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Solving the Aboriginal health crisis requires the gusto of the Northern Territory Intervention with exactly the opposite approach. While the intervention was fundamentally flawed in many ways, the insistence that the health and social problems of Indigenous Australians required an urgent, expansive response was absolutely true. The idea that the details of this response should be devised by bureaucrats in Canberra and enacted by federal military and law enforcement was chief amongst its failings. The policy of community consultation as afterthought must end. So too the defeatist notion that Aboriginal health is too large a problem to solve quickly. An Aboriginal child born today can expect to live between 10 and 17 years less than a non-Indigenous Australian. The same child is more than twice as likely to die before the age of 5. This child cannot afford the customary sluggish paternalism that we have come to expect in Indigenous affairs in this country. We have become so accustomed to unnecessarily slow progress in matters relating to our Indigenous people – from the shamefully late granting of voting rights and retraction of terra nullius to the long overdue apology for the Stolen Generations – that we think that ‘slow and steady’ is the necessary pace. This expectation of delay is misguided. Closing the gap in life expectancy need not be some distant possibility achieved in decade-long increments. After New Zealand conducted a sustained, targeted approach to improving Maori health outcomes during the 1960s and 1970s, life expectancy discrepancy dropped from 17 years to less than 8 years within a generation. Likewise, Canada nearly halved the gap in life expectancy for its indigenous First Nations people in only 15 years. Two years ago COAG announced a partnership between the federal and state governments to closing the gap in life expectancy, among other measures, by 2030. While this date will be some 50 years after most comparable countries addressed the health inequality of their Indigenous people, it is an appropriately ambitious target that should be rewarded. Since that announcement the Rudd government has made many important symbolic gestures toward reversing errors of the past. The significance of the apology to the Stolen Generations and the recent promise to reenact the Racial Discrimination Act in respect to the Northern Territory Intervention cannot be underestimated. In more specific ways, the relevant federal ministers, Jenny Macklin and Warren Snowdon have shown themselves to be genuinely concerned with improving Indigenous health, unveiling a variety of measures that the government have formulated to combat the problem. The Federal and State governments have committed some $1.8 billion to various programs in their Close the Gap campaign. These achievements need to be acknowledged, but the government still needs to better recognize that any meaningful change in Indigenous health outcomes can only come from the Indigenous communities themselves. The 2030 target for closing the gap cannot be reached if Indigenous communities themselves do not take the lead. The fastest way to ensure change is to give the responsibility for change to those who have the most to gain by it. Aboriginal communities and families must be involved in the design and delivery of healthcare. The government must take responsibility for the overall improvement of Indigenous health, whilst simultaneously realizing that the only way to do so is by allowing different communities to identify their health problems and formulate their own solutions. Examples abound of oftentimes simple but effective programs developed by Aboriginal Medical Services and their Indigenous health workers and local elders to address health concerns that they have detected within the community. The Geraldton Regional Aboriginal Medical Service created a very successful antenatal clinic to improve maternal and neonatal health, which they had identified as a particular problem in the community. The Townsville Aboriginal and Islander Health Service has developed a Mums and Babies program that creates a culturally appropriate space for expectant mothers to be educated about the effects of smoking, alcohol and nutrition on their babies. In the 10 years it has operated birth weights have increased significantly, while perinatal deaths have more than halved. The Maya Living Free Healing Centre was established in Thornbury, Victoria by Aboriginal health workers to treat addiction and mental health problems amongst the local Indigenous population. The success of the centre lay in its merging of traditional Aboriginal concepts of healing with Western medicine. The Yorgum Aboriginal Family Counseling Service in Perth is an example of another long-running organization that has been very successful because Indigenous people with Indigenous concepts of holistic health devise its programs. A ban on take-away alcohol at Fitzroy Crossing in Western Australia was an initiative proposed to the State Government by local Indigenous leaders. Within 6 months, alcohol-related attendances at the local emergency department had been halved while school attendance increased. One of the major impediments to the improvement of Indigenous health in the past has been the small number of Indigenous health professionals. Research has shown that many Indigenous Australians would prefer to travel long distances than be treated by someone who didn’t understand or respect their cultural differences. The first Indigenous doctor, Professor Helen Milroy, did not graduate until 1983. Now there are 140 Indigenous doctors and another 140 in medical school. Similar growth has occurred in other health fields. This influx of Indigenous health graduates must not be squandered. Working alongside other experienced Indigenous doctors, nurses and allied health practitioners, and the communities in which they practice, they can bring their own innovative solutions to old problems at a community level. While the state and federal governments have made considerable progress on Indigenous Health in a short period, they must open the doors and give up the head seat at the table. The real experts in Indigenous health are Indigenous people. Things to Do Digg it Save This Page
Restructuring the Baby Bonus System to create a healthier generation of Australians |
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Opening Up Closing the Gap
