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Tuesday, 1 April 1980
Page: 1290


Senator KEEFFE (Queensland) - Before discussing the report of the National Trachoma and Eye Health Program, I want to take issue with a couple of things that Senator Jessop mentioned. I want to say quite clearly that whilst it is true that there are some problems in the environment in which people live, Aborigines are no more subject to the onslaught of trachoma, or sandy blight, than are the people of European descent. I do not know whether Senator Jessop has ever had sandy blight. He has probably lived in a very comfortable environment.


Senator Jessop - I have examined a lot of people who have had it.


Senator KEEFFE - The honourable senator can examine a lot of people, but I ask whether he has suffered from it. A lot of us who lived as kids in dry areas got sandy blight, but we lived in an atmosphere or environment where our parents were able to get access to available remedies.


Senator Jessop - You would have had acute conjunctivitis, not sandy blight.


Senator KEEFFE - All right, acute conjunctivitis. The honourable senator said a few moments ago that this type of complaint ultimately leads to trachoma. He cannot have it both ways.


Senator Jessop - You need a bit of education.


Senator KEEFFE - Maybe a good dose of conjunctivitis or sandy blight would do the honourable senator some good because then he would know what it is all about. There are thousands of white children who suffer from similar things and there are thousands of adult whites in this country who are suffering from the disadvantages of having attracted the sort of disease which leads to trachoma. The honourable senator should not shilly-shally about and say that he is holier than they are because his skin happens to be white.


Senator Jessop - I didn't say that.


Senator KEEFFE - The honourable senator is saying that it does not happen in some areas because white people are cleaner, or for some other reason. That is just not good enough. The disease is no respecter of race, creed or anything else. It is a tragic situation for anyone afflicted by it. The honourable senator has only glanced at the recommendations. I do not know if he operated in any of the areas where the trachoma teams were working. They did a magnificent job. I happened to come across the teams operating in the central regions of Australia on three or four different occasions. Nothing was left to chance. They were determined to see every patient possible. The only place they were held up was in Queensland, particularly in the northern areas, when the Premier of that State chased them out of the State because he said they were indulging in political exercises. Many people did not go back for the second interview when they were able to do so. They still have not been treated. That is not the fault of the teams which did the job. It is the fault of political bias. Incidentally, in the northwestern part of New South Wales, a certain Federal member of the National Country Party was about to publish a letter to stop the team moving into his electorate but he changed his mind when he saw the hullaballoo that broke out in Queensland.

I shall briefly refer to a number of matters. There are a number of credits in the preface of the report. I want these credits to be recorded in Hansard because the people who did the job deserve the credit that is due. Prior to 1 967 this sort of health organisation could never have taken place. After 1967, with the authority that was given to the Australian Government as a result of the carriage of the referendum held in that year, there was an opportunity. A national program had to be established. This cannot be done on a piecemeal ad hoc basis at the State level. Every health program, regardless of which section of the community to which it is directed, has to be carried out on a national basis.

The first paragraph of the preface to the report states:

It now seems a long time since the Council or the Royal Australian College of Ophthalmologists resolved on 12 April 1 975 'that Professor Hollows be asked to advise on the feasibility of the College organising a campaign to eliminate trachoma in Australia'.

That was a very big job. The first paragraph of the preface to the report deserves to be recorded in the history books of this country. The preface continues:

To conduct the NTEHP and compile this report has required an enormous effort by a great number of people. Foremost amongst these is a man of great humanity and unlimited enthusiasm- Frederick C. Hollows, Associate Professor of Ophthalmology, University of New South Wales. He has been remarkable for his untiring dedication to the task and his qualities have been an inspiration to all who have been associated with him in the Program.

Those involved in the program are too numerous to name individually.

I have wandered around Australia and seen the Program operating. I know that the people involved are too numerous to mention individually. The preface continues:

They include the 80 or more ophthalmologists who went voluntarily to the outback to participate in the campaign; the orthopists, nurses, optical dispensers, microbiologists and others who supported them; and then those who drove trucks, performed clerical duties or helped in other ways. On many occasions the field teams worked without time off for weeks on end and, in doing so, provided a coverage of rural Australia unmatched by any previous health exercise. The thanks of the College go to them all.

The thanks of all the patients go to the team. The thanks of every Australian should go to it.

The preface continues:

To the Commonwealth, State and Territory health officers who helped the Program in many different ways during the last three years, we also express our gratitude. Without their co-operation, the program could not have been fulfilled.

Of the Program's staff special reference must be made to the efforts of Dr David Moran, Misses Rosie Denholm, Susan Bennett, Reg and Rose Murray, Trevor Buzzacot, Sister Marjorie Baldwin, Penny Cook and Gabi O'sullivan and Messrs Gordon Briscoe, Jack Waterford and Dr David Jones of the N.S.W. Health Commission. Though tempted to name more, the only Fellows of the College besides Professor Hollows to be publicly thanked are Dr W. E. Gillies, the Chairman of the College's NTEHP Committee, and Dr Hugh Taylor, who did so much of the field work.

There are others such as Alanna Doolan and numerous other Aboriginal people who helped in some way towards the success of this program.

It is a very proud moment for me tonight to hold this report in my hand and make a short comment on the results of the total program. I am sorry that Senator Jessop has left the chamber. I am sure that he will be back as soon as he can. The National Trachoma and Eye Health Program, or NTEHP as it is referred to, is based on the Aboriginal words 'uwankuru palya ngalkulpai'. The broad interpretation of those words is 'better vision for all '. The controllers of the Program decided to use the Aboriginal flag but they modified the sun on the flag by substituting an eye. That in itself is a symbol of the depth of the Program.

I refer to a couple of other parts of the report. 1 will not argue with Senator Jessop and his expertise as an optometrist. He said that the disease had been here for many years. Whether trachoma was present in this country before the coming of white people is still a matter of doubt. The report states:

Trachoma has been endemic in Australia from at least the last pan of the 18th Century, originally affecting both whites and blacks.

Yet Senator Jessop tried to tell us that it is largely Aborigines who suffer from trachoma because of their poor hygiene. If he goes into the remote communities he will find many white people suffering exactly the same sort of" problems. The report continued:

Whether it was present in Aboriginal communities before the European settlement in 1788 is still a matter for debate, although there is some evidence to suggest that it might have been, perhaps introduced by earlier visitors to the north of Australia such as the Chinese, Japanese, Macassans and Indonesians.

The first description of Aborigines by European, William Dampier, in 1688, suggests that Aborigines in the Kimberleys region, on the north coast of Western Australia, may have had eye problems.

This is one of the worst areas at present. As Senator Bonner can tell honourable senators, other areas are the western parts of Queensland from north-west places such as Dajarra. Unfortunately, of course, we have a fair incidence of the disease in the coastal area. Dampier 's note read, as the report continues:

They have great heads, round foreheads and great brows . . . Their eyelids are always half-closed to keep the flies out of their eyes '.

Among the early settlers, however trachoma called 'Sandy Blight' was endemic and frequently led to serious visual loss. There is little doubt that the early explorers and the pastoralists and miners who followed them, had the disease. The pressures placed on Aborigines communities by settlement especially when large groups of them formed into settlement communitites, probably caused the disease to flourish.

The disease flourishes particularly in the fringe settlements around many of the western central towns of this country. We know that this is not because of anything that the Aborigines have caused. It is because of the very circumstances in which the white population in this country forces them to live, including inadequate housing with inadequate water supplies, medical treatment and employment to enable them to buy the sort of food they need. White people killed off the bush tucker that provided the protein and everything else that goes to make healthy people. The report further states:

Although trachoma had been occassionally noted among Aboriginal communities beforehand, there was very little understanding of its extent or effects until the early 1940's when Father Frank Flynn, an ophthalmologist who had had extensive experience with trachoma from his work at the Moorfields Hospital in London, was posted to an Australian Army Hospital at Alice Springs.

Nobody can pay a greater tribute to Father Flynn than the Aborigines whom he treated in those days. Allied, of course, to his work was the work in the 1950s of Professor Ida Mann. I want that aspect to go into the record and I will refer to it shortly. The report continues:

In his first surveys into the extent of the disease, Father Flynn found that up to 90 per cent of the Aboriginal population of the Centre had some signs of the disease, many in severe form, with up to 7 per cent being blind in one or both eyes.

Vision impairment amongst people living in those areas is very much higher than the percentage cited in the report.

I will quote two or three more paragraphs because they are consistent with the argument we are developing in this place on the reception of this report. The report continues:

In the dry and arid centre, cicatricial stages of the disease were frequently severe causing visual loss; as one went further toward the more tropical north, a smaller percentage of servere cicatricial cases were found, with fewer being blinded or suffering substantial visual loss.

Father Flynn identified some of the factors associated with this trend as being the presence of secondary infection, aggravating the course of trachoma, and the climate, which led to irritation of the conjunctiva and cornea; particularly the drying effects of low humidity, heat, wind and dust.

In Western Australia, Professor Ida Mann was beginning her surveys of trachoma in that State, starting in the Kimberleys in 1953 and covering in the next few years the whole State, seeing more than 10,000 people, about half of whom were Aborigines.

Yet we were told by Senator Jessop that Aborigines constituted almost the total number of people who suffered those infections. The report continues:

Her findings were met at first with shock and incredulity. More than 42 per cent of the people she saw in the Kimberleys, including 56 per cent of the Aboriginal population, showed some signs of trachoma, with 11.5 per cent of affected Aborigines blinded by it. In some communities, almost the whole Aboriginal population was affected by the disease.

Those honourable senators who are familiar with the Eastern Goldfields regions will realise that what I said earlier bears out the following statement made in the report:

In the Eastern Goldfields regions, about 58 percent of the Aboriginal population seen had trachoma; almost 70 per cent of the children had follicular disease, while about 4.7 per cent of those affected were blinded by it.

I do not want to quote at length from the report because Senator Grimes, in his contribution to this debate, set out the recommendations made by the National Trachoma and Eye Health Program Committee. We hope that this Government and succeeding governments will not let this report die. It is one of the best reports on Aboriginal health, particularly eye health, that has ever been produced. I again pay tribute to all the people associated with it.

But let us be a little more expansive than that. Why do we not conduct similar sorts of health surveys of people living in remote areas, including white people, as the members of the team involved in the National Trachoma and Eye Health Program did? Why do we not undertake a similar sort of health survey of the ear, nose and throat problems which are widespread in communities in which youngsters get insufficient food? Those problems affect kids aged from two to three years onwards in particular. It is tragic to see them. Why do we not undertake such a service in the Kimberleys and in those parts of the Northern Territory and Queensland in which Hansen's disease still has not been eliminated? With great respect, I suggest that the figures for the incidence of Hansen's disease in the last year or two have not exposed the entire incidence of the disease. I suggest that, in fact, there are some cases of the disease, in which the sufferers are still living, on which reports have not been made public.

Dr ArchieKalokerinos and other people in the medical field tell us that diabetes presents another very big problem amongst Aboriginal communities and some sections of the white community. But the disease goes untreated because a proper survey has never been made around the remoter areas of this country. Respiratory disease was referred to by Senator Grimes. As a medico, he would know precisely what sorts of problems can follow on from that, particularly with youngsters and with the very old. Sexually transmitted diseases have a fairly high incidence in both white and black communities, but we are not undertaking a proper survey of it. In fact, the trachoma team probably could have done a lot in relation to STD and diabetes but it was not allowed to do so.

Malnutrition in many Aboriginal communities has been encouraged by this Government through its cutback in expenditure. Today I asked a question of the Minister for Aboriginal Affairs (Senator Chaney) concerning this matter because I fear that at the end of this financial year another $10m, $15m or $20m will not be withdrawn from Treasury because the story will be told on behalf of the Government that the Aborigines do not need the money. Not only do the Aborigines in the depressed communities need the money, but also poor whites in this country who are living below the poverty line need it. But those of us who live in the famous bush capital of Australia, with our three square meals a day, with the comfort of a warm bed at night and a roof over our heads to keep us dry, do not know what happens in the remote parts of Australia, with the exception of those of us who have taken the trouble to carry out these sorts of surveys.

Finally, I commend again, as did Senator Grimes, the report of the Committee as a report which ought to be read by every Australian, not only those people who are involved in the field of politics but also many medical people who probably do not realise that this sort of privation and illness is rampant in many areas of Australia. I extend my thanks to the devoted team of people who carried out the survey and the treatment. I hope that this Government and its successors will carry on the necessary funding to eliminate not only the types of eye afflictions which have been recorded in this report but also all the other diseases I have mentioned, all of which would be curable with the expenditure of a few dollars. I hope that that sort of feeling will be taken to heart by governments and by the people.

Debate (on motion by Senator Scott) adjourned.







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