In the year 2070, the first chroniclers were beginning to record the dimensions of "the Australian problem". Their accounts began in 2020, when the forces from the north landed in strength on Australia's shores, and the country capitulated. The foreigners closed Australia's parliaments, social services, business houses, schools, churches, theatres and sports-fields, transferred all private property to their own immigrant settlers, and permanently relocated the entire Australian population in tent encampments in the arid country areas.
By the time the Australians attracted the interest and concern of the chroniclers, their camps were in dispirited disarray. Ragged and rotting tents scarred the landscape. Although fifty years had passed since their establishment, the camps had none of the water, sewerage, sanitation or garbage-disposal facilities of the towns. The rations, available from distribution points in exchange for work tokens, were polished rice and weekly supplements of vegetables. Inspectors from the Health Ministry were concerned at the prevalence of malnutrition, gastroenteritis, anaemia, leprosy, tuberculosis, parasite infestations and respiratory tract infections. The lifestyle conditions such as diabetes and cardiovascular disease contributed heavily to the premature mortality of the adult population. The babies generally were dying from acute infections.
Emotional illness was widespread. Even the relatively well-balanced Australians — among them former doctors, teachers, managers, tradespeople, politicians and students — passed the days in a depressed malaise, or buoyed up by intoxicants or the transient excitement of games of chance. There was some discussion among the authorities about whether the high suicide rate and psychological disorders were products of the Australian culture or were a post-invasion phenomenon. Most experts favoured a cultural explanation and rejected suggestions that the stresses of camp life might be implicated.
Early on, some camp-dwellers had aspired to lead and organize community improvement campaigns, but lost interest when officials, while giving their blessing, refused to relinquish control of any administrative or political functions. Field officers of the Department of Australian Advancement made many attempts to solicit the co-operation of the Australians in running projects devised by the Ministry for the betterment of the camps. The populace, however, evinced little interest in dog-farming, medicinal-herb cultivation and dry-rice agriculture. The Australians continued to reminisce perversely among themselves about study, books, free enterprise, salaries and job promotion.
The officials were kindly, but bewildered. They regretted the violent excesses of the early days of the invasion, but they could not understand the present recalcitrance of the Australians; their indifference to the government's exhortations to work the fields and improve themselves. Only the children, many of whom had no patience for the memories, values or traditions of their elders, had mastered the new tonal language and its alphabet of characters. Their English-speaking parents seemed either unable or unwilling to master these simple skills themselves. The adults consistently resisted the adoption of the introduced language, culture or agrarian lifestyle. They also undermined official efforts to recruit the young to a new ideology by covertly teaching them Australian history, English literature, writing and arithmetic. Even more troubling was the failure of the people to embrace the state religion, a synthesis of Hindu and Buddhist theologies. Most Australians irrationally retained more primitive Christian or agnostic beliefs and seemed foolishly unconcerned about their own enlightenment.
The spirit of the camps was no less a concern to administrative staff. They deplored the internecine strife among camp segments, and extolled the virtues of co-operation between families, whether or not they had known each other or come from the same social strata before settlement. And they despaired of the propensity of residents to "go wandering" from camp to camp for no apparent reason, or, at best, to join relatives for archaic festivals, which the Australians called "birthdays" and "Christmas". Perhaps the most disruptive force within the camps was the core of people who talked about their former houses, suburbs and jobs, and about "going home". These 'fomenters" were few in number, and so were watchfully left alone. However, the young dissident settlers in the towns who agitated for "home rights" for the Australians were subject to the attentions of security services.
One of the government's greatest concerns was health. The new leaders were discomforted by discussions in the World Assembly about the inferior health status of subject peoples and the frequent references to Australians. They argued strenuously that every effort had been made to promote health, that the infant mortality, rate was now only four times the national average, and that the average life expectancy was only ten to twenty years shorter. Everything that a health service could do had been done — even to training some medical assistants to give out medicines, weigh babies and dress sores. The residual morbidity and mortality, they insisted, was the result of the conditions in the camps, which were not their responsibility, and the deleterious customs of the Australians.
The initiatives of health authorities, the government explained to its overseas critics, were being undermined on several fronts. Illicit bands of doctors and nurses (pre-invasion professions no longer recognized) moved among the tents at night, tending the sick. The patients often failed to come to camp aid stations, where excellent practitioners from the mother country offered medical care. Most people seemed unable to grasp the principles of disease causation, patiently explained (though not in English) by the health educators. They did not, or could not, appreciate the logic of the elemental theory of disease (the bodily balance of earth, fire, air and water) and clung doggedly to a belief in "germs", "public health", "physiological dysfunction" and such mystical entities as "cancer". Indeed, in all ways, the Australians, through ignorance or defiance, thwarted efforts to help them.
It was generally agreed that governments can only help those who will help themselves: until the Australians recognized the manifest benefits of the post-2020 civilization and its medicine, the "Australian problem" would continue to challenge the nation. . .
It has been said that Western medicine's epitaph will be that it was "brilliant in its scientific discoveries, superb in its technological breakthroughs, but woefully inept in its application of knowledge to those most in need". This book is about one of the world's societies most in need: the Australian Aborigines. It explores the social and ecological disjunctions that have eroded their health, the traditional knowledge and resources that supported health and guided healing, and the ways Aborigines are dealing with the changes imposed on them.
Since Europeans colonized Australia, Aboriginal health has been the subject of government inquiries, political rhetoric, learned dissertations and classroom exercises. Assaults on the "Aboriginal health problem" have been directed by health departments, specialist teams, missions and Aboriginal health services. But in Australia of the late twentieth century, as in the apocryphal Australia of the late twenty-first, Aborigines remain the sickest people in Australia — a developing nation within a developed country.
Why? What are the authorities doing wrong? Is it fair to say, as an eminent physician said of one state health department, "If Aborigines were animals, the R.S.P.C.A. would prosecute"? Is health the responsibility of health authorities? If not, who is at fault? The white Australian settlers and their descendants? The Aborigines? Is it, perhaps, true that the Aborigines' diet, their culture and their lifestyle are inimical to good health?....