Is being remote as ever a good or a bad thing?

REVIEW by ERWIN CHLANDA

It’s night at Rabbit Flat. The gas cooker on a camping tour bus blows up. A passenger is seriously injured.

The nearest hospital is 600 km away, in Alice Springs, where Dr David Scrimgeour (at right) is getting ready to turn in for the night.

He gets the call. The Flying Doctor Service is alerted.

The pilot finds his way by dead reckoning. No navigation aids. Lots of lights on the ground but only one is from humans – Yuendumu. All others are bushfires.

After some two hours in the air the pilot lines up for a landing on the roadhouse’s dirt airstrip.

No runway lights either side. Just the headlights from a car at each end. (One was me.)

The pilot greases on the twin.

After that aviation feat the medical one can start.

It’s a day – this time, night – in the life of “Dr Scrim”. The legendary bush doctor’s adventures are the kind of buzz that makes living in this vast, sometimes dangerous country so extraordinary.

But adventure is not something Scrimgeour dwells on in his book Remote as ever – the Aboriginal struggle for autonomy in the Western Desert.

He practiced for nearly half a century in The Centre, mostly out bush, in the west of the Northern Territory, the north of South Australia and the east of Western Australia.

In other words, the Western Desert.

Quite a patch, hours on dirt roads, sleeping in the swag, cooking on a campfire, and learning to fly himself, getting around in a Cessna.

His interest went well beyond the traditionally medical: As he says in the book, clinical decisions were always his alone, but he was happily working alongside a ngangkari (a traditional healer) on many occasions, with good results because the patient would feel more at ease.

For decades Scrimgeour was a close observer of Aboriginal politics, of tribal relationships governed by the importance of “country” and the relationship between Aborigines and what they regard as the outside world.

But he was deliberately on the sidelines in negotiations by Aboriginal-controlled health services employing him, talks at times bridging state boundaries, and dealing with mainstream health services.

Not always easy: During a stint in the Alice Springs hospital Scrimgeour obtained permission to access records of people at Kintore and outstations, his patients.

But “there was a ‘Catch 22’.

“I was told I could photocopy the notes but not use the department’s photocopier  … the only one in the building, nor take notes from the building.

“Such rules were indicative of the less-than-helpful attitude towards Aboriginal-controlled health organisations that existed at some levels within the health department at the time.”

Scrimgeour worked for a string of Aboriginal controlled health services and clearly favours them. Apart from being a doctor he was an advisor, and sometimes a mediator with the non-Indigenous world.

But he was almost never a decision maker, leaving that to the Aboriginal elders.

This extended to decisions such as the exodus from Papunya to set up Kintore and later Kiwirrkurra in WA, just across the NT-WA border, now the home for nationally celebrated artists (photo at bottom).

Scrimgeour is adamant that Aboriginal autonomy is vital. He quotes an elder from Jigalong in the Pilbara, Darren Farmer: “When people go out on country they say, ‘I’m here, I know who I am and I know where I come from, and I’m going to take charge of my life,’ and in doing so, they are dealing with the dysfunctional aspects of their lives and their families’ lives … dealing with the social issues that are going on in town.”

“Homelands” of 150 people are ideal, writes Scrimgeour, on locations of respective traditional belonging – on “their country”.

Scrimgeour doesn’t pull punches in his political critique: “The loss of control associated with the destruction of Aboriginal society and an ongoing denigration of Aboriginal culture is one of the major impacts of settler colonialism on Aboriginal people and their health.”

And: “Aboriginal organisations create opportunities to work within a system that is culturally secure for the clients and is less likely to reproduce the settler-colonial power structures.”

The “neoliberal” Howard government’s concept of “mutual obligation” underpinning welfare reform and Shared Responsibility Agreements made Aboriginal communities dependent on the achievement of goals determined by government, he says.

The book names lots of people, black and white, and locations in some five language group areas including of course Arrernte, Pitjantjatjara, Warlpiri and Pintupi, and organisations operating frequently across state boundaries.

While this is an extensive, diligent and useful record it is sometimes not compelling reading.

There is not a great deal of description of life in remote communities, for example.

Scrimgeour carefully records dreaming tracks and lore signifying country ownership. He respectfully accepts the confidentialities imposed by the story custodians.

The politics underlying health policy is a recurring subject.

“Around the turn of the twenty-first century, coinciding with the developing of neoliberalism, there was another policy shift, heralding a return to policies reminiscent of the so-called assimilation era.

“By then, however, both the homelands movement and the ACCHO [Aboriginal Community Controlled Health Organisations] movement had made significant gains and were able to maintain themselves in a more hostile, or at best ambiguous, policy context.”

Given Scrimgeour’s forays into political commentary, his outstanding knowledge of The Centre, and the catastrophic conditions some communities – and Alice Springs – are finding themselves in, it’s a pity he does not go further with his analysis.

He quotes a study of the Martu people in central WA: “For every dollar that was invested in the [health] program, approximately three dollars of social value was created.”

It would be useful to know how that was calculated.

The economies of homelands are almost entirely dependent on government – taxpayer – expenditure: Housing, water, health, education, welfare, pensions, unemployment benefits – most at a per-capita cost vastly greater than in the regional centres. There is little tax money coming back.

If that were extrapolated to the whole nation it would be bankrupt in the blink of an eye.

The line has to be drawn – but where?

Does it make sense to support a minuscule part of the nation’s population, living in the most remote parts of the country, yet keeping alive a unique and ancient tradition? Almost certainly, yes.

Should that support continue to be extended to people who’ve made it a generations-long career deliberately avoiding work that is available, being a burden on the taxpayer, and pursuing a lifestyle that has spawned a massive care industry?

Maybe there’s another book in that for Dr Scrim.

PHOTO at top: A pump made by the Alice Springs Centre for Appropriate Technology (CAT) in 2014. Below: Paintings by Kiwirrkurra artists in the NSW Art Gallery in 2015.