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Some insights from the health impact assessment of the NT Intervention

On Friday, the Australian Indigenous Doctors Association released the long-awaited health impact assessment of the NT Emergency Response. You can find the full report here, and this is a Crikey article about it.

Below are some extracts from the report which give a flavour of its contents:

• Many community members felt they were being blamed

“‘It was all our fault. No [recognition] that we were in deep crisis here and really neededsome help … [This is] all your fault you know, you’re drunks, you’re lazy, you’re undisciplined, uneducated and now you’re fucking your kids so just get on with it and cop this into the bargain because we’re decent. We’re a decent society and you can’t do that in our society. So we’re going to garnishee your wages. We’re going to sort of, you know, examine every orifice of your kids and we’re going to find these perpetrators.” Aboriginal Community Leader


***

• Many people experienced the implementation of the NTER as a return to the past – perpetuating the trauma that communities have experienced since colonisation.

“We’re leaving the community without our dog collar on. It’s that kind of mentality for a lot of the old people. In fact the feeling when it [the Intervention was announced] “it’s gone back to the old way now”. That’s what the old people said it’s gone back now to the old way … where the protectorate and where we were told we got to get bread and flower and sugar and Billy tea. It’s that dictatorship and it’s the controlling of Aboriginal people’s lives and how do they expect us to control our lives if they’re trying to control it in a culturally foreign manner and totally violating human rights.” Aboriginal doctor

“ What worries me is that they’re going to say “oh look we’ve spent billions of dollars on these people and look nothing’s happened, they’re unhelpable, look at all the money that we’ve spent”.’ Remote non-Aboriginal Doctor

“It is taking away our self management and autonomy, disempowering us. People are feeling pain in their hearts. There seems to be nowhere to go and all the roads seem to be blocked no matter which way we turn.” Aboriginal Community Member

“If politicians and government had sat down with [Deidentified community] we would have given them better ideas of how to proceed and what to do.” Aboriginal Community Member

***

• The objective of compulsory income management was to ensure that money was available to be spent on feeding, clothing and providing basic living conditions for children.

“Some families that had been in real trouble have been able to buy some stuff that they hadn’t been able to do previously.” Aboriginal Health Worker

• There were many comments in the community interviews on the improvements in food supply that had followed the licensing and auditing of community stores. Not all those interviewed agreed that they had been better able to budget their money. Several women spoke of the hunger their families experienced close to pay day. There were substantial practical problems in using the cards and the costs of these were borne by the recipient rather than Centrelink. These included the cost of transport and phone calls.

“I think it’s an infringement on people’s civil liberties that government has to manage and be involved in all those minute aspects of people’s day-to-day living. My mother’s book for child endowment was not in her house but hers and those of all the other Aboriginal mothers around the country, were held by the Superintendent of Native Welfare and she had to explain why she needed the money and how she was going to use it,etcetera,before he would let her have that month’s coupon.” Aboriginal Community Leader

• Rather than enabling Aboriginal families to better manage their money, the process of compulsory quarantining was seen as reinforcing beliefs that Aboriginal people were not able to manage their lives. This loss of autonomy about where to shop and what to buy was seen as degrading and shameful. Importantly it did not focus on whether people received enough money to be able to budget appropriately or provide skills in budget management.

“… stigma of shame attached to going to Centrelink and getting the card and lining up at Woolworths so lack of control in negotiation and consultation when it comes to food supply.” NGO Program Manager (non-Aboriginal)

***

• For many people the proposed building program was seen as a missed employment and training opportunity for Aboriginal people in the design, construction, and maintenance of housing and relevant health hardware

“Rather than having people flying in and flying out to build houses while you’ve got all these white fellas going in, building a house, and then shooting off. You’ve got the community, you know 50, or 60 or 100 Aboriginals sitting down watching them build a house. Non-Aboriginal Doctor

***

• Overall student enrolment appeared to have increased modestly in the first year of the NTER—by about 400 students in the schools within prescribed communities (Sarra, 2008).

• Some parents and teachers report that children are becoming angry as a result of other aspects of the Intervention (e.g. being harassed by police, income management), and are becoming more aggressive, rebellious.

“A lot of people in town and increasingly in some of the remote communities are saying that the children are more angry, getting more aggressive, more rebellious. It’s something people have noticed in the last year which is quite amazing.” Non-Aboriginal Doctor

***

• The putting up of signs banning alcohol and pornography was resented strongly by local communities who felt this to be a highly discriminatory action. The cost of the signs is wasteful, especially because they have had to be replaced by smaller signs due to community protest.

“Like them big signs they put up there. It is as though they thought all black fellas are alcoholics and paedophiles.” Aboriginal Community Member

• Portrayal of Aboriginal men as paedophiles and sexual abusers to the rest of Australia is likely to contribute to psychological distress, to an increase in health risk behaviours, and to add to feelings of political and social exclusion.

‘There’s a collective despair amongst Aboriginal men since they’ve been labelled  paedophiles and its proven to have very  negative impacts on how Aboriginal men respond to the Government and to the media and … because they feel ashamed of what they have been called. But they don’t know how to stand up for themselves to get the apology that these men deserved …. It was being publicised that 50 to 70% of all Aboriginal children had been sexually abused and it also indicated that most Aboriginal men were paedophiles and sexual abusers and I think that gave an untrue and unfair picture to the rest of Australia which had never been remedied.” Aboriginal Health Service Manager

‘It was like only our men, Aboriginal men, were interfering with children and I felt really sad about that. I have brothers, I have a son you know, he is a father and I just felt really sorry for our men.’ Aboriginal Health Worker

‘When you drive into an Aboriginal community, there is a sign on every Aboriginal community at every access point: no grog, no pornography …. They cost three million to put the signage up and because it was so offensive to Aboriginal people they said “well we’ll make the sign smaller” so they did but they haven’t taken down the big signs yet and so the three million they allocated for signs is now fifteen million because they got a different contractor to do the second lot of signs but they haven’t got a contractor yet to come and remove the old ones and because they’re smaller they couldn’t use the same posts, so we’re spending fifteen million to say no alcohol and no pornography.’ Aboriginal Health Service Manager

***

• Lack of recognition of existing services

“It disheartened a lot of people who’d been doing a lot of hard work in the Northern Territory for a long time. I think that was negative. People feeling, you know who’ve worked for 10, 15 years, working very hard suddenly felt that you know their contribution wasn’t valued. I think that was, that was a negative impact.’ Aboriginal senior bureaucrat

***

The HIA also included reviews by experts of various aspects of the intervention. These are in the appendices and well worth reading. They include reviews by:

• Dr Chris Sarra Executive Director, Indigenous Education Leadership Institute, Queensland University of Technology (education)

• Dr Heather D’Antoine, Senior Research Officer, Telethon Institute for Child Health Research, Perth (child health checks)

• Australian Human Rights and Equal Opportunities Commission review of human rights issues

• Professor Ernest Hunter, Regional Psychiatrist, Remote Area Mental Health Services, Queensland Health and Adjunct Professor, Psychiatry, University of Queensland (mental health)

• Professor Helen Milroy, Director, Centre for Aboriginal Medical and Dental Health, University of Western Australia (children’s mental health)

• Professor Sherry Saggers National Drug Research Institute, Curtin university of Technology (alcohol)

***

PostScript: Here you can see some of what Minister Snowdon and Pat Anderson (one of the authors of the Little Children are Sacred report, which preceeded the NTER) had to say at the HIA’s launch in Canberra.

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Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
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Population Health Congress 2015
2016 conferences
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#cphce2016
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2017 conferences
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Australian Palliative Care Conference
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