I have lived and worked in Coober Pedy, a remote desert town in the north-west of South Australia known as the “Opal Capital of the World”, since 1997. My partner is a GP and I run his practice. Our community is one of the poorest in the state and the poorest federal electorate on the mainland. I can tell you a GP’s work is cut out here.

Apart from the huge burden of chronic diseases underlying all of this is depression, generalised anxiety and a myriad of mental health issues driven by substance abuse, but the main culprit is alcohol, of course. It is a case of both cause and effect.

During last year’s media spotlight on indigenous issues, I and two other self-employed young community-minded individuals instigated a community petition and campaign to raise awareness of issues that affected our town. They revolved around the Dry Area, but the problems were complex and terribly intertwined with psycho/social/economic problems faced by people marginalised by successive governments. It was a state election year in South Australia last year and being a federal election year this year we set a process in motion to try and capitalise on this.

It did not matter whether the individual was indigenous or not, the underlying problems were basically the same. Anger, hurt, resentment, boredom, depression, frustration, and apathy about one’s own health, both mental and physical are common in all human beings. Cultural differences matter not as all human beings generally want the same things out of life — food, shelter, clothing, and to be happy, healthy, to lead a stable, safe and meaningful life.

As one young guy put it, “beer is the currency of central Australia”. This sort of mentality leads to a lifetime of chronic abuse but is driven by underlying personal issues. We organised our own summit at the end of the year to coincide with the presence in town of various government department stakeholders and the Alcohol Accord meeting driven by the local council and the office of the Liquor Licensing and Gambling Commissioner.

I can tell you cooperation was good. Some stakeholders were a little nervous by our “agitation”, but things had come almost to a standstill due to various factors — mainly the enormity of the problems faced had overwhelmed many leaders.

The lack of government funding for capital works for facilities and subsequent funds to run programs also had a huge impact. For instance, the local indigenous community, which has a floating population between 500 and 1000, has only one substance-misuse officer.

The local community of approximately 3000 to 3500 has only one drug & alcohol worker and a part-time mental health worker. The two long-term GPs are struggling under the chronic-disease workload generated by this abuse, and the never-ending revolving door of overseas-trained doctors being recruited but not retained, because they are absolutely gobsmacked by what they discover when they come to an “area of need”.

However, the “ripple effect” of having thrown a stone into the vast ocean that for us is the outside world appears to be having a subtle positive effect. Attitudes are changing. The Dry Area which blankets most of the town became very quiet almost overnight. Anti-social behaviour has dropped and Coober Pedy experienced the quietest summer that most locals can remember.

The troublemakers from the APY Lands headed down to Adelaide instead. The local white chronic drinkers were then exposed for the hypocrites that they were. Slowly one by one they too are cleaning up their act. Those who want to get away from the bad influences in town are heading down south for work in the mining industry.

The remainder have been shocked by quite a large number of heart attacks last year –some fatal, some not. People are listening to the messages.The bad habits of the past are catching up with everybody. However, help is still desperately needed.

It’s the women who have put their foot down, quietly behind closed doors, to protect the egos of their loved ones. If the men won’t change then some women simply move on. Sometimes the only way out of the alcohol cycle is by running out of excuses as to why you need to drink. It takes a long time for some people to realise this. This may be a man’s town, but it is the women who keep it going.