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A doctor from Far North Queensland in northern Australia is pleading with the government for coronavirus assistance in Indigenous communities, including basic masks and isolation facilities, in order to avoid hundreds of deaths.
Indigenous Australians have been told they are extremely vulnerable to Covid-19 due to underlying health issues such as diabetes, rheumatic heart disease and kidney disease, conditions they’ve been forced to battle since colonisation.
The Aboriginal community of Yarrabah is not only dealing with the shock of a government-enforced lockdown but is also grappling with the potential reality of what will happen if the virus reaches the town, just 45 minutes from the tropical North Queensland city of Cairns.
“If we don’t get to this, for a community like Yarrabah, that could be deaths in hundreds, and we need to avoid that at all costs,” Yarrabah Senior Medical Officer Dr Jason King told HuffPost Australia.
After weeks of hearing pleas from Indigenous groups, Prime Minister Scott Morrison used powers under the Biosecurity Act to give states and territories across Australia authority to restrict entry into Indigenous communities as of last Friday, a move welcomed by the National Aboriginal Community Controlled Health Organisation (NACCHO).
But doctors on the ground stress that there is still a lot of work to be done to protect Indigenous communities.
Without better government resources to facilitate proper self-isolation, Dr King, who is a Yued/Whadjuk Noongar man from Western Australia, warned the worst-case scenario for Indigenous people over 50 years old in remote communities during this pandemic is “poor outcomes, hospitalisation and mortality.”
“We have 3,500 people living in Yarrabah,” he said. “We have 580 people in the high-risk group, and the government projections of infection rates are around 25%, which I think is a conservative estimate for a place as overcrowded as Yarrabah.
“This means that we’re looking at about 750 patients infected with this.”
NACCHO CEO Pat Turning told ABC’s The Drum on Monday, “The minute COVID hits, the elders will be the first to go ― it’s highly unlikely there’ll be the health resources to save them.”
Health practitioners in Yarrabah have been transparent with community members and have started engaging residents about advanced life planning.
“The elders will be the first to go – it's highly unlikely there'll be the health resources to save them.”
“To tell people, ’Look, if this hits you, you’re not going to have a good outcome so you need to think about what to do in the situation and think about the possibility you might not get to a ventilator and survive that process,” he said, it’s “heartbreaking” to have such a conversation in what is meant to be a first-world country.
“We’re working hard to close those gaps and extend peoples’ lives and their quality of life, and now we’re in a situation where even if they are doing well, with their comorbidities, they’re going to be in a situation where this illness could put them at risk of needing to come to a palliative approach to life,” he said.
As the coronavirus threatens vulnerable Indigenous communities, it also has the potential to rob Aboriginal and Torres Strait Islander people of their cultural practices, such as Sorry Business.
When someone dies in a community, it’s not just the immediate family that comes together to mourn and share their sorrow, it’s the whole community. The process is called Sorry Business.
“Indigenous people don’t like to die in hospital if they have traditional values and beliefs,” an Indigenous palliative care social worker told HuffPost Australia.
The Far North Queensland social worker, who asked to remain anonymous, explained Indigenous people prefer to be “on country” during their end of life phase, and “the expectation is that the family will want to look after them at their own home and the patient would want to die at home.”
Health workers say that will not be able to happen with this virus.
“There’d usually be a lot of people milling around for Sorry Business, looking after each other and bringing food and comfort, but if a person dies from this virus, the Sorry Business is going to have to stop.”
It’s an issue concerning Dr King and his team.
“We’re deep in discussions with individuals about ‘How do you carry out Sorry Business for a person that has passed when that process could spread the virus further in the community?’” he said.
Lack Of Resources
Though Gurriny Health, the Aboriginal Community Controlled health service in Yarrabah, is doing its best to educate the community, Dr King said a disconnect between state and federal governments, dwindling resources and the spread of misinformation are raising tensions.
“We have enough PPE (personal protective equipment) to get through another seven days of testing people here, after which we’ll run out,” he explained.
“I hear every week there are so many million more masks arriving. I would love for some of those masks to reach us.”
Although Gurriny Health had 50 masks as of Monday, Dr King stressed frontline health care workers in communities are in dire need of “full gowns, face shields and gloves” in order to keep medical staff healthy so they can continue to protect those high-risk members in the community.
“Without frontline health care workers, this is a wildfire that will rip through society,” he said.
But there’s not just a shortage of medical equipment. Since the lockdown at midnight last Thursday, police patrolling Yarrabah’s borders have turned away food trucks because individual drivers were not “on the list.”
But the main challenge in Yarrabah is self-isolating individuals when overcrowding is common.
“We have 10 people to a house on average here,” Dr King said.
“We’re calling on governments and health departments to come to the party in terms of giving us that ability by supporting isolation centers which require a lot of logistics and resourcing support.”
Dr King also called out Scott Morrison’s current strategy of placing Australians arriving from overseas in mandatory quarantine in five-star hotels.
“We live 45 minutes from a city with 150,000 people with thousands of hotels that are now empty,” he said.
“Our people need to have access to the same provisions as people who’ve returned from their international holiday or cruise ship or a private jet or politicians or these sorts of people who’ve been given the opportunity to isolate in five-star hotels.”
NACCHO Deputy CEO Dawn Casey told HuffPost Australia some mining companies in Western Australia have offered vacant camps to help with isolation.
Since the government opened up Covid-19 testing for Aboriginal and Torres Strait Islander people, Dr King has been testing eight to 12 people a day but is still worried Indigenous Australians in remote areas will be bottom of the chain when it comes to receiving appropriate care.
“If we don’t flatten the curve in the rest of Australia, those communities with the most disadvantage, that are most remote, those who are most likely to have the poorest outcomes from this, are going to come late to the game,” he said.
“The severe cases for them will come when all the ICU beds are already full and ventilators are taken up by somebody else.
“There will simply be a decision to say to people, ’Even if you are sick enough for a ventilator, and you would survive it, we just don’t have those facilities available to you.’”
Dr King has two messages amid this pandemic: “Protect your mob” and “We need assistance ― that’s what we’re calling for now.”