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Understanding Indigenous Health

Rollo Manning
A Special Report on Indigenous Health from Northern Australia

Issue 74: August 2008
Page: 1 of 1 Author's Profile | Send to a Friend | Printer Version
Editor's Note: Currently there is a greater focus in repect of Indigenous health. And about time, some would say. Only very small pockets of the pharmacy profession have attempted to come to terms with this major problem, and they genuinely need your management assistance. Rollo Manning could well be regarded as the pharmacy expert in indigenous health, and he vigorously defends the 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 Job the Best Social Security Benefit -
Provide empowerment through work

The best and most cost effective way of alleviating poverty and delivering social security to disadvantaged people is to help them get a job .
Sounds simple but true.
A job creates a feeling of empowerment as the person is at last in charge of their own future destiny and is not dependent on the State for a livelihood. Children brought up by parents without a job do not have role models to drive their intent to a better future and the state of poverty the family is forced to live under is detrimental to all concerned.
So it was that since the mid 1970s when welfare payments to Aboriginal people in Australia started there has been a decline of social capital in remote Aboriginal communities that has continued ever since with the jobs that used to be done by Aboriginal people now being done by non-Aboriginals.
Reverend Steve Etherington, pastor with the Uniting Church and school teacher for many years in a remote community in the Northern Territory summed it up this way in a paper prepared for the Bennelong Society :

“IF YOU READ NO FURTHER THAN THIS…

It’s about jobs: not overcrowding.
It’s about jobs; not about culture or ethnicity or missions, or history.
It’s about jobs: not about grog and drug abuse.
It’s about jobs: it’s not even about child abuse.
All these are merely symptoms of long-term unemployment.
It’s about jobs.”

There is little evidence of anything being done towards encouraging communities to take charge of their own future. All that is evident is the old and long term frowned upon dominant culture wanting Aboriginal people in their communities to “be like us” – it will never happen. There is a need for programs that are positive, focused on the individual and actionable at community level. It is probably time to go back in history and read the writings of people like A P Elkin in the mid 1930s. It is all there. We need to pay attention to the past to plan a better future and one of the failings of the past 30 years is to ignore what has gone before.
It is all there.
We should use the experience of wise people who have been there and done that. The words of John Singleton back in 1979 still apply in 2008 as they did in 1979. He wrote in The Bulletin:
“…every time I look at one of those bearded university-trained southern do-gooders, I wonder if they will ever realise that they can never solve the Aboriginal problem because they are the problem”.

There is a need to engage with communities in a meaningful way. Stop “fly in – fly out” visits and genuinely be prepared to live amongst them to understand the way they think.
Government at the three levels needs to review what its role should be in enterprise/economic development. It is likely that the interference at the local level by trying to micromanage the spending of public money is having an adverse effect on motivating local people to act.

Mark Latham , writing in 2002 said “…inequality and social exclusion have become …entrenched in our society, despite high levels of welfare spending. The welfare state has been built around bureaucratic structures instead of around the capacities of people. It has placed its dead hand on innovation and self-help in disadvantaged neighborhoods.”

There is a need to provide “seed” funding to catalyse establishment of core business functions for emerging enterprises. The early availability of “seed” funding is necessary to build capacity at the local level and take the opportunity of initiatives that come from the grassroots.

A “bottoms up” approach is needed with government seeing its role as providing the infrastructure to allow enterprise to grow with the assistance of local facilitators paid by government in the same way that “business enterprise centres” came about 30 years ago in mainstream communities.

A pharmacy enterprise in a remote community has the opportunity of providing jobs, training and a cash flow from the provision of medicines under the government paid for Pharmaceutical Benefits Scheme. The opportunity to put to work all the knowledge a pharmacist has obtained through their undergraduate experience should make this a richly rewarding experience for young pharmacists. There are other opportunities especially if the industries that used to be there are listed and returned to produce the products they did in yesteryear. Things like a bakery, poultry farm, market garden, saw mill or cleaning service.

An analysis of the comparable shopping opportunities between an established country town in New South Wales with a remote community in the Northern Territory shows that for a comparable population base the NT community has only five retail outlets compared to 18 in the NSW country town. Another way at looking at this is to wonder how much of the retail spend stays in the town (in NSW) compared with the amount that goes out of the remote community because of the fewer businesses being owned by people external to the community.

If there is a budding entrepreneur in a remote disadvantaged community they only need to look around and see who is making the money out the products consumed and ask themselves why they could not be doing the same.

The jobs could be there is there was a planned co-operation between government, private sector and local people. It is possible that money put into job creation could have a more lasting impact on improving better health outcomes than money being put into new health clinic s or the provision of primary health care staff, including doctors.

To look at the world through the eyes of the people is essential if useful opportunities are to be made available for those same people to develop their own potential. Young people especially need role models to look up to who work and set an example. Against all indicators this is not happening. By example they must be shown that there can be businesses in remote communities that will help the hours in a day pass more pleasurably than by doing nothing. This is also the ONLY way to solve the attendance at school problem. Show children why they must go to school. A child cannot be blamed for not seeing a need for school when the adults do nothing all day long.
The example is the key.

References:

1. “…the fact remains that the best way to get out of poverty is a job.” ACOSS president Andrew McCallum in Annabel Crabb, “Labor plan to help poor buy shares”, The Age, 7 May 2002.
2. http://www.bennelong.com.au/occasional/etherington2007.pdf  Accessed 2nd August 2008
3. Mark Latham. “From the suburbs. Building a nation from our neighbourhoods”. Pluto Press 2003

Comments and questions welcomed to rollom@iinet.net.au

For more reading on Rollo’s views on remote Aboriginal life go to
http://remoteaboriginals.blogspot.com/

Rollo Manning
RWM Consultancy
PO Box 98
Parap NT 0804
2nd August 2008


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