Re Hal Duell (Posted June 13, 2012 at 2:05 pm): …

Comment on Shires: either revenue must go up or expectations, down by Bob Durnan.

Re Hal Duell (Posted June 13, 2012 at 2:05 pm): the problem of feuding families, clans and language groups does follow many people into town. You only have to look at the regular playing out of major scenes from on-going Yuendumu, Willowra, Laramba, Watiyawanu and Ntaria feuds occurring in Alice Springs during the last couple of years to see this. However some of the intensity of of these skirmishes could be lessened were the alcohol tap to be turned down to a more manageable level.

Bob Durnan Also Commented

Shires: either revenue must go up or expectations, down
Further in reply to Hal Duell (Posted June 13, 2012 at 2:05 pm): Hal,
I agree that “it’s unrealistic to imagine every small outstation can have all the amenities needed for modern life, amenities like roads, schools, stores and medical clinics.”
Despite this, I believe those few outstations which are consistently occupied do need to have their access roads graded, plus sometimes some other road repairs, to enable their occupants to maintain access to their closest “schools, stores and medical clinics” without constantly damaging their vehicles in the process. To do otherwise will only worsen the already considerable problems of over-crowding and social dysfunction in the main settlements, and risk completely wasting the substantial and often worthwhile investments in housing and essential services that have been made on the outstations in the last forty years.
This necessity should stand beside the undeniable need for much more robustly constructed and better maintained connector roads between most of the communities, or settlements. In the west-north-west sector of greater central Australia out from Alice, these settlements include places such as Nyirrpi, Willowra, Yuelamu (formerly Mt Allan), Walungurru (formerly Kintore), Kiwirrkurra, Balgo, Watiyawanu (formerly Mt Liebig) and Ikuntji (formerly Haasts Bluff), for example, as well as the few places anointed as “growth towns” in this sector, such as Hermannsburg, Papunya, Yuendumu and Lajamanu.
These places are much larger than outstations (or homelands as they are sometimes known, especially in the Top End). Outstations consist mainly of single extended family groups living in a handful of houses and /or tin shacks, some of which may not be occupied. Outstations do not normally have schools, stores or clinics, except for some of the larger outstations, or groups of outstations, at Urapuntja (aka Utopia) in the Sandover region to the north-east of Alice, which do have primary school buildings. (The many Hermannsburg outstations had three outstation schools operating in the ’80s and ’90s, but these are no longer functioning, owing to too few students in their vicinity. Attempts at providing schooling and clinics out of the backs of Toyota Troop-carriers, and delivered by travelling staff and local assistants under trees or in tin sheds, were made in the mid-to-late 1970s, but ceased decades ago on most other outstations in central Australia).
On the other hand, the settlements, or communities, like the twelve cited above, mostly contain multiple clans and many family groups, many houses of varying quality, usually have much overcrowding, and most seldom have vacant houses for any serious length of time unless a death of an important person who has lived in the house has occurred. These places usually have what is by contemporary Australian standards mostly rudimentary infrastructure that includes a school, a clinic, some very poor sport/recreation facilities, some staff housing of varied quality, small basic council/shire offices, access to an airstrip of some description, and some poorly bitumenised streets.
These places, unlike outstations, do need to have some of “the amenities needed for modern life”, but these amenities – roads, schools (including pre-schools), stores, police stations, youth/recreation centres, medical clinics and family/early childhood centres – need to be of sufficient standard, quality and size to meet the needs of the local population and the people who often have to move to the community for a few years to ensure the services are able to meet the needs of Australian citizens in the 21st century.
If the Australian tax payers aren’t willing to foot the bills for this infrastructure and the workforce that must go with it, then they are going to be saddled with a mostly perpetually dependent and increasingly troublesome remote population which will gravitate towards places like Alice Springs anyway, but which will have neither the education nor health to permit them to go forth into the wider world for secondary and further education, training, jobs and life’s adventures without falling foul of too many problems and traps, and thus becoming an even greater burden on the state and its beleaguered tax payers.


Shires: either revenue must go up or expectations, down
The sooner the notion of “growth towns” in central Australia is discarded the better. It is only serving to confuse the issue and divert attention from rational planning for the future of remote communities and their relationships to each other and to Alice Springs.
There is little logic in the charade being played out about these local growth towns, as there is very little apparent or likely economic, legal or social basis for the establishment of viable private businesses beyond a handful of single person or single family or other very small enterprises in them.
Likewise there is no foreseeable ability by either the NT government or the Shires to invest sufficient resources in these places to change their current economic and social trajectories.
The figures that Kieran quotes about roads clearly indicate the problems. To prioritise spending on local roads (presumably mainly to outstations) within 50 km of Yuendumu above the completion of sealing the Tanami as far as Yuendumu, or over the need to upgrade and properly maintain the entire lengths of the arterial roads from Yuendumu to Willowra and Nyirrpi, or the Willowra-Ti Tree connector, would appear to be sheer folly. Similarly, to privilege other development in places like Yuendumu (which was losing population well before it was declared a growth town, and appears to have gone on doing so at a greater rate since then) and Lajamanu over the rest of the Stuart electorate communities on the basis of fanciful preferential status rather than allocating funds according to need is indefensible.
There are strong demonstrable needs for infrastructure investment in many other remote communities which haven’t been dubbed growth towns, and it is unbelievable that senior politicians and public servants are continuing to bury their heads in the sand about this.
The fact that the major towns in the NT continue to have their astonishing sporting and other civic facilities upgraded year after year while significant bush communities go for decades begging to get culverts installed and sufficient grading and repairs on their main access roads so they can safely send an ambulance to town or otherwise try to conduct their necessary business in a safe manner speaks for itself.
The standard of sports facilities, where they exist at all, in most remote communities is worse than shameful. Airstrips are often inadequate for night time and wet weather evacuations.
It is rare to find an adequate youth centre or recreation hall or civic centre building in these places, despite exceptionally high needs.
People in Alice Springs wonder why people from the bush want to escape from life in these badly under-resourced and neglected places …


Recent Comments by Bob Durnan

The millions and the misery
Jones (Posted June 10, 2018 at 12:46 pm), you display an unreasonably negative and incorrigibly antagonistic attitude towards the Central Australian Aboriginal Congress and its considerable achievements in the health field.
You may have heard the old adage that a little knowledge is a dangerous thing? This certainly applies to you. You continually use your ignorance as a cloak for confidently, and very unfairly, maligning Congress.
For your information:
1. The primary causes of most renal disease are very long term, and are mainly associated with poverty. The impacts of the chronic stresses from living in poverty begin in utero, then early childhood, with kidney stones and infections much more common. The stress burdens and infections contribute to weaknesses in organs such as the kidneys. These experiences are all imprinted on a person in ways that may lead to renal disease in later life, irrespective of what health service a person attends. As already discussed, a great deal of the global obesity / diabetes epidemic is socially determined, and health services can only do so much on their own.
2. The rate of end stage renal failure requiring dialysis amongst Congress’s own long term resident clients is vastly less than the rate in the rest of remote central Australian Aboriginal communities. The rate in remote areas is generally more than eight times greater than the town. If you are going to use data, you should use it correctly.
3. There is no basis for your statement that “the [overall] incidence of this terminal disease [i.e. renal failure] is a good measure of the success or failure of diabetes programs for which Congress has responsibility”. The situation is much more complex, as explained above, and health services can only do so much.
4. In light of the above facts, there is no validity in your statement that “the incidence of end stage [renal] disease is out of control despite the tens of millions of funding provided to Congress.” Rather, it would appear that Congress’s funded programmes have contributed to the rate of end stage renal disease being much lower in the long term Alice Springs Aboriginal population than it would have been without those programmes.
Jonesy, it is now incumbent upon you to relinquish your pathological denial of Congress’s achievements, and “agree that Congress has long been a leader and good practitioner in prevention and early intervention strategies and practices.”


The millions and the misery
Yes Evelyne Roullet, I have heard of HTLV-1. It would be hard to not have, given the recent publicity.
But no, I don’t know how much Congress, or anybody else, contributes for research and cure of it.


The millions and the misery
You are being perverse, Jones (Posted June 8, 2018 at 7:18 pm), and you are not nearly as well informed as you seem to think that you are.
Being a provocateur perhaps, just for the sake of it?
I pointed out that Congress (Central Australian Aboriginal Congress, or CAAC) has helped to greatly increase the average length of Aboriginal life expectancy in our region.
CAAC has played a leading role in achieving this increase in average life expectancy, not just by medical interventions, but also by fostering social and behavioural changes, such as by helping to ensure that when children are quite sick that they are brought to Congress by their parents, and are referred to hospital when needed.
You are possibly unaware that before Congress started providing health services in 1973, many sick Aboriginal babies were not being treated in the hospital, for a range of reasons.
Most important was the fact that the hospital was only desegregated in 1969.
Added to that was the fact that the hospital had also formerly played a key role in informing the Native Welfare Branch about the presence of mixed race children in the hospital, or where they were living, and this often lead to their removal.
Thus there were some powerful legacy issues.
In this context, many parents had been very reluctant to take their children to the hospital.
Although you agreed with me about CAAC helping to greatly extend the average rate of Aboriginal life expectancy in our region, you then went on to condemn CAAC for not preventing diabetes, and for allegedly not taking effective steps to intervene in its progress.
These are clearly unreasonable accusations on your part, based on a simplistic understanding of the complexity of the relevant issues, and the history of the situation with diabetes.
Much of what you say about this matter is factually untrue.
It is clear that you have not looked at the CAAC annual reports carefully, otherwise you would know the proportion of Congress diabetic patients who have their blood sugar tested regularly each year is quite high. Further data shows that a high proportion of patients have excellent sugar control.
These figures and many other key performance indicators (KPIs) are published every year in Congress’s annual reports.
This is in stark contrast to most other general practices, which rarely publish such data in their annual reports.
Please have another, more careful look at the CAAC annual reports, which are available on line.
You will find a wealth of information which you and other interested members of the community can use to judge the success of Congress.
As for prevention of diabetes, it has a very long development period.
Most of the CAAC diabetes prevention programmes are also long term by their very nature, and begin with trying to ensure healthy pregnancies, healthy births, and good early childhood health and emotional wellbeing programmes.
CAAC is now providing these services to many of its clients.
However, some of these programmes have only been funded in the last 10 years, some of them only starting quite recently. Several of them are not yet funded in many remote Aboriginal communities.
As you may be aware, the diabetes epidemic is a massive global health crisis that has been caused by what is known as our “obesogenic” social environment, which is rich in high fat, high sugar, high salt, high carb ultra-processed foods, and increasingly sedentary, inactive lifestyles.
Congress alone cannot be expected to change this.
There is much that is still needed to be done in public health terms.
For example, Congress has been advocating for a sugar glucose tax of 20% for more than a decade.
Congress has long advocated that funds raised by such a tax should be hypothecated, or reserved, to be spent solely on a subsidy to ensure fresh fruit and vegies are affordable in all remote communities.
This key position and advocacy has been Congress policy well before the AMA and other peak medical groups around the world adopted it.
Congress removed soft drink machines back in the late nineties, something that most of Australia’s public hospitals and major medical centres are only starting to do now, 20 years later.
Another key endeavour, where CAAC has had some success in recent years, is in the area of reform of the NT Government’s regulation of alcohol consumption and sales, in order to reduce the average level of consumption amongst problem drinkers and those at risk of becoming problem drinkers.
This is widely acknowledged to be a necessary pre-requisite before many further advances in the preventative programmes area can be expected to take place.
You can’t have it both ways, Jones.
You should admit that Congress has long been a leader and good practitioner in prevention and early intervention strategies and practices.


Fewer pokies, help for gambling addicts
Bev Emmott, I don’t understand some of your comments, but I get the drift. “Where are the drunks in Sadadeen,” indeed?
Maybe you could try some of these activities?
Swimming, athletics, archery, shooting, motorbike riding, keeping bees, knitting, embroidery, playing pool, darts, training dogs, raising birds, keeping cats,
following non-Aboriginal art at Araluen, the Art Shed and elsewhere, doing painting, visiting the prisoners, assisting the disabled, helping young single mums, volunteer work, making sculpture, writing, cooking, helping Maureen York, soothing Matthew Langdan’s feelings, dining out, dining in with friends, cycling, walking, running, netball … etc etc etc.
There are not enough hours in the day, or days in the week, or weeks in the year!


The millions and the misery
Re Michael Dean’s mean minded aspersion against the Central Australian Aboriginal Congress (CAAC) staff (Posted June 5, 2018 at 11:37 am: “Amazing … $32m budget and $28m in salaries. They know who to look after, don’t they.”)
Michael, you need to stop and think a bit before you make statements like that.
Consider that the 333 full-time equivalent (FTE) positions on the Congress payroll include about 20 FTE doctor positions, covering seven town clinics (at Gap Rd, Sadadeen Shops, the Diarama Village shopping centre, the Alukura Women’s Clinic on Percy Court, the male health Ingkintja, the youth mental health service at headspace, the after-hours service for the whole community at the hospital), plus a clinic at Amoonguna and four remote clinics (at Mutitjulu, Utju, Ntaria and Ltyentye Apurte).
Most of the rest of the staff are nurses and other health and allied health practitioners, working over these same twelve sites, as well as doing outreach into other services and agencies.
If you deduct the salary packages and on-costs of the doctors from the total, you will see that the average annual wage packages, including on-costs, of the 313 FTE non-doctor staff is around $75,000 per annum.
This is not excessive, considering their skills, the difficult jobs that many of them perform, and the remote locations in which many of them work.
In the last 20 years this workforce has contributed greatly to improving the life expectancy of local Aboriginal people and reducing the gap with other Centralian residents.
Considering the continuing shorter average life expectancies of Aboriginal people, and the gap between their health and the average health levels of other Australians, do you really think that this expenditure is not warranted, Mr. Dean?


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