The politics of Aboriginal health

Wednesday, March 4, 1992

Aboriginal Health and Society: the Traditional and Contemporary Aboriginal Struggle for Better Health
By Sherry Saggers and Dennis Gray
Allen & Unwin, Sydney, 1991
Reviewed by Nick Everett

"Aboriginal health is a political issue", argue Sherry Saggers and Dennis Gray in this refreshing analysis of the state of Aboriginal health in Australia.

"The poor health status of Aborigines is the direct consequence of invasion by a capitalist society which established its dominance over the indigenous hunter-gatherers, expropriated their land and effectively destroyed their mode of production."

Aboriginal Health and Society confronts many of the myths that persist about the origins of white Australia and the contemporary situation of Aboriginal Australians. It examines, in a historical context, how Aboriginal people have become the most disadvantaged in terms of health.

As Saggers and Gray describe, Aboriginal Australians have much in common with oppressed peoples in other colonial situations, and their state of health is more typical of peoples of Third World, rather than advanced capitalist, countries.

The authors stress the marginalisation of Aborigines within the economy of colonial white Australia. The use of convict labour made the decimation of the Aboriginal population, through dispossession of their land and disease, of little concern to colonisers.

In the 19th century, pastoral expansion brought about massive confrontation over land. One of the sources quoted in the book estimates that the 1788 Aboriginal population was reduced to one-tenth within 60 years. Saggers and Gray describe the conflict as illustrating the contradiction between "a capitalist society which views land as a commodity with exchange value, and a pre-capitalist society in which land is owned inalienably, for its use value alone".

Here the link between struggles for land rights and contemporary Aboriginal health is posed. These struggles necessarily challenge the way in which our society is organised and the vested interests of a minority within white Australia. Consequently, "gains once made must be continually fought for".

Saggers and Gray's social view of health draws also on other Aboriginal struggles, such as those directed at the rising level of violence faced by Aborigines.

Aboriginal women face increasing violence and sexual assault. Domestic violence affects Aboriginal women disproportionately because of the stress placed on their households by unemployment and economic disadvantage.

In the 1980s, Aboriginal men particularly have become the subjects of violence by police and prison officers. Between 1980 and 1988, Aboriginal people made up 21% of all deaths in custody, despite being less than 2% of the population. In 1987, there was a sharp rise in the revious years.

Unfortunately, Saggers and Gray examine deaths in custody in the context of Aboriginal suicides, although acknowledging some of these deaths have been at the hands of prison officers. What is important here is that suicides in custody, as well as deaths by police brutality, occur at the hands of the state. An examination that focusses on government responses to this crisis will therefore not provide answers as to why this violence is increasing.

What is needed is consultation with organisations independent of the "justice" system. The Royal Commission into Aboriginal Deaths in Custody came about only because of the campaigns of black organisations. There have been no police or prison officer convictions to come out of the inquiry. What this reveals is that the state itself poses major obstacles to better Aboriginal health.

Saggers and Gray correctly target private interests within the medical profession: "The current problems of medical care systems are not due merely to an immediate 'fiscal crisis', but reflect the growing contradiction between health and the pursuit of profit under capitalism".

However, the credit they give to governments for establishing Aboriginal health services should be balanced by the increasing reluctance of governments to enact such progressive reforms in the 1990s. As Saggers and Gray point out, in 1990 the Liberal and National parties promised to cut $100 million from the Aboriginal budget should they be elected, and the federal Labor government has failed to introduce any national land rights legislation.

Furthermore, Labor government have set back the struggle for land rights by allowing some mining in national parks (and Aboriginal land), and the recent juvenile justice legislation introduced by the WA Labor government can only lead to a greater incidence of police and prison officer brutality against Aboriginal youth.

Saggers and Gray describe historically how Aboriginal people have become the most disadvantaged in Australian society and how the medical profession perpetuates their ill health. However, the predominantly white students and health workers who will read this book need a knowledge of where Aboriginal communities stand in challenging increasingly unsympathetic state and federal government policies.

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