Senator EGGLESTON(7.20 p.m.) —There was an article in the Canberra Times this morning headed `Aboriginal infant mortality three times that of others'. I would like to say a little about Aboriginal health in Australia and Western Australia in particular. Much has been said recently in the media about Aboriginal health and, more specifically, World Vision over the last week or so has criticised the record of Aboriginal health in Western Australia.

I would like to put on record in the Senate the other side of the story about Aboriginal health issues in Western Australia and I am sure in other parts of Australia as well. The truth of the matter is that, while there are certainly still significant health problems in the area of Aboriginal health, a great deal of progress has been made. I think the very dedicated people who work in the Aboriginal health area deserve to be recognised for their contributions. Instead of a constant stream of disheartening brickbats, I would like to see those dedicated health workers receive a few bouquets.

The most important point I would like to make is that, were the solutions to the problems of Aboriginal heath simple, the problems which exist in Aboriginal health would have been solved long ago. Were it just a matter of providing more funding for Aboriginal health, again the problems would have been solved long ago.

The reason why Aboriginal health problems have persisted is precisely because the whole question of Aboriginal health is very complex indeed. Factors which are relevant to the problems in Aboriginal health include cultural factors, such as the fact that Aborigines living in remote communities often sleep with dogs which, for example, carry scabies, which is thereby passed on to both children and adults. The Pilbara Public Health Service now has a program to encourage Aboriginal communities to accept the need to treat diseases in dogs and vaccinate dogs in camps. Only experience would have brought that problem to light.

Also relevant is the fact that Aborigines in remote communities do not like living in western style housing, but prefer to live in open style accommodation in which there is little protection from the elements so that babies and older children get frequent chest infections. Last November, I attended the Kimberley medical conference in Broome at which Aboriginal health issues were discussed.

One of the problems which was highlighted was that resources are not unlimited and medical services can only be provided to reasonably permanent communities. Servicing difficulties arose with the proliferation of temporary out-stations located away from the main communities. The out-stations often comprise only small groups of people and it is just not physically possible for medical staff to maintain services to them. The same applies to the provision of other government funded infrastructure such as housing, water, sewerage, power, schools and roads.

The health problems faced by adult Aborigines include a high incidence of blood pressure and diabetes which is undoubtedly related to the adoption of a western diet. The key to dealing with these problems is to change the diet of Aboriginals, but that is more easily said than done. It seems that Aboriginals are genetically disposed to storing excess energy as fat. This is said to be due to the effect of the so-called thrifty gene. A Monash University study showed a few years ago that when Aborigines are returned to their traditional diet they lose weight and their diabetes and high blood pressure gets better.

There have been significant improvements in the health of Aboriginal people in Western Australia over the past two decades. These improvements are particularly reflected by child health statistics. In 1970 in Western Australia, Aboriginal infant mortality was estimated at 46 deaths per 1,000 live births compared to 15 deaths per 1,000 live births in 1993.

In Western Australia, the case fatality rate for gastroenteritis in 1970 was approximately five per cent among Aboriginal infants. It is now close to zero. There has also been a significant decline in infant and child hospitalisation rates for respiratory tract diseases in Western Australia over the same period. While there was little information about immunisation coverage among Aboriginal children in 1970 there are now very high rates of coverage—in excess of 95 per cent—for vaccine preventible diseases in Aboriginal children throughout Western Australia. Furthermore, in the Kimberley region of WA there has been a significant increase of about 50 grams in the mean birth weight of Aboriginal babies over the past 20 years.

These improvements have been primarily due to the concerted efforts of public and community health services that provide such services as maternal and child health programs, immunisation programs, screening programs for diseases, abnormalities in young children and the provision of preventative services to counter problems such as sexually transmitted diseases and alcoholism and to improve the diet of Aboriginal people.

Over the last decade, there has been an increasing recognition of the importance of the role of Aboriginal health workers and Aboriginal environmental health workers in the improvement of the health of Aboriginal people. This led to accredited training courses and career structures for health workers in 1994 and current negotiations to develop a similar training program and career structure for environmental health workers.

The health department of Western Australia increased the focus on Aboriginal health in the 1980s by the establishment of an Aboriginal health policy unit. In November 1995, a restructure of the health department led to the establishment of the Office of Aboriginal Health which aims to deliver an effective and efficient health service that best meets the cultural and traditional needs of the Aboriginal people of Western Australia.

I would like to name a few of the dedicated individuals who have made great contributions to the improvement of Aboriginal health in the north of Western Australia in the last 20 years. Dr Lawson Holman was for many years the Kimberley regional surgeon based in Derby. He thought up the concept of mobile field nurses who could take preventative medical care out to Aboriginal communities which developed into the WA Community Health Nursing Service. Dr Randy Spargo, as the Director of Kimberley Public Health, did important work on nutritional deficiencies in Aborigines for which he was awarded an Order of Australia.

There are nurses such as Helen Sullivan, who also received an Order of Australia for her work with Aboriginal communities in the Fitzroy River Valley, and Sister Sally Murray Connelly, who for nearly 20 years has once a week driven a four-wheel drive vehicle out to the Yande Yarra community on the banks of the Yule River in Pilbara to provide largely preventative medical services to that community. There are many more doctors, nurses and Aboriginal health workers, such as Vicky Dhu, Jenny Baraga and May Eckerman, who have likewise worked hard to improve Aboriginal health.

In conclusion, while significant improvements have been made over the last 20 years with respect to some aspects of the health of Aboriginal people, unfortunately it is still true that the level of ill-health among the Aboriginal population of Western Australia and Australia in general remains disturbingly high compared with levels in non-Aboriginal people. That is a matter which should rightly concern the Senate and all members of the Australian community.

However, I believe the Senate should respect the fact that a great deal of effort is going into bringing these sad statistics about Aboriginal health into line with the record for other Australians and not be tempted into the trap of accepting the kind of simplistic criticisms which are made by people in organisations who really know very little about what is being done to improve Aboriginal health in this country.