To the Editor: As a junior doctor working in Central Australia, who has spent the past year rediscovering my own Aboriginal heritage, I read the recent articles on the Northern Territory intervention- with interest. All authors agree that the current state of health in NT communities is shameful, and that the causes include a wide range of social determinants. However, beyond these similarities there is almost complete discordance between the article by Glasson (of the NT Emergency Response Taskforce) and the other three articles by NT-based doctors (Tait, Boffa et al, and Brown and Brown).
Glasson paints a demeaning and misleading picture of NT communities as exhibiting “a complete breakdown of normal mores”. This fits snugly with the “white blindfold” view, described by Tait, that will only further disempower marginalised Aboriginal people and communities. Glasson ignores the vast accumulated knowledge and successes attained by Aboriginal community-controlled health services (ACCHSs) and health workers, relegating their contribution to a half-sentence in his acknowledgements. Boffa and colleagues clearly outline the remarkable successes of ACCHSs and their repeatedly ignored calls for more resources. Glasson leaves no room for real community participation, and justifies the government’s heavy-handed approach as necessary for such a “crisis”. Brown and Brown describe convincingly the absolute necessity of Aboriginal rights and participation in any intervention conducted on their behalf, and the valiant long-term struggles by Aboriginal people to tackle the current situation.
In response to the government’s intervention, in June 2007, Mark Wenitong, President of the Australian Indigenous Doctors’ Association, expressed concerns that remain relevant today: “As medical professionals, we question the notion that you can treat poverty, dispossession, marginalisation and despair (the root causes of substance misuse and sexual, physical and emotional abuse) with interventions that further contribute to poverty, dispossession, marginalisation and despair.”
Indeed, the Ampe akelyernemane meke mekarle: “little children are sacred” report was very clear about the necessary approach to addressing the issues it raised: “What is required is a determined, coordinated effort to break the cycle and provide the necessary strength, power and appropriate support and services to local communities, so they can lead themselves out of the malaise: in a word, empowerment!”
My experience working in NT Government hospitals and ACCHSs has revealed both the enormous challenges facing Abori-ginal people in the NT, and their remarkable resilience and capacity to achieve against all odds. As health professionals and Australian citizens we must recognise these efforts and support interventions that are evidence-based, respectful, and conceived in partnership with Aboriginal communities and their ACCHSs. Without this, the most expensive intervention will only ever amount to a superficial facelift.
- Hamish R Graham
- Alice Springs Hospital, Alice Springs, NT.
- 1. Glasson WJH. The Northern Territory Emergency Response: a chance to heal Australia’s worst sore. Med J Aust 2007; 187: 614-616. <MJA full text>
- 2. Tait PW. Protecting little children’s health — or not? Med J Aust 2007; 187: 619-620. <MJA full text>
- 3. Boffa JD, Bell AI, Davies TE, et al. The Aboriginal Medical Services Alliance Northern Territory: engaging with the intervention to improve primary health care. Med J Aust 2007; 187: 617-618. <MJA full text>
- 4. Brown A, Brown NJ. The Northern Territory intervention: voices from the centre of the fringe. Med J Aust 2007; 187: 621-623. <MJA full text>
- 5. Australian Indigenous Doctors’ Association. Indigenous doctors demand real and long term results in Aboriginal and Torres Strait Islander kids’ health [media release]. Canberra: AIDA, 11 Jun 2007. http://www.aida.org.au/news.asp?id=1 (accessed Apr 2008).
- 6. Wild R, Anderson P. Ampe akelyernemane meke mekarle: “little children are sacred”. Report of the Northern Territory Board of Inquiry into the Protection of Aboriginal Children from Sexual Abuse. Darwin: Northern Territory Government, 2007: 13. http://www.nt.gov.au/dcm/inquirysaac/pdf/bipacsa_final_report.pdf (accessed Dec 2007).