What is a public hospital in a fragile state? In Papua New Guinea, dis-
courses of state failure are equated with the state’s inability to provide basic
public ser vices such as health care and infrastructure. But state hospitals
have not disappeared. Th ey exist as layered landscapes, bearing the living
traces of successive failed state- building and development programs. In a
country where the private health sector is confi ned to the resource extrac-
tion industry and a scattering of urban clinics aimed at expatriates or the
Papua New Guinean elite, the public hospital remains the only health-care
option for the vast majority of patients and the only workplace for many
trained medical and nursing professionals. It has also been the object of
ongoing intervention for foreign governments, development agencies, and
international organizations focused on improving national development
through health. Th e public hospital lies at the technological heart of the
public health system, but it is unable to operate as people (politicians, donor
agencies, health workers, or patients) expect. How, this book has asked,
do medical professionals, nurses, and patients experience this ambiguous
space of modernity and development? What kinds of hopes for the future
and what kinds of disappointments are generated within its walls? Perhaps
most important, what kinds of lives does it make possible?
Th e public hospital has often been construed by anthropologists as a
technology of governance, a place where the biological individual is made
medically legible and amenable to classifi cation and control, and where
engagements with medical technologies shape both expert and patient sub-
jectivities in ways that facilitate the monitoring and regulation of the body.
Biomedicine in a Fragile State
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