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10. Reflections on a remote settlement and its arid zone setting
D.N. Parkes, I.H. Burnley, and S.R. Walker
Arid Zone Settings and Settlement Ecosystem
The most significant factors influencing general urbanization patterns and processes in the arid region of central Australia are geographical remoteness from the major population centres and, paradoxically perhaps, relative proximity to landscape features that have a tourist potential. There is also a certain locational advantage simply because Alice Springs is more or less at the remote geographical centre of a continental land mass. Climatic, physiographic, and hydrological features also contribute inputs that influence urbanization, especially in relation to the consequent structure of migration streams, service provision, and delivery.
Population growth has been dominated by migration from the coastal cities, but the remote location and the perceived harsh, hot, and dry "outback," as viewed from the coast, induce a selection procedure that emphasizes the migration of single people or those in the early child-rearing phase of the life-cycle.
The most important migrant origin area is Adelaide, 1,712 kilometres to the south of Alice Springs, to which there is rail and air transport but as yet no continuous sealed road. This urbanization feature has historical roots in Adelaide's role as the one-time administrative centre of the region, but its present significance is the perpetuation of a connection between Alice Springs and "the South" rather than with Darwin 1,526 kilometres to the "Top End," except in official, government terms.
Apart from continuing its rote as a communication node and service centre for the pastoral industry of central Australia, a role it has played since its foundation as a telegraph station on 27 August 1982, Alice Springs is now an international tourist resort and central place for tourism into the central Australian region. Now the very fact of remoteness becomes an attractive attribute, stimulating curiosity and intense and periodically very high levels of urbanization through tourist flows. The winter climate, especially, and the unfamiliar and alluring physiographic features in the central Australian ranges attract the peak tourist population. The winter is not only the period when temperatures are least stressful, but it is also the time when the geographical remoteness of Alice Springs is least likely to be exacerbated by flood and consequent disruption to movement. On the other hand, the winter period is not in optimal phase with Australia-wide holiday periods, and this may be a most important factor in the conservation and management of the arid zone ecosystem. Associated multiplier effects from tourism are also urbanizing Alice Springs through high-technology-based demands to match the expectation and experiences of visitors from among the world's largest and most technologically advanced cities.
The impact on the arid zone, especially along the 400 km of the Macdonnell Ranges, is likely to become intense in years to come, yet the total number of physiographically attractive nodes, usually gorges and water holes, is very small. In addition to individual and private group trips by residents and tourists, large group tours from Alice Springs have the potential to inflict irreversible damage upon these unique, often small-scale, ecological niches. This potential for disruption is increased because of the general image held of central Australia, that there is unlimited space. There is in fact a desertification hazard, to date unresearched, which has its source in the large-scale forces of urbanization operating through small-scale but intense urbanism in such attractive "oasis" foci). Hazards are perceived, and disasters are real but unwanted events; both hazards and disasters have a very important role in human adaptation. The identification of hazards and the dissemination of information about them should be used as an ecosystem management device, to forestall disaster. Heathcote (1980, p. 122) draws attention to the multiplicity of definitions of desertification, but in spite of the "confusing variation" he points to the majority view that it is the interplay of natural and human factors which is the principal cause. The United Nations University studies of desertification in four areas (Heathcote 1980) allowed certain succinct and valuable conclusions to be drawn which are also relevant to this research programme; more importantly:
The continued existence and possible expansion of desertification seem to be the result of a complex interplay of many factors, which might be summarised as the interrelationships between the natural event systems (or physical environment) and the human activity system (or human environment).... Significant in these interrelationships are the human resource managers' perceptions of the resources and hazards which the natural environment appears to offer to their particular activity system.... Unrecognized and ignored these perceptions will lead to continued and locally [emphasis added] expanded desertification; recognised and used in planning of resource management they could significantly reduce the future threat from desertification.... It is the demands upon the natural event systems from the human activity systems, therefore, which create the conditions where desertification is most likely" (pp. 120, 121).
Among the management and other coping strategies required are those that can apply time-management or scheduling programmes that will limit access and so allow the natural attributes of the local setting to adjust to high space and high time density human impact. In human ecological terms there is some danger that the human biomass generated by tourism is going to be too great for the limited number of niches that are most popular with tourists. This may be the single most important arid-zone-related consequence of the urbanization process that is focused on Alice Springs. This is because urbanization induces human activity systems which are, essentially because of the remoteness-distance factor, group related. Such land-management programmes should probably be similar, in their philosophy at least, to the land husbandry now practiced in cattle and sheep rangelands of the arid and semi-arid regions.
Water supplies do not appear to be an immediate problem for the permanently resident population of an urbanizing Alice Springs. However, the costs of supply from the more distant Amadeus Basin are likely to increase rather rapidly, the town basin no longer being considered suitable as a water supply source for human consumption. This situation will be exacerbated, however, because Alice Springs is susceptible to considerable variation in the timing of total demand because of the periodicity of tourism activity. In a high interest rate economic environment there is some danger that adequate capital works will not be undertaken and the permanently resident population will be required to finance rather high proportions of capital works through their recurrent rates.
One of the most valuable resource management programmes that can be initiated in the central Australian region will be to educate the short-term resident and the tourists to have a heightened awareness of the fragility of the desert environment and coincidentally to impress upon them the recency of the presence of "holiday man" in that environment. This amounts in effect to adjusting the behavioural expectations of tourists (and residents alike) from a short-term, almost hedonistic intent based on perceptions of unlimited space and tough, or harsh, landscapes, to behaviour patterns which are cognizant of the pre-perceptual or real behaviour settings that exist; settings that are available to them only for limited periods of time in limited numbers and for a limited variety of activities. Traditionally, all desert peoples have been clear about one thing-the climate and physiographic features of the desert setting will not provide either a persistent or a periodically available habitat if present or immediateuse-demand is allowed to dominate and so disrupt future dependence on the same ecosystem for the same behaviour demands, let alone for those which have yet to be thought of.
Faced with the sort of urbanization which is now occurring in Alice Springs, and therefore related to its geographical setting, the conjecture can be put that the majority of present users (many residents and most tourists), having "experienced the outback," will not return. Not because it lacks habitat or recreational amenity but because it is remote, "ecologically" distant. The future for them is therefore not an issue. Great responsibility is consequently put on the entrepreneurs (as resource managers) whose future does rest in central Australia and in Alice Springs to constrain their potential to maximize market-based gains -in housing, light industrial and commercial enterprise, and especially perhaps in tourism. State and Federal governments have a similar need to be aware of the pressure put upon the desert ecosystem by human activity, especially through the growth in tertiary and quarternary sector public services, which already compose a high proportion of the employment and investment base of the settlement of Alice Springs and its environs. The direct impact is not significant. It is the multiplier effects and the activity patterns generated over and above the public service functions fulfilled by an employee which make the impact. Of course, as with tourism, it is also to some extent the very remoteness of the geographical setting of Alice Springs that leads to high levels of public service employment and dependence. Recent moves towards statehood further stimulate growth in public sector activity based on Alice Springs as a "central place." There is a bi-polar urban impact, north in Darwin and south in Alice Springs. Stimulation of urban growth at Tennant Creek and Katherine will also help to reduce the desertification hazard centred about Alice Springs.
Settlements are composed of man-made structures arranged with varying degrees of efficiency on small "patches." "The concept of patchiness derives from the observation that the environmental factors affecting the immediate behaviours and long-term evolutionary fitness of organisms [in this case, the settlers] are distributed discontinuously in space and time" (Wiens 1976, cited in Winterholder 1980, p. 151). A patch is an area "distinguished by discontinuities in environmental character states from [its] surroundings" (ibid.). Other ecologists view a patch as "a 'hole,' a bounded connected discontinuity in a homogeneous reference background" (Levin and Paine 1974, p. 2744, cited in Winterholder 1980, p. 151). All boundaries are relevant to study when they have significance for adaptive behaviour, and not only when they provide an appropriate basis for analysis of some sort. Patchiness is "organism defined" (Wiens 1976, p. 83) and Winterholder argues that it must be determined relative to the size, mobility, habits, and perceptive capabilities of the population studied (ibid.).
Set within a region the size of central Australia with population sparsely distributed beyond the settlement boundary, Alice Springs itself becomes an ecological patch. The adaptive behaviour in the town, to date, has been from that of the other distant urban centres and not from the arid zone ecosystem within which it now settles. Nor is there much evidence that behaviour beyond the urban patch of Alice Springs into the surrounding region is adapting to the inherent properties of the desert biome. The daily and other periodic demands of the urban dwellers and visitors are for features little different from those available and planned in the coastal regions of the continent.
Within the settlement of Alice Springs it is with the built structures as dwellings, work-places, recreation nodes, and movement paths that day-to-day behaviour is concerned, and there is little evidence from the field studies undertaken in Alice Springs and reported earlier that the residents of Alice Springs have evolved or show any desire to develop a new life-style which can be distinguished from that in non-arid regions of Australia.
This is visually apparent in the townscape in terms of the spatial scale and design of buildings and the functions they perform. It also appears to be the case in daily patterns of behaviour. There was no evidence that either the remoteness of the location or climatic and other arid ecosystem elements acted as special entrainment factors (Parkes and Thrift 1979, 1980) to the sequencing or tempo of human activity on a dayto-day basis. Field study in the hottest summer months of January and February and in the colder winter month of August in turn did not reveal any behavioural adaptations different from those experienced with less extreme temperature changes in coastal cities such as Adelaide or Sydney. However, it is possible and useful to consider certain relations among human activities (behaviour) and the temporal domain of the life-stream in a settlement such as Alice Springs, giving attention to the ecologically dominant element of remoteness and associated demographic features of the population, which, it has been argued in previous chapters, are to a large extent a function of selection processes related to remoteness and perceived isolation, whether the moves are voluntary or employer-directed.
The life-line of an individual begins on the day of birth and continues as a path, without any breaks, until death. We are familiar with this idea of tracing a path over a lifetime in the term biography. Certain key events during the individual's life may be recorded on this line. In addition, biographies may be grouped into charts according to any classification scheme which is convenient or meaningful to the analyst; for instance, as family, socio-economic, racial, or ethnic groups, or by regional location. We might, for instance, chart the life-lines of a sample of all persons living in Alice Springs. What would be the common characteristics of the life-line? What have been the key generating factors? Such a chart of the "flow" of a single person through life, or through a single day, especially when compared to the life-path or day-path of others, is a useful device for evaluating the behaviour of a population. Individuals who are capable of physiologically unconstrained movement and who lead a normal healthy life in fact trace out a bewildering maze of paths through time and in space.
However, before any sort of intended movement can occur, there must be a supply of time and supply of space. It is people who supply time and space, and it is people who demand them. Both are supplied in order that needs and wants can be satisfied. But both are limited. There is not, even in the vast expanses of central Australia, an unlimited supply of suitably timed and usable space. Nor is there an unlimited supply of time. We have seen, for instance, among the expressed views of the residents reported by Parkes (chapter 4), that there are excessive delays in the delivery of many services. This is in the strictest sense a time-supply problem for that category of population demand that is affected. To the extent that Australia's arid zone towns are all "remote" towns, they all have a time supply problem, especially in relation to the availability of certain goods (spare parts) and services. When such shortages mean inconvenience, an adaptation mechanism will occur. Outmovement is one such response, a contributive factor to high transience levels and a sense of isolation. Both time and space may be seen as resources which are to some degree renewable, as with the birth of a person or the arrival of a "useful" migrant, e.g., a doctor, but both are also finite when it comes to appraising them for a particular purpose. This is especially so because they are always used in conjunction. It is not possible to consume one without the other, and both are consumed in combination with various energy inputs by the activities engaged in. Typically these activities are routine and recurrent but usually also involve having to join with others or with "tools" of one sort or another, in order to effect them.
It is therefore necessary to ease the co-ordination of the paths of the settlers and the tools which they need, in order that the various apparently disparate tasks of any one individual may be combined into a productive project of benefit to a wider community or group of people. For the settlement as a whole, such easing of co-ordination becomes an aid to management and to appraisal of the future when the possible paths (or activity predispositions) of the population are distinguished from the impossible. It is necessary also to ensure that what is possible is also socially and ecologically acceptable, and this involves rules and regulations: authority constraints of one sort or another. It is also necessary to ensure, within socially acceptable limits, that what is impossible becomes possible. For instance, Parkes (chapter 4) has shown that open water surface recreation is impossible but desired. Where and when can it be made possible? What will be the human ecological impact in terms of withdrawing population demand from other activities? What will be the sustainable limit of people per unit area per unit time at the proposed water surface in an environment in which a permanent surface of water is an alien environmental element?
The quality of life in any community, whether that community is a persistent or an intermittent one, depends very heavily on the perceived relation between the possibility and impossibility of achievement of intended tasks. When linked together, intended tasks form a project in an individual's life biography. Because it requires time and space consumption to complete any task and many individuals within a population may be competing for the use of the same time period and the same location, it is not surprising to find that social mechanisms of one sort or another have been developed to allocate both. There are many devices, ranging from the entirely informal (say, common courtesy) to the entirely formal (such as licensing laws), which define time locations, as well as the more familiar town planning legislation which defines space locations. Other constraints are either formally or informally imposed, for instance by delimiting those population categories that may use the formalized times and spaces, and those that may not. Such a division between possible and impossible users is evidence of at least some ecological ability to manage the population supply and demand for space and time and therefore of the potential for its formalized extension into other realms of behaviour directly relevant to the conservation of the arid zone ecosystem.
We can formalize these (and other) generalizations with the aid of a few principles that may prove useful to decisionmakers and others concerned with urbanization-related issues in remote arid zone environments. Satisfaction with life in any community is largely determined by the ability to complete various tasks and projects according to personal predisposition and preconditional constraints. This ability is often limited by one or a combination of the following constraints: capability, coupling, and authority (Hägerstrand 1970). Each of these constraints operates to limit or to control access and influences the schedules of conduct that people are faced with. This is important because in the sort of "urban" place which a town like Alice Springs is rapidly having to become, the schedules of conduct that every person has to fit in with are becoming increasingly specialized. If the specialists are not there, then there is no time supplied by that population category (e.g., medical practitioners, plumbers, teachers). The immediate resource management need is to ensure the time supply of that particular item. Some of the most important behavioural adaptations in very remote settlements therefore relate to undermanned environments of one form or another. The chapters relating to adequacy of service provision in Alice Springs implicitly demonstrate the operation of this principle (Barker 1979). Field-based research in Australian arid zone settlements is being undertaken by Parkes to evaluate the incidence and ecological impact of undermanning.
The capability constraint limits the range and number of activities that an individual can participate in because of the behaviour-dominating need for sleep and food but also because of the limitations imposed when access to certain "tools" is denied; for instance, access to a car, telephone, radio, computer, or air conditioning. In fact, most material innovations, and many non-material ones, are intended to exend our ability to reach goals that would be beyond reach in space and/or time if we had to operate entirely within the capabilities of our own corporeality. Specifically in relation to Alice Springs we might ask what items in response to some of the findings from the surveys in 1980 and 1981 are needed (public transport vehicles, air conditioning, libraries, telephones, creches, vehicle spare parts, etc.) in what quantities of both space and time in order to enable certain community goals to be achieved, and how is their availability limited because of remote location, population resourcefulness, undermanning, etc.?
In order for the necessary community items and tools to exist, what categories of people must there be in the settlement? Where would such people be likely to come from, and where and when would the "tools" be used? if they are highly skilled, does the system need them for the whole year? The capability constraint concept allows evaluation of what is impossible because of the lack of certain tools (spare parts, for instance) and also evaluation of what is now possible because of the availability of certain tools. But what will be the impact of population growth on the time and space resources of the settlement and on the arid ecosystem in general? Anxieties expressed in the surveys (Parkes, chapter 4 and Burnley, chapter 5) about the future size of Alice Springs and intended response if it doubles present size need to be evaluated in these time resource terms as well in order to appreciate their full significance. Would there in fact be the same high level of intention to leave if the settlement system were perceived to be able to satisfy needs and wants at appropriate time scales?
The coupling constraint "defines where, when and for how long the individual has to join with other individuals, tools and materials in order to produce, consume and transact. Here of course the clock and the calendar are the supreme antidisorder devices" (Hägerstrand 1970, p. 14). To the extent that general arid zone resource management and settlement management involves the minimization of ecosystem disorder, then time management becomes an anti-disorder device. The appropriate scheduling and pricing of freight services and of all interpersonal communication, whether by telephone, mail, rail, air, or road, and the management, if necessary by quotas, of visitor arrivals and movements seem likely, if distasteful, strategies. There is considerable frustration expressed by the residents of Alice Springs in the irregularity and delays of services. The fact of remoteness as such is appreciated, the poor scheduling is not. Unsatisfied expectations about when a spare part, new tool, or piece of household paraphenalia will arrive is expressed as an important factor in the development of a sense of isolation, leading to low commitment to the community, short residence levels, and a general sense of irritation which is communally unproductive, leading to comments like, "I'm not a Territorian, why should I care?"
The third of the universal constraints includes the set of authority constraints. These constraints subsume those general rules, laws, economic barriers, and power relationships that determine who does or does not have access to specific domains at specific times to do specific things (Pred 1977, p. 208). Associated with this constraint is the familiar notion of density, but in space-time we use the term packing. The concept of packing recognizes that there is a limited facility to put people, their tools, and the things they wish to do into any geographical (i.e., space-time) region. The authority constraint limits packing by design. It is useful to think of all events in terms of the domains of authority within which they are set, and to evaluate their selective impact on different population categories. Authority constraints, which are intended for the benefit of the community at large, may give unreasonable advantage (or access) to some groups at the expense of others. They may occur simply because of a lack of appreciation that settlement structure is cyclic and that constraints which operate effectively for some phases of a cycle may militate against community well-being at other times. The space-time domain of most authority constraints is determined so as to "protect resources, natural as well as artificial, to hold down population density and to form containers which protect an efficient arrangement of bundles" (Hägerstrand 1970, p. 16). These bundles are simply a grouping of several or many individual space-time paths, such as, for instance, a tour party at the site of a scenic gorge in the Macdonnell Ranges.
These three sets of constraints interact in various way to permit the survival of the living system of events that occur everywhere. By first identifying those particular spacetime-contained events operating in an urbanized settlement, it becomes possible to identify their impacts on the ecosystem of their containing arid lands and on the settlement, often not noticeably different from any other non-arid zone settlement in the Australian context, except that remoteness can have certain very significant effects.
Migration and the Alice Springs Context
In the previous chapters remoteness has been treated as a pre-perceptual, ecological factor. It is geometric distances and geographical time-cost-distance that impose severe constraints on frequency of movement between Alice Springs and all other settlements in Australia. Isolation on the other hand has been treated as a perceptual factor dependent on various preconditional (age, sex, marital status) and predispositional (expectations, experience) attributes of the population.
It has been argued that remoteness actually causes specific compositional attributes to occur in the demographic (e.g., age profile), economic (e.g., tourist industry), and infrastructural (e.g., government employees) matrix of the settlement, distinguishing it from other Australian urban places. This causal relation between remoteness and human ecological structure is most evident in relation to migration and therefore to the ability to make certain adjustments among the set of predispositional attributes held by those individuals in the migration stream. However, remoteness and isolation are related, for instance, because perceived (or anticipated) isolation is partly a function of known or perceived remoteness. In this interaction between the preperceptual ecological fact of remoteness and the perceived isolation lies the beginning of the selection procedure that eventually conditions both structural and behavioural characteristics of the resident population. Each of the surveys reported above has inevitably absorbed elements of this interaction in the results obtained. The migration survey, discussed in chapter 5, revealed that one adaptive strategy used by migrants was the development of quite extensive friendship and acquaintance networks, ostensibly as a response to a sense of isolation, through remoteness from close family. This adjustment procedure was evident in the results reported in chapter 4, where social relationships, often acting as family surrogates, were seen as the most favourable aspects of life in Alice Springs.
It appears likely that the pattern of settlement growth and
community life-styles will be influenced further into the
foreseeable future by high population turnover rates. Rising
costs of transportation effectively increase the remoteness of
the settlement as a place for permanent residence, and therefore
increase the probability of the development of a sense of
isolation. The ecological domina
tion of government employment and of great dependency on it also means that a high proportion of the in and out migration occurs at the whim and fiat of employers, and this employment-dependent group is likely to experience isolation more intensely than those who have migrated because they were predisposed to do so. The increasing frequency of association between employer and employee movement patterns in other parts of Australia has been noted (McKay and Whitelaw 1977). Transient migration will therefore continue to be a strong feature in Alice Springs due to the high proportion of employees in tertiary and quaternary levels of government service, because remote area postings are invariably of limited duration. In itself this is an undesirable feature of such appointments, giving as it does a sort of official "imprematur" or nihil obstat, a term of service. In many cases the consequent implications are not hard to deduce.
Notwithstanding this high population turnover, there is likely to be strong growth through the 1980s as the Northern Territory moves towards full statehood. Once again, because of remoteness and the bipolar structure with Darwin, Alice Springs will assume more centralized functions required by government. There will be associated growth in a range of service and light industries to support the resulting urban population, and this may induce some resident stability, especially if risk factors associated with high levels of unemployment make movement out of Alice Springs more difficult.
Over half of the in-migrants (52 per cent of the sample) stated an identity with the Northern Territory; 70 per cent of those who were born in the Territory identified with it. This implies that there is also a large residual out-migrant potential from among the so-called Territorian population. There was concern about the small population size of the Northern Territory being a constraint on effective self-government. Federal Government capital inflow amounts to about A$650 million, and this is seen by some as indicative of the lack of an independent economic viability commensurate with that of the other Australian states. (The total population of the Northern Territory is less than that of many of the local municipalities within metropolitan Sydney.)
Apart from the career transient, "spiralist," or "transilient" pattern of migration among professional, managerial, and administrative personnel in public service and other quasiautonomous government organizations, there was also a secondary movement of opportunistic persons, predisposed to small-town life-styles. However, the migration survey (chapter 51 and the more comprehensive attitudinal survey (chapter 4) both revealed that this group was also fundamentally transient in structure. Montague (1980) and Brealey and Newton (1980) have noted similar structural characteristics in some of the small towns in eastern Australia and in the newer mining towns in the north and west of Western Australia. The scale, dynamics, and structure of the migration stream, in both directions to and from Alice Springs, for black and white population sub-groups is in need of urgent further research. It is critical to the future of the settlement.
Service Provision and Delivery
It has been suggested in previous chapters that many Aboriginal people, for reasons of environment, poverty, crowding, and poor housing, may develop multiple disease syndromes. A common example, given by hospital doctors in Alice Springs, is that the presenting illness is bronchopneumonia, but with secondary iron deficiency anaemia, roundworm and ringworm infestation, pediculosis and diarrhoea, lactose intolerance, chronic suppurative otitis media and oral disease, leading to behavioural disturbances. An unfortunate complication of this kind of situation, which the statistics presented in chapter 9 only hinted at, is that the families of individuals who face such multiple health problems are often resentful or suspicious of outside help, especially if government agencies are involved. This may have caused the sick person and the family to withdraw from their neighbours and from their own community leaders, if they have not already been rejected by them as hopeless.
A feature not shown in many studies of Aboriginal health is the incidence of symptomatic and other ischaemic heart disease. This suggests that the Aboriginal communities may be experiencing stressful conditions, some of which may be caused by the adoption of inadequate life-styles as an aspect of urbanization. Some may result from poor diet and alcoholism, which are also consequences of inadequate adjustment to an urbanization process with easy access to chemically and technologically complex processed foods and alcohol.
In this connection, the European population also shows some unexpected morbidity risk-alcoholism in particular, especially among white males, as well as symptomatic and other ischaemic heart disease-but not to the same levels as for the Aboriginal people. One hypothesis, given the male-dominant sex ratio and the higher incidence of single or unattached men in the town, may be the operation of a "social isolation" factor in ill health. The relationship between isolation from collective life and suicide and other ill health was developed in a classic work by Emile Durkheim (1921) and more recently researchers have expanded this path of investigation into community integration and disintegration and psychiatric ill health (Leighton et al.1963; Burvill 1975), and physical illnesses (Young 1976; Burnley 1980). There is also growing awareness that upper respiratory tract infections among the white population may be caused by the increasing ubiquity of air conditioning systems; an example of the impact of an urban technology on a very dry environment. It is not suggested that the Alice Springs population is in a state of social disintegration, but rather that some sub-groups among the Aboriginal and the white population (but the latter to a lesser extent) are at risk, through poverty, poor housing, and associated complexes for the former and life-style, isolation, and rootlessness for the latter. The sample surveys suggest a satisfactory level of community adjustment and friendship formation, but there was a considerable degree of expressed remoteness from kin.
At least three basic developments are necessary if the health status of the population of central Australia is to be improved. First, the medical aspects of Aboriginal health, with respect to diagnosis, treatment, and management, include a need for awareness of the wide range of communicable infectionssome occur in the general population in strength; the associated and causal aspects of malnutrition, malabsorption, and lowered immunity (Moodie 1977); the frequent coexistence of several diseases in the same individual; and the often chronic burden of sickness in families. Fifty-seven per cent of Aboriginal children in the Alice Springs region under 15 years of age were admitted to the Alice Springs hospital at least once in 1977-1978 (32 per cent in 1978). Most of these were in the 0-2 age group. Approximately 85 per cent of children under age 1 were in-patients of Alice Springs hospital at least once in 1977-1978. Not only do such figures illustrate the burden of illness within Aboriginal families, but they also testify to the importance of the Alice Springs hospital, the Royal Flying Doctor Service, and other ancillary services in keeping Aboriginal and child mortality levels down.
These considerations lead to the second basic development area-housing. Housing conditions-sanitation deficiencies, overcrowding, dirt, polluted water, and the risk of fire-all result in the perpetuation of environmental aetiologies conducive to ill health. Further, poor housing not only affects the physical health of Aboriginal people but through reinforcing their marginal societal position it reduces their opportunities to participate in employment and educational activities, which in turn engenders severe psychological pressure, forcing people who cannot conform to white expectations into depression (Drakakis-Smith 1979). The hospital morbidity statistics presented above show the effects of the latter in alcoholism, alcoholic psychosis, the effects of violence and self-inflicted injuries, and symptomatic heart disease. All in all, the housing, environmental, and living conditions of Aboriginal people will have to be considerably improved in and around Alice Springs if the illnesses reported on here are not to recur, however efficient the treatment and delivery of medical care may be. Improvement in sanitation, housing, diet, and education need not mean either the adoption of absolute European models or the further disintegration of traditional ways. The use of traditional Aboriginal medical methods might be encouraged and perhaps blended with those of the wider society.
The third development may be aimed more at the general population, such as community centres allowing productive social relations to ameliorate the disintegrative patterns evident within the European population-most notably alcoholism, neuroses, other ischaemic and symptomatic heart disease, and some respiratory diseases, the latter of which may relate in part to alcoholism.
Other improvements towards a better health status could be in the area of water cleanliness, since dysentery and some water-borne illnesses were above average levels for the nonAboriginal) population, although not as high as for the Aboriginals. At the hospital itself, interpreters in each of the major local Aboriginal languages should be on hand for assistance in accurate diagnosis and counselling. The admissions and separations morbidity statistics could be improved by further cross-classification to include length of residence in the region, occupational status, and marital status; the latter two of which are significant in mortality differentiation at the national level.
Many of the difficulties of health service provision in remote arid land towns are related not to the absolute levels of provision but to the quality and type of service available. Attracting qualified staff to arid zone towns is a problem faced both by the teaching and medical professions and reflected in community attitudes towards these services (in effect, as argued in the first summary of increasing and maintaining appropriate time supply). Hence the residents' perception of the adequacy of service provision frequently differs from an assessment based on objective criteria (such as hospital beds per capita). Kuz (1978), for example, has warned of the danger in "quality of life" studies of basing findings on only either objective or subjective variables. In this study, medical, education, and recreation facilities are viewed by residents as being relatively poorly provided, despite objectively high standards of provision as revealed in the aggregate statistical analysis discussed by Walker in chapters 6 and 7 and by Burnley and Walker in chapter 9.
Moreover, however adequate the overall provision of services may appear to be, inequalities remain very evident within the settlement; the contrast between Aboriginal and European living standards is often visually marked. This is probably even more so the case when compared to communities outside the larger settlements of Alice Springs or Tennant Creek. Providing services suited to the use of one group within a settlement rather than all groups may result in resentment and conflict and not serve to reduce present disparities. For example, although one section of the community has substantial expressed need for a lake near Alice Springs (Parkes, chapter 4) to alleviate the perceived effects of the aridness of the environment, the necessity for such a facility may be questionable when more basic needs for services to other sectors of the community remain unfulfilled.
The studies of service provision and delivery satisfaction also show that improvement to facilities, however desirable, will not of themselves solve certain fundamental problems with which remote, usually arid zone Australian towns are faced. Certain relatively high morbidity rates may be more related to social and other environments than to the lack of service provision per se.
Problems reported by residents of Alice Springs and other arid zone towns (Brealey and Newton 1978) -racial tension, prejudice, alcoholism-are related to the political and social structure, and will not be solved through palliative measures of increasing service provision alone. It has also been pointed out, and there is some support from the analyses by Walker discussed in previous chapters, that equal expensiture does not necessarily lead to equal outcome. In the case of arid zone towns, normative standards applicable to other locations in Australia are possibly unsuitable for translation, since services may in fact have to be overprovided to be adequate in the remote, low population density environment of central Australia.
TABLE 10.1 Per Capita Expenditure Comparisons, 1979-1980: Northern Territory and Standards for Other States
|Type of expenditure (selected categories)||Standard¹ expenditure per capita (A$)||Northern Territory expenditure per capita (A$)|
|Legislature||4 43||39 95|
|Total (all categories)||777.90||2,410.12|
1 Standard states: New South Wales and Victoria. Source: Northern Territory Treasury, Submission to the Commonwealth Grants Commission, in support of an application for special financial assistance for 1979-1980.
While some of the restrictions to service provision in the towns studied related to the aridness or to the remoteness of the location (such as the cost of retail goods, lack of fresh products, and administrative and travel costs), there are also many other constraints of a structural nature. The political and social structure may be such that private professional practitioners cannot be attracted to remote arid areas; the industrial or economic structure may be such that security of employment can be maintained in certain towns but not others; and the expressed demand for recreational facilities and the expressions of racial tension and alcoholism may be at least as much related to cultural values and societal factors as to the harshness of the physical environment.
As long as there is an efficiency requirement (in the form of economies of scale) in the provision of services, then towns in arid lands may also remain at a disadvantage by reason of their relatively small size. Size of settlement is a limitation on the provision of specialist services and a broad range of goods and services, although as the population size of the town increases, the towns will be able to support more specialist activities and attract more private concerns. The expansion of tourism also offers a means of increasing the level of services available: both the additional numbers of people (which boost the town size temporarily) and the additional income and spending capacity is likely to mean the provision of facilities beyond what might be expected for a town of that size, as in Alice Springs, which has a population of 18,000 people.
Urban growth and the selectivity of migration have had a number of implications for the provision of services. A lag effect in housing construction and accommodation availability and other facility provision has been noted. The particular age structure of the migrants has placed heavy demands on certain services, such as obstetrics, paediatrics, and primary school education. Specialist facilities will have to take account of the special needs of the population of these towns. The high percentage of Aboriginal people in the central Australian area requires extra provision of hospital services, especially to assist those living outside the towns. The sociodemographic nature of the non-Aboriginal migrant to the arid zone town will also affect the type of service required (for example, with respect to leisure and cultural facilities).
However, costs of providing services to centres in remote arid zone areas are considerably greater than similar costs in other areas. Some of these costs are borne by the consumer, but others have to be accounted for by the government. The Northern Territory has submitted that to provide the same level of services as the standard states the per capita expenditure has to be approximately three times greater (table 10.1) and has argued strongly against a standard of cost provision that does not take into account the special difficulties of the Northern Territory (Submission 1980, pp. 230-233).
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