In 1987 I began work at the Brisbane Aboriginal and Islander Community Health Service (AICHS), my first real job outside the hospital setting.
Today, First Nations doctors increasingly fill such roles. For good reason, First Nations Peoples often prefer to see First Nations doctors. The Australian Indigenous Doctors’ Association continues to call for more First Nations graduates from medical schools. But back then, there were only one or two Indigenous doctors in all of Australia, and AICHS’s community-controlled Board gave me the job.
I was generously mentored when I started out by the other GP at AICHS, another non-Indigenous woman who no doubt lay awake at nights fretting over my outrageous inexperience.
Nevertheless, I gave it my very best. How disturbing it was the other day to hear a First Nations Senator, beamed into our living rooms and social media feeds, assert there are “no ongoing negative impacts” of colonisation.
You already know about the high rates of chronic disease, mental health problems and substance abuse disorders amongst First Nations Peoples. You already know how these and other problems, which ( - according to First Nations Elders, Royal Commissions, prominent academics, numerous reports and research studies, experts in epigenetics and inherited trauma, and also common sense - ) persist as intergenerational effects of colonisation and culminate in reduced life expectancies.
When I heard the Senator on the news denying this and asking us to vote no to the Voice, memories from AICHS began to trouble me again. It's a GP’s job to engage with illness and trauma, physical and psychological. But at AICHS I encountered a frequency and severity of physical illness and psychological trauma never again repeated throughout my working life. I remember my AICHS patients’ high glucose and blood pressures readings, heart arrythmias and murmurs, absent peripheral pulses. I remember crackling lungs, swollen livers, oedematous legs. I remember chatting and laughing with one young woman as she lay back on the examination couch, my hands gently on her body. I remember some things she told me. I never forgot. How could I? A few days later she was in the news, murdered, her body discarded in an urban creek.
Australia has lagged behind other countries’ efforts to address the impacts of colonisation on the health of their Indigenous Peoples. Although health inequities between First Nations Peoples and other Australians have improved on some indicators in the decades since I started out, the burden of disease in First Nations Peoples is still 2.3 times that of non-Indigenous Australians.
In my two years at AICHS I learnt more than I can tell you, including about First Nations’ generosity across cultural difference. And as a GP in her late twenties hoping to have children herself, I was particularly affected by what I learnt about certain traditional values and practices in caring for babies and young children, which seemed to be shared, as far as I could tell, across the many different cultural groupings of Australian First Peoples.
Since then, I’ve spent much of my professional life reflecting on how to better address the overwhelming problems faced by contemporary women caring for their babies. Certain health system approaches to breastfeeding and infant sleep and cry-fuss problems are still shaped (believe it or not) by values and practices imported with, or shaped by the values of, the British Empire. I know, because of my research interest in historical as well as cross-cultural infant care practices, how these persistent sociocultural beliefs contribute to unnecessarily high levels of distress for new parents, despite the strengths of our Australian healthcare system, one of the best in the world.
I started at AICHS just six years after Emeritus Professor Annette Hamilton published her groundbreaking participatory research with Anbarra women and their infants. Her report was called Nature and nurture: Aboriginal child-rearing in North-central Arnhem Land, and it helped shape my own child-raising and the rest of my professional life. Thirty years later, the Secretariat of Aboriginal and Islander Child Care published Growing up our way, an important First Nations’ document which includes quotes from the Anbarra women who generously allowed Professor Hamilton into their lives.
I’ve muted what I’ve had to say over the years about my early professional influences as I’ve developed an innovative set of programs for the support of women and their babies with breastfeeding and unsettled baby problems, because I’m acutely attuned to the disrespect and complexities of cultural misappropriation. But did you read the incredibly gracious Uluru Statement from the Heart, where it says:
When we have power over our destiny our children will flourish. They will walk in two worlds and their culture will be a gift to their country.
I received a gift of culture as a young Australian GP, and this gift has shaped my life and my work in profound ways ever since.
And then (no, I’m sorry, I can’t finish yet, I have to go on ….) there’s the matter of my own family history.
As Baptists, my mother’s forebears had little hope of shaking off the shackles of poverty and minimal access to education in England. So in 1849 my great-great-great-grandparents brought their seven children in a sailing boat’s steerage to Moreton Bay, The Promised Land. My father’s grandparents in Scotland, who were Presbyterians, did well enough breeding Clydesdale horses but could only ever lease their dairy farm from local landowners, would never know the security of owning land. Finally, in 1914, after her husband was killed by a Clydesdale’s hoof and with the First World War looming in Europe, my great-grandmother brought her teenage sons out to the small town of Biggenden, in hope of a better life.
On both sides of my family, my forebears took up (very) cheap land. They integrated into an increasingly wealthy society built upon the riches of vast swathes of agricultural and pastoral country, some holdings the size of small European nations.
I haven’t properly researched, yet, how my own family interfaced with the violent … alright, let me speak the truth … with the genocidal displacement of First Nations Peoples in Queensland, so that we could secure this cheap land. My forebears belonged to a conquering Empire, who assured us we had the right to it (terra nullius). If, as it turned out, settlers had to spill some human blood (rivers of it) to secure this land and better their children’s futures … there was no going back.
But our forebears were ashamed. They kept this secret from the children. It wasn’t the family history we wanted to tell.
I was shocked to discover when I worked at AICHS that the Darling Downs, where I grew up, was a site of bloody frontier conflict. And how distressing it was to see spots marking massacre sites spread like the measles across the map of Queensland in Rachel Perkins’ 2022 documentary The Australian Wars. My home state was the site of more massacres of First Nations Peoples than any other. Is this why so many of my generation in Queensland are planning to vote no? Is it because we just can’t bear it?
My maternal forebears thrived on successful farms and in stable employment. My mother’s great-grandfather Samuel Grimes was even a Member of the Queensland Legislative Assembly for 24 years, unthinkable if we’d remained in England. I’ve seen a headline in The Brisbane Courier celebrating him as “Queensland's first agriculturist". My father’s family had a harder time since the land left-over by the turn of the century was less fertile. Still, they made a good-enough life, owning various small properties. Because of the intergenerational opportunities offered by this prosperous country (and assisted by other social movements including second wave feminism, equitable funding of public schools, and Gough Whitlam’s free universities), I became in 1977 the first in my family ever, right back through our family trees, to go to university.
Cheap land, a wealthy society. (And the rivers of blood).
There is no doubt, once you wade through the misinformation flooding the media right now, that a Voice is what the overwhelming majority of First Peoples are asking for, after a nation-wide consultation process and regional Dialogues. This, at least 80% of First Nations People say, is the next step in reckoning with our painful shared history.
The Voice is simple. It doesn’t threaten any aspect of the Australian way of life (except perhaps the silencing of our history). Each successive government will have the right to determine how the Voice operates. The Voice is advisory only, on matters relevant to First Peoples only. So that it cannot be dismantled, as has happened to First Nations’ advisory bodies in my lifetime, the right to an advisory Voice will be enshrined in the Constitution.
It's a small and gracious request by First Nations Peoples, the request that we vote yes on 14 October 2023.
For myself, when I write the letters y-e-s, I will also be saying:
I thank you.
Pamela Douglas MBBS FRACGP IBCLC PhD
27 September 2023