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The Colonial Medicine of Settler States: Comparing Histories of Indigenous Health

2007; Volume: 9; Issue: 2 Linguagem: Inglês

10.1353/hah.2007.0033

1839-3314

Warwick Anderson,

Australian History and Society

TheColonial Medicine of Settler States: ComparingHistories of Indigenous Health WarwickAnderson The history of Indigenous health connects inextricably with matters of geography and colonisation. 'Indigenous' usually connotes a place, often figured as marginal or isolated or developmental- as somewhere else.1 More pertinently, Indigenous status implies- or rather, is predicated upon- a history of colonisation and dispossession, with consequent resistance and adaptation to invaders and settlers. The term marks the contrastbetween original inhabitantsand colonisers. The effort to identify some special Indigenous essence or type ultimately is futile since the status emerges out of political subordination under settler colonialism.2 The history of Indigenous health thusdemands sensitivity to the impact of both colonialism and the incipient white nation-state. Moreover, it requires a critical awareness of the dark sides of contact, 'civilisation,' and 'development,' as well as an appreciation of themultiple implications of therelatedprocesses of assimilation, integration, and self-determination.3 Since first contact with European invaders, Indigenous people on the whole have been sicker and died younger than non-Indigenous inhabitantsof the same colony or state.4These health disparities have lessened significantly in North America and New Zealand, but remain severe across Australia.5During the late-twentieth century, some historians attempted to explain the initial colonial impact on Indigenous societies in biological terms. Thus infectious diseases swelled the 'ranks of death,' as Indigenous people suffered 'virgin-soil' epidemics, the natural result of 'ecological imperialism.'6As most of these historians later conceded, such biological analysis tended to discount the unnaturaleffects of warfare, dispossession, and demoralisation on health and social organisation.7 Biological explanations of contemporary health disparities are largely out of fashion- the 144 Health&History, 2007.9/2 ComparingHistoriesof IndigenousHealth 145 'thrifty gene' hypothesis notwithstanding.8 Rather, historians of continuing Indigenous illness and disability now are more likely to address the lasting effects of racial discrimination, dispossession, family disruption,poverty,social marginalisation, and limited access to health care. As Mick Dodson reported to the United Nations Working Group on Indigenous Populations: 'We are all partof the world community of Indigenous peoples spanning the planet, experiencing the same problems and struggling against the same alienation, marginalisation, and sense of powerlessness.'9 Just as attitudes toward the causation of Indigenous illness and death have changed, so have proposed solutions to health disadvantage varied over time. When Europeans moved intoAustralasia andNorthAmerica, they frequentlyrepresented the original inhabitants as primitive nomads rambling over isolated yet strangely desirable territory. Indigenous people thus were cast as feckless, immature, and vulnerable. For some observers they were a dying or 'doomed' race, requiring only some perfunctory palliation of their passing.10 Others eventually recognised the potential- especially of those of mixed ancestry- for assimilation into the predominantly white national community so that problems of Indigenous health should gradually dwindle into ordinaryproblems of proletarian health.11More recently, policies of 'self-determination' have allowed some Indigenous people to influence the framing of their communities' health problems and to participate actively in responding to their distinctive challenges of illness and disability. Yet it remains difficult for any settler society to invest seriously in people whose continuing existence etches in clear relief the illegitimacy and violence of the state. Settler states are more comfortable intervening to correct health disparities the morereadily they recognise sufferersas similarto ordinarywhite citizens. While self-determination efforts assert difference and independence, and thus generally meet with state indifference or hostility, assimilation policies permit some basic civic recognition, thus demanding larger financial commitment and political attention from national leaders. Unfortunately,it seems even the illusion of autonomy is incompatible with delivery of government services. 146 WARWICK ANDERSON Aboriginal Australianhealth became a distinct historical issue in the 1970s during the period of self-determination. Before that, it was subsumed in accounts of contact and assimilation, or employed as colourful backdrop to medical biography, or lost in a sad footnote to the history of medicine in white Australia. Not surprisingly, anthropologists led efforts to situate more traditionalAboriginal ideas about illness in their proper social and historical context. When Janice Reid began her study of Yolngu health beliefs in 1974, it soon became clear that without carefully considering the history of contact with outsiders, notions of resilience, continuity, and change in disease explanation had little...