Inside Story

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Is the media part of the Aboriginal health problem, and part of the solution?

Is the media stopping us from seeing the real problems and doing something about them, asks Melissa Sweet

Melissa Sweet 3 March 2009 4635 words

Sandra Bailey, chief executive of the Aboriginal Health and Medical Research Council of NSW. Jeremy Piper

SIMON HOLDING doesn’t look much like a couch potato. He’s tall and has the broad shoulders of someone sporty. But if you met him at a party he’d probably tell you that he watches television for a living. Or, as he sometimes puts it, he’s a “broadcast media observation engineer.”

Actually, he spends his days in an office at the University of Sydney, methodically categorising the health-related stories appearing on Sydney’s five free-to-air television stations. He watches the news and current affairs programs, as well as a selection of other shows with a health element, from Biggest Loser to RPA. Since starting the job in May 2005, he’s digitally clipped about 17,000 stories and coded them into twenty-one main categories – such as health services or cancer – and about 250 sub-categories.

Over that time, he has learnt much about how the media covers health issues, and the impact of that coverage. He’s seen how it is enlisted in campaigns to have medicines listed on the Pharmaceutical Benefits Scheme, for instance, and he is bemused by the disproportionate number of stories about breast cancer. “It is massively over-represented in the coverage relative to the numbers affected, compared with other cancers,” he says.

On the other hand, there are so few stories on Aboriginal health that they don’t rate as a major category. Instead Aboriginal health is the thirty-sixth sub-category, with 255 stories at last count. This places it just behind wild animal attacks, with 286 stories, and cosmetic surgery, with 296, but ahead of rural health, the forty-eighth sub-category, with 194 stories. Common descriptors for the Aboriginal health stories include petrol sniffing, child abuse and alcohol. Holding, a senior research assistant, observes that the news about Aboriginal health tends to deal in stereotypes and to be unrelentingly negative. “It wouldn’t be very flattering if you relied on the media for an understanding of Aboriginal people,’ he says.

Holding’s database is the brainchild of Professor Simon Chapman, a public health expert internationally recognised for his work in tobacco control, and especially for his use of media advocacy to achieve changes in policy and community attitudes and behaviours. Mind you, when I first came across Chapman sometime in the 1980s, he was not always described in such flattering terms within newsrooms. “Media tart” was the disparaging term sometimes applied to him – and to anyone else who was a regular on the phones with tips for stories.

Looking back, I think the comment reveals something of the media’s conflicted attitudes towards its own power. On the one hand, we know it and gloat about it. On the other hand, we often have very little insight into the impact of how we exercise that power.

Certainly, when I profiled Chapman for the Sydney Morning Herald in 1997, I played up the suggestion that his high media profile reflected a healthy ego. This may have said something about Chapman but it said more about my own unsophisticated grasp of the role of media advocacy as an essential tool for public health advocates. These days, after more than twenty years of writing about health, I have quite a different view of the media from a time when I thought my job was simply to write the sort of stories likely to grab news editors’ attention and garner a good run. I was much less interested in whether they were stories that were worth writing, I am not particularly proud to say, or in the impact they might have.

My focus now is much less on complying with news editors’ expectations and more about trying to subvert the traditional media formula of health reporting – which so often gives undue prominence to “medical breakthroughs” and hospital crises, and much less attention to matters such as primary care and issues related to equity, including Aboriginal health. Not coincidentally, Chapman is no longer simply a contact; he is both friend and colleague, and I have a peripheral involvement with his news database project.

I BEGAN REFLECTING on the significance of how the media covers Aboriginal health last April as I sat in a conference room overlooking Sydney’s Darling Harbour and listened to people talking about the need for researchers and Aboriginal people to find news ways of working together and critiquing the traditions of Aboriginal health research.

I heard about the mistrust that had built up, and of researchers who took but did not give, who imposed their own world view, who appropriated Aboriginal people’s stories for their own ends, who endlessly described the problems rather than developing and testing solutions, and who used language and methodology in a way that stressed the negatives and neglected the positives. “We’re tired of being told that we are helpless, hopeless and useless,” one Aboriginal academic told the conference, convened by the Coalition for Research to Improve Aboriginal Health.

I was there as a paid scribe and later wrote in the conference report: “Public and professional discussions and reports about Aboriginal health are often framed in negative terms. This impacts upon the self-esteem of Aboriginal people, as well as the attitudes and beliefs of the broader society. It also affects the willingness of Aboriginal communities to participate in research, and thus the usefulness and relevance of that research.”

It struck me that all of these problems of research also applied to my own industry. Concerns about how the media covers Aboriginal affairs are not new, not in a country where a lauded magazine such as the Bulletin could declare on its masthead, right into the 1960s, “Australia for the White Man.” This shamefully recent history was recorded by the Royal Commission into Aboriginal Deaths in Custody, which noted that “Aboriginal people generally claim that they have had a very bad deal from the media.”

In 1970s Perth, not long after the Bulletin changed its masthead, an idealistic young doctor called Fiona Stanley collected newspaper articles about Aboriginal health for a year, and found that 90 per cent of them were negative. It was, she thought, proof of the media’s inherent racism. Now heading the Telethon Institute for Child Health Research, which employs many Aboriginal researchers, Stanley remains angry about what she sees as the unrelentingly negative coverage and the sense of hopelessness it engenders among individuals and policy makers and within the broader community.

She says there is mounting evidence, from work at her institute and elsewhere in the world, that Indigenous children’s self esteem, resilience and educational outcomes depend on how they believe the dominant culture perceives their culture. “The more that the dominant culture reports negative stories about Aboriginal people, the more that Aboriginal children feel bad about being Aboriginal,” says Stanley.

Positive stories matter at many levels, she says. For years, researchers at her institute published academic articles about the benefits of swimming pools for Aboriginal children’s health, with relatively little impact. But just one positive front-page story in the Australian “resulted in swimming pools being put in all over the place.”

Says Stanley: “I have these fantasy conversations with Rupert Murdoch and say, ‘you could actually turn around Aboriginal people if you could change the way you report, even if you just made just 50 per cent of your articles positive, you could reduce suicide rates.’” But winning coverage for the positive stories – “I can give you umpteen communities that I’ve been to where the kids look great, the swimming pools are working, the houses are fantastic and the mothers are just wonderful” – is an uphill struggle, says Stanley. Even for someone with her public profile.

As I sat in that Darling Harbour conference room hearing earnest pronouncements about closing the gap in Aboriginal disadvantage, I thought about how media reporting had contributed to public health advances in other areas – from tobacco control to road safety and alcohol. And I began to wonder whether Australia has any chance of achieving real change in Indigenous health if there are not some systematic and constructive efforts, by both Aboriginal health advocates and the media, to develop a more useful public debate.

THAT IS the question I took to Canberra on an unseasonably chilly morning last December, where I was meeting with Dr Tamara Mackean, a Perth academic, trainee public health physician, and president of the Australian Indigenous Doctors Association.

But before we got around to talking about the media, Mackean told me something of her own history, including some distressing incidents. Some of these – scoliosis, surgery and two car accidents which have left her in ongoing pain and unable to pursue her early ambitions of becoming a surgeon – are the sort of misfortunes that can happen to anyone. But some relate specifically to the past and present history of Indigenous Australians. A small, intense woman who waves her hands expressively and exudes an air of power, Mackean has clearly thought deeply about the personal, professional and political in response to her own experiences of trauma.

When she expresses anger at the media’s portrayal of Aboriginal people for “perpetuating a discourse of total negative deficit” and describes my industry as one of society’s racist institutions, I can’t help but find it confronting, even though I agree with much of what she says. It’s not pleasant to hear how the sort of stories that journalists typically describe as “great” – so sensational that they’re bound to end up on page one – can affect people like Mackean.

“When Indigenous people read about a trauma, it becomes their own or their mothers or their grandmothers,” she says, gesturing dramatically to show how “the massive gaping wound” of intergenerational trauma is ripped open, once again, when there’s yet another prominent story about child abuse, violence or family breakdown.

Mackean says many Aboriginal people are hesitant about interacting with the media because journalists so often portray them as always fighting and lacking leadership. If journalists want to engage a broader range of Aboriginal voices and expertise they will have to learn work differently and invest the time needed to develop respectful relationships and trust. “I would like to get a small number of key journalists and get them to listen to the people, and to hear Aboriginal peoples’ concerns about how they are being portrayed.”

Since meeting Mackean I’ve heard many similar comments from Aboriginal people. The avalanche of negative stories leaves another doctor I spoke to feeling utterly exhausted, and she has been known to find herself yelling angrily at the newspaper in her hands. A law graduate adds that the reporting of trauma affects her at a deep personal level: “It lays your soul bare.” The media’s focus on child sexual abuse around the NT intervention made her self conscious about how her own family were being perceived in Sydney. “I thought, my son is nine, going on ten… People see that you’re an Aboriginal kid and therefore you must be at risk of being abused. That’s an aspersion on his family and home-life and identity.”

But some of the most searing critique comes from within the industry. “If Redfern riots and Palm Island burns, the media smacks its lips,” says Jeff McMullen, who has worked in commercial and ABC television and now spends much of his time working with a range of groups in Aboriginal health. “When you hear of some brilliant Indigenous person working in any of the professional sectors or down at the community level, putting forward the ideas and pathways which close the gap, the media turns away,” he goes on. “The truth is, the media is collectively conveying a sense of hopelessness and despair that feeds the trauma, the general mental illness, the sense of powerlessness amongst the most disadvantaged people. The media needs to shift its message to an empowering one that gives individuals and families as a whole a sense of inclusiveness.”

McMullen acknowledges that many of his criticisms could be levelled more broadly – conflict and catastrophe being the staples of the media diet generally – but says there are specific problems around Aboriginal affairs because so many journalists and news managers are ignorant of Indigenous history and culture. His comment reminds me of how Graeme Blundell began his review of the series, The First Australians, in the Weekend Australian, by confessing that he grew up in the 1950s, knowing nothing of Australia’s original inhabitants. “I blush slightly as I write this,” he said, “because it became obvious to me, when viewing this first episode, that my understanding was hardly greater than it was fifty years ago.”

I clipped the review because it rang a personal bell. Many of us grew up at a time when, if we were learnt much Australian history at all, it was with brave white explorers in the starring role.

AT THE END of that meeting with Tamara Mackean, I felt the familiar sense of unease that comes when someone has exposed their vulnerability, and you know that writing about it may only add to their distress. Strangely enough, I also have this unease at the end of a long, intense phone interview with a non-Indigenous journalist, Chris Graham, editor of the National Indigenous Times. When a journalists interviews another journalists it can be awkward for all concerned, and I came to the conversation expecting him to weigh his words carefully, knowing how they could be used against him.

Instead, Graham speaks so frankly about the toll his work has taken – he talks about burnout, people thinking he’s “an arsehole” and “a sandwich short of a hamper” – that I’m reminded of other interviews with traumatised people. Graham is angry with the media, angry with governments and angry with white Australia for not caring enough to insist that real money and political will are invested in improving services and opportunities.

The anger began to build from around 1996, when he moved from Sydney to work on a newspaper in Inverell. “I assumed that the paper in this country town would be one place where Aboriginal people got a voice, and was stunned to realise that everybody in town hated Aboriginal people,” he says. “And the blackfellas hated the whitefellas. The hostility was so open and so overt it was stunning. There were people in the newspaper who were sympathetic to Aboriginal people but there were other people who were openly hostile. I’d never seen anything like it. In my time in Inverell, I saw extraordinary cases of racism. I don’t think it’s that different to any other country town.”

After Inverell, Graham spent time in Bateman’s Bay, where, as editor of the local paper, he found the Aboriginal community ready to engage with him. He ran eight pages of photos covering the Moruya River Bridge Walk, held on the same day as the Sydney Harbour Bridge walk in 2000. He and a more senior colleague tried to convince their bosses at Rural Press that they were in a unique position to set up an Aboriginal newspaper, as they had so many mastheads in areas with large Indigenous populations, but the company was “beyond uninterested.” In 2002, Graham helped establish the NIT. Its beat, he says, is campaigning journalism.

Unlike most editors, Graham seems to put as much effort into having other outlets pick up stories as in having his newspaper break them. Time and again he’s shared leaked documents with other journalists to ensure the news breaks widely. “We’ve been very successful in getting issues into the mainstream but, my God, sometimes you have to walk over fucking hot coals to do it. The stories that really, really matter don’t make it.”

Describing himself as “a hopeless optimist trapped in the body of a bitter, twisted pessimist”, Graham despairs about the media’s readiness to spotlight problems in Aboriginal communities but its lack of interest in investigating government under-spending or incompetence. “No media anywhere in the country, apart from the National Indigenous Times and what we supply to Crikey, covers the Indigenous component of the Federal budget in any detail whatsoever,” he says. “I will bet my house that no newspaper in this country [in May] will provide any serious analysis of the Indigenous affairs budget. I will guarantee it because I’ve watched it happen six years in a row.”

Graham is beginning to wonder whether trying to use media coverage to influence public and political processes is a lost cause. “The mainstream media is a commercial entity with a commercial imperative to report Indigenous issues the way Australians would like to see them reported,” he says. “Australians don’t want to be challenged over their breakfast cereal over the horrendous conditions that Aboriginal people live in. Australians just want to be reassured that it isn’t their fault, and the government will occasionally do something because we don’t want to look like pricks on the world stage… We get the media we deserve.”

Generalisations about the media, a beast with many heads, are always fraught, however. Some organisations and individuals provide thoughtful, useful reporting and analysis. In this article, I’m sticking deliberately to generalisations; to go into the specifics of the Australian’s coverage, for instance, which is extensive but often judged to be agenda-driven and to favour a small group of Indigenous leaders, or the overall reporting of the NT intervention would take a book or two, given the polarised and often-heated views these topics generate.

I REALISE I’ve fallen into that familiar journalistic trap, of searching only for the negatives in any story, partway through an interview with Sydney Morning Herald journalist Debra Jopson, who has written about Aboriginal affairs for around thirty years. Jopson is describing an epiphany she had while taking a holiday nineteen years ago in the Pitjantjatjara Lands with her young daughter. Surrounded by people speaking a language she’d never heard before, she resolved to give away her aspiration to become a foreign correspondent. “This is incredible,” she remembers thinking. “This is much more interesting than most of the things I’d seen in years and years of travel.”

Jopson returned to Sydney and undertook a part-time degree in Aboriginal studies while working as a freelancer. It was tremendously helpful for her subsequent reporting, and not only because of the understanding and knowledge she gained.

“I remember on one of the teleconferences that everyone had to go through [as part of the course], this terrible emotional angst of talking about what happened at colonisation,” she says. “The tutor almost became like a counsellor. I sometimes think that in some ways you need to go through that process, and to get out the other side of it, in order to really understand how a lot of Aboriginal people feel and to get a sense of what needs to be done. Part of the reason I get on very well most of the time with the Aboriginal people I am talking to and working with is because I have gone through that process.”

My own epiphany comes when Jopson recounts repeatedly encountering assumptions that covering Aboriginal affairs must be traumatic and difficult. It can be like that, she says, and getting a run at the Herald can be a struggle. But the round is also “fantastic.”

“I’m not just talking about it as rewarding from a ‘Miss Save The World’ point of view,” she says. “It’s just the biggest adventure, the Aboriginal round. I’ve been all over Australia, in four-wheel drives, light planes and sat around campfires with really old blokes. It’s just so much fun apart from all the angst you go through. You have this great Aboriginal sense of humour and just amazing experiences.”

Jopson adds that after all the spin and formulaic reporting found in general news, it’s refreshing to meet people who are talking to you from the heart. “A lot of what people tell you is very genuine and truthful,” she says. “We’re often dealing with media virgins in our field… they don’t know much about the media or how it’s going to end up, so you have to be careful.”

But so much about the media industry militates against journalists being willing or able to offer that care. The clash of media and Aboriginal cultures – operating on such different timelines, values and worldviews – creates endless potential for miscommunication, misunderstanding and mistrust. The media often struggles to report sensibly on health issues generally, and is even more challenged in Aboriginal health, where the complexities are not easily captured by standard journalistic practice. There are no miracle cures in Aboriginal health; indeed, it’s quite likely that journalists who really want to make a difference should focus far more on what is happening in education than in the health system.

IT’S NOT IMPOSSIBLE to change the way the media reports on specific issues. Mental health advocates have, for example, had some success in changing coverage. But I’m not alone in thinking that the most effective way to influence public dialogue around Aboriginal health will be to improve the skills and capacity of advocates in that field. Even better if such efforts can be informed by research evidence about what strategies are most likely to be fruitful and backed by some significant resources.

Professor Ian Anderson, director of the Centre for Health and Society and the Onemda VicHealth Koori Health Unit at the University of Melbourne, is part of a group applying for research funding to study media coverage of Indigenous health, with the aim of generating just such evidence.

“People can only report what they’re told,” he says. “There’s a capacity in the interface between media and advocacy that’s missing. I think a lot of Indigenous activists are not very media savvy.” The situation is not helped, says Anderson, by non-Indigenous public health experts who often tiptoe around the area, reluctant to join their expertise into public debate for fear of treading on toes. This is a “cop out,” he says firmly.

In Western Australia, the Aboriginal health sector is hoping to improve its engagement with the media, and a research project at Curtin University, funded by the health promotion agency Healthway, plans to test an intervention providing media training. The project aims to empower both Aboriginal professionals and journalists to engage more effectively with each other. It’s likely, however, that projects like this will encounter some of the same barriers that journalists often strike, a difficulty in finding people – beyond the small group of leaders who regularly pop up in the headlines – who are willing and able to stick their heads up above the trenches.

Some of the reasons for this become clear when I meet Sandra Bailey, chief executive of the Aboriginal Health and Medical Research Council of NSW, a peak body for Aboriginal community-controlled health services. At a big picture level, she describes how the history of governmental policy means there has been a lack of the representative structures – in health and more broadly – that might help support and facilitate a wider range of advocates entering into public debate.

At the micro level, I am stunned to learn that Bailey’s organisation, with thirty-five staff and a $5 million budget, does not have a communications officer. With so many other demands on her time, this means she simply does not have the ability to engage much in public debate. But she is hoping to win funding to employ one. “I’d like us to have more capacity to respond and to be more proactive,” she says. “If you tend to speak out, they [journalists] come to you – it’s like fish in a pond, chuck a crumb in and they come to you.” Not that she expects a media officer to overcome all the barriers: “Governments generally don’t like organisations speaking out.”

That’s an understatement – and true, in my experience, of governments of all persuasions and jurisdictions. Members of the National Indigenous Health Equality Council, for example, have been asked to sign contracts, pledging not to speak out about council business.

WITH MORE than two decades of experience as a journalist and as a media officer for various Aboriginal organisations, Alastair Harris knows well the frustrations of all parties – the journalists and the advocates. “You couldn’t find two groups of Australians with a more divergent sense of timing and deadlines,” he says drily. Cairns-based Harris, communications manager for the Cooperative Research Centre in Aboriginal Health, has become convinced that the best way forward is to upskill the Aboriginal health sector.

But first, there’s an onerous job ahead in convincing colleagues that it’s worth the effort. “There’s a tendency, and it’s probably got good historic reasons, for Aboriginal people and organisations to be extremely distrustful of the media,” he says. “There is some legitimate criticism of the media but there’s also a degree of ignorance within the Aboriginal community about how the media works.”

Harris argues that upskilling Indigenous advocates is not only more likely to be effective than focusing on the media, but is also empowering. “It’s a way of actually balancing what’s a very unbalanced power relationship at the moment,” he says. “Given that journalists’ work is often determined by their chief of staff or editor rather than themselves, and you have to deal with subs, then I think it’s probably better in the long run for Aboriginal people to have a bit more power in the relationship, and that can only be achieved by Aboriginal people understanding how the relationship works, and understanding that they can be valuable to journalists. I think sometimes there’s a tendency for Aboriginal people just to think, ‘well that’s just the way it is, that journalists are a bunch of rednecks and there’s nothing much we can do about it.’”

All of which suggests that efforts to close the gap in Aboriginal health and disadvantage also need to tackle the gulf between Indigenous Australia and the media industry. At the moment, it’s quite possible that many consumers of the mainstream media don’t fully appreciate what they’re missing out on. Perhaps the emergence of new media forms will generate opportunities for finding fresh ways of telling the stories important to Aboriginal health, as well as stimulating the public appetite for such stories. •

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