I’ve not been feeling very well for about 6 weeks now. First I had the flu, and sinus infection. Getting over that, I developed pain in my right shoulder. This impingement got so bad that I’ve had to stop all swimming with my arms. I am reduced to kicking with the float boards which is very frustrating. And to top it off, in Port Hedland I got bitten by sandflies, and about 4 days later developed a serious case of papular urticaria. The itching has been so bad that I sleep only by taking 50 mg of Benadryl and taking an ice pack to bed with me. The antihistamine makes me hung over until about noon each day. So I am not my usual perky self. The good news is that my students passed their OSCE’s. This week we are having final tutorials before they leave Derby next week for final exams in Perth.

Last week was the Aboriginal Health Summit in Broome. I stopped and attended for a couple of days on the way back from Port Hedland.

Two talks caught my attention.

First, a talk by an architect, Paul Pholeros talked about housing and health in Aboriginal communities. The prevailing Australian prejudice is that “Aboriginal people are given free houses that they don’t take care of, and in fact actively destroy”. Even my hairdresser here in Derby repeated this attitude to me this week. The truth, based on surveys of 5232 Aboriginal homes, is that only 10 percent of 91,819 items in these homes were damaged by overuse, misuse, abuse or vandalism. A much bigger problem is that 70% of repairs were needed for shoddy or incorrect initial construction. The remainder of problems were due to the harsh Outback environment. Outside of urban areas, most water in Australia is very high in mineral salts, which results in rapid corrosion of tap seats, for example. In one community, 40 of 76 hot water units fitted in a government program were leaking due to a manufacturing fault, yet warranty claims were not honored. In essence, government housing programs put in very expensive housing- up to $AUD 400,000 per Outback home- which goes to the lowest bidder and results in a sub par construction that does not last. As a result, in many Aboriginal communities, only 33 % of homes had a working shower, only 55% a functional toilet, over 90% had unsafe electrical systems, and over 95% did not have a functional kitchen where food could be stored, prepared and cooked. Is it any wonder that poor nutrition, skin diseases, and diarrhea and respiratory diseases run rampant?

Mr. Pholeros is part of a project in South Australia called HealthHabitat. They go into a community and teach the local people to survey, then repair the problems. His plea was that it is much cheaper to build homes correctly the first time, and provide local people with skills, tools and supplies to maintain the homes. Their program focuses on improving housing to promote the Nine Healthy Living Habits. Just fixing the water systems in one community saved $AUD 67,000 in water bills and over 100 million liters of water in this arid country.

Unfortunately, in 2006 the Minister for Indigenous Affairs could not account for how more than $AUD 2 BILLION had been spent on housing in the previous decade.
Perhaps a new government will spend the money more wisely? Mr. Pholeros has been researching and writing about these issues since 1993. He is the soul of persistence.
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The second story was about an Aboriginal community, Baryulgil, in New South Wales. These people were able to keep their land and preserve their culture. They were even lucky enough to find jobs on their land, mining a valuable natural resource. Unfortunately, this resource was asbestos. A similar story unfolded in Western Australia around Wittenoon and Roeburn. The presentation was focused on efforts to gain the communities’ trust. In one community, the son of the chairman went to University and studied anthropology and oral history collection. He has been hired to interview the old peoples’ stories about the mines, in order to collect data for compensation. This is needed, because the company that ran the mines, James Hardie, suffered “mysterious fires” that burned only the file cabinets containing the personnel health records of the miners. Also, the original chest x-rays of all these workers were sent off for review by the company, and also “disappeared” from the face of the Earth. While a settlement was negotiated two years ago, the company has not paid a cent yet to victims. When I shared this story with my mentor, Dr. David Atkinson, he said, “The irony around Aboriginal health never ends.” Barristers plan to bring new test cases to the courts.
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Finally, the newly released draft drinking guidelines for Australia are getting a bit of press here. Most of the controversy is not about the science or safety of the guidelines, but whether they are "realistic".

Labels: Aboriginal Health