Drought disease

As Australia experiences one of the most severe and prolonged droughts in its history, a pervading sense of powerlessness and hopelessness is beginning to pervade many rural communities.

In health terms drought can be considered a chronic slow-onset disaster somewhat akin to slow-viral epidemics like HIV-AIDS, in that many of its effects are insidious, often hidden from view and may be spread out over a long time period.

In addition, the link between drought and human health is not always a direct one, but one that may operate through a complex web of interconnected linkages. Historically, the drought-famine relationship has been one of the most critical for human societies, and the historical record of drought indicates death and disease on a massive scale.

The drought-famine in Northern China in 1876-79 for example, affected at least 100 million people and probably caused the death of at least 13 million. The droughts in the 1890s and 1910s in the US High Plains caused widespread malnutrition and starvation and probably thousands of deaths.

Quite possibly the 1895-1903 drought, one of Australia’s most severest, produced high levels of malnutrition and premature illness and death. Since then, personal resources, government intervention and other support mechanisms, have largely removed the threat of starvation, malnutrition and outbreaks of infectious disease during droughts. Now, these have been replaced by a raft of adverse psycho-social outcomes such as stress, depression and psychosomatic illness, in many cases leading to the exacerbation of chronic conditions like stroke and heart disease.

Droughts like all disasters tend to target the most vulnerable groups in our society and underscore existing health differentials in the population, exaggerating the position of those groups which normally experience the highest levels of social and economic disadvantage.

Drought also impacts on those nearer the margins of our society living on rented or heavily mortgaged properties, or perhaps export-orientated farmers who over commit financially or who make risky farming decisions.

In Australia, country people suffer higher levels of deaths from coronary heart disease, cancer, respiratory disease, injury, road accidents and diabetes than do urban dwellers, and levels of family violence and alcoholism and teeth loss also appear to be much higher.

There are also reports of more illness and higher rates of hypertension and psychiatric illness in rural populations compared to urban dwellers. Most distinctive of all, is that rural areas have high suicide rates, particularly among young adult males, where the rate is at least 50 per cent higher than that prevailing in metropolitan areas.

There is also a severe shortfall of health workers and counsellors in rural areas.

Drought undoubtedly compounds such rates, and adds another toll to the distinctive health disadvantage of living in rural Australia.

Elmer Kelton in his novel about the effects of the 1950s droughts on people in the rangelands of West Texas captures some of the effects of such events. Charlie Flagg, a long-time rancher and the novel’s hero, watches while drought kills his livestock, causes his heart attack and the suicide of his best friend. But it does not drive him from his land.

In many respects we are seeing this in the present drought in Australia where the incidence of suicide would seem to be increasing as well as high levels of anxiety, stress and severe depression. Overall, drought has created landscapes of hopelessness, powerlessness and despair. Such things are not readily quantifiable, but in health terms are as important as the starvation and malnutrition consequences of drought.

A number of factors contribute to mental health problems in rural areas during drought. Stock and crop losses alone are stressful, as is the business of carting feed and water and droving stock, but droughts also bring forth a myriad of other family and financial problems. Generally, there is a feeling of helplessness and frustration, particularly with the inability to influence farm or local events, or to have any say in decisions concerning such matters as mortgage or loan repayments, transport services, farm product subsidies or import restrictions.

Other factors such as the need for people to seek off-farm work as well as to continue to work on the farm, the loss of leisure time and a decline in the amount of time spent with family, all add considerably to stress and depression.

Many farming men do not admit to stress or the resultant physical and mental health problems as drought and financial hardship increase. Some resort to increased physical labour with a related decrease in emotional contact with immediate family. Such emotional isolation may impact on other family members and can be a factor in producing lowered self-esteem and depression in rural women.

Alcohol and substance abuse may be one release. The impact on family members can be devastating and lead to inconsistent parental discipline and parent-child conflicts. The disruption and stress to teenagers and young adults who may have to move off the farm or abandon education to seek work, is equally important and can lead to depression and in extreme cases to suicide.

The lack of mental health services in rural areas greatly compounds these sorts of problems and even where they do exist, physical and emotional isolation may reduce the ability of farmers and their families from accessing them because of loneliness, depression and loss of interpersonal skills.

The mental health effects of droughts are not well understood in Australia. Yet they would seem all pervading, particularly in the context of rural health disadvantage. Given that drought is a regular feature of the Australian scene, we need to fully appreciate all its effects, and develop relevant health and other support services available to all people in rural areas.