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INTERNATIONAL

Boots on the ground cannot replace faces in a community

  • 09 January 2008

More than 30 years ago a task force was commissioned by the Commonwealth to tackle a national disaster among Aborigines, which, particularly in remote areas such as the Northern Territory, was robbing young Aborigines of their childhoods and scarring them for life.

It was no mean expedition. Before it was over it had visited more than 600 Aboriginal communities and country towns in all parts of rural Australia, and seen over 110,000 people, including 60,000 Aborigines, at least once. Each had a substantial medical examination. From the results of the initial examination, about a fifth were given a more intensive specialist examination by some of Australia's most skilled doctors. Nearly 2000 people received surgical operations, a good number in special army hospitals in the middle of the Australian desert, and another 6000 mostly older people were given glasses.

Around 30,000 people in the Northern Territory, South Australia and Western Australia were involved in the month-long mass-treatment programs.

There had been no expedition on this scale before, and there has been none since. The model of its organisation, and its practical findings, were widely admired, and the model and the experience was later used overseas.

The task force approach was the National Trachoma and Eye Program, led by Professor Fred Hollows. It was focused on blinding eye disease, but neither the conditions it encountered nor the instincts of Fred Hollows limited it only to looking at eyeballs. Every person the program saw was given a general health examination, and, in particular areas visited, the program made extensive additional studies of particular problems being encountered, including the incidence of sexually transmitted disease, respiratory disease, skin infections and infestations, middle ear conditions, and diabetes.

The program was the genius of Gordon Briscoe, now Australia's most senior Aboriginal historian, who had earlier played a key role both in establishing the Redfern Aboriginal Medical Service and in recruiting the wild and irascible Fred Hollows to be its foundation medical director. Its establishment was also funded by a challenge that a bright doctor-come-politician, Peter Baume, threw at the various Australian medical specialist colleges – that, if they really were about the public interest rather than their self-interest, they ought to prove it by getting involved in improving Aboriginal health. The College of Ophthalmologists took up the challenge, and not only with a tight salaried task force, but with the additional and unpaid assistance of hundreds of ophthalmologists who volunteered. Many of these are still involved in providing ongoing services to Aboriginal communities. The program cost the Commonwealth about $4 million in 1979 dollars. At various stages, when, for one reason or another funding was in the balance,