杏吧原创

As a doctor in refugee camps in Sierra Leone, you鈥檇 expect Marlene Kong to be hardened to suffering. As an indigenous Australian, however, she is so shocked by the Aborigines鈥� poor health that she even suggested shaming the government by inviting international aid organisations to the country. But as she tells Rachel Nowak, Aborigines also need a big dose of 鈥渟oul strengthening鈥�.

What does it mean to be an Aboriginal Australian?

I鈥檓 a descendant of the original occupants of this wonderful land we call Australia. I鈥檓 a Koori, the indigenous name for Aboriginal people living in the states of Victoria and New South Wales. A common misconception is that most Aborigines live in the outback, but we make up about half a million of Australia鈥檚 20 million population, with the majority living in urban areas of Queensland and New South Wales. Unfortunately, Aborigines also suffer the worst health in Australia.

How bad are things?

While Australia has one of the longest life expectancies in the world at 80, it鈥檚 really shameful that an indigenous person鈥檚 life expectancy is only 63. We have high rates of diabetes, and cardiovascular and lung disease. Infant and maternal mortality 鈥� two of the most important indicators of a population鈥檚 health 鈥� are at least three times higher than for non-indigenous people, and getting worse.

This sounds third world, like something out of the M茅decins Sans Fronti猫res missions you worked in?

A better term is fourth world: the conditions among the Aboriginal communities are all the more atrocious because they are happening in a first-world country. Australia is the only developed country where a significant proportion of the population suffers from trachoma, an eye disease that can cause blindness. At any one time, 18 per cent of Aboriginal children have an ear infection, which can cause hearing loss and play havoc with education. Rheumatic fever, TB and scabies are problems in some urban areas because of overcrowding. You can even find leprosy, one of those rare diseases that have been eradicated from the broader population. In some places, childhood vaccination rates are 50 per cent, compared with more than 90 per cent in Uganda. It鈥檚 been a critical situation for 30 years, and something needs to be done.

鈥淵ou still find rare diseases like leprosy among Aborigines鈥�

Is mental health a big issue too?

Yes. Not only do Aboriginal people deal with discrimination, they live with a very negative history on a daily basis. We were robbed of our culture, land and language by the way the country was colonised. My grandmother was punished for speaking her own language, and all her brothers and sisters were taken away. As late as 1969, Aboriginal children were put in care with white families for no good reason: they are called the Stolen Generation.

Today, many Aboriginal people still have no hope and poor self-esteem, and alcoholism and domestic violence go hand-in-hand with that. Suicide rates are at least 40 per cent higher than the national average 鈥� it is endemic in some communities 鈥� and there is little research to understand why. Families are struggling, and it鈥檚 difficult for children to continue their education if they have to help with family finances. They鈥檙e in a vicious poverty cycle. Naturally, mental health suffers, and it鈥檚 very hard for anyone to succeed.

Did you feel that you should have been looking after your people rather than working in Africa?

You could ask that question of any doctor: 鈥淲hat are you doing in private health in Sydney, earning thousands of dollars when you could be helping Aboriginal people?鈥� I don鈥檛 think it鈥檚 just the responsibility of the indigenous doctor, it鈥檚 the responsibility of all people working in health in Australia. That鈥檚 part of the problem 鈥� people disown the problem of Aboriginal health.

Your father is Chinese. Do people question your Aboriginal identity?

Yes, and I think, 鈥淗ow dare they?鈥� Identity is a problem for many Aboriginal people because a lot of them are of mixed descent, and they spend a lot of time working out who they are. It鈥檚 another psychological issue to come to terms with. I came to terms with it because I have a mother who鈥檚 very proud of our Aboriginal identity, and I鈥檓 also proud of my Chinese heritage. I adore my father鈥檚 family in Malaysia as much as my mum鈥檚 family here.

Your family is unusual in another way鈥�

My mother, Grace, was one of the first indigenous trained nurses in Australia. She lived in atrocious conditions growing up, but as the eldest of 12, she was looked up to, and even before she started her training people came to her for help. She became like a community doctor because Aboriginal people couldn鈥檛 afford a real doctor. My twin sister Marilyn and I were the first indigenous people to apply to and graduate from medical school at Australia鈥檚 oldest university, the University of Sydney. It was a very proud moment. My Aboriginal grandfather, Poppy Russell, once said that the only difference between a white man and a black man is his education. It鈥檚 a shame that he didn鈥檛 live to see us graduate. He would have been so proud.

Are you all in general medicine?

Marilyn is the first indigenous obstetrician and my younger brother Kelvin is the first indigenous surgeon, specialising in ear, nose and throat surgery. Both specialities bring great things to the Aboriginal community, but no matter what they had gone into there would have been a great need for it.

Is it true that the three of you make up 5 per cent of the indigenous doctors in Australia?

Yes.

Why has the Australian government failed to solve the health problems of its Aboriginal people?

The government has the money 鈥� we鈥檙e a very small population compared with places like Africa, where millions suffer. Officials have seen evidence-based report after evidence-based report, but changing policies takes more than evidence 鈥� the problem needs to be high on public, media and political agendas. The majority of Australians voted for John Howard, and he continues to cater for people who don鈥檛 care about Aboriginal health. This apathy is passed on, generation to generation.

There鈥檚 also been the wrong focus. People have ignored the underlying issues of social well-being and mental health, crucial for physical health. And a lot of health research has been done in the rural areas, though most of the population lives in urban areas.

Do you have any solutions?

I suggested to my colleagues at M茅decins Sans Fronti猫res that we set up missions in Aboriginal communities, but the idea makes people nervous because it would be such a political statement, such an embarrassment to the Australian government.

That鈥檚 pretty challenging. Do you have other ideas?

I recently spent a year studying public health at the Hebrew University of Jerusalem. One of my teachers asked: 鈥淲hat is a community without a soul?鈥� He meant that without a soul, a community is destined to fail. There is a lot of pain, anger and grief suffered by Aboriginal people, and they don鈥檛 have much hope for the future. Aboriginal communities have lost their soul. It鈥檚 been made worse because of something that鈥檚 important to people 鈥� and perhaps especially to Aboriginal people: their ties to the land. That has been largely ignored by the government.

How else do you strengthen a community鈥檚 soul?

When I was in Israel I was shocked to learn that German Jews received compensation from the German government for their suffering. Why can鈥檛 our government do that? It鈥檚 not about money, but about recognising suffering. Or why not a simple apology? My grandmother would be in tears if it were to happen. An apology would bring psychological healing, and that鈥檚 a number-one priority for addressing health issues. But Howard has refused, despite a lot of public support for one. While we wait, we have to carry on celebrating what we have achieved: Aboriginal people who are striving and succeeding, the land rights we won, and our flag, which represents the land, the people, and the sun.