Parasitological studies in an aboriginal community : an interpretation of public health implications

Abstract

There is an extensive literature on the growth and physical status of Australian Aborigines. These investigations which recorded anthropometric, physical and biological data, often formed the bases for medical intervention. The resulting health statistics generated wide public interest in the health and welfare of Aborigines and stimulated increased Government involvement and support. Numerous studies were extended beyond examination and treatment to inves— tigations of the underlying factors associated with the poor health status of the Aborigine. Subsequently, reports incriminated malnutrition, poverty, life-style, environment, sub-standard hygiene practice and general ignorance of disease aetiology as fundamental Socio—physical factors exacerbating disease. Infection with intestinal parasites was considered to be associated with the poor physical status of Aboriginal children and in 1970 a major programme was initiated to record the distribution, prevalence, transmission and treatment of parasites in Queensland communities. As part of that programme, extensive and intensive parasitological studies were conducted at Cherbourg between 1970 and 1980 and these investigations are reported in this thesis. Cherbourg Aboriginal Community showed many of the characteristics of progress that would be expected in any Australian country township in a similar stage of development. The growth of local industry and commerce, the establishment of community-based health,education and welfare services and the pursuit of social and recreational activities, illustrated the advancement of the community. Throughout the ten years reviewed, Aboriginal children living in Cherbourg were found to harbour heavy loads of many intestinal parasite species. The risk of infection was associated with poor personal hygiene and an intimate contact with the contaminated environment. A situation of infection, re-infection and superinfection existed in the community which had a high parasite endemicity. Short—term treatment programmes for parasitic infections under these circumstances had little or no value. The successful control of Ascaris Zumbricoides over the study period (1970-1980) highlighted the efficacy of a long-term approach that involved repeated examination and treatment, environmental monitoring and public health education programmes. However, because there was no recorded reduction in the prevalence of any intestinal parasite species other than Ascaris Zumbricoides, it is suggested that chemotherapy was responsible for this improvement. The major findings and observations related to public health intervention, supported the conclusions of many senior Australian medical investigators. Foremost, was the concensus that Aborigines must be allowed to take increased responsibility in the management of their own health. This should include involvement in the organization and administration of health services, the identification of health problems and involvement in the planning, implementation, maintenance and evaluation of health programmes. This participation will not guarantee success but will ensure that future public health campaigns include decisions made by Aboriginal people.