The federal intervention into indigenous communities in the NT — started by the Howard government and continued under Rudd’s watch — is likely to cause more health problems than it fixes.

That is the damning assessment of an exhaustive health impact assessment (HIA), due to be launched in Canberra today by the Australian Indigenous Doctors Association (AIDA).

The long-awaited report calls for the government to reinstate the Racial Discrimination Act, to drop compulsory income management and to stop imposing external leadership on communities.

It also concludes that the bans on alcohol and p-rnography are unlikely to work, and have the potential to cause long-term damage.

The HIA was conducted jointly by AIDA and researchers from the Centre for Health Equity Training, Research and Evaluation at the University of NSW, and was funded by the Fred Hollows Foundation.

It considers the likely impact of various elements of the NT Emergency Response (NTER) upon five dimensions of health: physical, psychological, social health and wellbeing, spirituality and cultural integrity.

It is based upon an analysis of the relevant legislation and media announcements, consultations with four communities in 2008, experts’ reviews of the relevant evidence base from the health and social literature, and interviews with 21 key stakeholders, including government and NGO employees.

Work began on the HIA in 2007 and it was completed in the middle of last year, but it has been released only after lengthy consultations with NT communities. HIAs are normally done before policy is implemented but there was no time for this with the hastily executed NTER.

The document notes that some aspects of the intervention are likely to bring benefits. “It is likely that new investments in education, housing, and health care, for example, will make a contribution to improved physical health for some people,” it says.

“However, the ways in which the NTER was introduced and is being implemented are likely to contribute to the continuation of the high
burden of trauma and disease already carried by Aboriginal people across generations — a cumulative burden to which the NTER is likely to add.

“The HIA predicts that improvements in physical health may be outweighed by negative impacts on the psychological health, spirituality, and cultural integrity of a high proportion of the Aboriginal population in prescribed communities (and, arguably, in the NT).

“The loss of trust in government will limit the ability of governments and communities to work together effectively in the future.”

The document notes that throughout the HIA process, community members and stakeholders expressed “shock, frustration, shame and anger at the discriminatory, racist nature of the NTER”.

“Many people had thought that the days in which governments would act in this way had passed, that their democratic rights as citizens of Australia were secure. The fact that the level of engagement in planning the NTER and its implementation was much lower than that which would be considered to be normal by all other citizens will have multiple negative, unintended impacts on the health and wellbeing of the residents of the prescribed communities and, more broadly on Aboriginal Australians across the country.”

The AIDA president, associate professor Peter O’Mara, and the HIA steering committee chair, Dr Tamara Mackean, told Crikey they were hopeful the government would be open to refining its policies in response to their findings.

How the government responds will say much about the implementation chances of one of the report’s central recommendations — the need for “respectful and significant engagement between governments, communities, professionals and leaders at all levels”.

Former PM Malcolm Fraser made some pertinent points at the Sydney launch of his memoirs on Wednesday night. Asked what would help achieve progress in indigenous affairs, he nominated “respect”. He also noted that the current government has the same bureaucratic advisers as the previous one.

Peter Fray

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Peter Fray
Editor-in-chief of Crikey