than just rebuilding every few years. Since the traditional building materials (wood and thatch) are still in use, I suspect not. (I also suspect even traditional buildings were simply replaced when they become faulty.) The spattering of sheet metal buildings seem to be similarly in disrepair. And I'm not sure the PNG see it as a fault, this living day-to-day. Traditional wasy of living don't require it, but I suspect if they want to adopt a Western way of living (or at least of building) they will need to learn to maintain and plan.