Remote Australia Online

OBJECTIVE: To evaluate the costs and health outcomes associated with primary care use by Indigenous people with diabetes in remote communities in the Northern Territory. DESIGN, SETTING AND PARTICIPANTS: A population-based retrospective cohort study from 1 January 2002 to 31 December 2011 among Indigenous NT residents ≥ 15 years of age with diabetes who attended one of five hospitals or 54 remote clinics in the NT. MAIN OUTCOME MEASURES: Hospitalisations, potentially avoidable hospitalisations (PAH), mortality and years of life lost (YLL). Variables included disease stage (new, established or complicated cases) and primary care use (low, medium or high). RESULTS: 14 184 patients were eligible for inclusion in the study. Compared with the low primary care use group, the medium-use group (patients who used primary care 2-11 times annually) had lower rates of hospitalisation, lower PAH, lower death rates and fewer YLL. Among complicated cases, this group showed a significantly lower mean annual hospitalisation rate (1.2 v 6.7 per person [P < 0.001]) and PAH rate (0.72 v 3.64 per person [P < 0.001]). Death rate and YLL were also significantly lower (1.25 v 3.77 per 100 population [P < 0.001] and 0.29 v 1.14 per person-year [P < 0.001], respectively). The cost of preventing one hospitalisation for diabetes was $248 for those in the medium-use group and $739 for those in the high-use group. This compares to $2915, the average cost of one hospitalisation. CONCLUSION: Improving access to primary care in remote communities for the management of diabetes results in net health benefits to patients and cost savings to government.

Objectives: To assess the cost, cost differential and affordability of current and recommended (healthy, equitable, culturally acceptable and more sustainable) diets in the Torres Strait Islands and compare with other Queensland locations. Methods: The Aboriginal and Torres Strait Islander Healthy Diets ASAP (Australian Standardised Affordability and Pricing) methods protocol was applied in five randomly selected communities in the Torres Strait Islands. Results: The current diet was 32% more expensive than that recommended; ?discretionary? foods comprised 64% of the current diet cost. Families could save at least A$281.38 a fortnight by switching to recommended diets. However, these cost 35-40% more than elsewhere in Queensland. Recommended diets would cost 35% of median and 48% of welfare household income in the Torres Straits. Conclusions: While less expensive than the current diet, recommended diets are unaffordable for most households. Consequently, many Torres Strait Islander families are at high risk of food insecurity and diet-related disease. Implications for public health: Urgent policy action is required to further lower the relative price of recommended diets, and also increase household incomes and welfare supplements to equitably improve food security and diet-related health, and contribute to environmental sustainability in the Torres Strait Islands.

A syphilis outbreak among Australian Aboriginal and Torres Strait Islander people (respectfully referred to as Aboriginal) has resulted in almost 4000 notifications by 2020, with several congenital syphilis cases and infant deaths. Outbreak control efforts became coordinated under a National enhanced test and treat response in 2017. We evaluated the impact of these efforts and of expansion of testing interventions on syphilis prevalence.We developed an individual-based mathematical model of infectious syphilis transmission among young heterosexual Aboriginal people aged 15-34 years living in and move between regional and remote areas with which we assessed the impact of existing and hypothetical outbreak control responses on syphilis prevalence.The increased testing coverage achieved through the response (from 18% to 39% over 2011-2020) could stabilize the epidemic from 2021. To return to pre-outbreak prevalence (<0.24%) by 2025, testing coverage must reach 60%. The addition of annual community-wide screening, where 30% of youth in communities are tested over 6 weeks, would reduce prevalence to the pre-outbreak level within four years. If testing coverage had been scaled-up to 60% at the start of outbreak in mid-2011, the outbreak would have been mitigated.Our results suggest that to control the syphilis outbreak the response needs to be delivered to enable the maximum coverage of testing to be reached in the shortest time in order to reduce the prevalence to pre-outbreak levels. Reduction could be hastened with community-wide screening at similar time periods across all communities together with increases in annual testing coverage.

The concept of policy 'success' has been subject to much contestation. In the Indigenous higher education setting, Indigenous (and non-Indigenous) scholars have brought attention to the relevance of experiential knowledge to understanding the effects of power and race on policy, including how success is theorised. This paper aims to interrogate the notion of policy success by exploring how Indigenous users of higher education policy in the Northern Territory (NT), Australia, conceive the term 'success'. We conducted semi-structured interviews with twelve (n = 12) Indigenous people with expertise in NT Indigenous higher education policy. Our findings highlight that while some of our participant?s conceptions of policy success align to those within current policy frameworks, there are also differences due to power and race relations. We reflect on the impact on policy outcomes, and discuss how a critical understanding of such relations can advance Indigenous higher education policy in the NT.

This paper proposes a multi-size Split-diesel generator (Split-DG) model with three different sizes of DGs and more switching configurations compared to the existing split-DG models. The proposed multi-size Split-DG system is examined for optimal sizing of remote microgrids with and without renewable-battery system. As a novel concept, multi-size Split-DG is used to reduce contamination, cost, and dumped power by using multiple small DGs to replace the single-size large DG. As another contribution of this study, a practical model is developed by considering the capacity degradation of components, spinning reserve, as well as DG’s and fuel tank’s constraints. The optimization problem is solved using a variable weighting particle swarm optimization (VW-PSO) algorithm. The effectiveness of the proposed Split-DG systems, optimized by the developed VW-PSO, is verified by comparing the results with conventional single-size DG system and the system optimized by conventional PSO. While the formulated optimization problem is general and can be used for any remote microgrids, an aboriginal community in South Australia is examined in this study. For this purpose, realistic data of load and weather, as well as technical and economic data of components, are used. It is found that the Split-DG-PV-WT-BES system has the lowest electricity cost compared to the systems without BES, or without PV and WT.

The Malkumba-Coongie Lakes Ramsar Site has extensive terrestrial and freshwater ecosystems (largest Ramsar Site in Oceania, 2,178,952 ha, designated in 1987), including freshwater and salt lakes, lignum swamps and river channels in central Australia. It is supplied by Cooper Creek, a free-flowing Lake Eyre Basin river system. The area includes pastoral leases (97% of site grazed, including a regional conservation reserve (35%)) and a National Park (3%), with the largest oil and gas production field in Australia. We developed a Strategic Adaptive Management (SAM) Plan, linking science, monitoring and management of this social-ecological system, involving stakeholders and workshops. This involved developing a shared vision and hierarchy of objectives linked to management actions and identified outputs and outcomes. We exemplify this approach with explicit and measurable end-points (thresholds of potential concern) culminating from low level objectives for fish communities, particularly the alien sleepy cod Oxyeleotris lineolata. We describe this framework, highlighting the benefits in prioritizing management actions and monitoring in collaboration with a diverse range of stakeholders, driving adaptive feedback for learning. The whole approach is aimed at successfully achieving mutually agreed management objectives and the vision to maintain the ecological character of the Malkumba-Coongie Lakes Ramsar Site.

Within management scholarship and practice, corporate community investments are heralded as an important form of corporate social responsibility. Yet, community development scholars have engaged in discourse and debate regarding corporate community investment, surmising that in some instances it does more harm than good. Where management research has not focused?and can substantially contribute to both theory and practice?is on how to implement corporate community investment for mutual gain. Integrating the fields of management and community development, I provide an evidence-based theory for understanding corporate community co-development, addressing relational and psychological pathways for behavioral change. This model emerged from a qualitative ethnographic study of 35 corporate-community investment programs involving members of at-risk remote Indigenous Australian communities, large corporations, and a nonprofit organization. Programs involved initiatives such as family income management, educational trusts, literacy programs, nutritional, and substance abuse campaigns. The results in competency building and community development have exceeded the expectations of all parties. Implications for theory, research, policy, and practitioners in management and community development are included.

Background: Digital mental health tools can promote access to culturally safe early intervention mental health services for Aboriginal and Torres Strait Islander young people. Participatory design methodology facilitates user engagement in the co-design of digital resources. However, several challenges have been identified that limit the methodological rigor of this approach. Objective: This paper aims to present an in-depth account of the second phase of participatory design in the development of the Aboriginal and Islander Mental Health Initiative for Youth (AIMhi-Y) app. Methods: A first idea storyboard, generated from a formative phase of the AIMhi-Y project, was refined through a series of youth co-design workshops and meetings. A narrative review of the literature, 6 service provider interviews, and engagement with an expert reference group also informed the design process. Generative design activities, storyboarding, discussions, and voting strategies were used. Results: The participatory design process identified the app features preferred by young people and service providers and assessed their alignment with current recommendations from the scientific literature. Findings from the co-design process are presented across 9 app characteristic domains. Integration of findings into app design proved complex. Although most preferred features identified by young people were included to some degree, other inclusions were restricted by budget, time, and the need to integrate best practice recommendations. A process of prioritization was required. Conclusions: Participatory design is often cited in the development of digital mental health resources; however, methods are diverse and often lack detailed descriptions. This study reports the outcomes and strategies used to determine priorities in the second phase of the development of the AIMhi-Y app. We provide an example and the key learnings to inform others seeking to use participatory design with a similar cohort.

Each year, around one in five, or 960,000, remote and rural Australians experience a mental disorder. The prevalence of mental disorders in remote and rural Australia is the same as that in major cities, making mental disorders one of the few illnesses that does not have higher prevalence rates in country Australia compared to city areas. Yet suicide and self-harm rates are higher in remote and rural Australia than in major cities, with residents of very remote areas twice as likely to die from suicide as city residents. Farmers, young men, older people, and Aboriginal and Torres Strait Islander (Indigenous) Australians face the greatest risk of suicide. The RFDS delivers mental health services to many remote and rural Australians experiencing mental disorders and collects data on the services it provides. The current report presents these data for the first time. When considered alongside data from other providers of mental health services, these data can be used to inform the development of evidence-based solutions to improve health outcomes for remote and rural Australians experiencing mental disorders. A number of factors exacerbate mental health acuity in remote and rural Australia, including: poor access to primary and acute care; limited numbers of mental health services and mental health professionals; reluctance to seek help; concerns about stigma; distance and cost; and cultural barriers in service access. In combination, these factors may have a detrimental impact on the mental health of remote and rural Australians, resulting in the need for an aeromedical retrieval to receive emergency hospital treatment for a mental disorder, in the most extreme circumstances. Several risk factors have been identified that may give rise to the onset and progression of a person’s mental disorder. These risk factors comprise family history, stressful events, physical health problems, substance use, personality factors, and changes in the brain. An additional set of risk factors have been identified as heightening the risk of suicide in remote and rural areas, including: economic hardship; easier access to means of death; social isolation; less help seeking; and reduced access to support services. With poorer service access that results in people in very remote areas accessing mental health services at about one-fifth of the rate of people in major cities, remote and rural health services are less able to intervene in response to signs of known risk factors. The mental health of Indigenous Australians living in remote and rural areas warrants particular attention. Many Indigenous Australians conceptualise mental health differently to non-Indigenous Australians—they take a holistic view of overall health, with cultural, spiritual, and social wellbeing acknowledged as integral components of overall health. The term ‘social and emotional wellbeing’ (SEWB) is the framework through which mental health of Indigenous Australians is often described. Indigenous Australians are 1.2 times as likely to die from mental disorders than non-Indigenous Australians, and are 1.7 times as likely to be hospitalised for mental disorders. Indigenous young people aged 12–24 years are three times as likely to be hospitalised with a mental disorder as a non-Indigenous young person of the same age. Mental disorders are also associated with other illnesses, such as cardiovascular disease (CVD), diabetes, cancer and preventable injury. People with mental disorders also experience disproportionally higher rates of disability than people without mental disorders and these rates are even higher in remote areas of Australia. The RFDS has provided an extensive emergency and primary health care service across remote, rural, and now metropolitan Australia, for almost 90 years. During this period, its primary care services have cared for large numbers of patients with mental disorders, and continue to do so. The RFDS also operates 13 separate and specific mental health and SEWB programs across Australia (summarised in Table i), that provide treatment services to remote and rural Australians with mental disorders or assist in improving mental health and SEWB. All of the programs are delivered in partnership, including with other health services, community organisations, federal and state/territory governments, Indigenous organisations, schools, universities, and/or research organisations. The RFDS also provides aeromedical retrievals of patients from remote and rural areas who experience an acute episode of a mental disorder. This research and policy paper presents, for the first time, aeromedical retrieval data of mental health patients cared for by the RFDS in the period from 1 July 2013 to 30 June 2016. During this three-year period, 89,053 aeromedical retrievals were conducted—of these, 2,567 were for mental disorders. Analysis of the 2,567 RFDS patient records for people retrieved for mental and behavioural disorders by the RFDS revealed: > Males (n=1,568, 61.1%) were 1.6 times as likely as females (n=998, 38.9%) to require an aeromedical retrieval for a mental disorder; > Retrieved patients ranged in age from less than 4 years of age to 85 years of age or older; > One in every two retrievals (47.8%) for a mental disorder was for a person aged 20–39 years; > The mean age at which patients were retrieved was 35–39 years (non-Indigenous Australians mean age 40–44 years; Indigenous Australians mean age 25–29 years); > Males were more likely to undergo an aeromedical retrieval than females for all age groups except 10–14 years and 60–64 years, when females were more likely to be retrieved than males of the same age group; and > 2.2% of retrievals for mental disorders were for children under the age of 15. Age-specific aeromedical retrieval rates were calculated and were higher among Indigenous Australians than non-Indigenous Australians. Indigenous Australians of all age groups were between 3.5 times and 40.6 times as likely as non-Indigenous Australians to be retrieved for a mental disorder. The age-specific retrieval rate was highest in Indigenous Australians aged 35–39 years (3.25 per 1,000 population), closely followed by Indigenous Australians aged 25–29 years (2.57 per 1,000 population) and 30–34 years (2.24 per 1,000 population). Age-specific aeromedical retrieval rates for non-Indigenous Australians ranged from less than 0.01 retrievals per 1,000 population (non-Indigenous children under 10 years of age) to 0.12 retrievals per 1,000 population (non-Indigenous Australians aged 20–24 years, 30–34 years and 40–44 years). The three main diagnoses that triggered a patient’s aeromedical retrieval for a mental illness were: 1. Schizophrenic psychosis; 2. Depressive disorders; and 3. Drug psychosis. Actions to improve mental health outcomes of remote and rural Australians require: > Stronger recognition in the Fifth National Mental Health Plan of the significant barriers and challenges, including the large geographic and travel distances, that are faced by those in remote and rural areas when seeking to access comprehensive mental health services, as well as consideration of how these can be overcome; > Implementation of innovative service models, including consideration of further use of RFDS infrastructure to deliver necessary, appropriate, and more comprehensive mental health and suicide prevention services more often; and > Appropriate resourcing by all levels of governments, to provide more long-term funding certainty. Finally, mental health and SEWB programs in remote and rural Australia need to incorporate ten key components. Programs should: 1. Be provided in identified areas of need; 2. Focus on prevention and early intervention; 3. Be evidence-based and evaluated; 4. Be locally relevant, address community risk factors and include input from the community, consumers, carers and Indigenous Australians in decisions about new services; 5. Take a social determinants of health approach and be holistic; 6. Be implemented in collaboration with other organisations delivering mental health and SEWB services; 7. Be implemented in collaboration with consumers, families and carers; 8. Be culturally appropriate and safe; 9. Be provided with a comprehensive primary health approach; and 10. Facilitate access by all members of the local community.

Aim The aim of this study was to examine the perspectives of experienced Australian Remote Area Nurses about remote nursing staff retention strategies. Background There is low retention of Remote Area Nurses in remote Australia. Retention of Remote Area Nurses can be improved by a supportive environment including good management, professional development and supervision. Method This is a qualitative study using in-depth interviews with seven registered nurses with a minimum of 3 years remote area nursing experience. Participants were interviewed by phone, with the interviews audio-recorded then transcribed and analysed thematically. Results Participants had on average 12 years experience as a Remote Area Nurse. They valued teamwork, effective and flexible management practices and the ability to maintain their own cultural and social connectedness. A flexible service model with regular short breaks, filled by returning agency nurses to enable continuity of care and cultural connections, was seen as a viable approach. Conclusion Flexible management practices that encourage short breaks for Remote Area Nurses may increase retention. This would need to occur within a supportive management framework. Implications for Nursing Management Management strategies that reduce isolation from personal and social networks can increase the retention of skilled Remote Area Nurses.

Background The higher burden of post-caesarean infection in the remote Kimberley region of Australia is intimately associated with poorer social determinants of health. This results in a confluence of environmental factors such as overcrowding and limited access to clean water and host factors such as diabetes mellitus and obesity which result in heightened susceptibility and vulnerability to infection. Aim To ascertain infection rates following caesarean section in Broome Hospital, before and after the implementation of evidence-based strategies intended to reduce bacterial load and mitigate the impact of poor underlying social determinants of health. Materials and methods This is a retrospective observational longitudinal audit study including women who underwent caesarean section in Broome Hospital between the time of 1 January 2019 and 1 May 2019 or 1 January 2021 and 1 May 2021. Files and theatre records were audited to determine demographic, surgical and post-partum infection in women who underwent caesarean section at Broome Hospital. The main outcome measure was infection within six weeks post-caesarean section. Results This study found a statistically significant improvement in post-operative infection rates in women who underwent caesarean section at Broome Hospital (41.7% vs 11.6%, P = 0.002). The two groups were statistically similar in background. Conclusion The combination of various infection prevention initiatives targeted at reducing infection burden can result in clinical and statistically significant reductions in post-caesarean infections in high-risk populations with poor underlying social determinants of health.

Research remains a site of struggle for First Nations peoples globally. Biomedical research often reinforces existing power structures, perpetuating ongoing colonisation by dominating research priorities, resource allocation, policies, and services. Addressing systemic health inequities requires decolonising methodologies to facilitate new understandings and approaches. These methodologies promote a creative tension and productive intercultural dialogue between First Nations and Western epistemologies. Concurrently, the potential of critical theory, social science, and community participatory action research approaches to effectively prioritise First Nations peoples'; lived experience within the biomedical worldview is increasingly recognised. This article describes learnings regarding research methods that enable a better understanding of the lived experience of rheumatic heart disease - an intractable, potent marker of health inequity for First Nations Australians, requiring long-term engagement in the troubled intersection between Indigenist and biomedical worldviews. Working with Yolngu (Aboriginal) co-researchers from remote Northern Territory (Australia), the concept of ganma (turbulent co-mingling of salt and fresh water) was foundational for understanding and applying relationality (gurrutu), deep listening (nhina, nhama ga ngama), and the use of metaphors - approaches that strengthen productive dialogue, described by Yolngu co-researchers as weaving a 'mat we can all sit on'. The research results are reported in a subsequent article.

The outstation movement and the Aboriginal art movement have something in common: they are both often said to have originated, even to have been invented, at the beginning of the 1970s. Each is associated with myths of origin that privilege the agency of non-Indigenous actors. One is that the rise of contemporary Aboriginal art was initiated by a Papunya schoolteacher in 1971; another is that the outstations were an initiative of the Whitlam Government associated with land rights. Some have given H. C. (‘Nugget’) Coombs a primary role in influencing the direction of both: in the case of Papunya, the important contribution made by the Australia Council; in the case of the homelands, Coombs’ romantic socialist imagination (Hughes 2007). Aesthetics and socialism come together in Helen Hughes’ articulation of the primary motivations of those white intellectuals and public servants who supported the outstation movement: ‘The homelands were designed to enable Aborigines and Torres Strait Islanders to enjoy their traditional lands as hunters and gatherers with culturally rich lives’ (Hughes 2007: 5); and they were thought ‘to have inherited communitarian social structures that were free of private property concepts’ (p. 12).

In recent years, there has been an acrimonious debate about the existence and significance of outstations or ‘homeland communities’ as they are sometimes called. These debates have cast various interpretations on the motivations for the establishment and support of these small and remote Indigenous residential formations. For example, outstations have sometimes been characterised by traditionalists as a retreat from modernisation, and from time to time they have been characterised in very negative terms. Indeed, one government minister called them ‘cultural museums’ (Eastley 2005; see Kowal 2010: 182). We hope to show, however, that such views give little hearing for an Aboriginal perspective, and trivialise complex policy issues and deeply held views. In these debates, we fear, something of the lived experiences, motivations and histories of existing communities is missing. For this reason, we invited a number of anthropological witnesses to the early period in which outstations gained a purchase in remote Australia to provide accounts of what these communities were like, and what their residents’ aspirations and experiences were.

In September 1957, nearing the end of my studies at the University of Melbourne, I met the Reverend Victor Coombes, general secretary of the Presbyterian Board of Missions, to discuss the possibility of serving on a north Queensland Gulf mission. What motivated my interest in Aboriginal missions in an era when the more exotic overseas missions such as in the New Hebrides (Vanuatu) and Korea received more attention? Growing up in a very small country town in the Wimmera region of Victoria in the 1930s, I had little knowledge of Aboriginal people and their history. Monuments on nearby roads bearing the words ‘Major Mitchell passed by here’ suggested that this was the beginning of history. A rare meeting with an Aboriginal person was when a ‘swagman’ passed through my hometown of Lubeck. In return for the food my parents gave him, he cut firewood and gave my father an incised boomerang—now one of my prized possessions.

A short account of the return to the Petermann Ranges might begin with the stirring of interest in the Welfare Branch of the Northern Territory Administration in Darwin in 1958 and end with the arrival of Max Cartwright, the first manager, at the nascent Docker River outstation in late December 1967. I thought it more interesting to start the story earlier to illustrate how ideas about the use of Aboriginal reserves changed over time. In 1920, when the large South West or Lake Amadeus Reserve was created, it was intended to rule out any alienation of the land as well as allowing the inhabitants to continue in undisturbed occupation. Nevertheless, the Mackay Exploring Expedition, which included Dr Herbert Basedow, was allowed to traverse the range in the winter of 1926 and reported that the country was exceedingly dry but that the party had friendly contact with groups of up to 30 or 40 of the locals.

"Gustav Malbangka (Malbunka) and his family lived at the Hermannsburg Mission in central Australia. Like many other people, they wish to leave the social problems of the congested settlement behind them and return to their traditional land at Gilbert Springs ... to carve out a more satisfactory life for themselves, drawing strength from being in the homeland again. ... Encouraged by the ‘out-station movement’, many people like Gustav left the mission to return to their traditional country, leaving Hermannsburg looking ‘like a ghost town’. Life at Gilbert Springs is not easy: until bore water is provided, everyone has to live close to the Springs in bush shelters. Gustav, however, has plans to build houses with running water, and to establish a viable station with a church and a school, growing produce and raising cattle. [For the moment they depend] on a weekly visit from a travelling ‘store truck’ and have their financial affairs managed by the truck’s operator, Murray Pearce." (Levy 1975). This passage is part of the cover note to a film made in 1975 by the Australian Institute of Aboriginal Studies (AIAS), directed and produced by filmmaker Curtis Levy with anthropologist John von Sturmer acting in the role of associate producer. The film was narrated by the late Gus Williams, a Western Arrernte man. Members of the Malbunka group first moved out of Hermannsburg Lutheran Mission in the Northern Territory in 1974 as part of a larger group that camped along Ellery Creek. Soon they began to move again, this time west to their ancestral land, which soon harboured numerous camps. These initiatives east and west of the mission were, to the east, close to an ephemeral creek that allowed soakages and wells used in the past both by Aboriginal people and by pastoralists. To the west, the camps were close to ancient underground springs that fed permanent waterholes. In a desert region, both the creek and the underground springs held ritual as well as practical significance. Other sites that became outstations posed greater problems concerning potable water. Nonetheless, these initial shifts presaged a major move by Arrernte and some Luritja and Luritja-Pintupi people also resident at the mission, which was established in 1877. By mid-1976 there were 17 outstations, with an Aboriginal population of about 450. Eight more camps would be added by the end of the year. Outstations were located at distances up to 60 km from Hermannsburg, which, at the time, retained little more than 100 people.

Looking back at the experience of the Pintupi outstation of Yayayi over the initial period 1973–75, when I was a PhD student doing field research there, I am divided between nostalgia and ambivalence. One can hardly ignore the memory of Pintupi people’s excitement to be away from the tensions and density of the large government settlement of Papunya, or the distinctive embrace of the resurgent civil rights movement expressed at Yayayi in a language of ‘Black Power’. Yayayi was one of the very first ‘outstation communities’ in the Northern Territory under the umbrella of changes articulated by the Whitlam Government’s embrace of something we call ‘Aboriginal self-determination’. A powerful notion at the time, as Peter Sutton (2009) has testified, this phrase needs to be kept in quotation marks, as we should, I suggest, explore what this political slogan meant. The exuberance of Pintupi returning to Yayayi, 40 km west of Papunya, was palpable. Their enthusiasm was matched by indeterminate expectations, by inchoate ideas of a future. Nonetheless, for me to have been there, as a young man with an equally un-nuanced progressive view of a possible future, is the source of my nostalgia, which, I suspect, is shared by many who lived or worked on the early outstations. Let me consider for a moment, then, what I mean by ‘ambivalence’. What did Yayayi amount to? I want to think about this because in recent years, the political screw has turned and one routinely now hears that the project or policy of ‘Aboriginal self-determination’ was a failure, the source of a perceived current severe dysfunction in many remote communities (see, for example, Hughes 2007; Johns 2001; Howson 2000). Many of us who did research in remote communities in the 1970s were strong supporters of an Aboriginal right to self-determination, as Peter Sutton has (again) pointed out, and in that sense, we may feel implicated in these results. What went wrong? It is important to say here that these policies were not really the consequence of the sympathies of anthropologists. The movement for Aboriginal self-determination was embedded in and catalysed by international movements of national liberation, civil rights and human rights.

Mount Liebig, known by Anangu as Amunturrngu and referred to by the regional shire as Watiyawanu, is part of the regional constellation of Pintupi-Luritja settlements that also includes Haasts Bluff, Papunya and at least 16 outstations, the majority of which are still inhabited.1 The 2011 census recorded Mount Liebig with a population of 156 people,2 while the Mount Liebig and Outstations Quickstats showed a slightly higher population of 184 people.3 Note that both of these figures also include non-Indigenous people. Mount Liebig—though now regarded as a ‘state suburb’ for the purposes of the census—itself began as an outstation. This chapter will trace the emergence of this place as it became the focus of both Pintupi-Luritja sentiment and respite from the earlier days of Haasts Bluff and the later coercive assimilationist vision of Papunya. That its relatively informal and incremental development into a substantial settlement has been led by Anangu, rather than the state, also has implications for the ways in which the place has emerged as a community, rather than merely a settlement. Unlike Papunya, which has been described as ‘mixed up’, Mount Liebig has an internal coherence that was led by succession processes and subsequent re-territorialisation. The reconfiguring of people at this place has been enabled by the new Indigenous language of Pintupi-Luritja; residents who chose to remain after the 1980s actively identified with this new language, referred to by linguists as a communilect. By foregrounding endogenous political processes, this essay conceptualises self-determination as a process in relation to other Aboriginal people as well as in relation to the State. The emergence of the Luritja language in this region, and its consolidation at Mount Liebig and surrounding outstations, was an expression of the need to regroup and reformulate a local identity after unprecedented historical interventions.

This chapter discusses an exceptionally remote region of the Western Desert in which outstations have played a significant role. Outstations have not, however, necessarily or always been linked with self-determination here in the way suggested by the title of this volume, giving us one matter to disentangle from the start. But another question also immediately follows: was the arrival of self-determination necessarily such a watershed moment, as the premise of this volume’s title seems to suggest? That is, was there one basic trajectory that applied throughout remote Australia, within which at a certain point self-determination provided the compelling response? We do not suggest that self-determination did not make a big impact in the Ngaanyatjarra region, as elsewhere, and bring with it many gains, but we do wish to problematise the historical part that it played. We begin by considering some manifestations of outstation phenomena that came well before the self-determination era and accompanying outstation movement ‘proper’ of the 1970s. We will sometimes refer to the latter as the ‘winds of change’ movement, alluding to the national political associations and flavour that it had. We identify the first local manifestation of phenomena generically classifiable as outstations to have been the ‘summer holiday camps’ or ‘Christmas camps’ that are associated with Warburton Mission history from the 1950s through to 1972. Virtually the whole Aboriginal population of the mission, which was the centre at which most Ngaanyatjarra people settled, would go to stay temporarily at one of several camp areas out from Warburton, remaining for up to three months, while the mission itself went into ‘stand-down’ mode for the summer. A degree of mission support would be provided, but other than this, the people would live off the country and do whatever they wished. In effect, these were ‘intermittent’ outstations. They did represent at least partially a ‘return to country’ and a return to a life less influenced by the mission, but the people would go back in between times, and for stays of much longer duration, to the centralised mission world. Also, of course, such camps did not represent a decentralisation of the population as such, and a winding down of the influence of the mission as a place of colonial congregation, in ways that are associated with the outstation movement proper and with the accompanying notion of self-determination. In fact, during the heyday of the summer camps, the mission was increasing in size and to some extent in influence. The summer camps developed out of, and as a consequence of, the people’s increasing involvement with the mission, and in one sense, it could be argued, were a means of facilitating their increasing incorporation into the European world by softening what might otherwise have appeared as too drastic a step to take. But it could equally be argued—and this is much truer to the general Ngaanyatjarra view on the matter—that the people actively chose, for a long time, to become only partially involved in the mission environment, and that the summer camps represented one of the compromises that they negotiated with the mission to retain some autonomy while engaging in a gradual adaptation to a more sedentary, incorporated life. To better appreciate these and other matters pertaining not only to the summer camps but also to the subsequent period of the outstations proper, it is necessary to go back further in time to the beginnings of Ngaanyatjarra interaction with the ‘whitefella’ world.

Australia in the 1970s saw sweeping changes in Indigenous policy. In its first year of what was to become a famously short term in office, the Whitlam Government began to undertake a range of initiatives to implement its new policy agenda, which became known as ‘self-determination’. The broad aim of the policy was to allow Indigenous Australians to exercise greater choice over their lives. One of the new measures was the decentralisation of government-run settlements in favour of smaller, less aggregated Indigenous-run communities or outstations. Under the previous policy of ‘assimilation’, living arrangements in government settlements in the Northern Territory were strictly managed with the aim of integration into a mainstream Australian way of life. Under the new policy ideal, Indigenous Australians would, in principle at least, be given greater freedom to live in the manner of their own choosing.

On 5 May 1972, I set out from Yuendumu with six older Warlpiri men on my first bush trip to visit the Waite Creek area on the southern portion of Mount Doreen Station, more than 400 km west of Alice Springs. We visited a number of sites, including the important sacred site of Warntungurru, belonging to people of the J/Nampijinpa-J/Nangala patricouple, marked by a metre-high vertical stone 100 m or so from the creek. We drove south alongside the creek on a station track, stopping off to see various soakages in the creek bed. One of these places was Nyirrpi, a soakage at the edge of the creek adjacent to a clump of trees that formed a very small island in the middle of it, approximately 125 km from Yuendumu as the crow flies. It was remote, the nearest occupied place being the station homestead 40 km to the north.

This chapter is about the rise and fall of outstations in Aboriginal Australia. In the 1970s, governments, both State and Federal, were at first enthusiastic about these settlements, encouraged by an ideology that promoted outstations as beneficial—in terms of health, social well-being, cultural maintenance and the preservation of links to country, which were generally recognised as being of singular importance for Aboriginal Australians. But funding outstations proved to be expensive, and progressively, funding responsibility was devolved to the States, which in turn showed a developing reluctance to spend money on often isolated and costly support services. Moreover, as ideologies shifted, outstations were seen as too often wasteful of scarce resources and generally did not provide much needed health services. Training and employment—seen by many as the way forward for Indigenous Australians—were conspicuously absent from most outstations. This chapter tells something of the history of program support for outstations by reference to both a national evaluation of funding for outstations and a case study drawn from the author’s own fieldwork. The future of outstations as settlements for Australia’s Indigenous people is uncertain since governments are unable (or unwilling) to justify the considerable expense involved. However, there are indications that Aboriginal Australians in some circumstances are diverting their own resources to facilitate choice in their place and mode of residence, although this is an option available to only a privileged few.

This is a practitioners’ chapter, focusing on outstations in the Aurukun region of western Cape York Peninsula, and based on our experience spanning nearly four decades. We are father and son: David Martin, now an anthropologist, who established and coordinated an outstation support organisation in Aurukun for some eight years from the mid-1970s; and Bruce Martin, whose mother is a Wik woman from Aurukun, and who in 2011 worked with his community to establish a community-based organisation, Aak Puul Ngantam (APN), focused particularly on developing productive livelihoods on country. The key aims of this chapter are to outline and critically evaluate the principles and practices of the original outstation project against the concept of ‘self-determination’, and to contrast these principles and practices with what is being attempted now in a profoundly different Indigenous policy environment. The chapter has arisen as part of a long-term and ongoing engagement and dialogue on such matters between us. However, the first sections on the original outstation movement are largely written by David Martin, and those on APN’s work by Bruce Martin. The concluding section of the chapter is jointly written.

Leaning on memoir, and extensive photographic and written records, this chapter presents an eyewitness account of just one of many Aboriginal outstations that broke away from population centres in remote Australia in the 1970s and later. The context is western Cape York Peninsula, Queensland. The event was the re-establishment in 1976 of Peret Outstation, named after the well Pooerreth near a cattle yard, as a homeland centre rather than the mission pastoral operation for which it had been created. It was, in part, a staged return to the countries of origin of Cape Keerweer people, who had in recent decades become settled in the Presbyterian Mission township of Aurukun to its north (Map 12.1). It was also a time of hope, adrenalin, politicking and pre-eminence, desperate shortages, bogged vehicles—Land Rovers, tractors, small planes—the luck, feasting and starving of hunting, happy children dancing by firelight, old people singing now forgotten song verses, the strains of camp life, and yet also a curiously sedate existence, as yet largely without media, alcohol, drugs or crispy fried chicken wings. Each character seemed larger than life. Perhaps they were.