Paul Alexander

Economic Change and Public Health in a Remote Sarawak Community

Physical health standards in remote Sarawak communities have been raised by a series of public health measures including the virtual elimination of formerly widespread diseases, improved maternal and child care, lower infant mortality, and rapid treatment of illness and injuries. But these undoubted successes should be contextualized by situating public health interventions within the broader processes of economic and social change that are rapidly transforming such communities. From the point of view of the Lahanan, a small group of horticulturalists living on the upper reaches of the Rejang River, each welcomed benefit has had a concomitant cost: new needs have been created faster than the means to satisfy them.