6 days ago
The unlikely killers near Australia's most dangerous river crossing
First Nations people living in the remote Northern Territory are still not expected to reach their 70th birthday.
A rare visit inside one of the NT's oldest bush clinics demonstrates why.
Kakadu National Park's notorious Cahills Crossing is the only road in and out of the Aboriginal community of Gunbalanya.
Every day during the dry season, drivers plough their vehicles through the East Alligator River, navigating high tides and saltwater crocodiles as tourists look on.
During the wet season, the remote community is cut off by road entirely.
Cahills Crossing is known for its saltwater crocodiles and dangerous river conditions. ( ABC News: Tristan Hooft )
But it's not crocodiles harming locals out here — it's preventable diseases.
In the Northern Territory's remote west Arnhem Land, common health problems are growing into unlikely killers.
High blood pressure is leading to kidney dysfunction and skin infections are resulting in permanent heart damage.
First Nations Territorians suffer disproportionately high rates of rheumatic heart disease. ( ABC News: Dane Hirst )
A patient waits to be treated at the Gunbalanya health clinic. ( ABC News: Dane Hirst )
The decades-old clinic is still operational. ( ABC News: Dane Hirst )
Despite the region's high burden of chronic illness, many patients dread going to Gunbalanya's makeshift health clinic.
The decaying facility was originally built to manage a leprosy outbreak in the mid-20th century, according to Aboriginal health organisation Red Lily Health Board.
"[It] was not designed to be a community health centre," its chief executive Brad Palmer said.
The clinic was transferred from the NT health department to Red Lily Health Board earlier this month.
Inside the asbestos-riddled building, paint is peeling off the walls and under-resourced health staff have become experts in compromise.
Aboriginal health support worker Houston Manakgu finds patients and encourages them to visit the clinic. ( ABC News: Dane Hirst )
The clinic has fallen into disrepair. ( ABC News: Dane Hirst )
Health clinic staff make do with few resources. ( ABC News: Dane Hirst )
The biggest issue for patients is a lack of privacy.
About 1,350 people from different clan groups live in Gunbalanya and everyone knows each other.
The local clinic is so small that patients are sometimes asked to discuss personal health information in the same room as an acquaintance.
Health support worker Houston Manakgu said the building's inappropriate design was a major deterrent for patients.
"In Aboriginal culture way, man and female … have to be separate," he said.
Avoiding "poison cousins" — certain relatives who must be avoided under Aboriginal kinship systems — is near impossible inside a bush clinic with one unisex toilet.
Houston Manakgu says the Gunbalanya clinic does not consider cultural protocol. ( ABC News: Dane Hirst )
There's only one unisex toilet inside the building. ( ABC News: Dane Hirst )
The building is riddled with dangerous asbestos. ( ABC News: Dane Hirst )
Mr Manakgu said many people avoided the clinic altogether.
"[They] say, 'Big mob in there, maybe we come back later'," he said.
Aboriginal Medical Services Alliance NT chief executive John Paterson said delaying medical treatment was a common issue in remote communities, where chronic illnesses often developed into health emergencies.
"If it goes untreated, then it worsens and worsens," he said.
"It gets to the stage where it requires the patient being uplifted from remote communities and brought into an already overcrowded Royal Darwin Hospital."
John Paterson says preventable diseases are turning into serious medical emergencies. ( ABC News: Dane Hirst )
Recognising the building's flaws, the former Labor government promised Gunbalanya a new health clinic in 2020.
Five years later, the community is still waiting.
Now, there's even further doubt after the Country Liberal Party government removed the $20 million project from its first budget.
"My first reaction was surprise, because it had been promised," Mr Palmer said.
"The design had been completed, the tender documents had been completed. It seemed it was a done deal."
Red Lily Health Board chief executive Brad Palmer said his team was blindsided by the funding cut. ( ABC News: Dane Hirst )
Mr Palmer said Red Lily Health Board had since been kept in the dark about the project's future.
"We just don't know anything," he said.
"There hasn't really been any explanation of the reason why it was removed from the budget."
In a statement, an NT government spokesperson blamed the previous Labor government for promising infrastructure projects it couldn't deliver.
"Labor had announced a record number of projects but failed to allocate sufficient funding to deliver them," the spokesperson said.
"We have not ruled out delivering a new health clinic at Gunbalanya, and it remains on the forward program for consideration."
Mr Paterson said this kind of chopping and changing of government policy was holding Australia back from closing the gap on life expectancy.
The NT has Australia's lowest life expectancy. ( ABC News: Dane Hirst )
Australia hopes to close the life expectancy gap by 2031. ( ABC News: Dane Hirst )
The most recent Productivity Commission data shows First Nations boys born in 2020-2022 are expected to live to about 72 years and girls to 75 years, while non-Indigenous children are expected to live to about 80 years and 84 years respectively.
The gap is even wider in the remote Northern Territory, which has the lowest life expectancy in Australia.
In communities like Gunbalanya, Aboriginal men are expected to live to about 65 years, while Aboriginal women are expected to live to about 69 years, data from the Australian Bureau of Statistics shows.
The data shows life expectancy for First Nations women in the NT is worse today than it was 15 years ago.
"Politicians and governments will only do stuff on a three-year cycle in between each election," Mr Paterson said.
"There's no long-term generational planning and funding commitment to really make a difference."
Red Lily Health Board chairperson Marcia Brennan said listening to Aboriginal people was key to making progress.
Marcia Brennan says improving First Nations health outcomes requires genuine collaboration. ( ABC News: Dane Hirst )
She said the government's failure to consider cultural protocol at the health clinic was just one example.
"In our community, culture will always be there," she said.
"It doesn't matter if we're in a balanda building or at home."
Ms Brennan said the clinic's transition from the NT health department into Aboriginal community control was a step in the right direction.
"Aboriginal staff need to be in Aboriginal clinics," she said.
"We have to work together."
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