Ideas@TheCentre
Blinding trachoma still plagues Australian outback
Australia has the unenviable distinction of being the only developed country in the world to still have trachoma.
Trachoma is a nasty bacterial eye infection that left untreated can cause a painful form of permanent blindness. The eyelids turn inwards causing the eyelashes to scratch the cornea.
The recent National Indigenous Eye Health Survey found that 60% of remote Indigenous communities have children with trachoma. In some very remote inland communities, almost 23% of the children have trachoma.
The depressing thing about the prevalence of trachoma in Australia is that it is totally preventable. Basic personal hygiene, such as washing faces, can prevent trachoma, and antibiotics can treat active infection.
Trachoma disappeared from mainstream Australia more than 100 years ago. Blinding, endemic trachoma now only occurs in areas with poor personal and family hygiene and is linked to a lack of hot water, the absence of toilets, flies, overcrowding, and poverty in general. It is a Third-World disease and should not occur in a country as wealthy as Australia.
That it does speaks volumes about the state of dysfunction in remote communities and the health care delivered to them. Over the years, numerous government programs have tried to combat trachoma and other infectious diseases in Indigenous communities. But, while rates of trachoma and blindness have fallen nationally, these programs have failed to make a difference in some outback communities.
Thirty years of welfare dependency have infantilised these communities to such a degree that they no longer take personal responsibility for their own hygiene. Government programs cannot be expected to work when people are too apathetic to wash their own faces! What’s more, programs promoting basic hygiene practices have rarely worked because they don’t address the underlying causes.
As far back as 1987, a study identified a range of healthy ‘living practices’ and the ‘health hardware’ such as hot water, sinks and showers needed to carry out these practices. But many houses in Indigenous communities don’t have functioning ‘health hardware,’ and water and sewerage systems frequently break down.
The latest government initiative to build new houses and address overcrowding in Northern Territory Indigenous communities has wasted millions of dollars of taxpayers’ money on bureaucracy and to date not one house has been built.
The World Health Organization has set a goal of eliminating blinding trachoma by 2020. If Australia is to meet this target, it cannot continue to throw money into a black hole. The National Indigenous Eye Health Survey has shown where incidents of trachoma are highest. Government should be responsible for providing health care and proper infrastructure, such as water and sewerage systems to these communities. Residents also need to also take responsibility for their own personal hygiene. It is a paradox, but someone needs to teach them to be independent. Perhaps it is time for government to step back and let someone else take over this role, as clearly it has failed.
Sara Hudson is a Policy Analyst with the Indigenous Affairs Research Program at The Centre for Independent Studies.
