IT has been a year of achievements for indigenous Australians. Parliament opened with a historic apology to the stolen generations and closed with the announcement of a $1.6 billion investment in Aboriginal and Torres Strait Islander health over four years. This is intended to help close the appalling 17-year life-expectancy gap between indigenous people and other Australians.
We now need to make the most of this investment with a national indigenous health plan developed in partnership with indigenous people.
Of course, improving the basics — from housing to education and health — costs money. In Western Australia, a state where the life expectancy gap is widening, the state Treasurer has announced that it will cost $1 billion just to provide decent housing.
In addition, many Aboriginal communities do not have access to potable water, and more than 150 of these communities in WA have not had their water tested.
Indigenous Australians have the worst health outcomes when compared with indigenous people in other developed countries including Canada, the United States and New Zealand.
The lesson from countries that have entered into treaties with their indigenous population is that giving indigenous people control over their own lives can be an important element in closing the gap.
These countries have also implemented self-determination measures such as giving control of tribal lands to aboriginal councils that make decisions — as has happened in the US — and, in Canada, the establishment of a Healing Foundation led by aboriginal staff and aimed at overcoming trauma and grief. The latter has reduced suicides markedly.
Prime Minister Kevin Rudd’s ambitious agenda includes a special Close the Gap meeting of the Council of Australian Governments next year. This is a recognition that substantial progress will only be made with co-ordinated action at state and federal levels.
This COAG meeting needs to focus on time-bound, measurable indicators for improvement in indigenous health and wellbeing, with goals to be reached in the life of the current Parliament. It needs to cement a new era of commitment to partnership with Aboriginal people, through a plan for national action.
Aboriginal and Torres Strait Islander Social Justice Commissioner Tom Calma’s 2005 Social Justice Report kick-started the Close the Gap campaign, so the news that he will play a key role in establishing a new indigenous representative body is welcome.
Earlier this year, Kevin Rudd and then Opposition leader Brendan Nelson signed a "statement of intent" to work in partnership with indigenous Australians to create a comprehensive, long-term, well-resourced national action plan. But this partnership and this plan, essential if progress is to be made, has yet to appear.
Peak Aboriginal and Torres Strait Islander health groups from across the country have already set out a comprehensive set of health targets they would like to see put into action, and many state-based groups are developing their own targets. They are ready to be invited to negotiate a joint plan with government.
These organisations include Aboriginal and Torres Strait Islander doctors, nurses, psychiatrists and health professionals who have planned, managed and implemented an excellent array of projects, including 140 community-controlled medical services in urban, regional and remote Australia.
Because they work with a broader definition of health, these services go beyond the clinical.
They make people more comfortable through language and cultural understanding when trying to pinpoint and tackle the causes of ill health.
This approach is proving itself already. When Derby Aboriginal Health Service medical workers visit Pandanus Park (a remote community in the Kimberley), the women are happy to take their babies for a check-up, immunisation rates are high and the children get the best start to life.
Everyone is better off when there is an approach that builds on local strengths.
A similar project in Queensland succeeded in halving perinatal deaths in Townsville, while the Victorian Aboriginal Health Service in Melbourne consistently reports that 91 per cent of children are fully immunised, compared with an immunisation rate of less than 50 per cent for Aboriginal children across Victoria.
Cleary effective, sustainable benefits only occur when people are given responsibility for their own future and are involved in the planning, management and implementation process.
While the Federal Government has a clear responsibility to lead the way in closing the gap, it cannot do this alone. Only by establishing partnerships with Aboriginal and Torres Strait Islander people will its efforts succeed.
Andrew Hewett , Executive Director of Oxfam Australia.
This opinion editorial was published in The Age on 30 December 2008.
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