This was not intended as a thematic volume, but we are able to present a series of major articles and one research report relating to the topic of Indigenous health, including use of bush foods and medicines. These are introduced by Research Fellow--Health, Dr Graham Henderson, who explores the interrelated-ness of these contributions.
The final major article is unusual in that it is more of a personal explication of the role of a visual artist in a process that its author, Juno Gemes, describes as 'The Movement'--the developing concerted movement of Indigenous activists and their supporters towards obtaining rights for Indigenous Australians. Ms Gemes, a professional photographer, had an early and formative involvement with peoples of the Alice Springs area and Mornington Island and later in southeastern Australia, whose concerns she adopted and whom she supported through her considerable expertise and flair in action and portrait photography. AIATSIS recognised the importance of her photographic collections for contemporary Indigenous Australian studies and provided her with a grant to archive and conserve her photographs, copies of which are lodged with our Audiovisual Archive.
In July this year, Linda Burney, New South Wales MP, opened Ms Gemes' remarkable exhibition at the National Portrait Gallery in Canberra, a collection of black-and-white photographic portraits of Indigenous Australians. The exhibition, entitled Proof: Portraits from the Movement, drew on a series of photographs made by Gemes over the last quarter-century of a process of development of individual and cultural aspiration that she called 'The Movement', one led by a variety of Indigenous activists, photographed by Gemes in diverse, often historically and politically significant contexts. Publication of the catalogue of the exhibition was supported by AIATSIS. The opening of the exhibition was preceded by a forum entitled Aboriginal Activism: Then and Now. (1) On the afternoon of Sunday 17 August, photohistorian, Dr Catherine De Lorenzo (2) (University of New South Wales), and psychoanalyst, Dr Craig San Roque (Sydney), joined the photographer 'In Conversation'.
The article published here is an edited version of Ms Gemes' presentation plus a selection of photographs (the dramatic cover photograph is already iconic), including some of Institute Members, from her exhibition and archives. Ms Gemes asks that this caution be brought to the attention of our readers: Warning: Please be aware that this article contains portraits and names of Indigenous persons no longer with us.
We are pleased to introduce this departure from our normal run of articles and encourage our Members and other readers to consider contributions along similar lines.
(1.) Aboriginal Activism: Then and Now. Friday 11 July 2003, 9.30-12.30 pm, National Portrait Gallery, Commonwealth Place (chaired by Gordon Briscoe and coordinated by Frances Peters-Little, Australian Centre for Indigenous History, Research School of Social Sciences, The Australian National University).
(2.) Dr De Lorenzo's review of Christopher Pinney and Nicolas Peterson (editors), 2003, Photography's Other Histories is published in this issue.
Graeme K Ward
Introduction to the other major articles
The health of Indigenous Australians is poorer than that of non-Indigenous Australians by most measures used in public health. For example, the life expectancy at birth for Indigenous Australians was 56 years for males and 63 years for females in the period 1999 to 2001. The comparable figures for all Australians were 77 years for males and 82 years for females (ABS & AIHW 2003:182).
The major causes of this excess premature death among Indigenous Australians during 1999-2001 were diseases of the circulatory system (e.g. acute rheumatic fever, chronic rheumatic heart diseases, hypertensive diseases, ischaemic heart diseases, cerebrovascular diseases), external causes (e.g. accidents, intentional self-harm, assault), neoplasms (i.e. tumours, benign or malignant), diseases of the respiratory system (e.g. acute upper respiratory infections, influenza, pneumonia), and endocrine, nutritional and metabolic diseases (e.g. diabetes mellitus, malnutrition, obesity and other hyperalimentation) (ABS & AIHW 2003:193). However, this description does not expose contributing causes that occur over a life course, such as socioeconomic disadvantage (e.g. unemployment, poverty), alienation, discrimination, and loss of land, culture and heritage.
This difference in health outcomes is huge and unacceptable. What can be done and what is being done about this situation? A recent significant report about Indigenous health (NAHSWP 1989:ix) states that:
'Health' to Aboriginal peoples is a matter of determining all aspects of their life, including control over their physical environment, of dignity, of community self-esteem, and of justice. It is not merely a matter of the provision of doctors, hospitals, medicines or the absence of disease and incapacity.
and (NAHSWP 1989:x) that an Aboriginal perception of health is:
not just the physical well-being of the individual but the social, emotional, and cultural well-being of the whole community. This is a whole-of-life view and it also includes the cyclical concept of life-death-life.
This perception of health requires an holistic approach to health policy development and practice. Research must play an important role in this approach to provide the necessary evidence base. The new Cooperative Research Centre for Aboriginal Health, in which the Institute is a core partner, promises over the next seven years to contribute significantly to a more holistic and less ad hoc approach to Indigenous health research in Australia (CRCAH 2002).
This issue of Australian Aboriginal Studies has a broad collection of research papers that may be viewed from the general perspective of Indigenous health. The papers provide insights about the past and present that may help us move forward in our current understanding of the determinants of poor Indigenous health, and provide guidance for better policy development and practice.
Wendy Beck and Jane Balme advance a good case for the importance of dry rainforest as a reliable and resilient habitat in the past lives of hunter-gatherer Indigenous Australians. The dry rainforests may have provided a valuable source of accessible nutritious food, particularly seeds and fruit, and other materials that enabled many Indigenous Australians to live successfully in the periodically harsh landscape of much of Australia. Research has provided evidence that there may be a measurable improvement in various health indicators of Indigenous persons after a temporary reversion to a traditional hunter-gatherer lifestyle from a Western lifestyle typical of most Australians (O'Dea 1991).
Philip Clarke provides a broad and interesting description of ethnobotany in Australia. He informs us of the rich flora of Australia that was used so effectively by Indigenous Australians, and how ignorant the European colonists largely were. There appears to have been a gradual realisation among colonialists and their successors of the wisdom of the Indigenous peoples in their use of the native flora in their lives. That is, the rich nutritional, medicinal, cultural and other qualities of the native flora that the Indigenous Australians had known for thousands of years. Contemporary health experts and others are becoming increasingly aware of the health advantages of the native flora.
Richard Smith and Pam Smith have 'reconstructed' the likely composition of the diet consumed by the Aboriginal people studied by Gould in the Warburton area of Central Australia in the 1960s in terms of major nutrients. They have then compared this 'traditional' diet (consisting largely of plants) to that of a modern recommended diet (in the light of our current understanding of the relationship between nutrition and good health) and found a remarkably close similarity. This may help explain the apparent lack in traditional Aboriginal people in past times of the chronic non-communicable diseases of modern life (circulatory system diseases in particular) suffered by many Australian peoples. Here we have an insight into the harmful effects of colonisation in terms of the diet changes forced upon Indigenous Australians as their land, culture and lifestyles were taken away.
Heather McDonald looks at the contrasting Indigenous Australian and other Western views of animal fat. She then examines recent nutritional and biochemical research into fats (some of which analyses hunter-gatherer diets and their relation to metabolic and cardiovascular health). McDonald argues that nutrition programs for Aboriginal people should include Indigenous knowledges and practices as well as knowledge based on Western biomedical research.
Maggie Brady and colleagues describe how one small rural Aboriginal community in South Australia has managed over a 16-year period to tackle the devastating effects (medical, social, cultural and environmental) of alcohol abuse in their community. The community achieved this by gaining legal controls over off-premises sales of alcohol, and thus restricting the ready availability of harmful amounts of alcohol to susceptible community members. This achievement has set a community framework for a more hopeful and healthy future.
Mark Moran's may appear at first glance to be an 'odd one out' in this series of papers considered to have an Indigenous health theme. However, in the holistic definition of health, greater consideration of and planning for community, family and individual social and emotional well-being will potentially make an important contribution towards improved health outcomes. Moran evaluates a participatory community planning process for the community of Old Mapoon in far northern Queensland. He describes the initial community development planning process of which he was a part, then evaluates how effective this was by returning some years later to observe the various implementation stages that had occurred subsequently. While some success was evident and there are lessons that can be applied elsewhere in Australia, Moran considers that the concept of participatory community planning needs wider understanding among the various players and stakeholders in community development.
Hilary Bambrick, who received a small research grant from the Institute in support of her doctoral studies, describes in a report about her thesis the high prevalence of non-insulin-dependent diabetes mellitus (NIDDM) in the Indigenous community of Cherbourg in Queensland. Diabetes is an important cause of morbidity and mortality in the Indigenous population throughout Australia, at levels significantly higher than that of the non-Indigenous population. Bambrick discusses two major hypotheses about the aetiology of NIDDM beyond nutrition and lack of exercise, including the 'thrifty genotype' hypothesis of Neel and colleagues, and the 'programming' hypothesis of Barker and colleagues. Her thesis appears to provide some support for the programming hypothesis whereby a poor developmental environment (e.g. poor nutrition and poor living conditions) in early life (i.e. prenatal and postnatal), measured by low birthweight and disrupted child growth, causes some irreversible development change in the foetus, baby and infant that leads to a greater susceptibility (risk) to diabetes in later life when exposed to a typical energy-dense Australian diet.
These papers will be of interest to those readers broadly interested in Indigenous health, and in particular those conducting research and implementing health strategies in Indigenous Australian communities.
ABS & AIHW 2003 The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, Australian Bureau of Statistics and Australian Institute of Health and Welfare, Canberra.
CRCAH 2002 Application Form and Business Plan for a Cooperative Research Centre for Aboriginal Health: Submission to Cooperative Research Centre Program 2002 selection round, Cooperative Research Centre for Aboriginal Health, Darwin.
NAHSWP 1989 A National Aboriginal Health Strategy, National Aboriginal Health Strategy Working Party, Canberra.
O'Dea, K. 1991 Westernisation, insulin resistance and diabetes in Australian Aborigines, Medical Journal of Australia 155(4):258-64.
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|Author:||Ward, Graeme K.; Henderson, Graham|
|Publication:||Australian Aboriginal Studies|
|Date:||Sep 22, 2003|
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