MEDICUS FEBRUARY 2016

L E T T E R S

IN HIS COMMENT on the AMA Report Card on Aboriginals in custody, WA State President, Michael Gannon, correctly states that the high rates of imprisonment of Aboriginal and Torres Strait Islanders should be a priority health, social justice and human rights issue. ( Medicus, December 2015, p17, Urgent action needed on Indigenous prison rates ). In the early 1970s, I was a GP in the far west of New South Wales. During the years 1971-72, 50 per cent of the Indigenous men and 8.5 per cent of the Indigenous women aged 15 years and over, were arrested and kept in the – always full – local lock-up. Most arrests were for disorderly behaviour when drunk. The resultant magistrate-ordered fines further depleted the already low incomes of Aboriginal families and contributed to the poor nutrition of their children. The Aboriginal Legal Service was, in part, born out of this law and order discrimination against Aborigines in NSW. The Royal Commission into Aboriginal Deaths in Custody in Australia (RCADC) reported, that in 1988, the ratio of Aboriginals to non-Aboriginals in custody was 20:1. The predominant crimes were drunkenness, disorderly behaviour and assault, i.e. fighting. In 2012, the Law Council of Australia reported that one in 52 Aboriginal adults were in prison compared with one in every 775 non-Aboriginals. When a problem has been in urgent need of a solution for four or more decades. it has either been ignored, been too difficult to solve or as in this case, a bit of both. As a GP who does remote area locums, I see the worst of this unchanging, revolving door problem. I do not have any magic solutions.

Neither do the affected Aboriginal families or the long- suffering police, ambulance services, nurses and doctors who are all aware that we run a thankless band-aid service. If there is to be any solution to reducing the Indigenous prison rates, we (Aboriginals and non-Aboriginals) must replace our long-failed punitive methods with innovative and experimental approaches. Lessons can be learned from the successes of drug courts as an alternative to incarceration and family breakdown and through examining other areas of reported success. One example is the empathic approach to young Aboriginal recidivists practised by Antoine Bloemen when he was the resident magistrate in the Kimberley.¹ Political will is also important and well-publicised biennial AMA Report Cards on Aboriginals in custody can help bolster it. Emeritus Professor Max Kamien Retired GP

Reference: 1. Antoine Bloeman. No Regrets, A Bicycle Dreaming from Belgium to Broome.

Wise beyond years

CONGRATULATIONS DR ATTREE ( Medicus December, p52, To advise or not to advise? That is the question... ) on your attitude to enquiries outside your areas of competence or comfort. Wise beyond your years. You have a strong supporter in Bob Dylan. Tell me where it hurts you honey, and I'll tell you who to call. Dr Warwick Ruse Long-gone President, AMA (WA)

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Professor Marcus Atlas, ESIA Director speaking at the 13th International Conference on Cochlear Implants and Other Implantable Auditory Technologies, Munich, Germany, June 2014.

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