Poor medical outcomes in remote aboriginal communities

I watched the 4 Corners show last night on aboriginal deaths from rheumatic heart disease in the remote community of Doomadgee.   

This is a difficult issue, as the individual treatment the three women received appeared inadequate.  (Although, it should be noted, there was really not enough detail provided to make confident assessments of what was going on.)

But - there was absolutely no contextualising the difficulties of providing good medical treatment in those communities.   And perversely, Aboriginal leadership (and locals) crying "racism" - as they did repeatedly on this show - as the root cause is not going to help.  It's already hard enough to get medical staff to work at remote aboriginal communities, because they are isolated, often socially dysfunctional, and dangerous.   Throw in "and the locals will riot and call you racist if they think you caused someone's death" and you are only going to exacerbate the staffing problems.

I mean, there was frequent reference to the ill women being assessed at night through a metal grill at the hospital.  Was there any attempt to explain why these places have to be run like that at night?  No, none at all.  

This is a well known problem, and the ABC has at times run stories on nurses who bravely try to work at remote locations.  (In fact, I heard one story again on the radio today.)   And here are some extracts from an article in BMJ Open last year:

 

As I said, this seems some really important background if you're going to talk about cases involving poor outcomes, even in individual cases.   

Update:   I think I should also have added - given that the problems of working in these remote communities are well known, it would suggest that those who nonetheless try to give it a go are far from racist.