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When asked to describe my work as a nurse at the Palm Island Hospital, one word comes to mind: “Frustrating”. It was terribly frustrating to be working in a health care service that was clearly not working.  Although many health professionals lobby for increased funding for aboriginal health care, the difficulties at Palm Island Hospital were not due to a shortage of money. Instead, it was a question of how current resources were being allocated. High salaries, for example, were paid to two junior doctors whose inexperience frequently forced them to charter aeroplanes to transfer patients to Townsville General Hospital. This was expensive health care!

On Palm Island, like many remote aboriginal communities, there was poor sanitation, overcrowded housing, filthy drinking water, feral animals and an inadequate diet.  Yet, when a Palm Islander became acutely ill, no expense was spared. Palm Islanders, like all Australians, are treated in an Intensive Care Unit when they are critically ill. It would be unethical to do anything less. Yet, is it ethical to discharge a Palm Islander to the same socioeconomic and environmental conditions that led to the health crisis?

Without a long term vision of aboriginal health care, we practiced “sick care” not “health care”.

First published as a letter to The Age in 1997

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