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WSWS : News
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Northern Territory intervention
A third-world health catastrophe
Part 3
By a WSWS reporting team
2 July 2008
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World Socialist Web Site journalists Susan Allan and Richard
Phillips and freelance photographer John Hulme recently visited
central Australia to report on the social and political impact
of the federal governments Northern Territory Emergency
Response or police/military intervention into Aboriginal communities.
This is the third in a series of articles, interviews, video
clips and slide shows (1
and 2). Parts one, two,
four, five,
six and seven
were posted on June 21, June 26, July 15, July 24, August 6 and
August 25 respectively.
In mid-April, Northern Territory newspapers reported on an
inquest into the death, almost two years ago, of Julama Limbunya,
a 78-year-old Aboriginal man.
On August 21, 2006, Limbunya was flown home to Kalkaringi-Wave
Hill, a small Aboriginal community about 750 kilometres south
west of Darwin, after receiving treatment for pneumonia at Katherine
hospital.
Although Limbunya had recovered from his illness, he was blind,
could not walk unaided, spoke little English and had early signs
of dementia. Nevertheless, the elderly man was provided with no
escort on the specially chartered flight, nor were his relatives
or the local community told when he would be arriving.
While guidelines for transporting remote patients to Darwin
or Katherine stipulate that anyone frail, aged or chronically
ill must be escorted on medical evacuation flights, permission
must first be obtained by the outlying clinic from a District
Medical Officer (DMO) in Darwin.
Requests for a medical escort for Limbunya, however, were rejected
by a Darwin DMO and so the old man was dispatched alone to Kalkaringi.
The pilot dropped him off at the dusty unmanned airstrip, where
the temperature was 35 degree Celsius (95 degree Fahrenheit),
turned the plane around, and flew back to Katherine.
Limbunyas body was later found in bushland about 800
metres from the airstrip, one week after police had abandoned
their search for him. The 78-year-old was a former participant
in the historic 1966 Wave Hill strike, when Aboriginal stockmen
walked out to demand equal pay with white pastoral workers.
Limbunyas tragic death is symbolic of the bureaucratic
indifference and woefully inadequate health facilities for indigenous
people in much of remote Australia.
As Josie Crawshaw-Guy, Limbunyas niece, told the NT inquest:
We are the poorest and the sickest and yet cutting costs
seems to be a major factor when decisions are made about our health
care.
Crawshaw-Guy later told the press that little had changed since
her uncles death. She recounted a similar case in which
an old, frail woman with failing eyesight from Boroloola in NTs
east was sent unaccompanied to Katherine for medical treatment.
Its the culture that exists that Aboriginal people
just get substandard care in everything and especially in health
care, she said.
The circumstances that led to Limbunyas death are not
uncommon in outback Aboriginal communities. The NT government,
for example, is currently investigating the death in February
of two Aborigines from remote communities. The men died while
waiting to be flown to hospital for treatment. And in early May,
a three-week-old baby girl from Blackwater, a small outstation
near Papunya about 260 kilometres northwest of Alice Springs,
died simply because her mother was unable to call a nearby local
ambulance or on-duty nurses.
Blackwater has not had a working public pay phone since 2004,
despite repeated appeals to Telstra from the community. The mother
and grandmother were forced to walk to Papunya in the middle of
the night carrying the baby girl, who had died by the time they
reached the town.
These heart-wrenching stories were briefly mentioned in the
inside pages of the national press and then dropped.

Just prior to our visit to Alice Springs, Prime Minister Rudd
called a press conference to announce that his government would
close the gap between indigenous and non-indigenous
health within three decades. Rudds announcement was not
matched, however, by any serious injection of government funds.
According to Professor Jon Altman, director of the Centre for
Aboriginal Economic Policy Research, it would take 2,000 years
to bridge the gap between indigenous and non-indigenous life expectancy,
median income and unemployment, based on present trends and current
government spending.
The following is a summary of some of the indices of the health
inequality between Aboriginal people and non-indigenous Australians
from HealthInfoNet (For further information see here).
* Indigenous women are three times more likely to die while
pregnant, during labour or up to six weeks after giving birth
than non-indigenous women, a figure that has not changed since
statistics started being kept in the early 1990s.
* Babies born to indigenous women weigh on average 217 grams
less than those born to non-indigenous women. In the NT almost
17 babies died out of 1,000 births, more than three times the
rate for the rest of the Australian population in 2005.
* Respiratory illnesses in Aboriginal children aged 1 to 5
years are widespread and account for more than 15 percent of all
NT Aboriginal hospital admissions. The rate of bronchiectasis
amongst Aboriginal children in central Australia is one of the
highest in the world.
* Aboriginal children in the NT have high rates of growth faltering
and anaemia, while skin infections, such as scabies and streptococcal
pyoderma, are commonplace in remote communities. Up to half the
children are infected.
* Diabetes is about three-and-a-half times more common among
indigenous people than other Australians, with deaths from the
disease 10 times higher.
* Eye-conditions affecting the indigenous population, including
cataracts, trachoma and diabetic retinopathy, are endemic. Up
to 30 percent of indigenous children in the Northern Territory
suffer infectious trachoma.
* A recent Alice Springs Hospital survey found that Aboriginal
people are 11 times more likely to die with an infectious disease
than non-indigenous patients, a rate far higher than most third-world
countries. Tuberculosis infection rates are 10 times higher; and
haemophilus influenzae, which causes otitis media, conjunctivitis
and sinusitis, 14 times higher in indigenous children under 5
years of age.
* End-stage renal disease is 25 times more common for indigenous
people than for non-indigenous people, with the death rate from
kidney disease at least 10 times higher. Some medical experts
estimate that indigenous Australians in the Central Desert region
are 30 to 50 times more likely to need dialysis than the national
average.
* Indigenous people live 17 years less than the rest of total
population and only 3 percent live to 65 years, the official retirement
age. In central Australia, the average life expectancy difference
is 24 years.
We are so under-resourced
We interviewed Hilary
Tyler, an emergency doctor who has worked in central
Australia for three years, about the ongoing government neglect
of Aboriginal health. Her comments highlighted another side of
the interventionits debilitating impact on local medical
staff.
You dont need to be emotive about whats happening
here, she said. All you have to do is explain the
factsthey show the real extent of the disaster endured by
Aboriginal people.
In my first year here my favourite word to describe the
situation facing Aboriginal people was abhorrent.
There was such an obvious health crisis and yet so little money
or resources. Maybe it was my problem that I hadnt been
aware of the severity of the crisisthe low life expectancy,
the high rates of chronic disease and all that. But the government
is fully aware and yet it fails to provide enough money to seriously
address these issues. We are so under-resourced.
Someone will say we should have an alcohol and drug rehabilitation
service, which is great, and one is established but then not provided
with any real resources or funding and therefore cant function
properly. This sort of thing goes on all the time, and across
the board, the emergency doctor explained.
Commenting on the intervention Tyler pointed out: Theres
been a hell of a lot of duplication. Its almost as if they
assume that nothing has been done in the past or that anything
is already in place. They dont consult with any of us who
have been working in this area for years, or the acknowledged
experts, but just make up their own slap-happy rules about what
is good or not. Money has been spent, of course, but much of the
intervention work has been a waste of time.
For example, the intervention doctors identified about
80 to 100 kids who were supposed to have heart disease. But of
all those referred in for echoes [testing] none had heart diseasenot
one. And as far as I am aware, not a single child has been referred
in with a health problem that wasnt already known by local
health workers. Nor has the intervention identified any cases
of child sex abuse.
The intervention has estimated that 20 to 25 percent
of Aboriginal children have ear problems but this figure is wrong,
its much higher than that. This means it has duplicated
what we already knew but then doesnt get it right and yet
spends all this money to do so.

I was recently talking to a doctor friend in one of the
remote communities and he was really upset because he is not being
told what is happening with the intervention or able to participate.
His expert knowledge in the field is simply being ignored. If
this was properly planned you could put in some amazing health
infrastructure, but instead it all feels like a political show.
We asked Tyler what she thought about the Rudd government claims
that it would close the health gap in 30 years. That would
be great, she replied, but the money being promised
for this is completely inadequate.
The only way to make a real change is if you consult
with the people working on the ground. And most importantly, you
cannot improve health if you dont improve the quality of
life overallthis means better living standards, jobs and
everything else. Without that nothing will change. You can fix
up peoples ears, but unless you change the overcrowding
at home and other issues then the problem just reemerges.
Labor is great on the symbolismit comes out and
says its sorry to the Stolen Generation, but continues to
expand the intervention which is a racist piece of legislation.
These two things just dont go together and I find it incredible
that Labor hasnt reinstated the Racial Discrimination Act.
Welfare quarantining doesnt make sense either. How is controlling
somebodys income going to make them better citizens?
I agree with you that this makes it very simple to roll
out welfare quarantining onto non-Aboriginal sectors of society.
I guess the government could reinstate the Racial Discrimination
Act and then claim that what its doing with quarantining
and prescribed communities is not racist and therefore okay. The
end result for the government would be the same.
The other point I want to make about the intervention
is that theres never been any framework to discuss it objectively.
The government and media polarise the issueyoure either
for the intervention and therefore good, or against it and therefore
supporting pedophilia.
All this is part of the governments non-consultative,
almost colonialist, approach, where health workers and people
on the ground are just not asked what they want or what should
be done. There have been all sorts of delegations to [Minister
for Indigenous Affairs] Macklin, but she only acknowledges those
who are for the intervention. If youre against, youre
just ignored.
To be continued
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