The Voice is an important part of reconciliation for Australia

I live and work in Mparntwe (m’barn-twa), Alice Springs, in beautiful Arrernte country. I have worked here, as an emergency clinician and Director of Emergency Medicine, for over 16 years. The emergency department here sees over 42,000 presentations per year, and the majority of patients that I see identify as Indigenous.

There are rich, proud, strong, diverse Indigenous cultures in central Australia. There are six main language groups in town, and more than 20 in the area we service. Each language represents a different group, with varying cultures, traditions and beliefs. While there are similarities, there are also differences, and this makes it richly diverse.

In Alice Springs, I see the impacts of poverty and dispossession through the gap in life expectancies, first-hand. We see very few geriatric patients compared to other places in Australia. This is because not as many people live long enough to become geriatric.

“In Alice Springs, I see the impacts of poverty and dispossession through the gap in life expectancies, first-hand. ”

We see the diseases of poverty and overcrowding, such as bronchiectasis, trachoma, rheumatic heart disease and end-stage renal failure in people in their thirties – not in their sixties like you see on the east coast. 

Much of this is avoidable. It is primarily due to the complications of chronic skin infections in childhood, as well as crowded living conditions and poor access to showers and laundry, with scabies and lice endemic.

It is upsetting to see young people – mostly in their 30s and 40s but some as young as 20 – with end stage bronchiectasis and receiving palliative care.

It is upsetting to see so many young Indigenous haemodialysis patients in central Australia. While haemodialysis will extend their lives for 10 years, these patients have a life limiting disease and will never grow to be old.

This is especially upsetting because much of this is preventable.

These diseases have practically been stamped out in the rest of the country and are rare in the developed world. Yet they stubbornly persist in central Australia.

I am pleased to say that there have been improvements in the last 16 years. Trachoma is no longer as prevalent as it was and there is hope that it may be extinguished by 2035.

When I arrived in 2008, it was common for me to see young children covered in infected scabies and requiring admission for dehydration and sepsis. Now, it is rare. Progress is being made, and the community is driving it.

But there is still a long way to go.

I remember that there was excitement about the Uluru Statement from the Heart. It was held “just down the road” at Uluru and it represented the culmination of more than a decade of work. The statement calls for three key pillars of substantive reform: voice, treaty and truth-telling. The Voice to Parliament is the first part of the recommendations and the Voice was constructed in line with this.

So, why has this become so controversial?

Opinion is certainly very mixed in Australia, including in Alice Springs. There are varying views in Indigenous communities, and not all are supportive. This is partly due to the diverse cultural groups present in central Australia and part of a healthy debate.

When I listen to Indigenous communities, I hear a variety of reasons for people not to fully support the Voice. Much of it comes down to suspicion of yet another well-meaning intervention aimed at Indigenous people. There is concern that not all Indigenous voices will be heard and that more weight will be given to some voices than others. There is concern that it is just another layer of bureaucracy, and nothing will change, that all of this is futile.

And I can understand this sentiment. There have been so many ideas, so many interventions, so many promises to Close the Gap. Mostly broken. When you have been promised so much, over so many years – generations even – and there is no obvious result, I can understand being suspicious. Anyone would be.

At the same time, I feel this is a negative focus and that we should continue to focus our efforts on positive progress. I believe we need to keep trying. Failure is simply not an option.

I believe the Voice is an important part of reconciliation for Australia.

“How can we continue to make decisions about the health and welfare of Indigenous people without their strong voice in the room? I think we have already proven that we have not done this well, so far. ”

There is a principle diverse groups often use when talking to mainstream groups that I think applies to this situation. It is: nothing about us, without us.

How can we continue to make decisions about the health and welfare of Indigenous people without their strong voice in the room? I think we have already proven that we have not done this well, so far. If we are going to get better decisions and make real positive change, then we need to change what we are doing.

We know that diversity in the boardroom can result in better decision making and better results for a company. I feel the same can apply to governing a country.

Diverse representation in government is essential and it occurs through our democratic election process – even though it sometimes feels like we are making glacial progress in that regard.

“I believe that the Voice to Parliament is a once in a lifetime opportunity to take another step down the road to reconciliation, which we desperately need as a country. ”

But elected officials, including Indigenous politicians, must represent the entire community that voted for them. They are not permanent; their voices will come and go.

However, I believe that a permanent Indigenous Voice to Parliament, that is incorporated into our constitution, is different to this.

Indigenous people make up just over 3% of the population of Australia. They are the Traditional Custodians of this land, and yet are the most disadvantaged populations, with the poorest health outcomes. Leaving this purely to elections, we will not hear that voice. It will get drowned out, as it has for way too long.

I believe the Voice to Parliament is a once in a lifetime opportunity to take another step down the road to reconciliation, which we desperately need as a country. The Uluru Statement from the Heart was a consensus statement and one that came from a place of hope for the future. While the Voice may not be perfect, we should not let a drive for perfection get in the way of progress.

I trust in the Uluru Statement from the Heart and the roadmap towards reconciliation. The Voice is an essential pillar and I plan to support it.