The future of successful settlement and development in Northern Australia is entirely dependent upon the control of certain tropical diseases endemic or likely to become endemic in the tropical environment.
Prevailing environmental conditions will make the control of tropical disease difficult even in an enlightened white population. The existence of a substantial section of the population living at a low standard and unaware of or disregarding the personal responsibilities of the individual in the prevention of transmission, will make successful control impossible unless there exist special powers applicable to this class of individual. Whilst these powers may at times be required to be exercised in respect of certain individuals of white and coloured alien race, their general application to the native population as at present constituted, will be inescapable for some years to come.
Admitting that it is the aspiration and policy of the Commonwealth that natives, whether full blood of part aboriginal, shall enjoy full citizenship rights, it must be realised that the granting of this status to the generality at its present level of social and hygiene consciousness is inconsistent with the medical security of the whole population. Choice must be made between:
- sacrificing present and future settlement to an enduring and economically crippling incidence of endemic disease, and
- postponing attainment of the objective until backward people have attained a level of community consciousness and responsibility permitting uniformly successful application of measures of preventive medicine based upon enlightened and active individual cooperation.
Environment in extensive areas of the north is ideal for the intense endemicity of certain tropical diseases which may completely defeat attempts at settlement or so impair community health that the population survives only as a chronically ill, inefficient and economically dependent group serving as a focus of infection for other parts of Australia.
To avert this development the health authority must be assured of power whether exercised by itself or through another authority –
- to limit migration of the infected and possibly infected native.
- to prohibit movement into or out of certain areas,
- to conduct mass examinations and
- to undertake mass therapy and
- to control the conditions under which natives live and work.
- Migration:
In earlier years the reluctance of natives to cross the limits of the tribal area established an efficient inter-tribal quarantine which was invaluable to the health authority in limiting the dissemination of communicable disease.
In recent years the fear of entering other tribal country has largely been dissipated and it is common even for natives of the Aranda area to visit the Gulf of Carpentaria, Darwin or the Kimberleys and vice versa. Natives from the Liverpool River area and north east of Arnhem Land frequently make the journey to Darwin and the North South Road. The risk of dissemination of malaria, hook worm and other endemic disease involved in this migration is apparent and the dangers are accentuated by reason of the impossibility of providing effectual control measures at all times and places along the line of route.
The prevention of mass migration such as that involved in the movement of Arnhem Land natives is admittedly beset with considerable difficulty but another form of migration not less dangerous epidemiologically could be readily controlled. This is the movement of natives in employment or their transfer from locality to locality by the Department of Welfare. Attention has previously been drawn to the introduction of hook worm to the Hookers Creek Inverway Limbunya area following the official transfer of two infected natives from Darwin to Hookers Creek when that settlement was opened. The health authority must require from the Welfare Department an assurance that no native will be transferred from one district to another without prior medical check. This requirement has been the subject of agreement at previous conferences but does not appear to have been implemented. Restriction of movement of natives in employment can be readily applied by requiring the employer to enter into a reconnaissance before any native is moved and having the native medically examined before movement and after his return.
- Prohibited area:
The control of malaria in certain situations for example open cut mine fields, rice fields etc., will be beset with extreme difficulty if it is permitted to depend entirely upon mosquito control. However, before malaria can become established it will be necessary in most localities for the parasite to be introduced in communicable form. Prior medical examination to eliminate carriers can be readily effected where the introduction of labour whether white or native to a particular area is organised with this object in view. However, it will be impossible to prevent the introduction of parasites by infected natives on walkabout if these are permitted to enter the vicinity of the mine field and to remain there. It must be an integral part of any scheme for malaria control in the north that certain areas which it is desired to protect shall be prohibited to natives except those submitted to a prior examination and certified as fit to enter the area. This will involve the proclamation of prohibited areas and enforcement of the prohibited area clauses of the ordinance and regulations. There has recently been a tendency to relax this method of control.
The control of malaria in towns such as Katherine will involve exclusion of infected persons or possibly infected persons from the town area and its vicinity during the hours of darkness when mosquitos are feeding. It may become necessary to proclaim certain towns in certain areas of white settlement prohibited areas so that natives other than those submitted to medical check may be excluded from them or promptly apprehended and removed should they enter them.
The emotional argument that natives should be free to travel at will throughout their own country is specious. The areas concerned in this discussion are not within the tribal country of the bulk of natives now invading them. These natives have always avoided them out of fear of the local inhabitants or have visited and traversed them only with the concurrence of the local people. It is fortuitous that the local people are now white. The areas moreover are no longer “native country”. They have become centres of white population and civilised development, are built over and have no feature attractive to the native living at tribal standard or warranting his entering the area for traditional purposes. If it is desired that he should be permitted to enter and remain over-night for other purposes, his doing so should be contingent upon his prior medical examination and subsequent medical review. In principle this requirement is not inconsistent with the restrictions placed upon his movements by tribal custom before the advent of the white man.