As the Australian state of New South Wales (NSW) battles to contain a third wave of COVID-19 that saw a record 681 new cases on Thursday, a crisis within a crisis is unfolding for Aboriginal people experiencing disproportionately higher rates of infection and hospital admission.
A statewide lockdown was introduced last weekend after clusters of COVID-19 emerged in inland towns and remote rural communities in the west of the state, where one in four people identify as Indigenous.
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Some 300km (186 miles) west of Sydney, the sheep-grazing town of Dubbo that had been virtually untouched by the pandemic is now the epicentre of the western outbreak, with 167 active cases. Seven out of 10 of those diagnosed with the virus are Aboriginal people and nearly half of those are Aboriginal children and teenagers aged between 10 and 19.
“It’s spreading very fast in the Aboriginal community. There hasn’t been a comparable outbreak in such a concentrated space anywhere in regional Australia,” Dubbo Mayor Stephen Lawrence told Al Jazeera.
“It’s a double whammy because the health outcomes and vulnerabilities are particularly acute in these communities, and that makes them more vulnerable.”
Generational health gap
According to the World Health Organization (WHO), Australia’s 670,000 Aboriginals and Torres Strait Islanders have long suffered from poor health and still suffer from preventable diseases like trachoma that are found nowhere else in the developed world.
One-third die by the age of 45, and the average life expectancy for Indigenous people is more than 10 years less than non-Indigenous Australians. The rate of rheumatic heart disease among Australia’s “First Nation” peoples is the highest in the world – 75 times higher than the rate of non-Indigenous Australians. Gastroenteritis, kidney disease, diabetes, influenza – the list of chronic illnesses goes on and on and explains why Aboriginals and Torres Strait Islanders were identified as “a clearly defined vulnerable community” at the start of Australia’s vaccine rollout in February.
Nevertheless, vaccine uptake has been sluggish. Only 29 per cent of Indigenous Australians have had one dose compared with 50 percent of the general population, while only 15 percent are fully vaccinated compared with the national average of 26 percent. The numbers are even worse among Aboriginal people in Western New South Wales with only about 8 percent fully vaccinated, according to NSW Health.
Dr Kalinda Griffiths, an Aboriginal woman who lectures in data research for health at the University of New South Wales, says confusing messaging from the government about the safety of the AstraZeneca vaccine for young adults and church groups who are opposed to vaccinations are heightening vaccine hesitancy in Indigenous communities.
“We know a couple of church groups have gone out and told people not to take vaccines. The church has a very strong influence on people in remote areas, so it’s caused a lot of confusion,” she said.
Some 500km (311 miles) west of Dubbo in the poverty-stricken town of Wilcannia where 69 percent of the population is Aboriginal, six new cases of COVID-19 were identified this week.
“Right now, people are running scared,” a community elder in Wilcannia told Al Jazeera on condition of anonymity. “We have incredibly high unemployment, inter-generational socioeconomic disadvantage – and now this. It’s created a sense of resignation. People just shrug their shoulders and say I’m Black and poor and life is s***.”
A chronic housing shortage in Indigenous communities has exacerbated the outbreak in Wilcannia and other population centres in the arid lands in the far west of the state.
“The reality of living in remote rural communities is that there is still a housing crisis in 2021, that abject poverty is the norm and you are sharing a home with your aunties and uncles, nieces and nephews, and there are people sleeping rough on your couch,” the community elder in Wilcannia explained.
Dubbo Mayor Lawrence says large households make compliance and enforcement of lockdowns difficult.
“Lockdowns mean different things to people living in a nice house in the city to those in the country living with large family groups in crowded housing estates,” he said.
“We have a massive compliance operation under way right now but we’re facing big challenges because Aboriginal people in Dubbo are very tightly connected to communities in Walgett, Burke and other towns in the north. We’re the hospital base for those communities, so anyone who gets sick has to come here which also increases the chance of transmission. It’s not a double whammy, it’s a triple whammy,” he said.
Some 200km (124 miles) west of Wilcannia, the outback mining town of Broken Hill recorded its first case of COVID-19 since the start of the pandemic on Tuesday.
“The key strategy to reduce transmission is lockdowns,” said the town’s mayor, Darriea Turley. “But how do you lockdown in a small remote community like the ones surrounding us that don’t have many services, where the hospital has no intensive care unit or isolation ward and where essential workers are going home to houses where people are sleeping rough. How do you safely manage a workforce when you have housing problems like that?”
With transmission rates still climbing and the lockdown in western New South Wales extended until August 28, the government has sent in the army to help with welfare, enforce lockdowns and vaccinate people in the area.
Starting on Saturday, five “highly mobile, highly flexible and highly trained” teams of about 70 army personnel will monitor walk-in vaccination clinics where appointments are not needed for a Pfizer jab in Dubbo and other vulnerable communities out west. A further 50 unarmed soldiers will be assisting police with compliance and the distribution of care hampers to people who are self-isolating.
“We’re working closely with the Aboriginal community to keep them safe, to make sure that people are getting tested and making sure that people who have been in contact with other cases are aware that they need to isolate,” Dr Jeremy McAnulty, the executive director of Health Protection NSW, told reporters in Sydney on Tuesday.
But the community elder in Wilcannia says the statement only shows how out of touch bureaucrats in Sydney are with the far west: “With so much overcrowding, the idea of isolating at home is ridiculous. There are just no places you can go to isolate.”
Mayor Turley of Broken Hill voices similar sentiments.
“What is happening now was expected because when the outbreak started in Sydney, the state government refused to address regional travel. Vaccines take a month to start working so what they’re doing now, it’s too little, too late. All we can do is hold our breaths and see what happens within the next 48 hours,” she said.