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HomeVolume 28Closing health gap needs more than booze, crime control

Closing health gap needs more than booze, crime control

LETTER TO THE EDITOR

Improving the living conditions and reinvigorating social programs hold the key to Closing the Gap in health for Aboriginal communities.

Dr Simon Quilty

Today, National Close the Gap Day, while there is a lot of focus on alcohol, crime and violence in communities such as Alice Springs, it is the long-term, underlying issues that are the real problem here.

We are definitely experiencing difficulty in attracting, retaining and housing health professionals right across the NT, addressing this issue in isolation of the greater social disparity only makes the problem worse.

When our patients do not have adequate housing, and are living in conditions that are extremely detrimental to the health, education and basic safety of their residents, this provides fertile grounds for youth disengagement, domestic violence and social disharmony.

There is a pervasive sense of hopelessness that is a key contributing factor to the issues affecting these communities and this has been exacerbated by the social fallout after COVID which has resulted in the cessation of many social programs that previously supported many people, particularly youth, in these communities.

How does it look to our patients when doctors and nurses are provided with accommodation, when they are sleeping in shifts so they can fit in the increasing number of people needing basic shelter?

Extreme disparity exists even within our Aboriginal health workforce. Alice Springs Hospital Aboriginal Liaison Officers, who provide interpreting services essential to the delivery of health care to our patients, are the lowest paid interpreters in the country.

These are essential health workers, who speak many dialects, and the value of their skills must be equitable with interpreter salaries for government services for immigrants to Australia.

NT rural doctors are also calling for parenting programs that are culturally appropriate; alcohol management programs; grants for NT general practice resulting in increased service capacity; homes with social spaces for visitors and outdoor space (fire pit) for cooking and yarning; and safe places in Alice Springs, Tennant Creek and Katherine for children to go when home situation is not safe.

Once we have plans in place to address the underlying structural issues affecting Aboriginal communities, only then can we turn our attention to addressing the quality and supply of accommodation for our health professionals.

Putting the needs of health workers so far ahead of those of the communities they serve is counter-productive, and while it may look like a band-aid fix, in reality it is undermining the health outcomes and delaying Closing the Gap.

Dr Simon Quilty

Formerly based at Alice Springs hospital and currently working with Purple House.

PHOTOS above: Ringer Soak Health Clinic in WA. At top: Bush homes need social spaces for visitors and outdoor space, a fire pit for cooking and yarning. Centre for Remote Health.

3 COMMENTS

  1. Please name the remote communities where people are sleeping in shifts so they can fit in the increasing number of people needing basic shelter.
    In the seven or so communities I am familiar with, this is not the case although at times cultural obligations to visiting family may cause temporary overcrowding (a cause of celebration rather than complaint).
    Many communities such as Yuendumu, Willowra, Kintore etc have spacious, well built houses with culturally appropriate modifications such as stainless steel toilets, window security screens and bench tops fixed in place.
    There is a large gap between housing provision between regions with the Barkly communities most in need. Disgraceful to see communities like Station with families living in humpies.
    But this is not the overall situation and a great deal of money has been spent to upgrade remote community housing.
    A change that will lead to less crowding is the move to collect more rent because in some communities families “collect” houses by putting one relative in a four bedroom house, thereby excluding more needy families.
    This is a change that is now flowing through the system but should free up more housing stock.
    Important to base solutions to closing the health gap on remote areas realities.

  2. I often quote Kim Beazley Sr: “In Australia, our ways have mostly produced disaster for the Aboriginal people. I suspect that only when their right to be distinctive is accepted, will policy become creative.”
    IMHO much of this talk of overcrowding, poor health outcomes, safety, Closing the Gap, social fallout after Covid etc. is missing the point.
    Disempowerment and disrespect making locals on communities irrelevant on their own land are some of the root causes.
    The example of interpreters in the health system being undervalued is paralleled in the education system. The ability to speak an Aboriginal language in bilingual (two-way) schools is not reflected in pay and perks nor in recognition and status.
    I could put you all asleep with many more examples of discrimination.
    I don’t know how to fix this, nor do I consider it my prerogative to offer solutions.
    When you put a bulldozer in reverse, all that has been flattened doesn’t immediately spring back.

  3. Are NT rural doctors are also calling for parenting programs that are culturally appropriate?
    There is a myth that remote Aboriginal families don’t know how to parent so they need to be taught.
    The remote community parents I know are as dedicated to parenting as any others in our society. Sometimes their focus on parenting even seems obsessive.
    But it’s very different to non Aboriginal parenting.
    For generations, assimilatory programs have failed and parenting programs are just more of the same including those pretending to be “culturally appropriate”.

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