I believe Ralph (Posted October 20, 2012 at 7:51 am) …

Comment on NT needs someone to ‘call things honestly’ says Havnen … by Bob Durnan.

I believe Ralph (Posted October 20, 2012 at 7:51 am) is broadly correct: some communities’ populations may be generally more mobile than others, but multiple ‘residences’ and identities are the norm for many of their ‘residents’, some of whom may be more accurately labelled variously as ‘habitually travelling, occasionally itinerant, often wandering or sometimes semi-nomadic people’. The ‘over-estimations of remote community populations’ is a real problem, but under-estimations are also a problem. A health service will generally perceive a higher resident population than will the ABS, NTEC or the AEC, for example, as the clinic keeps records of all the people who define themselves as residents (i.e. ‘living’ in the community) at the time they visit the clinic, even if they unpredictably disappear, unbeknownst to the clinic, shortly afterwards, whilst the ABS and Electoral Commission workers, constrained by all kinds of niceties even if they are highly familiar with the community, will be unable to push past their agency’s guidelines, ‘protocols’ or resource constraints to identify where some people are living, and are unlikely to find any trace of many of those who are on the Clinic’s books at the time, even if they may still be most often residing in the community in question. The clinic and ABS figures both will probably be quite different to the average number of people present in the community in the course of the year. Outstation services and the old community councils had their own ways of measuring population numbers, but these were sometimes conflicted by their need to maximise numbers in order to maintain desperately needed funding levels.
The true average is a figure that nobody is ever likely to know with any accuracy, as the fluidity of ‘residence’ on a daily basis is shaped by various unpredictable and often very elusive factors, as well as by an ever changing combination of predictable causes.
However, when Ralph claims that ‘remote community men can, in no way, afford to not have an income’ he is largely correct, but on less stable ground. Although it is true that ‘remote community men can, in no way, afford to not have an income’, that does not mean that all men, at any given time, will actually have an income. Some of these men – a small number – for various reasons, will very often not have an income. The reasons for this range from rejection of sufficient co-operation with the welfare system, to simple social disconnection and inability to sufficiently comprehend the system’s requirements. For some, constant mobility is one of these factors, and may be enabled by relatives who feel pity for the ‘akunye’ (a ‘poor thing’, deserving of pity and, perhaps, care).
However, as Ralph indicates, the people working for Centrelink and in other segments of the welfare apparatus are these days mostly hyper-vigilant to minimize the instances of “people falling through the cracks”, so the numbers who do fall are far less than they were 20 or 30 years ago. The mythology that drives the popular assumptions that Ralph is attacking have their basis much more in data and lived experience from past decades than they have in the present, since the NTER enabled Centrelink to employ sufficient workers and establish systems to bring virtually all those who wish to be on welfare into the system on a relatively permanent basis.
This contrasts strongly with the situation in the 70s and 80s, when many men (at least, many men amongst those living on or frequently visiting town camps) did survive for considerable periods without any reliable income. I suspect that the now deeply engrained practices of humbugging for access to relatives’ and acquaintances’ cash, goods and cards, using a combination of bullying and distortions of reciprocal sharing traditions (‘demand sharing’), became more deeply entrenched as a survival mechanism amongst some groups during those desperate times, when the rate of alcohol addiction and its associated needs were far outstripping the ability of many individuals to maintain a commensurate personal income stream.

Bob Durnan Also Commented

NT needs someone to ‘call things honestly’ says Havnen …
Matt (Posted October 15, 2012 at 12:23 pm): Gathering from what I’ve heard on the radio today, I think the advice from both Havnen and Gleeson is not that international NGOs should be brought in to the NT, but rather that the NGOs working here should be encouraged to apply some of the better practices of progressive international agencies: for example, Olga mentions partnering with local organisations, something that has been fairly conspicuously absent from the approaches of several national NGOS who have taken on major projects in the NT over the last few years without trying to forge formal partnerships with locally-based Aboriginal organisations, and who you would think should have known better.
Although it should go without saying that we should understand and support “what works here”, this is not as straightforward as it seems, as the literature is littered with examples of fulsome praise for organisations, projects and practices which have been highly recommended by not necessarily neutral or capable assessors, only to see the supposedly praiseworthy enterprises fall over due to corruption, mismanagement or inappropriate program design shortly after the accolades have been articulated.
A major problem with the commonly held belief that we have large amounts of developmental treasure here which is under-recognised and under-utilised (“learning from what works here”) is that the writing about these examples of “what works” is too often short on realistic and frank critical analysis, and is therefore less then compelling when presented to politicians and public servants who often have much more direct experience of the local organisations and practices than that held by the proponents of their alleged virtues.
We badly need to foster a more mature climate for discussion of the merits and problems associated with our local developmental initiatives, and this is where people like Matt and his associates could be of immense assistance.

Recent Comments by Bob Durnan

Torrent of toxic Facebook posts after Mall melee
Russell Guy (Posted below on July 14, 2018 at 2:07 pm), as you and Sue Fielding (Posted below on July 14, 2018 at 8:46 am) both posit, “generational trauma, racism, alcohol abuse and domestic violence [are] some of the reasons for anti-social behavior among the young people responsible [for much crime and disturbance in our town]”.
What you and many others fail to recognise is that Chief Minister Michael Gunner, Territory Families Minister Dale Wakefield, and most other NT Cabinet members share this analysis. They are collectively taking serious steps to address these problems as quickly as possible.
They are doing this via several important measures, including by working in partnerships with Aboriginal community groups, organisations and remote communities to establish and support new out of home care and rehabilitation services; designing and building new therapeutic and educational rehabilitation institutions; as well as by assisting Alice Springs and other regional centres to develop positive directions and strategies.
As you observe, “Anger and frustration are two of the motivational issues, [as well as] mindless vandalism, which is existential for many kids”. However, anger, frustration and mindless vandalism, when permitted to flourish during the child’s development phases, can themselves become a driving habitual mode of operation and subconscious rationale for living.
These ingrained compulsions may be so strong that they become a huge obstacle to rehabilitation, and a powerful force undermining workers’ attempts to undertake generalised prevention strategies and early interventions with other young people who may be shaping up to replicate the patterns set by the dominant role models in their peer groups.
It is ignorant and patronising to suggest that [the politicians] are not completely aware of the need for investing “in healing, strengthening and skilling up young people”, and that they are not committed to achieving this as soon as possible.
The Chief Minister is providing strong support for both a national Aboriginal art gallery, and a national Indigenous cultural centre, in Alice Springs. He is also funding extra development of regional art centre facilities and staff accommodation in remote communities to help attract international tourists to spend time in Central Australia.
He is doing this to help provide direction for the town and region, responding to the requests by Indigenous leaders over many years.
His vision will extend the tourist season to year round activities, as these facilities will be air-conditioned and enable comfortable extended holiday breaks for Asian, European and North American visitors during the northern winter.
Trevor Shiell has some fine ideas, but he fails to see that the art gallery needs to be at the heart of the town, where it will maximise involvement not only of tourists, but also of townspeople on a daily basis, particularly local Aboriginal people, via jobs, training, social and cultural activities, and family events. A place to be very proud of, in a town that is providing futures for our youth, including Aboriginal youth.

Turn rock-throwing into backflips: how community can help
Nice exposition Rainer. Some very useful ideas and analysis there.
However, in relation to your advocacy for volunteer based programmes, such as on bus runs, night patrols or supervision of activities: I believe that it would be a grave error to make assumptions about the practicalities of these proposals.
Recent experience indicates that Alice does not have a reliable supply of such volunteers.
The midnight basketball came a cropper a few years back because of this factor.
The Uniting Church’s Meeting Place is not open very often for the same reason.
All the main existing youth spaces have appealed for volunteers at times, without much response.
A proposal to run Saturday night football for youth during the last Christmas holiday period failed for the same reason.
If a bus run or patrol is to operate through the night, I believe that it must be staffed by professionally trained, paid workers.
On the buses, a small core section of the client group are not easy to handle, even for the best professionals. Playing mind games with the driver becomes an integral part of their night’s fun. Chopping and changing explanations about what their problems and needs are, contradictory requests about where to go, and, in some cases, manufacturing reasons for not going being able to go home, are all part of the challenging behaviours displayed by some of the very alienated clients.
Threatening drivers and other staff may be a regular way for some to get extra attention. These rebellions sometimes become contagious within the cohort.
Your point about the need to employ workers who are fully cognizant of trauma informed theory and practice is, I believe, extremely relevant in this type of work.
For some young people, simply staying up all night and on the streets is their major act of defiance. They get a sense of achievement and success in their rebellion, including strong peer recognition, by this simple act.
The Department of Children and Families’ old YSOS unit (Youth Street Outreach Service) was very effective in dealing with these young people and their very difficult habits, before it was so tragically shut down by the Robyn Lambley/Terry Mills/Adam Giles budget cuts of 2012/13.
At the time, Giles said this service was no longer needed, because it was not dealing with a lot of clients.
Predictably, after its disbanding, problems associated with youth out at night rose inexorably, until things returned to the levels that had been occurring ten years ago, just before the YSOS was started.
It would now be very useful to find the people who worked on the YSOS, and get their views about what worked and why.

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.

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