Universal Health – Australia
The essential role of community action for First Nations people with disabilities during the pandemicJune Riemer and Karen Soldatic
Disability, chronic conditions and illness disproportionately impact on Australia’s First Nations peoples. According to a nationwide survey conducted by the Australian Bureau of Statistics in 2015, almost a quarter of the estimated 523,200 Aboriginal and Torres Strait Islander population were living with disabilities, compared to only 17.5 per cent of non-Indigenous Australians.
However, First Nations people with disabilities live in a variety of geographical locations, including inner-city areas, regional towns and remote First Nations communities. As a result, access to appropriate disability support and services varies and is highly uneven.
This has meant that many First Nations people living with disabilities experience what is commonly referred to as double or triple disadvantage, due to long-standing experiences of racism, disablism and, at times, geographical location. The intersection of disability, Indigeneity and geographical location has therefore resulted in specific outcomes and impacts for First Nations communities during the long lockdowns and continued uncertainty brought on by COVID-19.
Most importantly, it has been the leadership role of First Nations communities, organizations and services that have sustained community members living with disabilities, keeping them safe, well and supported throughout the pandemic, thanks to their respectful decision-making and democratic safeguarding.
Closing First Nations communities: Rapid leadership and direction
Given the level of health vulnerability experienced by many First Nations community members, particularly with regard to chronic illness and disease, First Nations peoples across Australia rapidly ‘shut down’ access to outside residents, officials and non-essential staff and workers in response to the outbreak of COVID-19. This occurred prior to the national Australian government shutdown. The decision to close down external access to First Nations communities, particularly in rural and remote regions, was driven by Indigenous medical expertise within the First Nations community-controlled health sector. Despite being under-funded, with experts often stretched thin given the large areas they are required to cover and travel around, the swift response kept community members safe, many of whom are among those most susceptible to the worst impacts of the virus.
As a result, First Nations communities in Australia, unlike other Indigenous communities facing settler-colonial contexts, were able to maintain one of the lowest rates of community transmission across the country through these active strategies of Indigenous sovereignty and taking control of their lands. Yet this strategy of self-imposed community shutdown was highly contested by local and state authorities. For example, in some regions, government officials removed First Nations’ community blockades to enable ongoing access, even though there were no national protective safeguards in place at this time. Community members persisted and resisted local authorities’ demands, instead trusting in First Nations’ medical expertise and recommendations.
Access to PPE and support for vulnerable family members
For rural and remote First Nations residents living with disabilities or chronic illnesses, one of the core issues to emerge was the lack of access to appropriate personal protective equipment (PPE) and disability supports. It took extensive lobbying of government at both the state and federal levels* to access the necessary resources to protect disabled community members and members living with chronic, potentially life-threatening conditions. These measures were necessary to ensure that critical essential workers moving in and out of the community did not unwittingly contribute to transmission of the virus. The large distances between First Nations communities, and between these communities and core, essential health and medical services within rural and remote Australia, mean that the movement of essential workers from community to community creates heightened risk of coronavirus spread across vast regions. Thus, timely, readily available PPE was critical for First Nations members living with disabilities or chronic conditions.
Nevertheless, even with extensive pressure from First Nations disability advocacy groups, consideration of disabled community members was often absent from both the formal First Nations community health services and the mainstream disability response. Communities often relied on the goodwill of trusted volunteers and family members to take up personalized support roles in the absence of specialist paid disability support workers. Additionally, Aboriginal organizations such as First Peoples Disability Network also mobilized their local workers to step in and support those communities where critical disability supports needed to be maintained. Again, it was the self-organization of First Nations communities and agencies that protected First Nations community members living with disabilities or chronic conditions.
Access to essential goods and services: Food insecurity
One of the core issues faced by many members of the disability community in Australia was the lack of access to essential goods and services, especially in relation to sustaining high-quality nutrition. Working in partnership with the Muslim charity Al-Ihsan Foundation Australia, local staff from the First Peoples Disability Network identified residents with disabilities in need of food, water and other essential items. Extensive lists were created to establish national distribution of food parcels. This effort played a critical role in overcoming food shortages brought about by urban residents – themselves reacting to the panic buying in cities – travelling to regional and rural towns to purchase items in bulk.
This not only had the effect of depleting local stocks, but also resulted in additional costs for First Nations communities. Often, after driving 200 to 300 kilometres to regional supermarkets from remote towns and communities, First Nations community members would find shelves empty of stock, forcing them to make the same journey again a few days later with no guarantee food supplies would have been replenished. This resulted in many First Nations communities spending large sums on petrol and transport, a situation which would quickly have proved unsustainable. The partnership between Al-Ihsan Foundation Australia and the First Peoples Disability Network was absolutely critical in shoring up food security for residents in remote locations living with disabilities or chronic conditions during this fraught time.
Sovereignty, self-determination and justice: Black Lives Matter
Finally, the death of George Floyd in the city of Minneapolis in the United States galvanized Australia’s First Nations peoples into action. Even though the federal and state governments attempted to foil the national days of action and demonstrations by suggesting the possibility of mass community transmission as an outcome, and in some instances refraining from issuing or withdrawing permits to protest organizers, First Nations peoples and allies rallied in cities across the country. First Nations activists carefully crafted and monitored these protests across the country to protect community members and allies, particularly as some members had travelled from remote rural areas. These protests were in response to the ongoing injustices First Nations people experience with police and the rise of Indigenous deaths in custody, despite years of First Nations advocacy, activism and lobbying aiming to change the situation.
The struggle for sovereignty, self-determination and justice continued throughout the pandemic, and First Nations in Australia have remained at the forefront of campaigns for racial justice, respect and self-determination. The First Peoples Disability Network and collaborating organizations have been part of these campaigns, given the high rates of First Nations community members living with disabilities who have been incarcerated. They have been particularly active around the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, undertaking extensive submissions. Their continued leadership in the midst of the current crisis is a testament to the essential leadership role of First Nations communities in ensuring their sovereignty and self-determination.
*Australia is a constitutional federation where there is a well-articulated division of responsibilities across federal and state governments, along with local governments. This creates a number of particular issues for First Nations peoples as their communities cut across multiple state borders and municipalities.
Photo: A painting by an Aboriginal sister telling the story of her younger sister with a disability and their mother, Australia. Courtesy of First Peoples Disability Network Australia.