s Social Inclusion | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Social Inclusion

Rollo Manning

articles by this author...

Rollo Manning has experienced pharmacy practice from all sectors of the industry – retail, administrative, policy and remote Aboriginal practice. He spent 10 years with Glaxo Australia and was the first Director of Public Relations at the Pharmacy Guild National Secretariat in Canberra.
He has also held the position of Pharmacy Policy Officer for Territory Health Services in Darwin.
Rollo is currently a Consultant working in his own practice with remote Aboriginal communities, in Northern Australia.

“Hey – don’t forget us – we were here first!”
Remote Aboriginals left out of inclusion agenda

Remote living Aboriginals and the cycles of disadvantage which place them at the bottom of the socio economic ladder in Australia must get special treatment from a new Government in Canberra. The fact that Australia’s first people are still living in “Third World” conditions in one of the wealthiest countries of the World is a shameful situation and only special treatment will raise their standards to a point where they can be considered “included” in Australian society.

The “social inclusion agenda” of the Rudd Labor Government said that it was a means of “building a nation in which all Australians have the opportunity and support they need to participate fully in the nation’s economic and community life, develop their own potential and be treated with dignity and respect.”
These words are admirable except that there is a need for an Action Plan to ensure it is followed through in reality. The population cohort of 150,000 Aboriginal people living in remote communities across the north of the country and in the central and western desert regions – are at present living in a constant state of “exclusion”.

The National Social Inclusion Board has been asked to take immediate steps to arrest the slide that has been happening since the introduction of “self government” and welfare dependency in 1970s. These are:

  1. A “Third World” classification is given by Government to remote communities that are home to Aboriginal people across the north of Australia and in the central and western desert. This is said to be essential for the rebuilding of social capital and economic prosperity to a standard required by the inhabitants to contribute to the Australian Society.
  2. The Aboriginal people themselves must be involved in identifying their own social priorities of need and establishing measures to alleviate these with funding available to initiate micro economic enterprises that will provide the incentive to work and shake off welfare dependence.
  3. The payment of money to individuals should cease on a universal basis when a clan or tribe group present a solid business plan for social and economic reform. Universal welfare payments have failed and worked against social inclusion. “Cashed out” Centrelink payments should be possible to put the same amount of money into targeted assistance packages and economic development.
  4. The life expectancy of remote living Aboriginal Australians should be expressed separately in order to show the difference between urban and remote.
  5. An acceptance of the fact that to educate young women between the age of 16 to 24 years will assist them and enable them to pass down to their children the need for an education and work ethic. Without this another generation will be lost to welfare dependency.


Remote living Aboriginals are a unique cohort whose life style and life outcomes are clearly delineated through statistical measurements. Nowhere near is enough use made of this information in planning change.  This is “Third World” country and has to be recognised as such. Some input from AusAid might be more useful for framing policy than bureaucrats used to dealing with mainstream populations living in communities with a wide range of services available in settings with already strong social capital. The remote living Aboriginal has none of these “luxuries”.
 

The cycles of disadvantage
The numerous cycles of disadvantage in remote Aboriginal communities are interrelated and synergistic in their effect on the individual. More research needs to be done to identify the priorities of need (as seen by the community) in attacking each one. Too often the cry goes out that it is “too hard” and nothing is done. The people themselves must be drawn into a conversation on the social priorities and needs for their communities. In this way moves towards building social capital can be commenced through social and economic development.
The main cycles are:

o        A denial of the human rights of the child such that abuse of those rights becomes the norm and is accepted by new generations. Housing, nutrition, education and leisure opportunities are lacking and this leads to a child frustrated from inactivity, opportunities to show creativity and exercise initiative. The overcrowded house is under estimated in the minds of government policy makers as a prime influence on this fact and each of those following. The overcrowded house brings with it immense unsafety, insecurity, a lack of food security, own space to reflect, household facilities that do not work because they were never built for so many persons living in the house. This absolutely hopeless situation is still evident with no real action to make an immediate response to this devastating influence on the ability to feel included in a social setting filled with joy and harmony. It is disgraceful that the policy makers allow a town of 2,200 people (Galiwin’ku) to have 152 houses while another in the white man’s world (Boorowa NSW) to have 857 for the same population. Galiwin’ku has five retail outlets against 15 in Boorowa – how much more serious can a lack of social inclusion get when people are denied choices, job opportunities but receive money for doing nothing and have little choices of what to spend it on.

o        Poor literacy and numeracy stems from an inability of children to understand why this is needed when all they see is adults sitting around doing nothing and no role models from their parents or carers who do not work. Creating work opportunities should be an essential part of the mix and is not receiving nearly enough attention at the local level. Unemployment is the norm and this becomes the key in removing welfare dependence. Much bolder mechanisms must be tried at the local level to encourage economic activities and employment opportunities such as “cashing out” Centrelink payments within a community or Clan group in a community. The writer is in the process of obtaining from Centrelink the stats on the quantum of money going into communities to ascertain how much would be available if people decided to “cash out”. The principle involved here relates to the social justice in paying money to individuals rather than to communities for economic and social development.

  • Substance abuse leads to violence and both are symptoms of a community without direction. The fact that substance abuse (alcohol and Marijuana or Gunja) is so widespread means that children are exposed to it at an early age and peer pressure may result in consuming drugs (marijuana) by age 10 years. This rules against any possible development of social dreams, hopes and ambitions. Future planning is absent and few children have any idea of what they want to do in a future life apart from nothing which carries with it distinct boredom and further substance abuse. The flow on is arguments, fighting, stealing for money to sustain the habit and prosecution. It is well recognised that recidivism for Aboriginal prison inmates is high following its acceptance as being “part of life”. The cyclical nature of family violence is strong, despite the resource of domestic violence orders which seem useless in alcohol and drug charged family disputes. Men and women seem to ignore the rights of the individual to lead a peaceful life free of torment, danger, uncertainty and stress. Mental health problems surge to the front of “health” problems and the resulting stress is a dampener on many a discussion regarding future hope. It is the survival of “today” that is the prime motivator not consideration of a peaceful future and how that can be attained. The definition of poverty given by Muhammad Yunus in an Interview with Andrew Denton describes the situation admirably:

    Poverty, is almost, you can describe is a living in a box, all with the thick wall, no window, no door, no light, so you don't know what's coming next, you have no idea of new day starting in different way, you repeat the same thing over and over again. No hope, basically. So you try to survive the day in very uncertain conditions. So that's poverty, you have no control over your life, that's total, that's it.” (ABC-TV 07/12/09)

  • Health, nutrition and physical activity – the cycle of poor nutrition and reduced physical activity leading to poor health has been gaining momentum since 1975. This has lead to a situation where all people born after 1975 have lived their entire life in a community with the health status on the decline. The child fed a breakfast of black tea with noodles thinks that is normal.  The two takeaway shops in town (two of the five retail outlets at Galiwin’ku) selling death through cigarettes, high fat content foods and sugar loaded soft drinks are making huge profits by selling sickness. The businesses of the two takeaways are owned by Darwin based syndicates and staffed by Asian workers on “457” Visas. And we allow this to happen to the most under privileged Australians who were here for 40,000 years before colonial British settlement. Social justice? Hardly. Social inclusion? No attempt. Only recently has there been evidence of organised sport for young people with the major emphasis having been on adult age football and basketball. The scope for athletics, swimming sports, junior football and basketball is immense and such activities could include the entire family.
    The end result is the early death – and at a much earlier age than the National average depicts – let’s get real and respect the huge differences where the median age at death for men is 43 years and for women 53 years. That is a lot of adults taken out of a community at a young age and this then becomes the norm in people’s minds as if this is the way it has to be.

     It does not have to be this way and a concerted effort under the banner of social inclusion which has with it a “bottoms up” approach to a social revolution might help to reduce the intensity of these cycles.
    Better health is not about building better health clinics and employing more clinical staff – it is about the relationship the dominant culture has with the people to enhance their understanding of the risks associated with lifestyle choices and the opportunities they create to reduce stress and lead a useful life. This was well expressed by Professor Fiona Stanley who said:

    “..the real gains in reducing disease and improving health will come from the social and economic circumstances operating in families, communities and the wider society. That is that the most effective preventive strategies lie OUTSIDE the traditional areas of the health professions.” (National Press Club. August 2003.)

The entrapment of cycles of disadvantage
 People are born into these communities and have no option when their families have lived there for generations and their ancestors respected and owned the land for thousands of years. There is an affinity to the land which is unique. It is the heritage a child takes on from its predecessors.
It is very important that when there are people who want to break out of the cycle of disadvantage that they are helped 100% in a quest to do so. If someone puts up there hand and says “I want to lead a better life” there must be the facility to make that happen. To follow the lead of overseas efforts in Third World countries it will be the young women who are targeted for improvement. Educate a girl and you educate a future family. We must put sexist attitudes aside and decide to concentrate on young women between the ages of (say) 16-24 years old. If nothing is done to help these young women there will be no role models coming forward to show the younger ones that good is a better choice in life than bad. Is it any wonder there are no persons from remote communities attending university? – there is simply not enough done to make it happen. The fault is not with the person but with the system that seems intent on having these people continue a life of poverty.

Mutual obligation has to work both ways
An example can be given of a 21 year old woman from a remote community who came to Darwin to “make good” and was shuffled between Centrelink and Job Services Australia (JSA) agencies for three months. All she got was appointments or on three occasions cancelled appointments that did not suit the JSA agent. So much for mutual obligation! The Prime Minister during the recent election campaign claimed a get tough policy on the unemployed who did not turn up for appointments. The same should apply to JSA agents who fail to meet appointments and more importantly fail to provide a training program. Sure excuses will be made as to how hard this is but regrettably no excuses should be accepted. It is imperative we return the obligation for to leave a person in a city like Darwin with all the distractions for three months with no work, no training and no future is just asking them to continue the exclusion.

What do the authorities planning this transition from welfare to work expect people to do with their idle time? Or are they so used to people that do not want anything to happen (like find a job) that when a person wanting to do better comes along they cannot handle the positive nature of the inquiry. It appears that the entire system is geared to mediocrity and the Centrelink and job finding agencies are so used to people that don’t want to work that they have no strategy to help those few that want to make good. There could be no bigger turn off for anyone than to be left in front of a TV all day waiting for the next appointment when what they really want is to learn and find work that suits their ambitions.

The problem of “disengaged youth” is attracting a lot of attention from Government programs and in the work of Non Government Organisations (NGOs). And yet little is being done to prevent young people from becoming “disengaged” when they really want to be more engaged. There are youths (aged 16-24yo) who want to be included in the world—not excluded like so many of their peers that end up in prison or on diversion programs.

In Darwin there is an 800 bed prison, Berrimah Gaol, costing $80 million a year for people who have chosen to be bad. The young Aboriginal inmate – and that is 90% of the prison population – is probably in there for some anti social behavior fuelled by alcohol and Gunja – will receive tuition in literacy and numeracy and computer skills.

Upon release they will be remanded to a formal rehabilitation program in a beautiful garden setting hostel style accommodation with all meals and training provided for a further 12 weeks.

Oh for such a facility for those those who want to do “good” – and not just for those who choose to do “bad”.

Government programs exist—the Job Services Australia network; Language, Literacy and Numeric Program; Step-Up; WELL; Youth Connect; the  Indigenous Youth Mobility Program; Youth in Communities and the exalted Youth Attainment and Transitions program - BUT there is no co-ordination and each program is delivered by a contracted provider that once having gained the  contract has little competition leaving mediocrity to reign.  
Glossy websites and publications mean nothing if the product is not being delivered. The so-called “mutual       obligation” means equal commitment from all parties and yet Governments seem to think their obligation is finished with the appointment of an agency to deliver programs. If the government funded agency fails to perform there seems to be no obligation but if the client does not arrive at an appointment the welfare payment can be stopped. This begs the question of why it is so hard to co-ordinate the efforts of these similar government funded programs with the same goals so that the clients get what they want. An element of “discretionary funding” must be made available for use at the local level to stimulate initiatives and help to fund the work needed to build plans to a point of applying for funding.                                                                                                                   

Breaking out of cycles of disadvantage 
Control of ones own life is an important element in building social capital. The principles that were espoused in the Australian Assistance Plan of the Labor Government in 1972-75 were said to be ahead of their times but maybe the time is NOW for Aboriginal communities to receive an Aboriginal Assistance Plan along the same lines that could involve the people in determining their social needs and priorities. This would also make micro loans available to seed new ventures that would create training, employment, independence from welfare and a purpose for rising every morning and getting the children to school.
The time is now when it comes to building stronger social capital in remote Aboriginal communities and this is well reflected in the words of Nobel Laureate Chilean born Gabriel Mistral who said of the needs of children:

Many things we need can wait, the child cannot. Now is the time his bones are being formed, his blood is being made, his mind is being developed. To him we cannot say tomorrow, his name is today.

There must come a time when the policy makers shed the shroud of fear about matters such as “paternalism”, “stolen generations” and “separatism”. In decrying paternalism self determination was brought in and it has now been recognised that has been a failure. The basic ability and understanding is simply not there for these Aboriginal people to negotiate the machinations for moving ahead in the western world. There does need to be considerable mentoring, guidance and fostering of confidence which can still be done in a facilitative way without being labelled as paternalistic. To wait until the people are ready for change could be to wait another one or two generations – a prospect that no Australian would feel comfortable in accepting. If there is tutoring and mentoring to be done we must do it in a vigorous manner and not just pay lip service to it against a backdrop of centralist policies and program development.
With respect to the stolen generation - there is no doubt the forced removal of children from their parents in previous generations was despicable. However this was forced removal. To suggest that an Aboriginal child may be assisted by attending a boarding school in another state is not forced removal. The paranoia that surrounds suggestions of moving must be diminished by examples of well being fostered from such experiences. Research should be done to demonstrate the long term benefit in voluntary removal to allay these fears. Even the “dormitory” style living and mentoring and caring for children who are disengaged would be better than the nomadic existence so many young children have to undertake when abandoned by their natural mother or father.
Separatism was a sensitive issue in the world in the early 1970s with vivid memories of the tour of the Springbok Rugby Team in 1971 still vivid in the minds of those of us around at the time. The apartheid movement in South Africa has finished and should never be seen again. It was the forced separation of one race of people from another with harsh penalties for anyone who crossed the line. However in decrying apartheid it should be acknowledged that there will be situations where one race of people may decide that it does not want to live in the same way as another. At no time in the history of the Aboriginal survival efforts have they been given the opportunity to decide the way they want to live. The Aboriginal men from remote communities seem unable to embrace a mainstream culture and legal constraints while for the women there are those that simply see themselves as “community girls” with no intention of even trying to live the mainstream lifestyle. If we do accept that assimilation failed and that self determination has failed then we need another word that will describe a phase whereby Aboriginal people are given the resources to develop a world of their own that takes what they want from the western world and allows them to remain in their own country.

Personal choice should play a part
Choices are made on a basis of knowledge so that the costs and benefits of a situation can be weighed up critically to choose a path. In the situation under review the people involved do not have an education or awareness of a logical framework in thinking that allows to them to participate in an analysis of choices.  The educated mainstream person does not appreciate the manner in which their upbringing in a culture that has thousands of years of development through many “revolutions” that have embraced invention to move that culture ahead in a manner that is “mind boggling” to a person from a culture that subsisted in the desert for thousands of years without even knowing what a wheel could do. It was not until the arrival of ships from foreign countries such as Holland and Indonesia (Macassans) in the 16th and 17th century that these people learned what metal was. The power of logical thinking that comes with an ability to manage a situation, prioritise things, file away messages and thoughts in the brain to a later date are all practices that come naturally to the educated dominant culture person in Australia. This value was highlighted during a recent visit to Australia of the Somalia born women’s activist Ayaan Hirsi Ali who said:

“We can learn from you and your centuries of critical thinking. You Westerners come to Africa with your money but you can keep your money - we want to share with you your values. The most important value – the value of critical thinking – questioning authority – no matter who it is – question why things are the way they are and why they cannot be done better.” (Interview with Monica Attard – Slow TV – August 2010)

To expect Aboriginal people to think through their options for survival in a world that none of them has grown up in is a tall order and the resolution needs a lot more talk and research to find the best path ahead. In 2005 the present Co-ordinator General for Remote Service Delivery in the NT, Mr. Bob Beadman wrote a paper in which he lamented the fact that something had taken away the ability for Indigenous people to have dreams for their future. He wrote:

“I am looking at human detritus  right here in Darwin, and wonder what dreams they might have once had for themselves. What dreams they might have had for their children? What dreams their children might have had for themselves? I wonder if people have abandoned those dreams, what caused them to give up, what is it about the world that surrounds us all that makes them think that their dreams are unachievable.” (Do Indigenous youth have a dream Menzies Research Centre, Canberra, 2004).

Work is needed to ascertain how many young people would like to see a better life and this needs to be carefully structured. The target population is not English speaking, does not understand concepts of space and time and is not confident in working with the dominant culture. The young people must be encouraged to question why the situation is the way it is and not to simply accept as normal or necessary for it to stay the same.

Somehow the minds of the young have to be engaged in wanting to see an improved life ahead for their children –  the next generation and social inclusion could be the agenda through which to make this happen.

Ends

30th August 2010

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