than 30 years ago a task force was commissioned by the Commonwealth to
tackle a national disaster among Aborigines, which, particularly in
remote areas such as the Northern Territory, was robbing young
Aborigines of their childhoods and scarring them for life.
It was no mean expedition. Before it was over it had visited more
than 600 Aboriginal communities and country towns in all parts of rural
Australia, and seen over 110,000 people, including 60,000 Aborigines,
at least once. Each had a
substantial medical examination. From the results of the initial
examination, about a fifth were given a more intensive specialist
examination by some of Australia's most skilled doctors. Nearly 2000
people received surgical operations, a good number in special army
hospitals in the middle of the Australian desert, and another 6000
mostly older people were given glasses.
Around 30,000 people in the Northern Territory, South Australia and
Western Australia were involved in the month-long mass-treatment
There had been no expedition on this scale before, and there has
been none since. The model of its organisation, and its practical
findings, were widely admired, and the model and the experience was
later used overseas.
The task force approach was the National Trachoma and Eye Program,
led by Professor Fred Hollows. It was focused on blinding eye disease,
but neither the conditions it encountered nor the instincts of Fred
Hollows limited it only to looking at eyeballs. Every person the
program saw was given a general health examination, and, in particular
areas visited, the program made extensive additional studies of
particular problems being encountered, including the incidence of
sexually transmitted disease, respiratory disease, skin infections and
infestations, middle ear conditions, and diabetes.
The program was the genius of Gordon Briscoe, now Australia's most
senior Aboriginal historian, who had earlier played a key role both in
establishing the Redfern Aboriginal Medical Service and in recruiting
the wild and irascible Fred Hollows to be its foundation medical
director. Its establishment was also funded by a challenge that a
bright doctor-come-politician, Peter Baume, threw at the various
Australian medical specialist colleges – that, if they really were
about the public interest rather than their self-interest, they ought
to prove it by getting involved in improving Aboriginal health.
College of Ophthalmologists took up the challenge, and not only with a
tight salaried task force, but with the additional and unpaid
assistance of hundreds of ophthalmologists who volunteered. Many of
these are still involved in providing ongoing services to Aboriginal
The program cost the Commonwealth about $4
million in 1979 dollars. At various stages, when, for one reason or
another funding was in the balance, government was given to understand
that, if needs be, the program could carry on by bulk-billing the
Commonwealth a GP fee for each examination, and a specialist fee for
each specialist examination, as well as surgical fees for all
procedures. Had we operated on that basis, the cost to the Commonwealth
would have been at least $8 million.
My wife and I worked
several years with the program. I first became involved, as a reporter,
during funding negotiations in 1975, and, once the program began
operating spent a month reporting (and pitching in) with task force
teams the next year, inter alia recording Fred Hollows' memorable
phrase that 'if the health services around here were organised for
animals rather than Aborigines, the RSPCA would prosecute''.
I was so bowled away by the disaster of Aboriginal health that I obtained a two-year leave of absence from the Canberra Times
and went to work with an Aboriginal medical service in Central
Australia, helping to set up new services. Then I went to work directly
for Fred as an organiser, dogsbody and report writer. My wife, Susan,
whom I met on the program, organised surgery programs in the wake of
the main teams' progress, and mass treatment programs.
is still around, but neither with the intensity and severity of old: in
1976 virtually every Aboriginal child in three quarters of geographical
Australia had the infectious, conjunctivitis, stage of the disease, and
about one in four old people (people aged 60 or more) were blind from
trachoma, corneal eye disease or cataract. There is still too much
Aboriginal blindness, but the likelihood of old-aged blindness among
the middle-aged remote Aborigines of today (who were kids or young
adults then) will be but a fraction of what it once was.
now, the root of trachoma, and almost all the other illness we saw, was
living conditions. Poor and over-crowded housing, if it could be called
housing at all, inadequate water supplies, an inability to separate
garbage and sewerage from the living environment, and poor diet.
Inadequate or non-existent medical services made virtually every
Aboriginal the host of what Dr Peter Moodie called 'a wardful of
diseases in each body''. Treatment helped, but exposure did not create
resistance, and those 'cured' were quickly sick again.
were times when, in describing what we saw, we used phrases such as
'national disaster' and compared the national mobilisation to help the
1974 Darwin cyclone victims with the resources going into Aboriginal
affairs. We made use of the army too, and had high praise for its style
of operation. But the army's help, and what was needed, had very little
in common with the impatient 'boots on the ground' approach and
coercive methods which seem to be favoured by Mal Brough, the former
soldier turned instant expert on Aboriginal affairs. Indeed it was as
much the failure of Brough-style authoritarianism as the lack of
investment which had created the mess with which we were dealing.
made us different? We consulted, liaised, talked, reported back, and,
so far as we could, we delivered too. Even in 1976 we found Aborigines
weary of 'yet another survey' and 'yet another lot coming through,
making promises, never to be seen again'.
The program employed
Aboriginal liaison officers who went into communities, long before the
teams arrived, to explain what we were doing and why, and to negotiate
assistance. Local liaison officers were appointed to help organise the
actual visits. We did not wait for people to come to clinics, but went
out and looked for them in the camps. In one community, which had been
the subject of regular visits by an eye doctor, (of his own initiative,
free, but based on people presented by a clinic sister) the doctor told
us that, because of his regular visits, there were no blind people
here. We saw 30, from the camps, in one afternoon.
Some of the
meetings we initiated metamorphisised into standing groups, not least
the Pitjantjatjarra Council, which was first convened, from
Pitjantjatjarra groups in South Australia, Western Australia and the
Northern Territory, in response to our request to discuss what people
could do about our findings.
We worked hard, in short, to make
the people partners in our program, and to give individuals, families
and groups a strong sense of ownership. Most of the time, of course, we
were heavily self-critical, thinking that we could have, or should
have, done it better, but that we were doing it better than it had been
done before we were always pretty confident.
I wish I could be
as confident about the task forces starting out – first with cops, then
with army officers, then some doctors not yet consulted or organised,
with alienated state infrastructure and no sense of engagement with the
service providers on the ground, let alone the objects of the
attention. Complete with abuse by the minister of the people whose
cooperation he needs, and the general implication that anyone who
stands in his way, or doubts his good intentions, is an apologist for
Jack Waterford has been an editor of the Canberra Times since 1995. He contributes to Eureka Street regularly.