Reprinted from The Medical Journal of Australia, April 30, 1949, page 569, read at a meeting of the Section of Public Health, Tuberculosis and tropical Medicine, Australasian Medical Congress (British Medical Association) Sixth Session, Perth, August 1948
By C.E. Cook, M.D., D.P.H., D.T.M. and H.,
Commissioner of Public Health, Western Australia
The importance of the Australian aboriginal and his descendants in the white Australian community is not sufficiently appreciated, even by those who purport to concern themselves with his welfare.
The pernicious influences which the coloured races exercise upon the hygienic, social and economic development of areas where white settlement is sparse, and upon the public health where hybrid remnants concentrate in the poorer quarters of cities or on the fringes of country towns, continue for the most part unsuspected. Amongst the public only a few ill-informed and unenlightened enthusiasts concern themselves with the native welfare, and their endeavours are chiefly directed consciously, or unintentionally, to minimizing his contact with the white race and to shielding him in an artificial environment during his formative years and from the influences of white civilization, beneficial and destructive alike.
This irrational and unpractical policy has, moreover, largely influenced the legislation of governments and the routine administration of native protection departments. Current protection policies tend to repress or shelter the native, not to adapt him to white civilization. The effect is for him to undergo evolution more or less in seclusion, with the ultimate production of a type unadapted to spontaneous integration into white society. Because these repressive or sheltering measures cannot be sustained throughout his life, or because they fail, he is sooner or later released into the community entirely unprepared psychologically, socially and economically to withstand the impact of the change.
In the present undeveloped condition of this State’s sparely populated tropical areas, where the white population is not predominant and where the conditions of is existence approximate to the primitive, there is a real danger that the ultimate product of community evolution will more nearly resemble the uncultured coloured component than the more civilized white. Evidence is not lacking that northern communities have already travelled some distance along this road.
Over the narrow strip of country north of the Tropic of Capricorn and extending from Exmouth Gulf to Wyndham, the population at last census totalled less than 5000, inclusive of hybrids and Asiatics, but exclusive of full-blood aborigines. The aboriginal population for the area was estimated at approximately 18,000. Differential figures for population and vital statistics in respect of racial components are not at present accessible, but it is important to realize that the proportion of coloured persons in what purports to be the white population is great, and that there is good reason to believe that the natural increase of the coloured races is far in excess of that of the white.
As long ago as 1932 an analysis of vital statistics in the Northern Territory revealed the disturbing fact that, whilst the natural increase among whites in that year was 0.3 per thousand, the natural increase of half-castes was 16.2 – some 50 times greater. The following comments made at that time on these figures are probably equally true today:
The figures reflect a serious position in that:
(a) Increase in the white population must be by immigration.
(b) The half-castes already approximating in number one-third of the European population, show a very high natural increase, a feature which presages a colour problem of the first magnitude. A very high birth rate is featured by other coloured races. Were figures available permitting the collation of births to females of child-bearing age, they would reveal a prolific fertility.
In order the better to understand the public health problem confronting us, it would be well briefly to survey the factors involved in it, as they relate to the conflict of two incompatible civilizations.
In his native state the Australian aboriginal was migratory, moving over a wide terrain in small groups, never establishing a permanent settlement, practising no husbandry or cultivation, but living exclusively upon the products of the hunt and the bush vegetation. It is probable that before the entry of the European to his country, he was practically free from infectious disease as we know it. The effectual measure of quarantine inherent in his natural mode of life would tend towards the elimination of the more acute air-borne infections and his habitual nudity made a valuable contribution towards his protection from those parasitic insects which have common vectors of disease amongst clothed white races. His migratory habit in tiny bands from water to water in a country subject to extremes of flood and drought – his total abstention from community life and impermanency of his camp sites, one must suppose, would have minimized to the point of ultimate complete elimination those acute disease of bowel-borne epidemiology which have so long harassed the white races. The latter, living in permanent closely settled and insanitary communities, has been over the centuries under the necessity of evolving measures to eliminate the epidemiological risks inherent in the concentration of masses of human wastes in the community and in the vicinity of its water supply.
Free from the scourge of epidemic disease, the native civilization evolved without any organization or religious or social sanction directed towards epidemic control, and one would expect – as indeed the white invader found – the native to be completely ignorant of the aetiology of infectious disease, quite devoid of any knowledge of the importance of sanitary prophylaxis and secure from infection, notwithstanding habitual breaches of the elementary principles of sanitation as we know them.
The intrusion of organized white settlement into such an unprotected community must inevitably introduce a number of major problems in hygiene for both races, and it is an unfortunate fact these problems have not been effectively met by either race.
The invasion of tribal hunting grounds and camping waters by the white man’s livestock necessitated the concentration of natives, as far as possible, near the homestead where they would not disturb the cattle. The economic demand for labour for the white man removed in great measure the more efficient hunters from the clan, leaving the aged and the young with a feeding problem which drove them to the vicinity of white settlement, there to supplement the now meagre native diet with European food. This was more or less liberally afforded them by the white intruder, as an encouragement to them to cease the migration which disturbed and impoverished his livestock, to remove the temptation to kill his cattle as a source of meat supply, and to remain readily available as a source of free labour about the settlement.
Aping the white men, these natives concentrated near white settlement and began to live in semi-permanent and permanent shelters, rather than behind the brush windbreaks of their forebears. Inadequate material being available for these, they evolved from scrap iron, timber, textiles or brush, and in them the natives and their dogs herded under conditions of gross overcrowding with fires to keep them warm. Air-borne disease introduced by carriers in the white population became a prolific source of acute and chronic disease amongst them.
Simultaneously natives acquired the habit of using clothing, usually that discarded as unserviceable by the white settlers. This clothing was worn with entire disregard for cleanliness or for climatic conditions, and without any appreciation of the conventional purpose of any particular garment.
The necessity of relying largely upon the bounty of the white settler resulted in serious disturbance in the quality and balance of the daily ration. Ration issues from the store were usually limited to meat, flour, tea and sugar, which assuaged hunger sufficiently to induce the recipient to neglect supplementing his diet with that native game and vegetable food necessary to assure him an adequate intake of protective vitamins.
Perhaps, however, the most serious consequence of this new and unfamiliar community life both to the native and to the white, was the gross insanitation of the camps. No provision was made for the safe disposal of food wastes and the accumulated filth bred swarms of flies. No control was exercised upon the disposal of human excreta, which, according to the natives’ usual practice, were deposited promiscuously throughout the camp and in its immediate vicinity. No measure was taken for the protection of water supplies, and as camps were inevitably sited in close proximity to the water, preferably in the beds of rivers and creeks where they were sheltered from the wind, the pollution of permanent and temporary water supplies became universal.
These conditions in most areas continue unimproved today, and, in fact, constitute the usual environment in which the white race and the black live together, not only in Australia’s sparsely populated tropics, but also where migratory hybrid families live on the outskirts of towns in the more densely settled temperate areas. In effect, therefore, a race wholly unadapted to community life has been brought more or less abruptly to live in communities, and the white agents in this social revolution appear to have been completely unaware of the epidemiological dangers involved, either to the natives or to themselves.
No effort whatever has been made to train the native in the obligations and necessary safeguards of community life. The incompatibility of the new environment with his own social training and experience has been overlooked, and he has been admitted to the white community wholly unadapted for integration into it. His inevitable failure to achieve and maintain a reasonably high standard of living in the abnormal environment into which he has been thrust without any preparation has resulted in his segregation by the community for its own protection, so that the influences obstructing integration continue unchecked.
The interbreeding of the native with other coloured races and with the white race, and the further process of interbreeding between these hybrids, has now aggravated this serious social problem.
It is inevitable that this mixed population, lacking as it does a stable social structure, and living under conditions of squalor and insanitation, should be exposed to a high incidence of communicable disease. From the public health standpoint the most important of these include leprosy, hookworm, amoebiasis, malaria and tuberculosis.
Leprosy
A quarter of century ago there was no leprosy problem in this State’s Kimberley division. Today the estimated incidence in the native population there is 1 in 50, with no sign of abatement notwithstanding efforts at rigorous control. The employment of natives in white households in intimate domestic contact with children having contact elsewhere with children of European stock, create a situation threatening the wide dissemination of leprosy from the coloured to the white race and imperil the security of the white population.
Hookworm
In 1928 hookworm was reported in the Beagle Bay area. Ineffectual methods of control since applied sporadically have failed to affect its incidence. This disease is now established as endemic in suitable foci of the Kimberleys, and unless eliminated will continue to be a lasting threat to the population of these areas by virile white people.
Recent reports on the sanitation of infected areas indicate deplorable conditions of neglect of the first principles of hygiene and the existence of practices eminently suited to wide dissemination of infection.
Amoebiasis.
The incident of amoebiasis amongst ex-prisoners of war and amongst immigrants from central Europe provides a nidus for the infection of native races. The grossly insanitary practices of the latter, more particularly in respect of nightsoil disposal and the infection of water supplies , threaten a wide dissemination of amoebic infection through both the coloured and the white populations.
Malaria.
The heavy and extensive breeding of vectors of malaria characteristic of the late wet and early dry seasons in the north, periodically sets the stage for epidemics of malaria.
From time to time introduction of the subtertian parasite has produced serious epidemics of high fatality. In 1934 such an epidemic had killed sixteen of the meagre white population of the Fitzroy Basin and not less than 150 natives before it was realized that the condition was not influenza.
Tuberculosis.
Tuberculosis, introduced by European and Asiatic immigrants, has now involved the native population. Its extent has not yet been ascertained, but it must be expected to spread rapidly and extensively through the coloured community, which will in turn serve as a reservoir for its further dissemination to the white population of the future.
Other Diseases.
The people of the Commonwealth are now also confronted with the real danger that smallpox, typhus, cholera and yellow fever may, owing to the disruption of health services in adjacent parts of Asia, and to the increased rapidity of modern air transport, be introduced to the north by aircraft at any time. The conditions existing there are such as to favour the uncontrollable dissemination of these quarantinable diseases should they be introduced, and their ultimate extension to the rest of Australia would then be an imminent probability.
The Problem.
Clearly the adaptation of the native to community life and his successful integration into the white social structure are public health problems of the first importance. Indeed, no department of government administration is more vitally affected than that of public health by the nation’s failure successfully to orientate the native component into its general population. Nor is any more suitably equipped for attempting the solution of the problems arising from this failure.
Measures necessary for meeting the problem include the following: (i) Education of the native in citizenship, with particular emphasis upon the eradication of his background of hygienic irresponsibility and substitution of a consciousness of community obligation. (ii) Education of the white community in its responsibility and obligations to the native and in the necessity for his social integration. (iii) Provision for the hygienic housing of natives in local authority areas. Suitably designed and sited dwellings, provided with adequate and safe water supply, sanitation and where available electric light and power, should be provided in country towns for the accommodation of native families at present living on the fringes of townships under substandard conditions. (iv) Particular requirements for the north: (a) an adequate health organization, including medical officers of health and qualified health inspectors; (b) adequate and safe reticulated supplied of potable water in all settled communities; (c) installations for the efficient bacteriolytic sewage treatment of nightsoil in townships; (d) complete cleansing of all centres of population and their environs, and the development of efficient systems of waste disposal; (e) demolition of substandard dwellings and their replacement by suitable living accommodation; (f) the clothing of the health authority with all legal powers in respect of the native necessary to permit control of the conditions of the employment and of the standards of housing, sanitation, diet, medical care and education to be maintained in institutions and elsewhere.
The cost of the necessary organization and associated public works would not be light, and it is to be expected that, there being no loud popular clamour for it, the expenditure involved would be unwelcome item on a State or Federal budget. Until a considerable body of public opinion realizes that the native population constitutes an increasingly serious menace to the health and add to the social security of the Commonwealth at large, it is unlikely that any effective effort will be made to meet the problem.
Perhaps the danger from quarantinable disease will be regarded as remote, or assurance will be derived from the reflection that the quarantine service has excluded these in the past and may be trusted to succeed in doing so indefinitely in the future.
Perhaps the incidence of endemic disease amongst natives and the white communities with whom they live may be dismissed by Australians at large, who do not at the moment share the risk, as a matter of relative unimportance. If these public health considerations carry no weight, there is yet a social danger of no little magnitude which may stimulate Australia’s complacent population to action.
Uneducated, bewildered, without any tangible point of contact with white citizenship and with no stable foothold in the social structure, psychologically unequipped for community life and outcast from white society, the native hybrid must remain a ready prey to agitators and a receptive field for subversive ideologies. His rapidly increasing numbers promise that he will shortly dominate the population in substantial areas of this continent, and at a time when it is considered expedient to provide for defence against invasion from Asia, neglect of this social and military problem within our lines can be viewed only as crass stupidity.