Edited by Roxanne K. Young, Associate Editor.
Dusk. It descends suddenly, decisively, in the tropics, a silent, cosmic curfew delimiting day and
its labor from darkness and its repose. As certain in the hospital as
in the village, sunset signals a respite from rounds and operating
rooms. So why the commotion as we arrive at the door of Tari District
Hospital? An entire Huli clan, always colorful but now also uncommonly
concerned, is clamoring for . . . what?
Dawn. It had come clear and cool to Papua New Guinea on the
13th anniversary of its independence—at least in the Southern
Highlands. Leaving the other two physicians at the hospital in the Tari
Valley below, I had greeted this dawn in the mountain rain forest at
8200 feet. We had gone, half a dozen Huli and expatriate friends and I,
hoping to sight the elusive bird-of-paradise. Clouds and fog shrouded
the valley of the Huli 3000 feet below. One of 700 distinct
tribes/languages in this southwest Pacific Melanesian island nation,
the Huli, hesitant to demand independence before it was granted by
Australia, now are eager for the annual celebration. We seven knew that
in the morning mist below, 30,000 Hulis were donning their
magnificent traditional headdresses and cous-cous skins. Home to a
million Melanesians, the Highlands of Papua New Guinea were not
"discovered" until the 1930s; only after World War II were they
extensively explored by outsiders. Despite unparalleled "progress"
since, there persists a primordial pride in clan identity—and the clan
warfare that preserves that identity. As a young general practitioner
I, with my family, had spent a thousand days in Papua New Guinea before
its actual day of independence in September 1975, when our youngest
daughter was born there. We stayed another thousand days after
independence. We learned. We saw our Melanesian colleagues give birth
to a new nation, delivered in peace, with a primal potential for
prosperity. A decade later I had returned, this time to Tari, a
thousand-soul "government village," 100 "Highland Highway"
miles from our prior home at Enga Hospital.
Pust RE. Underlying Cause. JAMA. 1999;281(3):215-216. doi:10.1001/jama.281.3.215