Alcohol-related deaths in the Northern Territory are 31 times higher than the rest of the country. What can be done?
It's just on dusk in the Kimberley community of Mowanjum. Five cars in various states of disrepair and filled with youths laughing and waving from the open windows head down the road on a grog run to Derby, a 10-minute drive away.
It matters little to the drinkers, many of whom are under-age, that they pass a large sign declaring that Mowanjum is dry, or that the council chairman Gary Umbagai is often forced to enlist the help of the local police to enforce the ban.
They know the police are stretched and the few officers will only respond to Umbagai's desperate calls if something bad happens - a suicide, rape or vicious assault. What is intriguing about the jubilant convoy is that the cars are driven by older men humbugged into making the trip by youths who don't have driving licences.
The grog run is a fixed ritual that involves buying enough booze at whatever price to last the weekend. But when the drinking binges end after the last slab of beer is downed, the result is total mayhem for the community of 250 men, women and children.
As Fairfax Media has previously reported, Mowanjum is where traditional owners cry for help amid the chaos, but help seldom comes.
Decades of saturation drinking can be clearly measured in appalling school attendance rates, welfare-dependent parents too inebriated to care for their children, 80 per cent unemployment and recently a ''cluster'' of suicides involving young people affected by alcohol.
I thought of Mowanjum and Gary Umbagai's futile struggle as I sat through the Northern Territory's ''Grog in the Territory'' summit in Darwin on Friday as speaker after speaker testified to the appalling damage done by decades of excess that have made both the Territory's indigenous and non-indigenous drinkers the thirstiest in the nation and possibly the world. Mowanjum may be in Western Australia, but there are scores of communities just like it in the Territory.
Donna Ah Chee, the acting CEO of Congress Health in Alice Springs, told the summit everyone is harmed by alcohol abuse. From 2004-2006 alcohol-related deaths in the Territory were 31 times higher than the rest of the country. About 90 per cent of assaults in Alice Springs involve alcohol, and Aboriginal women are 80 times more likely to be hospitalised after being assaulted than women living anywhere else. Territory taxpayers pay an estimated $4000 a year each to meet the costs of alcohol-related trauma and healthcare compared to $1000 elsewhere in Australia.
But it was a presentation by two extraordinary Kimberley women, Maureen Carter and June Oscar, that reminded me of Mowanjum. They are veterans of a long, bitterly fought campaign in the Fitzroy Valley to not only bring down catastrophic drinking levels, but to assess the impact of alcohol on a generation of children.
With experts from Sydney's George Institute for Global Health and Sydney University's faculty of paediatrics and child health, the women have successfully established the first comprehensive assessment of Foetal Alcohol Spectrum Disorder. (The results of the study will be published in May.)
It is a disorder that arises from the damage done to a foetus by a mother's alcohol consumption, usually in the first trimester before the woman may know she is pregnant.
In the most severe cases, FASD children experience total cognitive breakdown including day-to-day memory loss, making classroom schooling near impossible. They are also prone to engage in self-harm and anti-social behaviour.
What Carter and Oscar told the summit amounted to a wake-up call not only for the Territory's recently elected Country Liberals government, which is considering making grog available in remote communities that long ago elected to be dry, but the nation as a whole.
The Territory, as one delegate to the summit put it, seems to be suffering from a form of ''collective amnesia'' about the reasons liquor bans were imposed in the first place.
Oscar's blunt message, based on her experiences in the Kimberley, was that FASD affects far more children than previously thought. After decades of sustained heavy drinking in the Fitzroy Valley that led to 55 deaths in one year, the rate of FASD is alarmingly high. Teachers estimate it at 35 per cent of all children attending school.
Oscar puts it at 40 per cent and Fairfax recently published that in a cohort of eight-year-olds it was significantly higher.
''This is the biggest issue facing the nation and I cannot understand why Australia has been so slow to recognise it as a major public health issue as it is in Canada and the United States,'' she says.
Oscar, a forceful advocate and activist from the Bunuba language group, says much of the dysfunction in Aboriginal communities and welfare-dependent non-indigenous communities can be attributed to the disorder and the Territory government should be taking careful note.
Maureen Carter told the summit that Fitzroy Crossing was now a community under reconstruction after 40 years of chronic oversupply of alcohol. ''It was bad government policy, we had so many deaths, people were dying because of alcohol, we had 13 suicides in 13 months … we had seen rape, murder and assault. Kids with FASD were being incarcerated.
''Women took up the fight because they had a right to be safe, so do the old people who cannot look after themselves. But the decision all came from us, we did not rely on government; if the government had imposed the restrictions around alcohol they would never have worked,'' she added.
Oscar and Carter believe that if you look at the most dysfunctional communities in the Territory, much can be explained by FASD. Drinking mothers produce brain-damaged children who cannot learn, who grow into kids who overreact when love relationships go wrong, vandalise public property, steal and more often than not end up in the Territory's overcrowded jails.
What sparked the landmark summit was growing consternation over the decision by the government of Terry Mills to abolish Labor's banned drinkers register, which had prevented 2500 problem drinkers from buying alcohol.
Immediately after his election win, Mills promised to review alcohol bans in Aboriginal communities. Last week he said he would hold secret ballots to determine if alcohol bans in Aboriginal communities should be lifted or eased. But another election promise to establish boot camps for serial drunks appears to have been quietly shelved.
Just precisely what the Mills government is planning in the way of alcohol reform is a mystery box. Five ministers - Mills, the Health Minister David Tollner, Justice Minister John Elferink, Indigenous Advancement Minister Alison Anderson and the Minister for Central Australia, Robyn Lambley, are all having a say. A ministerial statement by Elferink has been widely criticised for its lack of enlightenment.
Tollner, the minister actually responsible, has undertaken to treat changes to the drinking laws as a public health issue, but declined several requests from Fairfax Media to elaborate.
This lack of clarity has led to much dismay and to claims being made at the summit that the government is ''playing with fire'' by pandering to indigenous interests that want ''wet canteens'' or taverns established on communities as a way of raising revenue, and to non-indigenous voters who want to see Aboriginal drunks forced out of town and back to their homelands.
Professor Peter d'Abbs, from the Menzies School of Health Research in Darwin told the summit there were many myths surrounding wet canteens. Past research indicated that where a tavern or wet canteen existed in the Territory, more men and women drank in volumes twice the national average. Mildred Inkamala, a Hermannsburg delegate, said: ''We don't want canteens, they are no good for us.''
D'Abbs said the idea of a community raising extra revenue from liquor sales had implications for whoever had control of a community's finances that in turn had implications for women and children who were generally disenfranchised.
''It's not a matter of clubs being good or bad; if the community wants a club that is their choice. But there are very real dangers involved.''
Surprisingly, in all its public responses, the Territory government has shown little enthusiasm for the groundbreaking programs run by Noel Pearson's Cape York Institute that have been directed at breaking the nexus between welfare and alcohol dependence with an emphasis on social responsibility, school attendance and community accountability.
Nor do they show any awareness of the FASD or crucial alcohol-related childhood development problems outlined in detail to the conference by Dr John Boffa of Congress Health in Alice Springs.
The summit, convened by the Central and Northern Land Councils, the Central Australian Legal Aid Service, the Aboriginal Medical service Alliance and the Northern Australian Aboriginal Justice Agency, was an attempt to raise community awareness before legislation covering the proposed changes is introduced. But it will take more than a summit to mobilise opinion on a much broader scale.
The summit ended with a call for the return of the banned drinkers register, evidence-based reforms, cross-cultural training for police and health workers and a general recognition that alcohol abuse is a health, rather than a criminal, problem. It also urged the government to learn from the reform efforts of the Fitzroy Crossing women.
The message from the conference was also complicated by the fact that not all communities face implacable alcohol problems, problems that are not solely confined to indigenous Territorians.
The Territory's government would do well to put its reform plans on hold at least until the federal parliamentary inquiry into FASD is tabled early next month.
While it is impossible to say what those recommendations might be, on the body of evidence presented, it appears likely to recommend initiatives for mainstream and remote Australia that are especially relevant to the Territory.
These are likely to include: a review of alcohol pricing (Australia sells the cheapest and strongest alcohol in the world), a restructuring of liquor outlets and mandatory public health warnings for pregnant mothers on all packaged alcohol.
A far more aggressive diagnostic approach to FASD along the lines already adopted by Canada and the United States has also been widely speculated on.
While there is great scope for reforming the laws surrounding the sale and consumption of alcohol in the Territory, it was clear from the summit the Mills government needs to take a more evidence-based approach for the reforms to be in the long-term interests of Aboriginal communities.
Russell Skelton is a contributing editor.