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Editorial: Aboriginal Health & History
Ian P.S. Anderson and Kim Humphery
It is relatively unusual for a commentator on Aboriginal health to consider this field outside even the vaguest of historical frames. Sometimes this is merely a gesture, a brief genuflection to the past, that creeps even into the framing of government action. The first National Aboriginal Health Strategy (1989) contained a preface that roared:1
In the planning of any National Aboriginal Health strategy, the reality of Aboriginal Australia must first be addressed.
But many of the realities of Aboriginal Australia—both pre- and post-colonial—have been obscured by the processes of both history and "history in the making" throughout the last two hundred years.
There is a great deal of truth in Napoleon's assertion that only conquerors write history—but there is even more truth in the assertion that only conquerors celebrate it.
Dressed in the hand-me-downs that are the legacy of dispossession and dispersal, Aboriginal Australia could have hardly felt at home at White Australia's extravagantly self-congratulatory, glitzy bash last year.
But the vulgar trumpeting, the epicly Philistine commercialism of the idolised nouveaux-beer-riches and the raucously adolescent displays of iron-fisted jingoism that were so much a feature of the Bicentennial all seemed entirely justifiable to a White Australia intoxicated by the "pioneering spirit".
For this is a history forged in the cauldrons of colonisation. A history in which the processes of mystification have been very much at work for the past two hundred years.
This preface by the distinguished writer and journalist, John Newfong, was oddly juxtaposed against the rest of the document, which was imbued with biomedical discourse and the language of bureaucratic rationality. More than a decade later, the review of the Strategy produced a draft document which again contextualised government within a historical frame. This time, the fissures produced by the ideologically driven debates in the history wars were too great. The new strategy was then split into two documents: one a context document, and the other the strategic document to which governments were asked to commit.2 |
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Today, Aboriginal and colonial history is a vibrant, dynamic area of research. However, despite some significant exceptions, the development of a historical focus on Aboriginal health is relatively patchy. It is quite a paradox that a field so often framed historically has had such poor uptake in academic history. This was particularly evident when this journal published, in 2001, a Maori health special issue that showcased the depth of the field of Indigenous history in Aotearoa/New Zealand. The collection brought together a number of different perspectives to the historical study of Maori health, with particular attention to both government responses and Maori engagement. Its publication prompted the editors of this current edition to see if it would be possible to bring together a similar collection for the Australian context. |
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The essays included in this special issue on Aboriginal health resulted from a call for papers that was circulated through the journal's readership and other relevant networks in late 2005. Abstracts of the papers were short-listed according to Health and History criteria. Papers that were subsequently submitted were reviewed using the journal's established peer-review process. |
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The essays that follow cover three principal themes: the Aboriginal experience of health and health services over time, the colonial and twentieth-century construction of medical knowledge in relation to Aboriginal health, and the recent history of Aboriginal health organisations. We also include here Warwick Anderson's important discussion of the historiography of Indigenous health. Anderson has surveyed the development of this field in British settler societies and found evidence of some landmark work in the study of Indigenous health histories. He has also found many opportunities to further our understanding of how Indigenous health has changed over time, and the institutional and societal responses to these dynamics. |
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In blurring the boundaries between the historical and the contemporary, between ethnographic research and historical analysis, a number of the essays in this volume breathe new life into the somewhat tired adage that history is the study of both past and present. In the context of Aboriginal health this is no adage at all: it is a socially and physically lived reality. History narrates itself literally through the body in the continued morbidity and mortality of Aboriginal people. Trauma, sickness and death in contemporary Aboriginal Australia is related to the inadequacy of contemporary policies, institutions and interventions, and to the personal and collective memory of health and welfare systems as a terrain of moral policing, neglect, incompetence and spiritual violation. This is clearly evidenced in a number of the articles published here. |
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In his challenging contribution to this collection, Brian McCoy takes us to the Kimberley in Western Australia (WA), recounting the history of the dormitory system at Balgo Mission. As McCoy observes, the dormitory system—where children were not removed from communities but separated from their parents and placed in living quarters under non-Aboriginal supervision—has received comparatively little attention as a form of intervention with traumatic intergenerational consequences. McCoy traces the workings of this system at Balgo from the 1950s to the early 1970s and, utilising contemporary ethnographic research, explores the impact of this experience on current generations at Wirrimanu, as Balgo is now called. While careful not to simply equate the dormitory system with the experience of the stolen generations, McCoy nevertheless demonstrates the particular type of trauma arising from this intervention and the consequences it has had for Aboriginal health. He emphasises especially the manner in which dormitories worked to sever the physical, emotional, cultural and spiritual links, and communicative bonds between generations, thus undermining the key cultural value of kanyirninpa or 'holding'. |
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From WA, we shift to southeast Queensland. Drawing on ethnographic research conducted for her PhD, Leonie Cox explores how, for residents of the Aboriginal town of Cherbourg, Aboriginal health status can only be understood as a product of 'both current and historical experiences of the health and criminal justice systems.' Cox ably demonstrates the deep interconnection between policing and health intervention for Murris at Cherbourg and elsewhere. As her interviewees make plain, the clinic, the hospital, and medical intervention generally, are associated in historical memory with normalising and disciplinary practices—and the experience of them continues to be one of colonisation and racism. Thus, it is not only inappropriate or inadequate health services provision that underlies Aboriginal ill-health, but Aboriginal resistance to, and warranted suspicion of, a historically shaped medico-legal system. |
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The lived reality of this collision between Aboriginal lives and institutional regimes is illustrated in the highly focused 'case study' offered by Bronwyn Fredericks. Once again, the emphasis is placed here on contemporary ethnography as history. Fredericks recounts the story of Kay, an Aboriginal woman from the Rockhampton area of Queensland, one of a number of women interviewed as part of a research project exploring Aboriginal women's experience of health and health services. Kay's story, as Fredericks contends, 'demonstrates how colonisation, discrimination and racism have been enacted at the coalface of everyday life.' This paper uses biography as a window into history, and the narrative it offers is both powerful and informative. |
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The medical, welfare, and legal systems, however, are not only experienced problematically by those made objects of their gaze, but they also express the imaginings and power of those who devise and administer them. Two further articles in this collection direct our attention to the construction of white Australian regimes of medical knowledge. Edmund McMahon provides a careful and thoroughly documented account of the rise of Australian ethnopsychiatry and of the central place of John Cawte in its development. McMahon explores the ideological and institutional conditions from the 1950s to the 1970s that gave rise to 'Aboriginal mental health' as a field of research and intervention and, in focusing on the work of Cawte, he seeks to 'critically evaluate the discourse on Aboriginal psychiatry that it produced.' While careful not simply to equate Cawte's evolving approach with assimilationism, McMahon implicates Australian ethnopsychiatry in a denial of Aboriginal agency and cultures. |
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In a further, illuminating essay, Caitlin Murray maintains the focus on Aboriginal mental health, or rather, on white constructions of it. Murray examines the discourse of Aboriginal madness or insanity that surfaced in the 1880s and was consolidated in the 1920s. In doing so, this paper convincingly argues that, in accordance with racist hierarchies, 'white madness' came to be seen as involving more complex mental processes than 'black madness.' As a consequence, Aboriginal insanity was 'normalised' as an inevitable product of the coming of white modernity, and as being merely the most visible expression of the 'innate primitiveness and savagery' of Aboriginal peoples. In tracing the contours of this process, Murray provides an insight into the construction of the category of madness itself, a category embedded in notions of otherness and race. Additionally, the short 'research note' by John Stuart on chronic ear disease in Aboriginal children continues the theme of documenting the 'white' codification of disease. |
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In the detailed essay by Rosewarne, Vaarzon-Morel, Bell, Carter, Liddle and Liddle, attention shifts from the construction of white knowledge to the making of Aboriginal organisations. Drawing on historical documents and oral testimony, this paper traces the first decade of the Central Australian Aboriginal Congress, established in Alice Springs in 1973. As a key player in Australia within the Aboriginal rights movement and the primary health care sector, the history of Congress—as it has become known—demonstrates the manner in which the rise of Aboriginal health, legal and other services have proved 'fundamental to the issues of Aboriginal self-determination and identity.' Placing the rise of Congress in the broader historical context of black/white relations, land rights, and the community health movement, Rosewarne et al. decisively establish their key point: that much greater recognition needs to be forthcoming of the role that Aboriginal health services have played over the past three decades in reforming Australian health policy and practice. |
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Finally, in an invited contribution, Warwick Anderson, as we have already noted, surveys the field of Aboriginal health history in Australia and elsewhere. This constitutes one of the first attempts to summarise this field. The scope of this survey is limited to British colonial settler societies in Australia, Canada, the United States of America and New Zealand—although Anderson does note a broader agenda for history in other Indigenous societies across the globe such as Latin America and East Asia. In all four jurisdictions, historiography and historical analysis have already made significant contributions to our understanding of Indigenous health. There is a particularly robust research agenda that has emerged in New Zealand which points to the possibilities that could be developed in Australia. Here, the potential agenda is much broader than charting the changing relations between Aboriginal people and the health system through time—although this is an important agenda in its own right. There are also many unanswered questions about the relationship between historical processes and health, both in terms of inter-generational relationships, and through the historical analysis of Indigenous populations and their health transition. Further, there are potential links with other lines of historical inquiry such as the role of health in the development of the Aboriginal political movement, and the role of colonialism and colonial discourses in the development of biomedicine and health care institutions. |
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The essays in this volume treat history dynamically, transgressing disciplinary barriers, mapping the experiential, exploring the discursive, and documenting political action and scholarly work. Together, they demonstrate a consolidating interest in understanding Aboriginal health in historical terms and impress upon us the need to grasp health, and health interventions, as a narrative rather than as a set of ailments, policies and services. We hope that this collection is both provocative and intellectually stimulating and look forward to the further development of a focus on Aboriginal health within Australian history.
University of Melbourne
RMIT University
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Notes
1.¾ National Aboriginal Health Strategy Working Party, A National Aboriginal Health Strategy, (Canberra, ACT: OATSIH, 1989). Available at www.healthconnect.gov.au/internet/wcms/publishing.nsf/Content/health-oatsih-pubs-healthstrategy.htm#1989.
2.¾ National Aboriginal and Torres Strait Islander Health Council, National Strategic Framework for Aboriginal and Torres Strait Islander Health: Framework for Action by Governments, (NATSIHC, Canberra, ACT: 2003); National Aboriginal and Torres Strait Islander Health Council, National Strategic Framework for Aboriginal and Torres Strait Islander Health: Context, (NATSIHC, Canberra, ACT: 2003). Available at www.healthconnect.gov.au/internet/wcms/publishing.nsf/Content/health-oatsih-pubs-healthstrategy.htm#1989.
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