Maningrida Tears

In the final weeks in Maningrida we worked as hard as usual (possibly harder as in the last 2 weeks I was on call and was called in 6 times out of hours which was very unusual!). Around work and the kids we had a lot of packing to do. Ed prepared the camper van for another big trip. We had boxes and bikes to put on the barge and eventually onto the backload of a truck going to Sydney (though sent at the beginning of June at the time of writing they have yet to arrive!). Ed had to move all his stuff into a small but perfectly comfortable little house under the Department of Education.

We had to re-home our turtle who had grown from the 10cm diameter baby to a 20cm diameter turtle who needed a bigger tank. We were lucky to eventually re-home her at the local pre-school who got her a friend. The two turtles fought in their huge tank so they built a perspex divider so they would have companionship without hurting one another. They had plans to build an outside pond area so that during the day the turtles could be outside in a more natural environment and the children could interact with them. A dream solution for Leili!

We also had to workout what to do with the most loyal dog in the world. We have all grown to love Max so much! We had a grand plan to temporarily house him with Mel but on the last day he wriggled under the gate and chased the car down the dirt road for at least a kilometre. Luckily friends later posted us photos of him as the Maningrida Covid vaccination mascot or we would have been very worried about him. I can report that as soon as Ed returned to Maningrida, Max found him and has settled into life in Ed's new house happily, although he is lonely without the kids and sits outside Ed's classroom every day.

Of course Maningrida teased us with the glorious early dry season, providing beautiful days, cooler nights, gorgeous flowers and spectacular sunsets.

We had a series of "lasts". Last playdates:

Last beach clean up:

Last pandanus collection. Here is Pansy, our neighbour, shredding pandanus.

Last visit from a local artist. This chap brought over a spear thrower and let the kids try to master it in the front yard. He had a lovely chat with us and didn't seem to fussed that we didn't want to buy it. We found the local people amazingly generous in sharing their culture with us throughout our time here.

An amazing last excursion. Olga, Mason and their boys Alex and Reid took us to the Blythe River. We found what Mason assured me was a safe, shallow area to splash around in. A few of us attempted to fish. Only Mason was a successful fisherman but he caught an amazingly fat Barra which we cooked right there and then, on the bank of the river.

School and work goodbyes:

We had an awesome goodbye party (note that the girls thought that they were VERY funny with those EMPTY beer cans. I can't have this level of irresponsibility here for posterity!).

And some quiet moments with special people.

I'm going to sign off with a version of a letter I wrote and sent to a few politicians. I wrote it in the car as we drove away from Maningrida and towards our holiday in WA. I think I captured my emotions at that time. This is a longer version of the letter I eventually sent. I later took out much of my own emotions and included a long case example which I can't share in this public space because the child that I featured, though de-identified, would be identifiable to Maningrida locals because of the details of his story. I'll include MY feelings here, to share with you.

"Honorable Michael Gunner

Minister Natasha Fyles

Minister Chanston Paech

Senator Warren Snowdon, member for Lingiari

Senator Malindirri McCathy

Mr John Patterson, CEO of AMSANT

Ms Pat Turner, CEO NACCHO

Dr Hugh Heggie, CMO NT

Mr Ken Davies PSM, CEO of Territory Families.

July 2021

Yesterday I drove away from the remote aboriginal community that I have called home for the last 2 years. In the last 24 hours I shed so many tears. Tears for friendships forged and now separated. Tears of uncertainty about the path ahead. Tears of pride for my contribution in that complex environment. Tears of exhaustion as the to-do list seemed to grow rather than shrink. Tears of deep appreciation for the privilege of being welcomed and accepted by a people who have every right to be wary. And an eventual realisation that some of the ache in my belly is actually a kind of survivor guilt.

Don’t get me wrong, I am not traumatised by my experience. We felt safe in our town. We met amazing and inspiring people, we learned more about this ancient culture than most Australians will ever know. The glorious moments far outweigh the difficult ones. Like many health workers and first responders around the world what I carry is some vicarious trauma.

I saw lots of confronting and complex situations in the course of my work and my life there but the resilience of the local people was an inspiration rather than a cause for despair. What really broke my heart was to continue to work in a system that is so deeply flawed. In the area of child protection, youth services and youth crime the system designed to support children can only be described as broken.

In late 2019 a colleague joined some dots and realised that rising lead levels amongst some of our teenagers was related to sniffing aviation fuel. This prompted more direct involvement of doctors in the care and coordination of at risk teens than had previously occurred. Like several other places in the NT, our town, from late 2020 through to quite recently, experienced a disturbingly sharp rise in crime. Why that occurred is outside the scope of this letter but now I had a front row seat to see how this perfect storm would be dealt with and boy, was I going to be disappointed.

The town was lucky to have a particularly dedicated group of people working in this space including very sympathetic and compassionate police officers, a counsellor, psychologist and youth worker who were deeply committed to grass roots interventions and collaboration with both families and Indigenous leaders, people working in youth diversion who really wanted to connect with the kids, a teacher from the school who knew the children and their family context intimately after working in the community for 20 years, and the Territory Families (TF) providers who certainly wanted to keep children safe and make realistic plans for their futures. The Volatile Substance Abuse (VSA) team in Darwin were unfailingly sympathetic and kind on the phone as they filled in their endless reports and as the CDC contacted me repeatedly to chase up the cause of the many cases of lead poisoning, they tried their hardest to minimise the extra workload they placed on us administratively without being able to provide any on-the ground support either. The visiting paediatricians took the time to counsel all these kids individually on their monthly visits and the school nurse chased them for their blood tests and other treatments with vigour. Despite this dedicated dream team, I watched as children bounced back and forth between service providers without any real progress and felt a growing sense of doom about what their future might hold.

We could spend years (I’m sure a bunch of academics already have) discussing the root cause for the social problems encountered by Indigenous youth. Intergenerational trauma surely underpins it all. These issues and more are incredibly complex and require a very long term investment of resources (both human and material) to address. For the moment, though, we have a small but significant proportion of children in community growing up in an environment in which, by the time they reach middle primary school, they can see for themselves is difficult to be happy in. The future looms and it doesn’t look pretty and they feel very little agency in their own lives. They can see no way forward. Sniffing, smoking gunja, roaming town in gangs and smashing stuff seems as good a response to this situation as they can find. As they disrupt the fabric of these small communities they become involved with services whose stated goal is to help them. And yet, so often, we don’t.

...

So how can Tom make any headway in life? And how can the poor staff on the ground do anything but slowly drown in the helplessness of his situation and the similarly dismal situation of a dozen other children like him. How can we be expected to get job satisfaction when we are stuck running like mice on a wheel that goes nowhere? We become emotionally invested, naturally. We get to know his mother and her struggles. We bond with a family member who works in the clinic. His grandmother attends regularly and cries out her fears to the staff who will listen but are helpless to do anything.

It is time for me to go. For lots of reasons unrelated to Tom and his mates. But I go with a heavy heart. I have made far less impact than I hoped I would. And on departure I disrupt all the bonds I have made and left in my wake another little hole that the next person will have to fill and it won’t be easy for them because these relationships are complex. I feel guilty as I head towards a latte and smashed avo life in the city. I’ll be with family and friends who have issues, sure, but a fraction of what the people in this town have to deal with all the time. I’ll show them photos of the beautiful landscape and the wonderful friends I made and the amazing cultural experiences I had. But Tom will still be there with no way out. All the Indigenous workers at the clinic will continue to show up day in and day out trying to contribute something to that community while at home their own families carry some mixture of these problems as well.

I guess all I have to offer now is this. This howl in the wind. A plea for change. It is tempting to publish this letter more broadly so that everyone can see just how messed up this situation is. Aside from the sociopolitical issues around my white voice airing these aboriginal problems there is my fundamental lack of trust that political action in response to any potential outrage from the public would be constructive. Better to air my concerns more quietly in the hope that leaders who are not already aware, can see how poorly their policies and structures work in real life, and have time and space to enact more considered responses. So, what do I want?

I want the media to stop fanning the flames of hatred for the police. In my experience these tough but sensitive souls work very hard and engage with their hearts as well as their minds. They are functioning in a broken system too.

I ask the government administrators to stop insisting that we send more and more reports up the line for no one to read or respond to. Let us get on with the real work.

I ask for fewer middle managers and more boots on the ground.

I ask that drug and alcohol services be amalgamated with volatile substance abuse services and the funding for both be hugely increased. The paperwork associated with the VSA Act is needlessly onerous and the issues at a social and medical level overlap with other drug and alcohol problems. Ditch the VSA Act, amalgamate these services and fund them properly so that service providers can be on the ground in these remote communities providing long term support and case coordination, education in schools and family support.

Mental health funding needs to be increased and services overhauled. Proper family support services and counselling support for children need to be accessible on the ground.

Everyone needs to take genuine interest in the social determinants of health including the role of intergenerational poverty, trauma and the extent to which environmental and land degradation erode trust and wellbeing. The health consequences of decisions made by all departments should always be considered.

I ask for change. Real, deep, long term change. That means long term funding for projects not short term grants for interventions that get up and then fall down. That will require real leadership and bipartisan support for long term plans.

And more. So much more. But these things would make a great start.

In the meantime I leave a little piece of my heart in that place and with those people.

Sincerely,

Dr Emma Skowronski