Indigenous health: sorry is not enough

Politicians have often gone AWOL on Indigenous matters, so should pay particular attention to a message from a former prime minister:

It begins with the act of recognition. Recognition that it was we who did the dispossessing. We took the traditional lands and smashed the traditional ways of life. We brought the disasters. The alcohol. We committed the murders. We took the children from their mothers. We practised discrimination and exclusion.

It was our ignorance and our prejudice. And our failure to imagine these things being done to us. With some noble exceptions, we failed to make the most basic human response and enter into their hearts and minds. We failed to ask - how would I feel if this were done to me? Paul Keating, Australian Launch of the International Year for the World’s Indigenous People, Redfern, Sydney, 1992.

Indigenous Australians suffered illnesses common in tropical climes prior to 1788, but British colonists brought new diseases like tuberculosis and venereal infections. There was even some controversy “within the general climate of frontier violence” as to whether smallpox was spread deliberately. Introduced illnesses were a major cause of Indigenous depopulation during the 18th and 19th centuries.

Aboriginal Protector James Dredge in the 1840s said “While we hesitate they die. Their condition is indescribably awful and perilous”, and he blamed government incompetence and settler maliciousness.

From the mid-19th century to the 1930s, there was a dominant European belief in the “doomed race” theory, that Indigenous extinction was “natural and unavoidable”, part of “natural evolution” with Europeans emerging as the highest form of human development (a view still heard in 1960s London). Even government and mission compounds were often characterised by poor hygiene, inadequate nutrition, and epidemic illness, described as stemming from “colonial attitudes”. Some cattle stations were also notorious for high levels of infectious disease.

In 1936 Western Australia’s Chief Protector found rural hospitals that “refused to take Indigenous patients, including women in labour”. In the 1930s authorities often sent leprosy patients to Darwin in neck-chains, sentenced to life imprisonment in leprosariums, a practice continuing until 1955.

Pastor Doug Nichols returned from the Warburton Ranges in 1957 traumatised, saying “My people are starving … everywhere we went they pleaded for food and water ... I wish I hadn’t seen the pitiable squalor … never, never can I forget”. In the 1960s student Freedom Riders on country tours found hookworm, ear and eye infections, unclean drinking water, lack of proper toilet facilities.

Author Frank Hardy wrote in 1963, “No white man, even in the depths of the depression, has suffered as much as the black man suffers now in the height of the nation’s boom”. Increasingly activist groups labelled the system genocidal.

Evidence shows “morbidity, mortality and risk factors … are highest among those living in the most disadvantaged areas”. In 2002 the average Indigenous household income was only 59 per cent of non-Indigenous income. “The prevalence of easily treatable diseases associated with inadequate basic sanitation and living conditions … as well as a lack of access to safe and reliable water supplies in many Indigenous communities provides strong evidence for conditions of absolute poverty” as defined by the United Nations. The authors also conclude Indigenous poverty is different from non-Indigenous poverty.

Inequality in itself also affects health. General research has shown those higher up the chain of command have less sickness than those lower down regardless of finance. There’s not only a difference between the boss and the lowliest office junior, but even between top brass and deputy top brass who might share the same lifestyle.

So if you have little income and also feel you’re at the bottom of the pecking order, so much the worse for your health.