For the last four and a half years I have been working in the NT as a doctor, mostly in remote aboriginal communities. It’s a job that takes you into another world, almost impossible to imagine.
My interest in aboriginal health was born in 1975, when a stuttering doctor from Groote Eylandt, just off eastern Arnhem Land, lectured me during my Diploma of Public Health studies at the University of Sydney. Perhaps the stutter gave me time to digest it all, but the seeds were sown, and pregnant with my second child, I flew for a week to see the newly established outstations (or “homelands”) where corrugated iron sheds acted as clinic rooms and schools, and holes in the ground as toilets. I swore that when the time was right I would return.
In 2002, with my youngest child finishing school, I headed off to the Northern Territory, and rapidly became enthused by working with people who suffered from many diseases I’d only seen in text books, having served the inner city worried well for so many years.
The burden of chronic disease is enormous, but being far from hospitals and trauma units meant I also had to rapidly skill up on emergency medicine.
It was not unusual at the remote community in Arnhem land where I settled for nearly two years, to have to evacuate two to three patients a day, after diagnosing, and then stabilising them by using simple old fashioned clinical acumen. No X-rays or other diagnostic facilities here.
But after four and a half years, I have had to come in from the desert wilderness, acutely aware that isolation from one’s peers, friends and family does take its toll.
Remote communities are challenging places. What an understatement. No coffee shops, no cinemas, no beaches and no book shops through which to browse and immerse yourself. A partner would have been helpful, but partners can present problems in having to find work in the preshrunk job market of aboriginal communities.
Punishing on call rosters have taken their toll and bickering whitefellas who won’t talk with each other make the few hours available for socialising an impossibility. If mediation is needed anywhere, it’s for the warring whitefellas in aboriginal communities.
Some communities are more viable than others, offering social opportunities beyond the work place. Examples are volunteer schemes where enthusiastic young trained people come and work for three months at the school, youth or art centre. The enthusiasm and freshness of some of these kids balance the jaded cynicism of often burnt out permanent staff.
Others have recreational facilities like fishing. Others have more than the standard single shop, offering a food choice extending beyond the ubiquitous Lite Spam.
But most communities where I have worked have one solitary shop, run by usually obese people who smoke, consume huge quantities of soft drink, eat pies and chips and ice cream, passing on their gustatory preferences to aboriginal people who have no choice but to buy the products of this one and only store.
Blame aboriginal people all you like, but working in remote aboriginal communities sheds a true light on the helplessness faced by many aboriginal people at the hands of incompetent whitefellas, some of whom are running away from the law, and others who would find it hard to find a job in a competitive market.
So, tired of all this, and the confusion and sometimes divisiveness of the NT intervention, I have decided to become a townie, live on a highway, settle down in a place which offers a library, a swimming pool, pub and a few motels. I’m still working at an aboriginal medical service, but it’s a lot easier. With no “on call”, a small hospital for emergencies, and a salary package which far exceeds that of any remote aboriginal community I’ve worked in, I now stand a chance of saving something for my old age.
My enthusiasm for the existence and continuation of remote communities has not waned. I think they are essential to the welfare and wellbeing of many aboriginal people who choose to live there. A place to call “home”, a place to call their own, a place where good, skilled whitefellas can work alongside indigenous residents, helping them negotiate the complexities of all that a mainstream whitefella dominated world involves.
But you’ll never get the good whitefellas if you don’t pay them and give them good working and living conditions. Just because a doctor or teacher chooses to work in aboriginal communities doesn’t mean she or he should accept lesser pay, poorer housing and inadequate work facilities.
To attract good experienced doctors, nurses and teachers to these places, let governments show how dedicated they are to improving the health, education and housing for indigenous people, by paying those who choose to work “out bush” decent incentives like the teacher bonuses suggested by Noel Pearson. Good on you Noel. $50,000 per annum tax free should just be a start.
As doctors, we get an annual bonus of $25,000, which should at least meet the figure proposed for teachers.
There are many doctors like myself, who for one reason or other find themselves with nothing in the Super. Although facing 60 this year, retirement seems a long, long way away. How about attracting a few more doctors like myself to remote areas, with carrots of big tax free bonuses that can go straight into the Super? If the best package I can find is offered in a town, I’ll stay here. But a substantially bigger tax free incentive could have me looking at a remote stint again, after I’ve lived on the highway for a year or two.