The Geography of Aboriginal Health

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Four years ago, floods swept through the Aboriginal community of Beswick, an hour's drive from Katherine in the Northern Territory, damaging eight houses so badly they had to be demolished. They were homes the 450-strong community could ill afford to lose-each house held an average of 18 people, with some trying to fit up to 30. Today, says community clerk Mike Popple, the situation isn't much better: each house is still accommodating around 15 people. And though work is underway on 13 new houses on higher ground, once they're finished, Popple says, the huge demand around the country means Beswick will have to join a long queue for more funds. The crowding creates social and health problems, and families, says Popple, have a simple request: "They would like just one nuclear family in each home."

There are communities far more remote than Beswick, with problems far worse. Just how much worse was mapped out last week with the release of the Atlas of Health-Related Infrastructure, described by the Aboriginal and Torres Strait Islander Commission as the most comprehensive document of its kind yet produced. The atlas uses new Australian Bureau of Statistics data to measure access to basic services, infrastructure and health care in 1,200 communities-"the first time," says co-author Ross Bailie, of the Cooperative Research Centre for Aboriginal and Tropical Health, "that we've had consistent information of this type across Australia." What the maps reveal is, in many areas, a daily reality of need. In 495 communities, for instance, children face traveling more than 25 km to primary school-for 136 communities the trip is more than 100 km. Around 30% of permanent dwellings around the country need major repairs or replacements, while 51 communities still have no sewerage system and 500 communities are at least 250 km from a hospital. Most communities of more than 50 people can reach an indigenous health worker but, despite well-documented substance abuse problems in Aboriginal Australia, most have no access to drug and alcohol workers or mental health services.

There are some small wins-in 1999, only one community was found to rely on carted water, compared to 56 communities in 1992. And some government officials have told Bailie they began using the atlas the day they got a copy. But the problems remain vast-as will be the sums required to right them, says Bailie: "A lot of money has gone into these areas, but nowhere near what is required."

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