them in going to school, help with reading and teaching basic discipline
and values in the culture in which they live.
By the same token a child can influence an adult to live a healthy and happy life with joy shared by each party as the years go by.
In the world of remote living Aboriginal people the children are left in many instances to fend for themselves as the parents pursue a lifestyle that their culture has only just discovered. The parents are still experimenting to see if it stacks up better than the traditional life of looking for food and shelter for the present and not worrying too much about the future. The pleasure of being able to have food readily available at a store or takeaway and the ready availability of alcoholic beverages make it a tempting lifestyle to pursue.
It could be said that there is no greater gift for a child than a healthy parent who lives long enough to see their grandchildren able to carry on the culture of the clan. As some say in the NT – “I want to live long enough towatch my grandson play football”.
In mainstream Australia the life expectancy at birth is one that Third World countries will envy while the Aboriginal person is not sure what this is all about. They never knew when a birth date was to know the meaning of life expectancy. In fact the life expectancy of the remote living Aboriginal is as low as 47 years in many communities. The average that is quoted far and wide is across the entire population that claims to be Aboriginal with the majority of these people living in urban areas. The statistic is correct. It is just that the definition of Aboriginal person casts the net over a far greater cross section of the community than those Aboriginals that are being subjected to the Federal Intervention into Aboriginal Communities in the Northern Territory. In fact only 7% of the Aboriginal population in Australia lives in remote communities in the Northern Territory.
It is necessary, when taking a holistic view of the world of the remote living Aboriginal, to acknowledge that that the children hold a very special place in the demographic. It should be
obvious that with such a low age at death the average age of a population will be lowered and children under the age of say 15 years will comprise a much larger proportion of the total than where the age at death is around 77 years.Aboriginal populations are made up largely of children and therefore attention should be focused on them if the future is to improve.
The influence children can have over their parents in this scenario should not be underestimated. Just like any other culture the child is special as shown through the title of the report - “Little children are sacred”.
It is fair to suggest that if a child learns about healthy lifestyle choices there is every chance this will be passed on to the parent and other family members.
It should also assist the young child understand what choices in education, food, exercise, sleep, happiness and good companionship can have on good health.
Unfortunately the parents of the young children in communities in 2008 have lived their entire life in a community with health status on the decline.
To the parent it is normal for a friend to die at 40 years of age; for a grandparent to have to go on renal dialysis; for a younger brother or sister to have to go to Adelaide for a heart operation; and, for a lot of people to have to go to an alcohol and drug rehabilitation program to withdraw from an addiction.
To the parent born in the last 40 years this is normal and never having experienced good health – bad health becomes normal.
The Federal Intervention is about stabilizing communities (Phase One) and then “normalizing” those (Phase Two) – but what is normal?
The Balanda (white person) view of a normal community is not necessarily the way the Aboriginal person living in 75 locations across the Northern Territory and which are subject to the Federal Intervention wants to live.
The change planning process must come from a close evaluation of the needs as seen by the Aboriginal people themselves – and not just because some Balanda thinks it should happen or try and become a “normal” community like the suburbs of a city. This should go without saying but is being said because it is one principle that the government policy planners have failed to do over the past 40 years.
2008 is the opportunity for the Australian Government to acknowledge that this is the year to start planning with the Aboriginal people a community that meets their values and culture and thus has a distinct “look” of its own. The time has come to stop trying to put these people into little boxes in the same way as Balanda like to live. The often claimed fact that houses are overcrowded implies that the Aboriginal people are at fault because they have too many people in the one house. The real fact is that this is how they want to live as a family unit and the roof was simply not big enough in the first place.
There needs to be model programs established that test a whole host of concepts and beliefs that bring together the wisdom of the Balanda and the vision of the Aboriginal older person who can see the way the decline is affecting their culture.
To take pharmacy as an example and the role pharmacists can play in both public health and primary health care it is possible to build a curriculum that if conveyed to children could have a significant impact on the health of the adult population. It could impact on those suffering from chronic diseases and the ongoing burden of illness due to the environment in which the people are living.
In taking the example of pharmaceutical care it should be possible for children to learn some of the following principles that are inherent in achieving adherence through pharmaceutical management:
1. Understand the condition and what put it there in the first place before starting to look at management through pharmaceutical care. This involves explaining to children through interactive media the common chronic disease states in the community.
2. The use of medicines in managing chronic diseases and the fact that medicines are for sick people 
and if well people take drugs they might get sick.
This poster (left) was drawn by Linda Joshua from Numbulwar during a pharmacy training session for Aboriginal Health Workers at Bachelor Institute. Input to programs by Aboriginal people is essential to success.
- 3. The importance of adherence – sticking to the doctors recommendations for dosing and when to take them. This would also cover the use of Dose Administration Aids and that Websterpaks (or similar) are the lifeline to a healthy life and should not be tampered with by anyone but the person for whom they have been prescribed.
4. The dangers of chemical substances when not used correctly or stored properly.”If its poison you can’t kiss it better” should be the slogan (or similar) to bring the message of safety home to young children.
5. Substance abuse and the problems inherent in drug and alcohol abuse by learning about the effect that these substances, along with cigarettes, have on the health of the individual.
6. Misuse of medicines and the way over use of some medicines can cause seriou
s problems. Emphasis can be given to the need to follow the directions on a pack or label. Paracetamol is the most used drug in communities and overuse of it combined with other liver damaging choices can create an insidious illness of hepatic failure that could easily be put down to simply “not feeling well”.
7. Public health programs through education on subjects such as smoking, nutrition, breast feeding, immunization, sexually transmitted diseases and healthy skin are all ones which a pharmacist can contribute to because of their understanding of the treatment processes.
It is to be hoped that in Stage Two of the Federal Intervention there will be the opportunity for pharmacists to be involved. The record of the health authorities at both State/Territory level and nationally is not great in giving pharmacy a status of much more than a supply agent. The value pharmacists can add to primary and public health education can be finally tested on an exercise such as the NT Intervention into Aboriginal communities.
Ends
