Don't Forget the backyard

Looking at the major news headlines during the months leading up to this article’s creation, one may be forgiven for not knowing precisely when in time one might find oneself. The Russia–Ukraine war, Israeli occupation of Lebanon, American conflict with Iran, and Chinese ambitions to secure reunification with Taiwan regularly pop up on my phone, television and computer screens, reminding me of a large, troubled world beyond my peaceful city of Darwin. I have been in Darwin for a year and a half, on what was intended to be a 12-month contract, proudly working as a doctor in some of the poorest and sickest communities in Australia.

I wrote this piece during Australia’s National Reconciliation Week, a time aimed at learning about and celebrating Indigenous history and culture in Australia, promoting reconciliation, and encouraging relevant activities between the country’s First Nations peoples and later arrivals. The week begins on 27 May, the anniversary of the 1967 Referendum, which asked Australians whether Indigenous Australians should be included in official population counts such as the census (more than 90% voted yes). The week similarly concludes on another significant date in Australia’s calendar: Mabo Day, on 3 June, which commemorates the decision by the High Court of Australia to overturn the legal fiction of terra nullius (the land not owned by anyone), giving rise to Native Title in Australia.

It’s fantastic that we get to celebrate such historic achievements and transformations, and continue to advocate for a better and brighter future between Indigenous and non-Indigenous Australia. However, this often begins to feel tokenistic, with organisations putting Indigenous issues in storage along with their National Reconciliation Week decorations once 3 June is over.

Likewise, we often feel paralysed to act by the endless stream of horrors and distress we see from all over the world; we often also get distracted by these events at the expense of issues over which we may have more control closer to home.

In Australia, we often discuss the Gap: measurable health disparities between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Readers may be shocked to find out that First Nations Australians, on average, live eight to nine years less than other Australians. Likewise, they are twice as likely to die in infancy, three times more likely to die by suicide as youths, and nearly three and a half times more likely to develop diabetes and kidney disease than their non-Indigenous counterparts. 

At the commencement of my article, I wrote about how world events make it difficult to orientate oneself to which time period we’re living in. How’s this for a puzzle – where and when would one find an outbreak of diphtheria and syphilis, as well as an outbreak of rheumatic heart disease? If you said today in the Northern Territory and in many First Nations communities living north of the 26th parallel, you’d be correct!

Diphtheria is a disease largely preventable with vaccinations – the NT is experiencing its worst outbreak, with Indigenous people primarily impacted. Syphilis may be prevented with condoms and regular testing, and treated with commonly available antibiotics – yet syphilis continues to rise among Indigenous communities, often leading to severe consequences, with devastating impacts on neonates and those not yet born. Rheumatic heart disease kills two Aboriginal and Torres Strait Islander Australians every week, according to the Australian Institute of Health and Welfare. It is a devastating but entirely preventable illness that disproportionately impacts First Nations communities.

The above are not occurring in some far-off nation, impacted by civil war and poverty, with a breakdown of institutions and global aid failing to make an impact. They are happening right on our doorstep, in one of the world’s richest and most developed nations (or so we tell ourselves). All the above-mentioned diseases could be eliminated with enough funding and determination.

During the past few months, a different type of headline crossed my eyes from the World Health Organisation – Australia becomes the 30th country to eliminate trachoma as a public health problem. Trachoma is an infection that impacts the eyes, typically first occurring during childhood. Repeated infections (or failure to treat them) result in long-term inflammation, leading to scarring, vision impairment and blindness. Whilst largely eradicated in urban environments due to advances in hygiene, sanitation and education, the disease continued to impact rural and remote Indigenous communities. A multi-decade-long campaign led by First Nations communities, with support from governments, institutions and individuals, has led to this historic achievement.

Overcoming these health inequalities is possible. It is also necessary. When we Bundistn discuss the work to create a shenere un besere velt, we must not forget our Aboriginal and Torres Strait Islander khaveryrim, who themselves have been fighting for this same goal. We must continue to support them when and where we can, and use our voice to amplify theirs.

Pirkey Oves teaches us that whilst it is not your responsibility to finish the work, you are not free to neglect it either. I encourage everyone reading this piece, and especially di yugnt, to consider moving to the Northern Territory and getting involved with the work of righting the wrongs of our country’s colonial past and present.

Chavershaft!