“Governments need to provide the appropriate financial investment into housing, food security, environmental health issues, water, power and primary health — there is gaping holes in our workforce .
This needs to be given priority. We can’t wait for another virus to come along, we’re running on a bloody oily rag.
Aboriginal people have a high risk of chronic disease and make up a high proportion of patients in the health system in the Northern Territory.
It is not unreasonable to assume these patients are significantly represented in statistical evidence in most disease outbreaks.
We are calling on the NT Government and the Commonwealth to continue to work closely with Aboriginal organisations and leaders post-pandemic.
Keep listening, we’ve got a wealth of experience and knowledge ”
Aboriginal Medical Services Alliance of the NT chief executive officer John Paterson
In the Northern Territory, Aboriginal people are often over-represented in the health system — but it’s a different story for COVID-19, with official data indicating there have been no Aboriginal coronavirus patients in the NT to date.
- There have been just 30 confirmed cases of COVID-19 in the NT and no community transmission
- AMSANT’s John Paterson was “surprised” no Aboriginal people in the NT had tested positive
- He said the pandemic showed how well governments could collaborate with the health sector
And as the Territory slowly starts to ease coronavirus restrictions, Aboriginal health leaders say now is the time to address some of the fundamental gaps in Aboriginal health care exposed during the pandemic.
Health groups have warned those rates of disease make COVID-19 a higher risk for Aboriginal and Torres Strait Islander people, who make up 30 per cent of the NT’s population.
Last week, the NT Health Department said of the 28 cases then recorded in the NT, there had been no Aboriginal or Torres Strait Islander patients.
Since then, two Australian Defence Force personnel who returned to Darwin from the Middle East tested positive to COVID-19 but, for privacy reasons, Defence has provided little information about these cases.
Mr Paterson was “surprised” there had been no Aboriginal or Torres Strait Islander COVID-19 patients in the NT, but said early measures — such as closing the NT’s borders — helped keep vulnerable Territorians safe from harm.
Dr Heggie explained strict border controls, restriction of non-essential movement into remote communities, mandatory quarantine and physical-distancing requirements had been “highly effective” so far in slowing the spread of COVID-19 in the Northern Territory.
But, “most significantly”, Dr Heggie said there had been no cases of community transmission of COVID-19 in the NT.
Lessons from COVID-19
Mr Paterson was heartened by how quickly and collaboratively the health sector and different tiers of government had worked together during the pandemic.
“One of the other positives I see coming out of this national pandemic, is it shows how quickly things can happen,” he said.
Mr Paterson is calling on the NT Government and the Commonwealth to continue to work closely with Aboriginal organisations and leaders post-pandemic.
“Keep listening, we’ve got a wealth of experience and knowledge,” he said.
Danila Dilba Health Service chief executive officer Olga Havnen agreed.
Ms Havnen said while “decisive action” by the NT Government — such as closing borders and restricting travel — helped protect Territorians, the Aboriginal health sector had been communicating information about COVID-19 and how to stay safe to Indigenous communities and their client groups well ahead of the Australian and NT governments, their agencies and other sectors.
Mr Paterson said one of the reasons COVID-19 health messages had been adopted so well in remote communities was because the posters and advertisements targeting Aboriginal people had been written by Aboriginal people, health groups and organisations.
“This deadly messaging, when our mob see it, they take notice of it,” Mr Paterson said.
‘We can’t wait for another virus’
The pandemic exposed some of the poor living conditions of people in remote Aboriginal communities, Mr Paterson said, including unreliable power, food insecurity, environmental health issues and shortages in primary health workers.
Ms Havnen said there was a need to address the fundamental problem of poor housing and overcrowded living conditions, which exacerbated the risk and likely potential spread of a pandemic in urban and remote Aboriginal communities.
More broadly, she said COVID-19 exposed major gaps, especially at the national level, in preparing for pandemics.
The Aboriginal primary healthcare sector relies heavily on Medicare billing to fund clinics, equipment and medications and employ staff.
“In the circumstance of a pandemic — where client and staff exposure must be limited, income immediately drops dramatically, just when it is most needed,” she said.
Large communities with about 2,500 or 3,000 people relied on clinics which were poorly staffed, Ms Havnen said, and smaller communities were reliant on fly in-fly out doctors who had been unable to visit due to pandemic conditions.
Although she welcomed the Commonwealth’s investment in telehealth, Ms Havnen pointed out that it wasn’t easy to move services online due to technological challenges, poor connectivity, cost and a lack of equipment.
What about borders and permits?
As restrictions start to ease in the NT, Mr Paterson wants people living in remote communities to to be able to leave without going into isolation upon their return.
“I would like to see free travel throughout the Northern Territory,” he said.
All non-essential travel to the Northern Territory’s 76 remote communities is currently banned and a 14-day isolation period applies for community residents wanting to return home from regional centres.
Ms Havnen said while the staged easing of internal restrictions would be a welcome relief to many, it would need to be done slowly and carefully, balancing the benefits against the risks to very vulnerable populations, especially those in remote communities.
“Widespread testing for COVID-19 is needed if internal border restrictions are to be loosened,” she said.
Mr Paterson said one of the “unanticipated consequences” of the Biosecurity Act was people living in remote areas had struggled to access food and other essential services.
He said the process of getting permits was “causing angst” in remote areas, because people needed to get one permit from the Land Council and one for the Government.
If the permit system couldn’t be removed altogether it should at least be streamlined, Mr Paterson added.
Both Mr Paterson and Ms Havnen agreed the NT’s strict border controls — barring interstate and overseas travellers — should stay in place for the foreseeable future.
“While there are signs of improvement in other states and territories, the NT will need to ensure that strict border controls are maintained until spread of COVID-19 is fully contained nationally,” Ms Haven said.
Chief Minister Michael Gunner has said on multiple occasions the last thing the Government will do is ease border restrictions.
“Opening the borders will happen dead last, I do not want the second wave to come,” he said.
Mr Gunner said these restrictions around remote communities would stay in place until at least June 18, and then it would be up to the Commonwealth, land councils, and communities to lift the restrictions.
“It looks like coronavirus is no match for the oldest living culture in the world,” he said.
What’s next for the NT?
Dr Heggie said NT Health had extensive pandemic plans in place for each region of the NT, including remote health plans, but warned the risk was not over.
“It is still likely there will be new cases of COVID-19 diagnosed in the Territory,” he said.
Ms Haven said the Territory’s challenge now was to avoid becoming complacent and to remain ready for any future COVID-19 cases.
“We consider that the Northern Territory and our community are extremely lucky to have avoided widespread community transmission and are enormously relieved and grateful,” she said.
“The great concern at this point is whether there is a likelihood of a second wave of infection and whether this is a matter of ‘when, not if’. That is a major fear.”