We need Aboriginal health in Aboriginal hands — not another Close the Gap report

Despite the best intentions of many, a glaring life-expectancy gap persists between Aboriginal and non-Indigenous people due to the brutal, rapid colonisation that disastrously impacted our way of life. When our lands were invaded, our people were disempowered. Taken from us were our ways of knowing, being and doing; our culture.  

Aboriginal and Torres Strait Islander communities continue to suffer, experiencing disproportionately poorer health and well-being. The 2023 Closing The Gap annual data report found an increase in suicides, families having their children taken, adults being incarcerated, and worsening outcomes in early childhood development. This is completely unacceptable.

Significant barriers continue to prevent communities from presenting to mainstream health services, with the biggest obstacle in recent decades being racism, which it pains me to say is still alive and well within Australian society. 

We saw racism rear its ugly head in the lead-up to and aftermath of the Voice to Parliament referendum, with many Aboriginal people and organisations subjected to vile hate mail and online abuse; myself included.

Then there’s the lack of trust in governments and mainstream service providers, stemming from the atrocities that are the lived experience of many still alive today. My mother, a proud Gunditjmara woman, has had to live with the pain of having six of her children taken from her. To this day, she still carries the guilt and blame for something that was not her fault.

My brothers and sisters lived with this trauma — of being taken from their mother, their family, their community and their culture. As a result, they suffered greatly as adults. Despite experiencing many serious setbacks that severely hindered their well-being, they found it almost impossible to present to health services. They died at a young age, decades before the life expectancy of 81.2 years for non-Indigenous men and 85.3 years for non-Indigenous women.

The solutions are complex, but there is one thing we do know: we don’t need another “Close The Gap” statement of intent. We need action, and most importantly we need Aboriginal health to be put in Aboriginal hands.

The solution lies in the vital work carried out by Aboriginal community-controlled health organisations (ACCHOs), which for over half a century have delivered extraordinary health and well-being outcomes for communities by providing services within an environment and atmosphere where culture is celebrated. Aboriginal people established these organisations, manage the clinics and run the services. They’ve transformed the lives of many and their families. 

ACCHOs understand the importance of the relationship between people and their communities, places, cultures and Country when assessing whether somebody is holistically healthy. They know their communities better than anyone, and by applying 65,000-plus years of Aboriginal knowledge and culture, they remove barriers and help us feel safe and heal.

Unfortunately, many ACCHOs are fighting with one arm tied behind their back, forced to carry out urgent work with insufficient funding. Some are given piecemeal support to stem the tide, but few are being financed to provide the complex and diverse range of care required. Without this support, ACCHOs can’t provide vital prevention support to keep families safe and strong, which leads to better education outcomes and employment prospects, and in turn, helps break cycles of disadvantage.

When Aboriginal health is in Aboriginal hands, the best quality care will be available, but there will of course be times when specialist and critical urgent care is required by the mainstream health system. That is why, alongside greater investment into ACCHOs, we need broader health system reform so that we create culturally safe healthcare experiences for Aboriginal and Torres Strait Islander peoples.

The Victorian Aboriginal Health and Wellbeing Partnership Agreement Action Plan 2023-2025 is a roadmap of initial, urgent steps that must be implemented to progress real change. All levels of government need to ramp up support for Aboriginal organisations so that they aren’t just helping communities survive, but empowering them to thrive.

ACCHOs hold the key to taking meaningful steps toward closing the life expectancy gap, but they can’t do it alone. They must be empowered so they can continue to ensure that the disadvantages that have long held back our people do not define the legacy of the next generation.

It’s too late for my siblings, but there remain many, many people just like them who don’t know where to go and need help. But we know the help that is needed, we know the solutions for change. We just need to invest in them.