Infant iron levels worse than in Zimbabwe

Lindsay Murdoch SMH April 7, 2009

than half the Aboriginal children under five in a large region of the Northern Territory are anaemic and face a substantial threat to their physical and mental development, a health service says.

The number of anaemic children in the 112,000 square kilometre area has almost trebled in two years, 18 months of which has been under the $1.5 billion indigenous intervention, the service says.

Irene Fisher, chief executive officer of the Sunrise Health Service, said the region's anaemia rate was worse than in countries such as Zimbabwe, Swaziland, Pakistan, Peru, Indonesia and Bangladesh.

"What is perfectly clear is that the intervention has failed to address a severe health problem that appears to be further deteriorating," she said.

Ms Fisher told the Justice Health in Australia Conference 2009 in Melbourne yesterday the level of anaemia in her service's region east of Katherine increased from a low of 20 per cent in the six months to December 2006 to 55 per cent in June last year, a level that was maintained in the six months to December.

She said early childhood anaemia was worsening in some other remote areas.

A member of the Aboriginal Medical Services Alliance Northern Territory had told her of a "devastating increase in anaemia and failure to thrive" in children under five in one area where a child centre was closed because of shire reform, she said.

Ms Fisher said anaemia in children suggested families could not afford healthy food containing iron, or the food was not available in community stores.

Anaemia was also associated with low birth weight, early stopping of breast feeding, recurrent infections, especially diarrhoea, and hookworm infestation. She said child health checks under the intervention found anaemia in 15 per cent of children tested across the Northern Territory.

But she said she challenged those results because the intervention checked 76 per cent of children compared to 98 per cent checked by Sunrise.

"The 24 per cent that weren't checked under the intervention were probably the most vulnerable children," Ms Fisher said.

The levels in the area serviced by the health service, which handled more than 80,000 client visits a year from 10 communities, "represent a severe public health problem", she said.

"As a proxy for much else in children's health, anaemia is … an indicator of poor health outcomes in later life," Ms Fisher said. She criticised the intervention, saying there was no evidence it is "tackling the social determinants of health in any thorough going way, and in fact the opposite might be the case".

"The style of the intervention - the involvement of the military and the notion of medicos from around the nation being parachuted into meeting the national emergency along the lines of Medecins Sans Frontieres hitting a war zone - tainted the whole process from the beginning," she said.

Ms Fisher said there was no evidence that the intervention and its income management in 73 targeted communities had reduced alcohol or other substance abuse.

"These measures - the control of land and income based on race and place of residence on Aboriginal land - are ideological, pure and simple.

"They are not based on evidence. It is a First World intervention with Third World results," she said.