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Not Part of the Public: Non-indigenous policies and the health of indigenous South Australians 1836-1973.

Not Part of the Public: Non-indigenous policies and the health of indigenous South Australians 1836-1973

Judith Raferty, Wakefield Press, Adelaide, 2006. Pp.333 + xi.

The current appalling state of Aboriginal health, Judith Raftery declares in her opening chapter, 'is a product of colonisation' (p.10). Her book is an elaboration of this proposition, focussing on South Australia. In meticulous detail she traces how the various governmental policies and practices of this colony, later state, that excluded Aboriginal people from 'the public' thereby excluded them from the enjoyment of good health. The 'public', a word to which she has frequent recourse, is a somewhat awkward term but there are few adequate alternatives in the English language. It designates here a body of people aware of themselves as a community held together by shared values and beliefs, mutual rights and responsibilities, and a commitment to each others' well-being--that is, an 'imagined community', and at a different level of political analysis the word 'nation' would be a close synonym. 'Nation', however, has been reserved for the Australian community as a whole, and to refer to one of its constituent parts Raftery has had to resort to the less resonant term, 'the public'.

The greater part of her book documents the processes by which, for nearly 150 years, South Australian Aborigines were rendered 'not part of the public'. Their exclusion, she makes clear, was not necessarily deliberate or motivated by ill intent. From the moment of colonisation onward, government authorities frequently proclaimed a grand ambition to bring Aboriginal people into membership of 'the public'. If this was sometimes lip-service, it was not always so; and many officials at the personal interface between Aborigines and colonists, such as Protector Matthew Moorhouse in the mid-nineteenth century, were genuinely committed to Aboriginal inclusion. The ambition, however, was subverted by, on the one hand, the fact that inclusion was offered on dictated terms, usually along the lines of Governor Gawler's 1838 exhortation to Aborigines to 'imitate white men'; and on the other, the fact that 'the public' tended to be indifferent, if not openly hostile, to accepting Aborigines into its membership. In consequence, Aborigines occupied a permanently liminal position, 'not part of the public' yet not fully separate from it either, subsisting on its fringes in a state of dependency and disempowerment. This, Raftery argues, was a recipe for ill-health.

Although the subtitle flags indigenous health as a focus of the study, this is not a dissertation on mortality rates, longevity and the incidence of disease. Raftery's conception of health is much broader, referring to 'well-being, that is, a state of being which enables individuals and populations to live a life that is good, according to their values and aspirations, and which, for individuals, extends as long and is marked by as much opportunity for human flourishing, as is experienced by others who share their time and place in history ... Thus health is relative and culturally and historically determined. It is also politically determined' (pp.9-10). The book, then, examines the socio-political determinants of health, drawing on the work of scholars such as Richard Wilkinson and Alison Quick who argue that health inequalities are the outcome of social inequalities. Their argument goes well beyond the banal observation that poor individuals are more likely to suffer ill-health than wealthy ones, to contend that relative deprivation at the group level is the key factor: any group whose access to public goods (such as money, power or knowledge) is substantially less than the societal norm will suffer high levels of ill-health. It is a reasonable and well-supported argument, but devoting an entire chapter to its explication, as Raftery does, is excessive. The social inequality/health inequality thesis is not a proposition she seeks to validate or test against historical data; it is a theoretical foundation upon which she builds. As such, a few paragraphs of explanation in the introduction would have sufficed. As it stands, the chapter devoted to this topic sits awkwardly against the body of the text: a chunk of public health theorising dropped into a pool of detailed and nuanced historical contextualisation.

After the theoretical exegesis chapter come five chronologically-organised chapters tracing the continuities and changes in South Australia's Aboriginal policy and practice over the designated period. Based on prodigious research into government and non-government records, both published and unpublished, these chapters manifest the traditional scholarly virtues of attentiveness to complexity and ambiguity while demonstrating a thread of consistency, not so much in intention as in outcome, in the governance of Aboriginal people. At times, the argument gets bogged in excessive detail, but Raftery always manages to extricate herself and get back to the point of explaining how Aborigines were marginalised and why this mattered for their health. At the close of the period under review (1973), she observes, policy makers had still not resolved the recurring dilemma of how Aboriginal people might be included in 'the public' without sacrifice of their Aboriginality: how, that is, 'the public' could become genuinely inclusive of Aborigines, as Aborigines.

Following the five substantive historical chapters comes a short chapter (or a lengthy conclusion) entitled 'Aboriginal--And Part of the Public?', dealing mainly with the period since 1973. Despite the question-mark in the title, Raftery indicates that in that period Aborigines have become more--though still imperfectly--'part of the public' than hitherto; and that there has been a greater--though again imperfect--governmental acknowledgement of the distinctiveness of the 'Indigenous Sector' (a term she borrows from Tim Rowse). Yet there has been little, if any, improvement in Aboriginal health. This could be read this as contradictory to the thrust of her argument, but it would be more appropriate to see it as recognition of the role and limitations of historical studies. Raftery is too astute an historian to regard history as a source of answers to current problems; at best, it can offer explanation. Her book offers insightful explanations of why the disparities between indigenous and non-indigenous peoples' health are so vast. It does not offer, and makes no pretence of offering, a simple solution for the future but does offer an informed explication of the legacy with which policy-makers and health professionals have to deal.

Finally, I must congratulate Wakefield Press for opting for footnotes rather than endnotes thus sparing the reader from having to scrabble to the end of the chapter or book to find the relevant reference. Other scholarly publishers would do well to emulate their example.

Reviewed by Russell McGregor, James Cook University
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Author:McGregor, Russell
Publication:Australian Journal of Social Issues
Article Type:Book review
Date:Sep 22, 2009
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