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Dr Jane Fuller

I am addressing you request for public submissions in the context of having recently completed a three week stint as a doctor providing health checks to Aboriginal children in remote communities in central Australia. I had a great time in those 3 weeks but did not think I was really helping anyone. I will comment on your numerical points as outlined in your submission request.

  1. The alcohol laws appear to have reduced the voilence in the communities. I was told the shops now stock a better range of products.
  2. The health checks are  doing not much more than gathering data about problems about which there is already plenty of data. Individual children may have been helped by being referred to a dentist or an audiologist etc but the value of one off assessments is limited. So much money has  basically disappeared into health professionals pockets with very little gain. The problems are more basic than a health check: wash your hands, blow your nose, put the litter in the bin, reduce the overcrowding, feed the children, look after or get rid of the dogs. The health checks have been imposed on the local clinics with v little consultation or explanation. They have occured in relative isolation from the usual delivery of health care and have been largely irrelevant because of that. Just imagine what could have happened if communities had been told in advance that a group of health professionals were available on a certain date and that the communities were invited to discuss how they could be best utilised. Ownership of the AGI within the communities could have occurred rather than imposition of the AGI. There has been an enormous amount of goodwill expressed by health professionals (and perhaps esp by the doctors who were paid far less than they usually earn, unlike I think, everyone else involved) and perhaps a lot of that has dissipated as the task was not adequately thought through.
  3. The NT economy must have been stimulated by all the visiting health professionals flying in and out, staying somewhere, eating somewhere, hiring cars etc. Some health professionals have been inspired to make a bigger commitment to remote communities by their AGI deployment. Hundreds of nurses have earnt the best money they've ever earned. Many communities have been alienated by the lack of consultation. Some health professionals have been alienated because the intervention doesn't seem to be headed anywhere.
  4. Not sure exactly what each NTER measure is. Consultation is crucial but very time consuming

Increased policing is useful but far from sufficent and numbers need to be increased substantially.

Housing needs are enormous and need to be provided in a culturally acceptable way.

The health needs are enormous. Basic hygiene and nutrition need to be addressed as does over crowding. The NT health department seems to have lots of good systems but health care on the ground is delivered at a variable level and the number of care givers too small. Dog numbers need to be addressed. Care/neglect needs to be judged in the same way as it is for white children. Compulsary education needs to be enforced. Every child must learn English

  1. There is better food in the shops. Less alcohol in the communities.
  2. Not the current suite. To turn things around I think there needs to be an enormous, sustained effort in the communities with a lot of emphasis on preschoolers, treating their ear infections, feeding them, washing them, teaching them English. By the time some children reach school they have a hearing loss, they do not understand English, they are anaemic, they have skin infections or scabies or headlice etc.They come from a back ground where education is not valued.  What can teachers do? Truant officers are needed so that teachers can teach and not have to round up children. Someone else needs to be feeding the children and attending to other social needs so that teachers can teach. Teacher numbers need to be increased ++
  3. A sustainable and better future will only occur with a sustained effort, and to some extent with the cooperation of the residents. It would be great if individual communities could be walked through a slow and inclusive discussion re what the community wants for the future and how they see that that can happen and what they are prepared to do to help realise change. But wise people would need to visit every community many times before effective consultation could be achieved .
  4. Perhaps new, clean, professionally staffed childcare centres (and they would probably need to be free) where small children could be fed and kept clean and taught English and have their ear infections adequately treated would help. Children are loosing hearing before they start school, they are going hungry and becoming anaemic and have a huge burden of infections. Perhaps if this can be halted in the under 5s, the children could learn at school and at least be exposed to options.
  5. Perhaps those who grew up in remote communities but no longer adopt the lifestyle could tell the wider community why they have done so. Perhaps these people have some of the answers which as a community we have been searching for for 50 years Are there the resources to allow large groups of people, teachers, nurses, public health officers, truant officers

Dr Jane Fuller