The remote community of Gunbalanya, located in the Northern Territory’s west Arnhem Land, grapples with significant health care challenges as it awaits a new health clinic. Their current clinic, one of the oldest bush clinics in the region, was built in the mid-20th century. It was originally formed to address a leprosy epidemic. Its old construction, lack of amenities, and basic footprint stand in the way of providing a robust set of health services.
The Gunbalanya health clinic was never designed to operate as a community health centre. In its latest version, it only has one unisex toilet which acts as a significant humanitarian deterrent, pushing patients away from receiving the care they desperately need. Houston Manakgu, a local health support worker, highlights the inadequacies of the facility, stating, “Big mob in there. Maybe we come back later.” He emphasizes the cultural significance of health care in the community, noting that “in Aboriginal culture way, man and female … have to be separate.”
Patients struggle even more with the realities of a clinic’s location. Additionally, the community’s unique kinship systems make accessing care difficult as people now need to contend with ties to “poison cousins.” This phrase describes relatives with whom one should not have close contact. John Paterson, a local health advocate, points to urgent need. In stark terms, he explains how barriers are allowing preventable diseases to worsen into dire medical crises.
The community has been waiting for a new clinic for five years, as many residents hope it will improve their health outcomes. Current life expectancy rates are a shocking reminder of the gap that continues to exist between Indigenous and non-Indigenous Australians. In Gunbalanya, Aboriginal men die at the age of about 65 years. At the same time, women experience a slightly longer life expectancy (an additional 5 years, on average) at 69 years. In the Northern Territory, the gap varies between 8 and 10 for males. For females, it is between 9-11 years.
Australia’s federal government has pledged to close this life expectancy gap by 2031. Yet local leaders are reporting that red tape and other systemic barriers are still blocking their ability to make headway. Marcia Brennan, a community leader and health care advocate, emphasizes the need for awareness of culture’s role in health care provision. “In our community, culture will always be there,” she asserts. Furthermore, she advocates for Aboriginal staff members to lead clinics that serve Indigenous populations, emphasizing that “Aboriginal staff need to be in Aboriginal clinics.”
Even with this obvious need and urgency, funding continues to be an issue. Long-time local politician and activist Brad Palmer was frustrated by the lack of answers around how much money would be allocated to run the new clinic. He stated, “There hasn’t really been any explanation of the reason why it was removed from the budget.” A spokesperson for the NT government admitted even Labor announced a record number of projects. They blasted them for failing to include enough funding to actually carry out those projects.
While the government has not completely excluded fulfilling its election commitment to provide a new health clinic in Gunbalanya, the spokesperson reiterated that still on the table was delivering a new health clinic at Gunbalanya. They haven’t taken it off the table and it still is on the long-term forward program.
One of the pressures on the clinic has been management change from the NT health department to Aboriginal community control. For many advocates, this amendment is a huge improvement in the right direction. Local advocates feel that moving to this kind of shift would make for greater consistency with cultural protocols and community needs. Brennan emphasizes, is a prescription for disaster, especially with the federal government’s reluctance to recognize these advanced protocols at every turn.
Once the rains start Gunbalanya will once again be cut off from access by road. Unfortunately, this isolation creates significant challenges for their residents in accessing timely medical care. The challenges experienced by this isolated community represent systemic inequities across Australia’s healthcare, especially Indigenous communities.
