Globally, March 21 each year marks the UN International Day for the Elimination of Racial Discrimination (IDERD). Bastardised by the Howard government many years ago to wallpaper over any issues Australia has with racism, it has often been referred to here as “Harmony Day”. This day was started to mark the Sharpeville Massacre in South Africa, when police murdered and injured hundreds of black anti-apartheid protesters.

This year, in Australia, IDERD coincides with National Close the Gap Day – a day that advocates for health and life expectancy gap closures for Aboriginal and Torres Strait Islander people. This day first began in 2008, with the bipartisan signing of the Statement of Intent at the National Indigenous Health Equality Summit. 

And so I find myself pondering this duality between health and anti-racism on this day. Is there really a more tangible measure of the racism Aboriginal and Torres Strait Islander people face in this society than the difference between our health outcomes and those of the rest of Australia? 

When the latest statistics are handed down today, I am not expecting any surprises. I say this as a middle-aged, city-dwelling Arrernte woman who has struggled with ear health her entire life (Indigenous rates of ear disease being significantly higher have long been documented), who battles chronic pain in the form of degenerative arthritic conditions in her spine, and who has recently experienced three of her elderly family members die not of old age, but rather of chronic health issues which, in at least two of the cases, were preventable conditions. 

This week, the World Indigenous Cancer Conference kicked off in Naarm (Melbourne). I note that there is a particular global focus for the conference on reducing rates of lung cancer and eliminating cervical cancer in Indigenous communities. The latter piques my interest, not just because the cervical cancer vaccine Gardasil has been available now for nearly two decades and it raises questions for me with regards to availability issues in our communities, but also because, as a slightly older Indigenous woman, I have already had three operations to remove reproductive area precancerous lesions. 

I have wondered how normal my experience is, both for women like me of the pre-Gardasil generations, but also for Indigenous women who, due to underfunding of our culturally appropriate services, shame or remoteness, may have been passed by reproductive cancer campaigns. I particularly wonder this as Indigenous women’s reproductive health only sporadically seems to make the news, usually in the form of remote communities and either period poverty, or the denial of the right to birth on Country. 

I also note that the increased rates of lung cancer in our communities have been raised in conjunction with the consistently higher rates of smoking. There have been longstanding culturally-appropriate anti-smoking campaigns which have had a great deal of success, however rates of smoking, and addiction more generally, remain higher than mainstream rates. The short of this is that we cannot deal with addiction issues in our communities without considering the broader historical and sociopolitical contexts; for example colonisation and poverty. 

Too often, the answer to addiction issues appears to be the criminalisation of Indigenous people. The NT Intervention and the anti-alcohol legislations have done more to demonise drinkers than they have to heal communities. In Victoria, “public drunkenness” has only now been removed from the criminal code – three decades after this was handed down as a key recommendation from the Royal Commission into Aboriginal Deaths in Custody, and only after the family of Tanya Day used their pain at her loss after being locked up for drunkenness to mount a public campaign.

Above all else though, what I am most concerned about when it comes to Close the Gap Day, is the Indigenous community’s mental health crisis and, more specifically, how this is manifesting in climbing rates of death by suicide in our communities. During the campaign for the Voice to be included in the constitution, it was noted by several sources that mental health distress due to racism had climbed, and NACCHO noted an increase in suicide rates in our communities. Calls to helplines had also spiked. 

This is nothing new. Whenever there are particular legislative proposals that impact our communities, similar increases tend to be noticed. The NT Intervention was an example of this, particularly the exorbitant climb in rates of suicide amongst young Aboriginal women. It breaks my heart that so many in our community feel so helpless, marginalised and demonised that we lose so many to this epidemic every year. Also, that Australia, after so many centuries of discrimination against our people, still needs to be convinced that the impacts of colonisation, and the presence of transgenerational trauma, are key drivers of not only these particular statistics, but indeed all other Indigenous health statistics. 

One of the most promising features the new Closing the Gap commitments have going for them is the call for community co-design, and the proper funding of appropriate, self-determined services. With more community control, slowly but surely we may see these health outcomes shift. That is provided that successive governments remain committed to working in collaboration, rather than imposition. 

One day, I do hope to see our mobs living full and healthy lives, in a society where we are not disproportionately impacted by legacies of racism. Where illnesses long eradicated in mainstream communities are also eradicated in our communities, and where the pressures of racism, stress and poverty don’t manifest in addiction but instead lead to positive community-building actions. But I also believe that for now, in a country that could not even allow the most powerless and conservative proposal to be included in the constitution, this remains a pipe dream. Simply put, I believe Australia does not actually want healthy and happy Indigenous communities. It is much more comfortable with our suffering and ensuring the “soothing pillow” agendas of their forebears play out. 

Things could be so different. Today, this dual anniversary throws down a gauntlet and asks us what the elimination of racial discrimination when it comes to health outcomes in communities would need to consist of. I hope the government, and society-at-large, sees the statistics, funds the services properly, and truly uses this opportunity to make positive change for the generations to come.