Australian Doctor Australian Doctor 7th July 2017 | Page 32

Guest Views

OPINION

DR EMIL DJACIK

My time with the NT intervention

It’ s 10 years since the notorious NT emergency intervention to tackle supposed child sexual abuse and neglect in Aboriginal communities. Tasmanian GP Dr Emil Djacik, part of the first team sent in to carry out health checks, looks back on his experience.

WE went into Hermannsburg, about two hours west of Alice Springs.

The team included myself as a GP and three nurses, two of whom had worked in Aboriginal health, as well as a range of government minders and logistics support from the army.

I remember the Monday morning we set off, getting a phone call from [ then health minister ] Tony Abbott, wishing me good luck.

We arrived in a couple of four-wheel drives and set up a tent behind the health centre.

The people in the town had probably had less than 48 hours’ notice that we were coming, as there had been a last-minute change of plan over which community we were going to.

They were quite reasonably fearful as to what this all meant. In fact a lot of people had already left town.

They thought we were looking for child abuse and feared we might take away their children.

But in fact we were just there to undertake some pretty routine health checks on children aged under 10— and to do an audit of healthcare in that age group.

Despite the media reports at the time, none of our work was focused around any issue such as abuse— physical, sexual or psychological.

It wasn’ t just the local people who were fearful. No real discussion had gone on with the existing nursing team there.

They were feeling aggrieved that this external body was being forced on them— and wondering what it meant for them, their services and patient care.

We were also treading on the toes of the Centre for Remote Health at Alice Springs. It looked like we were interfering with their own knitting.

Although we had quickly set up our consulting room to do the standard health checks, a check I think all children in Australia deserve, it was pretty clear by day two that patients weren’ t going to turn up.

The community needed to be shown respect— and

PHOTO: Chris Crerar / Newspix

Dr Emil Djakic briefs young mothers and children before their health checks, in Hermannsburg, in July 2007.

that was the big thing that was missing.

After all, in healthcare, respect is crucial, whether you are dealing with communities like my practice in Ulverstone in Tasmania, Box Hill in Melbourne or the desert. So I set out to find and talk to the significant elders at Hermannsburg.

I remember having a very important conversation with a respected female elder, who put her questions to me about what was going on.

I basically stood outdoors— in her space— and apologised to her very directly for how it had been done. And I remember a very clear moment of her looking at me and simply saying“ thank you”.

Late that afternoon, she came in with two young children from her family and we went through the process— which was just checks of weight, height, heart, chest, eyes and ears and so on.

In the end, once we got moving, we managed to see 107 kids in the space of two weeks. We think there may have been about 250 children in the community in all.

I’ d previously worked for 15 months in the Kimberley, so I wasn’ t shocked about what we found.

But my most vivid memory was of the discrimination against remote and rural places. Hermannsburg is a beautiful place.

I remember doing a morning interview with a Sydneybased radio presenter who said:“ Well here you are in Hermannsburg. It’ s early in the morning— so it’ s all full of dirt and rubbish isn’ t it?”

I said,“ Excuse me. I wish you were here right now. I’ m looking at the sunrise on the MacDonnell Ranges. I’ ve got beautiful colours in front of me. I’ m working with wonderful people in a community that absolutely love passionately the area that they live in. I really think you need to do yourself a favour and get out of your office.”

The biggest need we had was for information systems, a way of tracking and supporting patients.

Some patients had already been screened and their health issues had been identified, with referrals into Alice Springs.

But they hadn’ t gone to their appointments and they hadn’ t been followed-up.

I want to stress that the community clinic there was doing a fabulous job, but like all those communities, the staff were working under real difficulties.

They ran early morning walks to promote health. I remember walking along in the beautiful early morning light with an Aboriginal man— and he was a very big guy.

He said to me:“ I’ ve been doing this walking for six months now and I’ ve lost so much weight.” He’ d lost 60kg already.

The penny dropped— here in a community that we think is so disadvantaged there was a passionate group of people doing good stuff and getting the outcomes.

All they needed was better support, with information systems to ensure disease tracking could occur.

I’ ve never regretted taking part in the intervention. I felt it was a very worthy thing to do.

From a healthcare point of view, it really represented an independent audit for those kids. And there was a positive impact on the lives of some individual children as a result of the intervention. I remember one youngster who looked perfectly healthy and happy aged about nine months whose haemoglobin was about 40g / L, and who was clearly heading for disaster.

Looking back today, I think we really need to promote ways of getting more healthcare professionals to work and experience life in remote Australia.

There should be some system that facilitates urban doctors and nurses doing a fortnight a year in remote areas.

I think all children in Australia need to have a health system that is looking out for them. ●

Dr Djacik spoke with Clare Pain.

I’ VE NEVER REGRETTED TAKING PART IN THE INTERVENTION. I FELT IT WAS A VERY WORTHY THING TO DO.

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