Weekend Australian - Saturday, August 14, 1999
Editorial

YARRABA, an Aboriginal community in North Queensland, may seem an improbable starting point for a revolution in relations between Aborigines and the rest of Australia. It is a revolution that is much needed -- as much in the thinking that colours the Aboriginal debate as for the delivery of worthwhile improvements in Aboriginal health and living standards. The Yarraba community is developing a scheme designed to give Aborigines greater control of health services. The community has joined forces with the Federal and Queensland governments, and an American pharmaceutical company, in an attempt to overcome a wide range of health problems. The catalyst is growing evidence that one of the prerequisites for improving Aboriginal health is greater control and ownership of health services by Aboriginal people themselves.

At one level, it can be argued that the Federal Government, having identified the failure of the previous funding systems to deliver an improvement in Aboriginal health, has been diverted from developing coherent solutions by its focus on attacking the so-called Aboriginal industry. The diversion is understandable. Despite years of rhetoric, the system specifically established to help Aborigines has failed to produce an improvement in living standards. While reliable statistics are hard to find, a new report by the Australian Bureau of Statistics and the Australian Institute of Health and Welfare says babies born to indigenous mothers are more likely than other babies to die around the time of birth. Those who survive are more likely than other Australians to be poor, unemployed, suffer from violence, be imprisoned, develop a range of chronic diseases and die at a young age. This information, placed alongside the appalling picture painted by the latest Australian Bureau of Statistics report on the health and welfare of Aborigines and Torres Strait Islanders, means not only have the past policies failed to work, the problems they were designed to overcome are still growing. For all the talk of replacing top-down structures with community-based programs, too little has been achieved.

But are some Aboriginal leaders at fault? This week, Pat Dodson criticised the proposed preamble to the Constitution for dropping the word ``custodianship'' for ``kinship'' in describing Aborigines' links with the land. The preamble talks of honouring the nation's first people but Mr Dodson went on to complain that Aborigines were being honoured for being in jail and that the preamble would stand in the away of reconciliation. If Mr Dodson objects to our honouring Aborigines and Torres Strait Islanders, it is clear no words will satisfy his demands in the reconciliation process. Equally, the outcry that met Noel Pearson 's remarks challenging welfare dependency indicates there is no unity of voice in Aboriginal leadership and, to some, entrenched positions are more important than developing solutions to chronic problems. New thoughts and new leaders are needed.

The Federal Government can point to some practical contributions -- the use of the army to deliver reasonable housing and potable water to remote communities -- but these must be regarded as Bandaids. Only a comprehensive regime, directly dealing with basic problems, can deliver better results in health and welfare. It may well be that the process is incremental -- but it must be progress. Too often in the debate over native title and reconciliation, the life-and-death issues, literally, of infant mortality, life expectancy, deaths in custody and general disabilities are forgotten. The first, most important, step is to stop Aborigines dying before their time.