LIMITED DOSES: HEALTH AND DEVELOPMENT IN LAOS, 1893-2000

Abstract

THE STUDY SETS OUT TO UNCOVER REASONS BEHIND THE LAO PDR?S LONG-TERM LOW HEALTH INDICATORS AND POORLY RATED HEALTH SYSTEM. IT EXAMINES THE DEVELOPMENT OF THE BIOMEDICAL HEALTH SERVICES IN LAOS, WITHIN THE ACADEMIC FRAMEWORKS OF THE HISTORY OF MEDICINE AND INTERNATIONAL DEVELOPMENT. COMBINING ARCHIVAL RESEARCH AND INTERVIEWS WITH HEALTH WORKERS AND TECHNICAL ADVISORS IN FIVE COUNTRIES, THE STUDY RECONSTRUCTS A HISTORY OF EFFORTS TO PROVIDE HEALTHCARE OVER THE PERIOD 1893-2000. THE STUDY ARGUES THAT A SERIES OF OBSTACLES HAVE LIMITED CONSOLIDATION AND IMPROVEMENTS WITHIN THE LAO HEALTH SECTOR: DISTANCE FROM THE COLONIAL METROPOLE, DECADES OF CONFLICT, THE PROMOTION OF DOCTRINE IN A TRADE-OFF WITH TECHNICAL AND MANAGEMENT SKILLS, AND HIGH LEVELS OF DONOR DIVERSIFICATION. THE CUMULATIVE IMPACT OF MARGINALITY AND LONG-TERM DEPENDENCE ON DIVERSE SOURCES OF EXTERNAL ASSISTANCE HAS BEEN THE UNDER-FUNDED, UNDER-DEVELOPED AND UNDER-USED PATCHWORK OF HEALTH FACILITIES, STAFFING AND SERVICE MODEL