By Sam McQuillan
PORT KEATS, N.T. — There have been calls for an inquiry into the closure of a remote Aboriginal community health centre in the Northern Territory. The legality of this action by the Territory Health Department is being questioned.
Port Keats is the largest Aboriginal community in the Territory with a diverse and expanding population of around 2000. There are levels of malnutrition among children which exist only in Third World countries and which the World Health Organisation defines as a crisis situation.
In recent studies the Menzies School of Health has found an alarmingly high incidence of respiratory, cardiovascular, and renal diseases. The average life expectancy for people in this community is around 20 years less than for non-Aboriginal Australians, and the infant mortality rate is four times the national average.
The people suffer from overcrowded housing, with an average of 13 people per house. There is little meaningful work to which the people can aspire. The young population (1300 people are under 25 years of age) haven't had an adequate traditional or contemporary education, and particularly haven't had the chance to sustain themselves in a contemporary society.
Many people feel trapped in Port Keats. The extreme poverty, lack of food, chronic ill health, uncomfortable living conditions and lack of normal facilities (including adequate health services since December 30, 1997) have created a refugee camp situation.
The decision by acting health minister Daryl Manzie to close the Port Keats Health Centre on December 30, 1997, was made without briefing from departmental staff, and without any consultation with the community.
This punitive action followed a series of incidents, involving several youths in the community, which caused damage to Territory Health Services property. There were no physical attacks or injuries to any health personnel.
It appears that Manzie acted on sensational and inaccurate reports in the media, especially the NT News, which the people at Port Keats question. Port Keats has long been vilified by the media and is regularly referred to as a "hellhole" and a "war zone."
It has been the subject of numerous media reports, yet in the last two years only two journalists have actually visited the township. The people of Port Keats have been insulted and hurt by such biased and ill-informed reporting.
The provision and management of health services to remote communities have been severely restricted by the commonwealth government's funding policies.
Like other Aboriginal communities, Port Keats does not have a doctor. Patients are treated by registered nurses or Aboriginal health workers, and therefore no Medicare claim can be made.
Medicare benefits and the commonwealth government rural incentive program for GPs have been designed for urban environments, and simply do not work in situations where people with special health needs require extra medical attention.
Territory Health Services is funding these services from its own resources, which are inadequate due to the per capita funding policies of the commonwealth government. With only 170,000 people, the Northern Territory receives less funding than Geelong, despite its infrastructure being spread over 1/6th of Australia.
NT health minister Denis Burke came to Port Keats on February 5 to discuss the reopening of the community's health centre. He witnessed the people conduct a traditional smoking ceremony in which hurtful newspaper articles were destroyed. Eight young offenders were temporarily released from Berrimah jail and the Don Dale Detention Centre in Darwin and flown under escort to Port Keats, where they participated in the ceremony.
Discussions between the minister and the community resulted in a resolution of the current health crisis. This involves the provision of two nurses in the role of support to the Aboriginal health workers and an agreement to provide a new management structure for the health clinic which will involve more local control.
But governments seem unwilling to examine and address the underlying causes of the key problems which affect Port Keats. These problems of ill health, low educational standards and a broad failure to deliver essential services in remote communities are being exacerbated by the expanding population and limited resources and infrastructure.
Many people see Port Keats as being on the cutting edge of problems which will soon affect other Aboriginal communities. The NT government follows a mainstream policy which does not cater for the Aboriginal minority.
Although Aborigines make up one third of the territory's population and have obvious special needs, there is not even a Department of Aboriginal Affairs in the NT. Access to quality professional health care should be a basic human right for all Australians.