Editor's Note: Since the Rudd Labour government was voted in, a greater focus has occurred in repect of Indigenous health.
Rollo Manning could well be regarded as the pharmacy expert in indigenous health and he vigorously defends their rights of indigenous people to enjoy good health - just like the rest of the Australian community.
Rollo's sympathetic insights reflect his long association with, and understanding of, the issues surrounding indigenous health.
A state of shock is bad for health
It’s hard to imagine how it would be if every day was a matter of survival. Yet this is what it is like for people living in war torn countries in Africa. An article in the 26th April edition of Time Magazine by the Secretary General of the United Nations (Ban Ki-moon) talks about helping people to manage in the face of terror, famine, poverty and soaring prices on a negligible income.
On reading the article one can be excused for thinking about the trauma that faces our own Aboriginal people living in remote communities in the north of Australia. Across from Cape York, through the Northern Territory and over to the Kimberley and Pilbara regions of Western Australia - a vast distance yet home to some 50,000 people living in small settlements that were put together in the last 100 years so they could be better managed as a combined mass rather than small family groups. In many instances people from different tribes, clans, language groups and skin types we
re mixed for the convenience of the Aboriginal affairs policies of the day.
The life they had been leading for the previous thousands of years as nomads was living each day at a time and not having too much to worry about except where food and water was coming from and shelter from the elements of nature. It was a real survival of the fittest but at least they knew where they were and what the lay of the land was for that food and water.
Mr. Ki-moon writes about the need to address poverty and polit
ical stability as we move towards a more peaceful and happy world.
The key to this observation is the fact that health is not improved while people are living in a state of turmoil.
At present in the Northern Territory the trauma surrounding the people living in remote communities has been magnified by the introduction of the NT Emergency Response announced in June 2007.
Threats of cancelling work for the dole projects (CDEP), doing health checks on children and using Army people to muster them, taking away welfare payments, and cancelling permit arrangements so anyone can enter their land are a worry to people with little education.
This is not to say it was not needed nor that it has done no good – but the review that is expected to happen before the 12 months is up (and which has started with a Senate Committee taking evidence) will hopefully fine tune some elements of the “intervention” and bring a sense of normality back to an unbelievably abnormal environment – at least abnormal in comparison with mainstream Australia.
Welfare payments have been quarantined and a “store card” is issued so people can use it as cash at the local store.
The simple fact in all this discussion is that it is very hard to improve the health status of remote living Aboriginal people while their lives are in a constant state of trauma and survival. For those health professionals involved in Aboriginal health the scope of interest and action has to go beyond the treating of acute symptoms and prescribing for long term treatment in chronic disease management.
Just as the Secretary-General of the UN is concerned with the over arching issues causing war and trauma in Africa the health professional in the Top End has to be concerned with poverty, nutrition, better housing and the environment of dogs, dirt, Strongyloides worms and scabies.
The daily dose of survival has to be replaced with a dose of hope – preferably taken early in the day before Motivational Deficit Disorder sets in and is treated with the daily does of Marijuana smoked through a bucket bong.
This is the emergency – and not so much of cutting off CDEP, allowing free entry to communities and the quarantining of everyone’s welfare payments.
If you are considering coming to work in Aboriginal health, prepare for as large dose of social conscience taken before you leave home and washed down with a strong draught of tolerance.
Ends