Closing the Gap: Are we being told the full story?

Since the commitment to Closing the Gap in 2008 Indigenous death rates have actually increased.  

This is a graph taken straight out of the Prime Minister’s 2017 Closing the Gap Report (pg 82 or here), I added the horizontal grey line to show mortality rate in 2008. The report states that there has been a 15% improvement in Indigenous health between 1998 and 2015. But this improvement stopped and may even have reversed in 2008, the very year we committed to “Closing” the health gap. Does the report misrepresent how serious things are for Aboriginal people? Online the report does admit “However, there has been no significant change in the Indigenous mortality rate between the 2006 baseline and 2015, nor in the gap since 1998…Indigenous mortality rate is not on track to meet the target”. The reality, from their own figures seems to indicate that things may be actually getting worse for Aboriginal health in Australia.  It doesn’t need to stay that way. The Hope for Health program in Galiwin’ku NT has shown that Aboriginal people, even in the most remote of communities can take control of their own health.

The grey horizontal line in the graph above has been added to show when death rates of Aboriginal people nationally were at their lowest (in 2004 and 2008) and demonstrates that Indigenous mortality rates have not improved since 2008. In the community of Galiwin’ku, the reality of the situation all too obvious. The community has been hosting non-stop funerals since February, and right now has a line up of 5 bodies awaiting their turn to be buried.  The Yolngu people rarely hold more than one funeral at a time each of their small communities in this region but recently they have been overlapping the 1 week long ceremonies to deal with the rate at which people are dying.  

Has everything Australia has been doing to improve health for Indigenous people outcomes done nothing?  The unfortunate answer may be yes. The hands on approaches of all Governments since 2008 may have made things worse.  Is it a coincidence that 2008 was the very year “Closing the Gap” was committed to and the second year of the NT “Intervention”?  From our perspective this is not the fault of health services, it is because the bipartisan approach to “The Gap” is flawed.  The “interventionary” measures of the NT Emergency Response of the Howard Government, the Stronger Futures policies of Rudd/Gillard that followed, and the recent welfare policies, have all maintained an approach of increasing Government control over the lives of remote Indigenous people and contributed to a destructive disempowerment of the people.  These approaches have been top down, broad brushed across the whole of the NT and beyond and are constantly changing.  For example, welfare payment rules have changed every couple of years including welfare quarantining, the basics card, CDEP became work for the dole, which became RJCP, and became CDP.  The focus has been too much on managing and coercing whole communities to change rather than working at a level that is in touch with the real experience that the people are facing.  By focusing on forcing the Gap closed, rather than gently working through local experience and limitation, we have actually made the environment the people live in more out of control and chaotic for them. While it seemingly gets more organised and convenient for the bureaucracies.  The Government is keen to strengthen local capability but they fail to inform and resource motivated individuals, families and Yolngu leaders to improve things in their own way.  The result in Galiwin’ku has been waves of hopelessness and anger.  Leaders in particular have been highly stressed over this time trying to direct changes to have some positive effect.

Similarly, in the area of health, the focus has been on clinical service delivery and local health services are usually very good at this; but often Yolngu still approach the clinics or hospitals with trepidation. The Yolŋu know so little about health and disease that it seems like any visit to the local clinic might mean unexpected and terrible news.  Like being shipped off to Darwin of Gove hospitals for investigation that result in cancer or heart disease or kidney disease.  Preventative programs until now have not changed the peoples’ sense or knowledge of how to improve their health. As one of our participants explained to us, poorly paraphrased, “Yolngu see Balanda who are slim, fit and healthy and they always wondered what the secret was.” It should never have been a secret that eating natural whole foods can keep one healthy, and eating processed factory packed sweet foods make you sick. But it has remained so, because the underlying reasons behind these generalisations were poorly experienced, explored and explained.

“It should never have been a secret that eating natural whole foods can keep one healthy, and eating processed factory packed sweet foods make you sick.”

When people on the Hope for Health program experienced the effects of eating well and went through 14 days of health education, some were angry that no-one had ever worked closely enough with them before to reveal the truth behind these life saving knowledge.  The Hope for Health program worked at helping individuals to maintain diet change and improve their health because we worked closely with individuals in their specific situation and discovered the “gaps” they were facing.  We have found that in a two week health retreat we can give people an experience of vitality through good food and exercise. That enables Yolŋu the chance to connect education with evidence that food choices have repercussions.  Combined with education that explores deeply the causes of chronic disease and cancer, people who wanted to improve their health become passionate about implementing a healthy lifestyle back in their community.  Not only that, but the changes in participants’ health proves to others that eating good foods does make a difference.  We are seeing husbands and daughters and brothers of participants take on positive lifestyle change independently. The whole community is starting to ask what can I do so I do not become “a body in a coffin”. That is a huge shift from a community that has been eating themselves to death in ignorance,  and that should be grounds for hope that the situation in the deceptive graph above, can be changed.

Hope for Health started through people sharing their knowledge and discoveries about health with each other.  We believe when Yolngu share their Hope for Health discoveries with other communities and Aboriginal peoples, this movement might spread all over the NT and beyond.  The interest and impact for the Yolŋu people in Galiwin’ku is so dramatic and the movement so fast that we can’t help believe that this could turn the situation around.  

Please share our Hope for Health story with as many as you can.  Please write, Facebook or Tweet, to the Indigenous Health and Indigenous Affairs minister.  If you know a corporation or organisation that might what to partner with an effective charity let us know.   We would really like Government or corporate funding in order deliver the full program in Galiwin’ku and look at seeding elsewhere.  

You can sponsor the program and join the Hope for Health family on our donation page at support.hopeforhealth.com.au

By Tim Trudgen, CEO of Why Warriors Org Ltd

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