Australian Broadcasting Corporation
Good news on Indigenous health front
Reporter: Murray McLaughlinTERRY O'BRIEN: The picture of Aboriginal health in Australia remains a depressing and shameful one, much higher rates of chronic heart, kidney, eye disease and diabetes than for non-indigenous Australia. There is the added scourge of petrol sniffing amongst young Aboriginals. But, more than a glimmer of good news from one remote community in central Australia, which has improved its health situation so much it sparked international attention. Murray McLaughlin reports from a place in the Territory called Utopia.
MURRAY MCLAUGHLIN: Utopia is the name of a former cattle station located more than 200 kilometres northeast of Alice Springs. It's been Aboriginal freehold since 1979 and is now home to 1,000 people who live at 16 outstations spread across 3,000 square kilometres. They run their own health service and Karmananda Saraswati has been their doctor on and off since 1992.
KARMANANDA SARASWATI: Each of the outstations, we try to get there on the same day every week and do a good clinic there, so that is what we call primary health care.
MURRAY MCLAUGHLIN: With three nursing staff, Dr Saraswati works out of a clinic which is itself isolated from the 16 scattered outstations. Although the Federal Government in the 1970s wanted to include the clinic as part of a township at Utopia, Aboriginal traditional owners fought successfully to decentralise services.
KARMANANDA SARASWATI: With towns go all these sort of problems we see. If there is trouble everyone is disturbed whereas, in this sort of model, you've got 16 different places with 16 family groups living in their own place working out things in their own way.
TRACKER TILMOUTH, UTOPIA COMMUNITY ADVISER (1980-85): The benefits have been massive - education, social wellbeing, health, any of those indicators that are normally the sort of shame card for Aboriginal communities doesn't exist at Utopia. Probably this is the best model of a decentralised Aboriginal community that we've got in the Northern Territory.
MURRAY MCLAUGHLIN: Utopia's health service is such a success story that it's been written up internationally. Petrol sniffing is absent and the incidence of sexually transmitted diseases is among the lowest in central Australia. Over the past decade the mortality rate here has been nearly 40 per cent lower than the rate for indigenous people in the Northern Territory, and a lot fewer people have gone to hospital for heart problems.
DOCTOR: Do you take them tablets in the morning?
KEVIN ROWLEY, HEALTH RESEARCHER: They achieved prevention of obesity, diabetes and smoking particularly with the women and so, looking back, they are all really major risk factors for heart disease.
KARMANANDA SARASWATI: This place is called Inkawenyerre. It supports about six extended families, perhaps 100 people here. And they're a very artistic mob, this one.
MURRAY MCLAUGHLIN: If good housing is a precondition for good health, then the picture at Utopia is confounding. Many people at this outstation prefer to live and sleep outside in makeshift humpies.
KARMANANDA SARASWATI: It's paradoxical, but they have always lived outside and statistically their health is better for this than when there've been other ways of living imposed on them. They choose this way; they want primary health care coming to them regularly, but I think it is their choice so I think it is empowering them.
MURRAY MCLAUGHLIN: Researchers now plan to find out why the health statistics at Utopia are so outstanding. To Dr Karmananda Saraswati, the answers are self-evident.
KARMANANDA SARASWATI: They're on country, they have got their food source, their cultures, a lot of business and culture going on. They are coming from a good sense of themselves and we're tracking that and supporting that. This is called Indaringinya and this is the northernmost outstation that we service and our chairman lives here, he's named Albert Bailey.
MURRAY MCLAUGHLIN: Albert Bailey lives at this outstation with his two brothers and their extended families. His wife is the health worker. The land at Utopia has not been grazed by cattle for 20 years and wildlife abounds. The families here lay store by their ready access to bush tucker for their good health.
ALBERT BAILEY: Doctor and his sister come every Tuesday, while we get our bush tucker to keep him going. That's what we do.
MURRAY MCLAUGHLIN: The nearest shop is 70 kilometres from Albert Bailey's outstation. One survey of health at Utopia showed that the worst outcomes were among people living closest to here. For Albert Bailey, a trip to the store is only occasional.
MURRAY MCLAUGHLIN: Do you eat much stuff from the store?
ALBERT BAILEY: Only some time we go out there, money day, you know, pension day. But we don't get much. Sometimes buy flour and tea and sugar.
KARMANANDA SARASWATI: Bush tucker is tied in with culture, it's tied in with self-empowerment, it's tied in with the exercise to get the bush tucker. I think it is huge, it is probably the most important thing working for their health. Soapy Bore is a great outstation from my point of view because it has a functional clinic and husband and wife health workers and they're very good health workers.
MURRAY MCLAUGHLIN: The residents of Utopia also rely on traditional medicines extracted from local plants. Here at Soapy Bore outstation, they are brewing medicine in bulk for distribution by the staff to 15 other outstations.
KARMANANDA SARASWATI: The only medicine they're really after is the bush medicine, that goes off the shelf first. We work in well with it.
JOYCE JONES: This one we call Arata. We use it for scabies and for boils and for headaches, yeah.
LENNIE JONES: Your way and Aboriginal way, two sides. We can understand Aboriginal way too. We know everything.
MURRAY MCLAUGHLIN: At a time when the Federal Government is threatening to cut funding to unviable outstations and fold them into big communities, Utopia is a contradiction to tales of dysfunction. Its medical doctor has done the sums. It's costly to service far-flung and tiny outstations, but Dr Saraswati says the one comparison of 40% fewer hospital admissions at Utopia alone justifies the expense.
KARMANDA SARASWATI: Look at the cost of this 40 per cent extra people in your hospitals, for you, know weeks on end and having all those investigations and all the evacuations and flight. You give us all the costing of that and compare it to our service I guarantee you we will come out in front. I don't think there is an economic argument to be made for pulling back services to outstations where they're working.
KERRY O'BRIEN: One good news story at least on health in the centre. Murray McLaughlin with that report.