Northern Territory Intervention Help or Hindrance?

Dr William Glasson, member of the NT Emergency Response Taskforce, says that while it is still early days, he has seen how the response is already producing good outcomes.

"I believe everyone with concern for Indigenous health should continue to support this initiative. We cannot let this opportunity go," Dr Glasson says.

Dr Glasson says there can be little progress in improving the health of Indigenous children without improvements to their living conditions.

"We all know that social factors such as overcrowded housing, lack of education, and limited employment opportunities, along with environmental health issues such as lack of clean water, washing facilities, and functioning septic systems all influence health outcomes of individuals and the community.

"These factors combined with a cycle of welfare dependency lead to a loss of pride and low self-esteem. Substance misuse is a direct result.

"Therefore, any target medical strategy must have a broad focus and address all these wider issues which have an impact on the health of individuals."

In another article for the Journal, Dr Alex Brown, Director of the Centre for Indigenous Vascular and Diabetes Research in Alice Springs, and co-author Dr Ngiare Brown, Senior Research Fellow at the Telethon Institute for Child Health Research, say the intervention was badly thought through.

"Activities have been poorly coordinated, poorly planned, and liable to change and backtracking," say the authors.

"This has fuelled confusion and paranoia, and created enormous concern about the squandering of desperately needed resources, which are being used largely to install bureaucracy rather than provide services.

"Worse still, the current approaches are undermining successful programs already in place in communities."

Dr John Boffa, Public Health Medical Officer for the Central Australia Aboriginal Congress in Alice Springs, and his co-authors say the Aboriginal Community-Controlled Health Services (ACCHSs) in the NT had been offering child health checks for some time before the Government response.

"The only reason they had not already been provided to all Aboriginal children was a lack of resources," Dr Boffa says.

Dr Boffa says the health components of the intervention got off to a bad start with suggestions of compulsory sexual examinations generating widespread fear and misinformation in Indigenous communities.

"It has taken much work to explain to Aboriginal communities that these were the same checks that were already being done by ACCHSs."

Dr Peter Tait, a general practitioner in Alice Springs, says the current approach is disrespectful to Aboriginal people, and further inequalities between Indigenous and non-Indigenous people will only exacerbate health problems.

"The foundation social determinants of health are social equality and respect," Dr Tait says.

"For Indigenous people these are fragile, tenuous, or perhaps even lacking. . . . the logical solution is to create a more equal, tolerant, and respectful society.

"That doesn't mean handouts and welfare. It does mean working in a respectful manner and offering a partnership approach to helping with economic and community development."

In his review of Coercive reconciliation: stabilise, normalise, exit Aboriginal Australia for the Journal, Dr David Scrimgeour, Senior Lecturer in Public Health at the University of Adelaide, says a common theme from accounts of people involved in the intervention is that a lack of community engagement means the initiative is destined to fail.

Dr Scrimgeour says the book of 30 essays can be valuable in informing the medical profession about what is happening in the NT.

The Medical Journal of Australia is a publication of the Australian Medical Association.

The original articles can be viewed online after the embargo date at www.mja.com.au