Violent silence
23.11.1999
By: Tony Koch
The evacuation of health workers from an Aboriginal community is caused by violence which is neither uncommon nor surprising, writes chief reporter Tony Koch.
A YEAR ago, two sons of murdered South African freedom fighter Steve Biko visited the Doomadgee Aboriginal community. Their verdict of the living conditions there was succinct -- simply ``barbaric''.
The poorest street dweller in South Africa's Soweto black township, they said, had a better life than an Aborigine living in Queensland's Gulf Country ``Doom City''.
The life of a female nurse on a remote community is possibly the most lonely, dangerous and fearful occupation imaginable. And Doomadgee is probably the most depressing of all remote communities.
Last year the Faculty of Health Science, Central Queensland University, Rockhampton, completed an extensive report titled Context of Silence -- Violence and the Remote Area Nurse.
Questionnaires were completed by scores of nurses who worked on Aboriginal communities, and the responses detailed an appalling litany of abuse, fear and assault.
The summary of conclusions opens with the statement: ``Evidence from the study suggests that remote-area nurses are living with frequent threats to their personal safety whilst on duty, on call and off duty, and that violent incidents are often handled badly by employers, the community and nurses themselves.
``Alcohol was identified as the major cause of violence.''
The report made a disturbing finding which relates directly to Saturday's incident at Doomadgee in which the medical staff were flown to Mt Isa after a series of violent incidents.
The report said: ``Apart from offers to evacuate, the respondents stated there was little or no support forthcoming from employers after incidents of violence were reported. Perhaps as a result, only 52 percent of respondents indicated that they always officially reported incidents of violence.
``A significant number (32 percent) indicated that as a result of previous experiences with their employer regarding reporting violent incidents, they no longer felt confident about reporting to them.''
Patients suffering trauma caused through violence are the most common clients of hospitals and health services in remote indigenous communities in Queensland.
And alcoholism is almost invariably identified as the catalyst to the violence.
The incident which flared at Doomadgee -- population 2000 -- on Saturday was neither uncommon nor surprising.
But hospital staff are not expected to have to cope with personal violence and abuse.
To understand what ``violence'' means in a place like Doomadgee, two examples spring to mind.
Currently a 35-year-old Doomadgee woman is being processed through the legal system. When she was aged five, she and her siblings were asleep in a bed with their mother. Their father entered the room and slashed the mother's throat, killing her. The young girl has never been able to utter a word since that time.
In 1993, 20-year-old Brenda Diamond was sitting at a table drinking with friends at Doomadgee when her boyfriend, Barry Johnny, attacked her from behind with a knife, stabbing her in the arm and the right shoulder where it connects with the neck.
Brenda was taken to the Doomadgee hospital where a woman doctor ordered an X-ray and then sutured the wounds. The doctor failed to notice in the X-ray that 15cm of the knife blade had broken off and was embedded in Brenda's chest cavity.
She was in pain for the next 10 days, so returned to the hospital where another doctor examined the X-ray, noticed the broken knife blade, and surgically removed it.
Next week, Aboriginal Affairs Minister Judy Spence will table in Parliament a report completed by a committee of indigenous women headed by Griffith University's Boni Robertson, looking specifically at violence and alcoholism on communities.
Robertson yesterday said the Doomadgee incident was no surprise, given the findings of her committee -- which included a Doomadgee woman.
`ALCOHOL abuse is the root cause, and although Doomadgee is supposed to be a `dry' community, everybody knows who is bringing the grog in, and when it is arriving,'' Robertson said.
``It is called sly-grog, but there's nothing sly about it.
``These are very serious incidents that have occurred, and everybody -- staff and patients -- deserve and should have a safe working environment.
``But why is it when anything like this happens, it is the innocent community that suffers through the complete withdrawal of services? What about the people there now who are genuinely sick -- the old people, the pregnant women? What is happening to them today?
``If there is a criminal incident such as a drunken person threatening a staff member, surely it is a police matter that should be dealt with in an appropriate manner. The rest of the community should not be made to suffer.
``The last time there were drunken riots at Doomadgee -- a couple of years ago -- the Government responded by withdrawing funding for the women's shelter. It closed down the only refuge for the victims of the violence. This is just crazy.
``The people are just left all the more vulnerable. The women and children are exposed to potential harm because there are now no facilities at all.
``Surely this issue could have been resolved through dialogue among the community council, the hospital staff and police.''
Health Department statistics show that in Doomadgee and Burketown last year, 59 people were so seriously injured they required admission to hospital. They include victims of assault or rape (10), cuts or stabbings (11), child abuse (4) and other assault (32).
By comparison, Aurukun community on Cape York with a population similar to Doomadgee had 180 people admitted. A further comparison is the Torres Strait Island communities, the total population of which is several times that of Doomadgee -- yet the total hospitalised was 54.
The Violence and Remote Area Nurses report notes that anecdotal evidence exists to suggest that violence directed at health professionals is ``severe and increasing''.
``Furthermore, some remote area nurses have reported increasing evidence of violent interactions as a significant motivation for their departure from remote area nursing practice.''
That, in a nutshell, is the obvious result if violence on communities is allowed to continue.
CURRENT practices are not working. It is almost impossible to get an Australian-trained nurse or doctor to work on a community.
Most who serve in places like Doomadgee are nurses and doctors from overseas who spend the shortest possible time in the location, and get out with their savings for somewhere more pleasant and less threatening.
That is a situation which can never change unless the communities themselves change -- and the change required is to curb the consumption of alcohol.
The response of one nurse to the Rockhampton University's questionnaire sums up the situation: ``I have never felt safe as a remote-area nurse, especially after-hours doing a call. Every dog bark, or drunken fight in another language that catches my attention makes me anxious.
``There is nothing between you and death, rape or injury if you live and work in this situation -- when you know the only protectors (the local police) are so badly injured you're battling to keep them alive and keep their morale up and there is no one else to help.
``It is the most dreadful feeling of ultimate isolation, terror and powerlessness. It also opens your eyes to the darker side of human nature -- death, murder, rape and mutilation do happen in these communities and, as an outsider, you are usually not aware of many of the agendas associated with them.''
