In many countries we have taken the savage's land from him, and made him our slave, and lashed him every day, and broken his pride, and made death his only friend, and overworked him till he dropped in his tracks; and this we do not care for, because custom has inured us to it; yet a quick death by poison is loving-kindness to it.
-Mark Twain, commenting on a story he was told about an Australian settler giving arsenic to his Aboriginal neighbours, in their Christmas Pudding

The Natives were not used to clothes, and houses, and regular hours, and church, and school, and Sunday-school, and work, and the other misplaced persecutions of civilization, and they pined for their lost home and their wild free life. Too late they repented that they had traded that heaven for this hell. They sat homesick on their alien crags, and day by day gazed out through their tears over the sea with unappeasable longing toward the hazy bulk which was the specter of what had been their paradise; one by one their hearts broke and they died.
Twain, on the fate of the Tasmanian Aboriginal people

For Valentine’s Day Vicki gave me a collection of Mark Twain’s essays about Australia, from the book Following the Equator. He visited this Continent a little over 100 years ago, near the end of his life. Remembered today chiefly as a great humorist and for his novels, he is less remembered for his virulent anti-Slavery views and his opposition against racism in all it forms.

Twain was widely read and an astute observer or character. It is sad therefore to read his essays. Vicki and I find them as true today as they were 100 years ago.

We have been learning about Australian history. The earliest explorers declared Australia “terra nullis”, meaning “no one lives here”, despite there being a population estimated at 250,000 to 1 million.. Aboriginal and Torres Strait people have inhabited Australia for at least the last 45,000 years- the longest inhabitants of their territory of any people currently living on Earth outside of Africa.

Aboriginal people, during their long sojourn, developed a culture and indeed a physiology well adapted to living in this dry, hot land. Their culture is so bound up with the country they live in, that they see themselves as belonging to the land (and not the other way around.) The land gives them everything they need, and in return, they are caretakers of the land. Unfortunately, the clash of cultures resulting from Colonization was disastrous to these people. As detailed in the book Guns, Germs, and Steel, native cultures around the world were at a disadvantage when meeting Western Civilization. The lack of exposure to cows and centuries of East-West trading made them excessively susceptible to diseases like TB and smallpox. And the “high technology” of Europeans, expressed as guns and alcohol, finished the job of decimating the population.

Aboriginal people were therefore viewed as being a “dying race”. Overt racism also gave colonists license to mistreat and virtually enslave the survivors. Aboriginals were not seen as people until the 1970s, and their welfare was administered as part of the government department responsible for the entire flora and fauna of Australia- essentially part of the “Department of Fish and Game”.
To make matters worse, a systematic program of removal of children from Aboriginal families, in an effort to “breed out the black” was carried out in the 20th Century (as you can see in the movie Rabbit-Proof Fence), ending only in the 70s. The effects of the Stolen Generation are still being felt in Aboriginal communities and as one person told us, “this still hurts us”. I have met patients who never knew their parents, being removed from the home and raised in Christian orphanages, cut off from their culture and heritage.

The results, in a nutshell, are that Aboriginal people have some of the poorest health in the developed world. It took us only a few weeks to discover that many of the distinguished “old men” we saw in town were actually much younger than us. They just look 20 years older, due to poor health and very hard lives.

Aboriginal people don’t suffer the diseases of advanced age, like Alzheimer’s very much. This is because they usually don’t live long enough to become demented. The average life expectancy for an Aboriginal man is about 59 years at birth- which is 20 years less than for other Australians. In the Kimberly, Aboriginal people have high rates of death and disability from cardiovascular diseases, diabetes and kidney failure. I have seen many young people- from children to those in their 30s with severe hearing loss and chronic draining ear infections. And overcrowding- read lack of available decent quality housing- leads to high rates of common infections including parasitic diseases, skin infections like impetigo and lice, and severe diarrheal illness in infants and small children.

This is all over a background of disadvantages in education, employment and a “fair go” at life as they say here. Consider these facts:
• Indigenous unemployment is almost five times the national average. A January 2004 study by the Australian National University's Centre for Aboriginal Economic Policy Research found that labour market discrimination is more likely to manifest in an inability of Indigenous individuals to secure a job, rather than in being paid low wages
• Aboriginal households on average earn about $200 less per week than non-Aboriginal households.
• Aboriginal people are half as likely to have completed schooling and only about 40% are employed.
• Indigenous people are 14 times more likely to be imprisoned than non-indigenous Australians
• Indigenous people also suffer higher rates of crime. A 2001 study in New South Wales found that Aborigines are 5.5 times more likely to suffer domestic violence, 3.4 times more likely to suffer assault, 2.8 times more likely to suffer sexual assault, and 2.5 times more likely to be murdered.
• The Aboriginal infant mortality rate is 2.5 times that of the rest of Australia, with the rate in the Northern Territory four times the national average. Moreover, the number of babies of low birth weight is double the non-Aboriginal average and actually increased over the late 1990s. The figure is higher than those for Ethiopia, Senegal, Mexico and Indonesia.
• Suicide, which many Aboriginal languages have no word or concept for, has risen from the one of the lowest rates in the world to one of the highest in the last 25 years.

In the face of these medical problems, the Australian government was recently found to be spending A$ 225 per person in the non-Aboriginal population, compared to A$ 74 for each Aboriginal person.

Add to this an attitude toward these problems, as exemplified by our taxi driver, the first day we arrived in Australia. He asked why we were here and when told our plans to go to Derby, he commented, “well, they really different and primitive up North- I don’t think they are quite human, you know?” And he was serious and unfortunately not alone in this belief.

As an American, partly a descendant from Colonial ancestors, I am certainly not claiming any moral high ground when looking at these problems. This is just the milieu I am working in. And not everyone is ignoring the problem. More than 30 of Australia's key medical and social welfare groups say Indigenous Australians are dying because of a lack of political will and action and have called on the government to change course. I write about it as background for the next topics I will write about: Jarlmadangah, and DAHS.