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This article was first published on Wednesday, June 14, 2023
Introduction by Croakey: Central Australian Aboriginal Congress is the largest Aboriginal community-controlled health organisation in the Northern Territory and one of the most experienced primary healthcare services in the country.
A recent celebration of the organisation’s 50th birthday provided an opportunity for sharing important stories and achievements.
Central Australian Aboriginal Congress writes:
On Friday 9 June, Central Australian Aboriginal Congress (Congress) held an event to mark fifty years since the organisation’s founding in 1973. The event was centred around sharing outcomes from Congress Arrulenye (Congress from a long time ago), a study that looked into the organisation’s history and the impact it has had on Aboriginal health in Central Australia (the study is not yet published).
Today, Congress is a large Aboriginal Community Controlled Health Service (ACCHS) based in Mparntwe (Alice Springs), one of the most experienced organisations in the country in Aboriginal health and a national leader in primary healthcare. Congress delivers services to more than 17,000 Aboriginal people living in Mparntwe and remote communities across Central Australia.
Event attendees were treated to a warm reflection on where it all started from Congress’ founder and first CEO, Neville Perkins AOM, as he recalled the early years of the organisation.
Neville Perkins was instrumental in calling a meeting in Alice Springs on 9 June 1973, when over 100 Aboriginal people from across Central Australia met to talk about the need to safeguard and promote the interests of their communities.
The meeting elected a Cabinet to represent the Aboriginal people from Central Australia, and the name Central Australian Aboriginal Congress was chosen, modelled on the Indian National Congress and the African National Congress, who had led their own struggles for self-determination.
Historical context
At the time, Aboriginal people lived in very harsh conditions.
Families, language and culture were strong, but extreme poverty and poor housing was almost universal.
There were no land rights, and few health services especially in remote areas. What health services existed were marked by overt racism: the Alice Springs Hospital had been segregated into overcrowded Aboriginal wards and largely empty wards for non-Aboriginal people until 1969.
In the 1960s in remote areas up to one in five Aboriginal infants died in their first year of life, and life expectancy was around 55 years.
Congress’ initial aims were to be a voice for the Aboriginal people of Central Australia on all matters that concerned them.
But health remained a great concern, and in 1975, Congress started a Medical Service and began developing its comprehensive model of healthcare aimed at not just treating those who were ill, but also acting on the causes of illness.
Congress became the voice of Aboriginal health.
But Neville Perkins recalled that “Congress was always envisaged to be more than a medical service…” and that to realise the rights of Aboriginal people, “… we had to protest in the main street.”
Current Congress Chair Graham Dowling agreed, saying that “The goal of speaking out on behalf of our mob has always been an important part of what we do.”
Graham Dowling also paid tribute to the many staff who have contributed to the Congress journey, and especially the Aboriginal Directors who have led Congress since those early days.
“Many things have changed in the last fifty years,” he said, “but throughout that time, we have been guided by the dreams and aspirations of our community-elected Board members, and their dedication to justice and self-determination.”
Stories continue
The event also heard from Acacia Lewis, who has worked on the Congress Arrulenye (Congress from a long time ago) project to document the history of the organisation.
She described how the project has created an interactive digital portal, a cultural archive for the community that allows people to browse or search photos, documents and other media from Congress’ history, while providing controls to protect and prioritise cultural safety.
Through this, it is hoped that the stories – and the learnings – live on. “We want our young people to learn about the history of our old people – the stories of resilience, courage and strength. We are grateful for our old people and their contributions,” Acacia Lewis emphasised.
In addition, the project has created an interactive digital timeline that allows users to travel through Congress’ history and view organisational and community milestones alongside major changes in the national socio-political landscape.
Finally, the event provided an opportunity to ask the question: after 50 years, what has Congress achieved?
To help answer this question, Congress’ Chief Medical Officer Public Health Dr John Boffa presented some initial, indicative findings from the Congress history project, which demonstrates some significant improvements in the health status of Aboriginal people in Central Australia over the years.
While more work is needed to ‘close the gap’ in health status with non-Aboriginal people, improvements have been more marked in Central Australia than in other regions of the NT and include:
- More than halving ‘years of life lost’ before age 75, a key measure of avoidable mortality, especially for Aboriginal men for the period 1999 to 2013
- Improvements in the median age of death which in the mid-1990s stood at around 45 years for men and 55 years for women; but which increased to around 58 years for men and 66 years for women by the period 2014-18
- A dramatic fall in the infant mortality rate from up to 200 per thousand live births in late 1960s to around 15 per thousand live births in 2018
- Decreasing proportion of teenage mothers from around 30 percent to 40 percent in the late 1980s to around 15 percent in 2021.
Some areas are more complex.
For example, alcohol-related hospitalisations rose rapidly during the 1990s, and only started to fall again after the introduction of effective alcohol restrictions from 2013. Even with these improvements, Central Australia has more than 100 admissions per 1,000 people which is more than twice the level for Top End Aboriginal people and 20 times the national average.
Also, low birth weight of Aboriginal babies improved in the late 1980s – coinciding with the establishment of Alukura, Congress’ women’s health service, but have been gradually rising since then.
These findings support previous findings that demonstrate that health system improvements are the major reason for the better outcomes. Funding matters. The total funding for primary healthcare has increased dramatically from the late nineties across the NT.
In addition, from 2001 with the election of the Northern Territory’s first Labor Government there was a major increase in investment in public hospitals, increasing both their capacity and clinical safety.
However, analysis of Census data for the period 2001 to 2021 shows inconsistent improvements in only some social determinants of health (for example, education) mainly in Alice Springs itself but from a very low base, alongside increasing poverty and inequality in remote areas.
Given this, it is unlikely that the health improvements are due to any changes in the social determinants of health beyond those impacted by an improved health system.
In closing the event, Graham Dowling reflected on the improvements that have been seen and the growth of Congress since 1973.
“I think it confirms the wisdom, authority and knowledge of those who founded Congress 50 years ago, and all those who have contributed to the organisation since then,” he said.
“And we mustn’t forget the contribution of the many other Aboriginal organisations here in town and out bush, who have also been part of the struggle for our rights, and for justice and health for our mob.”
Further community celebrations of Congress’ fifty years are planned for October, with details to be released in coming weeks.
Croakey acknowledges and thanks Congress for the photos.
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See Croakey’s archives on the Aboriginal and Torres Strait Islander community-controlled health sector
