Serious consideration needs to be given as to the causes of the 20 per cent decline in the numbers of Aboriginal health workers (AHWs) in the past decade (ABC News: 30 Jul 2014).
AHWs play a key role in the independently-run Aboriginal-controlled health services such as Urapuntja or Wurli-Wurlinjang. Indeed, their ‘on the ground’ health workers are vital to the success of the widely acknowledged good health of the people of the Utopia region living on the dispersed homelands that come under the Urapuntja Health Service (as highlighted in John Pilger’s film ‘Utopia’). Compare this to government-run clinics in remote areas where, since the inception of the Intervention and subsequent Stronger Futures, communities have lost autonomy and control over their lives and thereby the key factors impacting on them and their health. The introduction of the super shires (NTG) and government business managers (AG) firmly cemented the loss of control and community involvement in the day-to-day running of community affairs.
The recruitment of short-term medical and other professional workers with a mindset (continually emphasised by media and government) that Aboriginal people are incapable of running their own affairs or handling the business of their lives adds to the disillusionment and lack of interest among AHWs, in what has now become an even less culturally comfortable and rewarding work environment.
The government’s push for ‘mainstreaming’ and full-time jobs disregards the more acceptable and flexible working arrangements that allow for casual or part-time hours that accommodate family and cultural obligations. The government’s rhetoric labels only full time jobs as “real” jobs. Under CDEP or with local community devised employment agreements, AHWs were able to tailor their work commitments to suit the requirements of their home life. Many city workers have the opportunity for flexible work conditions, so why not AHWs?
There are many skilled and qualified Aboriginal health workers in communities who now opt not to be engaged in the workforce at this point in time.
It is interesting to note that the Northern Territory Government is “already in discussion for a hand-back (of the health clinic) to community control at Wadeye and at Milingimbi” (NT Health Minister Robyn Lambley: 30 July 2014). Is this a partial admission that paternalism and disempowerment of community organisations was not such a good idea in the first place? It is certainly a small step in the right direction.
More community control of health service provision should enhance the opportunities for involvement and employment of Aboriginal health workers who play a key role at the forefront of primary health care.
Owen Gale & Marlene Hodder
Co-convenors, NT Greens