Josephine Cashman, a member of the Prime Minister’s Indigenous Advisory Council, will tell a UN forum in Geneva today that “the truth is that for every Aboriginal offender there are usually at least two indigenous victims”.

The Australian 16 June 2016

Photo above : Aboriginal women represent three per cent of all women in Australia, yet they make up six times that amount in family violence victims

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Nationally, indigenous Australians made up 27 per cent of the prison population, but just 3 per cent of the general population.

Malcolm Turnbull, in his reply to the 2016 Closing the Gap rep­ort, spoke of needing to address the “vicious cycle of young indig­enous people being placed into prison, reoffending and then returning to prison”, but Ms Cashman will tell a special session of the UN Human Rights Commission that in the Northern Territory “the majority of indigenous male prisoners are in jail for serious violent offences and the victims are in the majority their wives, girlfriends, mothers and children”.

“While many indigenous leaders and other activists claim the shocking indigenous incarceration rates should be attributed to a racist system locking up indigenous individuals for minor offences, the truth is indigenous prisoners are in the majority convicted of acts intended to cause injury,” she will say.

Using data collated from within the office of Prime Minister and Cabinet, Ms Cashman says that, while indigenous females in the NT account for just 0.3 per cent of females nationally, they represent 19 per cent of hospitalisations of ­females for assault by a family member nationally.

She will argue that, despite increased government expenditure, the problem is “perpetuated and encouraged by those including many activist groups who paint indig­enous offenders as victims rather than promoting personal responsibility and reform to encourage a cohesive culture of soc­ial norms for a safe society for all”.

Ms Cashman, an indigenous lawyer and entrepreneur with ­experience as a criminal prosecutor, will quote research by Ngaanyatjarra Pitjantjatjara Yankuny­tja­tjara women’s council head Andrea Mason’s showing Aboriginal women in the NPY lands are about 60 times more likely to be the victims of domestic homicide than non-indigenous women generally. “Anecdotally, the figures are being compared with Ethiopia, which has the documented world’s worst family violence statistics,” Ms Cashman told The Australian.

Indigenous affairs academic Marcia Langton said there were some parts of Australia where “rates of violence are the critical factor in disabling indigenous communities” including regional areas such as the Illawarra, south of Sydney, not just remote Australia.

“The problem is we need a ­national approach to collecting and reporting data on the problem,” Professor Langton said.

“The paradigm tells us that the communities are the relevant entity in the policy question, but there’s another view increasingly getting the attention of people looking at policy settings in indigenous affairs, and that is the family.

“Families and households are disabled by violence, which means the women in the household have been hospitalised, and children are unable to go to school … This is ­ignored in the big nationwide claim about incarceration rates without looking at the detail.

Indigenous violence: police must act for children’s sake

From The Australian

NURSES IN FEAR — Health workers assaulted, flee Cape communities”. That front page headline in The Cairns Post on March 1, 1992, signposted a report that read: “Cape York health workers fear for their lives after a series of assaults they blame on an Aboriginal backlash after years of neglect.”

I’ve used that quote several times through the years, most recently in response to the article by Jamie Walker and Rebecca Puddy in Inquirer (“Who will care for the caring professionals?”, April 9) about the murder in March of Gayle Woodford, a nurse working in the remote central Australian community of Fregon.

Aurukun often has been in the headlines since, most recently following the evacuation of 25 education workers in the context of widespread violence, including to the headmaster. Some have refused to return and on national television there have been images of street fights showing uniformed police in the background, with a commentary about condoned violence and “fair fights”. Understandably there is outrage and local leaders have said the violence must stop and that the police should take immediate action.

What action? Well, there are certainly plenty of police in Aurukun, more per capita than other indigenous communities and way more than rural towns of a similar size — not counting the extra officers regularly flown in to deal with crises. It is possible to intervene, and to detain and charge more residents. And it wouldn’t be new.

Shortly after the Royal Commission into Aboriginal Deaths in Custody, David Martin completed his PhD in the community (Autonomy and Relatedness: An Ethnography of the Wik people of Aurukun, Western Cape York Peninsula, 1993). Among the issues he considered were alcohol, fighting and policing.

He examined records for 1987 (the year the royal commission was empowered) and found that in that year most males aged 15 to 50 had been detained by police at least once. But among those in their 20s, “virtually every young Wik man … came to the attention of the justice system for drunkenness and other offences”.

For young Aboriginal men in Aurukun in the late 1980s, being charged was not only normative, it was more or less universal.

The royal commission ultim­ately focused on the over-representation of indigenous people in custody and recommended a range of measures that have had no impact on incarceration rates.

Since Martin’s work, others have written about violence in Aurukun including, controversially, Peter Sutton (The Politics of Suffering: Indigenous Australia and the End of the Liberal Consensus, 2009), who observed the tragic consequences for child development of what Martin nearly two decades earlier had commented on as the normative and “taken-for-granted nature” of drunken behaviour.

In a 2001 presentation that was the basis for his book, Sutton noted that the exposure to drinking and violence had resulted in a “lost generation” — that is, “young people who, unlike their grandparents, are functionally illiterate and unemployable in the ‘real economy’, but who have also received only a diminished education in their elders’ cultural traditions, if that”. In the 2000s, an alcohol management policy and wider welfare reform program were introduced in Aurukun and elsewhere in Cape York — again with debatable outcomes, though when prohibition was strictly enforced there was a reduction in injuries from violence.

Now, of course, cannabis use is endemic among young adults and there can be no doubt that enterprising pushers — black and white — are looking at the business case for ice in welfare-dependent indigenous communities.

Those substances add to the negative effects on the development of children of alcohol abuse, not only through further diversion of welfare-dependent sustenance incomes but by exposure to the behavioural and environment effects of drug use.

So, what to do? Do we need more workers? Well, is that in addition to the large numbers of police already on the ground, alongside the mental health teams, Wellbeing Centre staff, Family Responsibilities Commission workers, court diversion and youth justice programs?

Maybe, but from my experience as a psychiatrist in the region, the staggering growth in mental health and related staff in the region during the past 20 years has not contained the increase in behavioural and mental health disorders.

I am reminded of a comment at last year’s Melbourne Writers Festival by Will Self, an enthusiastic satirical commentator on the “Australian condition”. He was reflecting on the intractable marginalisation and consequent ill-health of Aboriginal Australians in a national political context dominated by alarmist rhetoric about the ending of the resources-boom-driven consumer dreamtime, in which, he stated, the response had been to “substitute public health for civic morality”.

By substituting health sector responses for “civic morality” I understand Self to mean that we continue to frame these social disasters (which are better understood in terms of justice and equity) as health issues, so as to be able to be seen to be doing something without actually changing anything of substance.

Of course, although that’s true, it’s not possible to be a medical bystander — that is, to stand by as ill-health and injury go untreated, regardless of their cause. Across the past two decades I’ve used the perpetrator, victim, bystander typology many times in considering various indigenous issues.

In relation to the decades-long tragedies at Aurukun (and some other remote communities), who is victim and who is perpetrator can be debated at great length.

Who is a bystander is just as complex, particularly when getting involved (by, for instance, “treating” symptoms rather than addressing “causes” in a health context) may simply be reinforcing a profoundly flawed political strategy. And that is the double bind the police are in, but to which they must respond.

There may well be experience and local advice that sanctioning particular violence (or at least not responding to it, which is sanctioning in a de facto sense) can defuse explosive inter-clan tensions and wider violence.

But while there may be traditional precedents, those prac­tices were not driven by alcohol, cannabis and disputes over money and vehicles. And the fights were not filmed and uploaded for everyone to review at leisure — with police officers in uniform in the background.

That’s the bind. The residents of remote communities are already contending with waves of distorted representations of non-indigenous society, from hi-tech violence and lo-tech porn to the mundane reinforcement of their marginalisation by comparison with the bizarre norms of Hollywood and reality TV.

There may be reasons police do not automatically intercede, but their non-intervention contributes to those distortions, particularly for children who are almost invariably in the circle. Standing back is still standing in the frame; in this context the bystander role blurs with that of the perpetrator.

Do I think that increasing policing will resolve the underlying drivers? Absolutely not. Might it make matters worse? Possibly; every incarcerated adult is a parent not parenting, and the detention rates are already a disgrace — and disempowering.

Does standing by make matters worse? Almost certainly. The message conveyed is that this is “normal”, and every child in the circle or watching the replay takes it in. Would police remain bystanders at a clan fight in Cairns? No. So why is tourists’ exposure to violence of more concern than that of impressionable children?

Ernest Hunter is a psychiatrist and public health physician who has worked in remote indigenous communities in north Queensland for more than two decades

“The 2014 Federal budget made damaging funding cuts to Aboriginal Health Services that have worsened the inequalities in health care.

Future funding needs cross party support. It needs to be allocated according to health needs and in consultation with the Aboriginal Community Controlled Health Services (ACCHs).

The ACCHS need to be considered as the preferred provider of health services to Aboriginal and Torres Strait Islander people.

Where it is appropriate for mainstream services to provide a service they should be looking to partner with the ACCHS to better meet local community needs”

The Australian Health Care Reform Alliance calls on all political parties to make the elimination of health inequality, discrimination and disadvantage experienced by Aboriginal and Torres Strait Islander people a Federal election priority.

The landmark Redfern Statement by Indigenous leaders on the 9 June 2016 succinctly appeals to all political parties to recommit to closing the gap to meet the national goal of achieving equality in life expectancy within this generation.

The 2014 Federal budget made damaging funding cuts to Aboriginal Health Services that have worsened the inequalities in health care.

Future funding needs cross party support. It needs to be allocated according to health needs and in consultation with the Aboriginal Community Controlled Health Services (ACCHs).

It needs to be indexed for growth in service demand and inflation, focussed on the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan (2013-2023) and maintain support for universal access to Medicare-funded health services.

It has become increasingly apparent that mainstream services lack the ability to provide culturally appropriate, sustainable person-centred care which includes both a biomedical and preventive health focus. The ACCHS need to be considered as the preferred provider of health services to Aboriginal and Torres Strait Islander people.

Where it is appropriate for mainstream services to provide a service they should be looking to partner with the ACCHS to better meet local community needs. The incoming government needs to take the financial strain off the ACCHS by resuming the indexation of Medicare.

Aboriginal and Torres Strait Islander people have difficulty in accessing appropriate care resulting in unnecessary welfare dependency, homelessness, drug and alcohol abuse, suicidality, as well as intolerable pain and suffering felt by people, their families and their communities.

The Federal government needs to ensure that mandated formal agreements between the Primary Health Networks (PHNs) and the ACCHS are maintained to ensure Aboriginal and Torres Strait Islander leadership at all levels, best practice and culturally appropriate primary health care.

The flawed tendering process, application, grant selection and roll out of the Indigenous Advancement Strategy (IAS) needs to be evaluated and made transparent. Essential funding needs to be reinstated to key health programs and services.

While Aboriginal and Torres Strait Islander people have shown extraordinary resilience over past decades, they also have one of the highest suicide rates in the world, more so the young people.

Funding is needed for the social and emotional wellbeing of the community, including an Implementation Plan for the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy.

That Strategy should focus on Aboriginal and Torres Strait Islander communities, organisations, and external bodies to developing local, culturally appropriate interventions to identify and respond to those most at risk.

The next Federal government needs to implement a sustainable National Aboriginal and Torres Strait Islander Social Determinants of Health Strategy to adequately address housing, education, employment and community support.

The Strategy must be developed in association with Aboriginal and Torres Strait Islander people and incorporate a holistic view of the health and wellbeing of Indigenous Australian people.

What we should be hearing from politicians of all persuasions are answers to questions like:

•  How do your policies increase access to care for Aboriginal and Torres Strait Islander people?
•  How do your policies ensure a sustainable partnership between the PHNs and the ACCHS?
•  How will your policies improve the social and emotional wellbeing of Aboriginal and Torres Strait Islanders and reduce suicide rates?
•  How will your government work with Aboriginal and Torres Strait Islander people to develop and implement a sustainable National Social Determinants of Health Strategy?
•  How will your government be addressing, reviewing and evaluating the tendering process of the Indigenous Advancement Strategy?

Contact Dr Vanessa Lee AHCRA Indigenous Health Spokesperson

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