East Kimberley concepts of health and
illness: a contribution to intercultural health
programs in northern Australia
Heather McDonald
AIATSIS
Abstract: East Kimberley concepts of health and illness
can be discussed within a framework of Aboriginal
cosmologies, ontologies, and relational practices. In
Australian Aboriginal traditions, the cosmos and its life-
forms were composed of ancestral substances and energies.
East Kimberley peoples subscribe to a flow theory of life
and a relational-moral causality. However, biomedical regi-
mes are tailored to the requirements of atomistic indivi-
duals, and chronic conditions self-management programs
are articulated in terms of self-motivating, goal-directed
clients. Health programs which cohere with Aboriginal
social requirements will be more successful than initiatives
directed at the individual level. Notions of social, relational
and family efficacies can be developed to facilitate beha-
vioural change in relational cultures. Indigenous concepts
of the body, health and illness can be used to humanise
Western physiology and produce health programs that are
meaningful to Aboriginal peoples.
86 Australian Aboriginal Studies 2006/2
In many articles and reports there are discussions of
the need for health professionals to understand the
cultural differences between Indigenous and Western
understandings of health and illness.1 Aboriginal
views of health and illness derive from hunter-
gatherer ways of being, and Western views derive
from industrialised and post-industrialised city-state
and nation-state cultures. Although Aboriginal and
Western peoples today inhabit common space and
time, in northern Australia there are major differences
between Aboriginal concepts of health and illness and
Western health professionals views.
In a 1997 random survey of 10% of Northern
Territory Health and Community Services health staff,
most (82%) Western staff reported difficulties commu-
nicating with Indigenous clients and all Indigenous
staff reported difficulties interacting with Western staff
(cited by Lowell 1998a). Miscommunication results in
patients taking prescribed drugs without knowing
their purpose or side effects, being admitted to hos-
pital unaware of the type of medical treatment they
are to receive, receiving medical treatment without
consent, and being returned home with a serious con-
dition (Lowell 1998b). A report on post-operative care
in a Central Australian hospital revealed that Western
nurses knowledge deficit regarding Aboriginal inter-
pretations of pain resulted in Aboriginal women
failing to receive adequate post-operative pain relief
(Fenwick & Stevens 2004).
The Cass et al. (2002) study of communication
between Northern Territory health professionals and
Aboriginal patients revealed serious and unrecog-
nised miscommunication about fundamental issues
in diagnosis, treatment and prevention. Factors
impeding communication include dominance of the
biomedical model, lack of control by patients, mar-
ginalisation of Aboriginal knowledge, lack of shared
knowledge and understanding, cultural and linguis-
tic distance, differing modes of discourse, lack of
staff training in intercultural dialogue, and failure
 East Kimberley concepts of health and illnessMcDonald
to use health interpreters. Health programs have not
been allocated the time and educational resources to
allow practitioners and clients to construct a body of
shared understanding of body organ physiology and
of the social, cultural and economic dimensions of
Aboriginal clients illness experiences.
Much contemporary literature on the social deter-
minants of health omits culture as a factor that
may work synergistically with other determinants
to perpetuate ill-health. Marmot (2001, 2004) sees
Aboriginal peoples primarily as socioeconomically
disadvantaged groups and did not take into account
cultural difference and possible cultural dissonance
with Western institutions. However, Kunitz (1994) and
Sutton (2001, 2005) argue that Aboriginal peoples are
not just oppressed victims of poverty and prejudice;
they have distinctive cultural practices that were
developed in particular environments but which, in
vastly different sociopolitical environments, may con-
tribute to ill-health.2
Aboriginal concepts of health and illness are
usefully discussed within a framework of Aboriginal
cosmologies, ontologies, and relational practices. In
Aboriginal Australian traditions, the cosmos and
its life-forms were composed of ancestral substanc-
es and energies. Life-forms are consubstantial with
the living environment and regenerative substances
flow through the land and through bodies (McDonald
2001). East Kimberley peoples subscribe to a flow
theory of life and an ethic of reciprocity. Tangible and
intangible items flow between persons; nurturance,
protection and retribution flow from the spirit world
to the world of human endeavour. East Kimberley
peoples, like those of other relational cultures, espouse
a notion of moral causality.
Alive and well
Ive got good blowing wind is a Gija and Jaru phrase
that can translate as Im alive and well.3 Bodily health
is not divorced from the health and wellbeing of the
country and cosmos.4 In East Kimberley traditions,
the water-snake (galaru) is associated with water and
wind in country. Galaru, spirit of the waterhole, stirs
the wind into action. The bodys lifeforce (birlirr),
which comes from water and is spiritually connected
to galaru, is associated with water and wind (and
with rushing thoughts and emotions) in the body.
Birlirr works in the giningi and jiluwa, breathing the
wind through the body. The giningi are respiratory
organs and channels (including the heart) located in
the chest. They are associated not only with physio-
logical processes but also with the bodys emotions
and volition. Jiluwa is a network of channels for body
fluids and life energies.5 Birlirr draws the wind into
the giningi and breathes the wind through the jiluwa.
The wind pushes the blood along the jiluwa just as the
wind pushes the water along a watercourse. The wind
also keeps the blood cool. The pulsing of the body is
the spirit breathing the wind through the body.
There is a strong connection in East Kimberley tra-
ditions between walking, breathing and blood flow.
Walking makes our giningi and jiluwa work. When
we walking, big wind goes inside our body (Gija
woman). The heart does not pump blood around the
body.6 When a person is walking or running, the spirit
breathes deeply and the force of the wind pushes the
blood around the body. Movement of spirit, breath
and blood from the bodys vital organs to its extremi-
ties keeps the person alive and active. Vital fluids and
energies enliven the faculties (of seeing and hearing,
for example) so that people can watch, listen and
understand. Words are breathed through the ears and
When you are talking, you blow wind (Gija woman).
Perception, speech, thought, consciousness, under-
standing, emotions and desires are related to breath
and spirit (birlirr).
Good blowing wind is only possible if the bodys
passages are clean. Gija and Jaru talk about bodies
being clean right through. A clean body is a conse-
quence of ritual and moral rightness. When people are
living the right way, their body organs and channels
will be clean, not clogged up with debris. A Gija
woman affirmed, I follow the way properly. My eye
is clean. My everything is clean. In the past, living
the right way meant following the ancestral way. For
some in East Kimberley today, living the right way
means following the way of the Christian god. But the
consequences are the same for failing to follow the
prescribed way. If people do not live the right way,
they will get sick.
East Kimberley youth who attend school, Technical
and Further Education (TAFE) colleges, and Alcohol
Education Centres learn that the heart pumps blood
around the body. The manager of Jungarni-Jutiya
Alcohol Centre in Halls Creek teaches the bodys
organ systems using mechanical analogies which
are very familiar to station people. The body is like a
machine. The heart pumps blood around the body as
the windmill pumps water into a tank or reticulation
system. A blockage in the pipe will cause the pump
to work harder and increase the pressure in the pipe
which may burst if the pressure is too great. This is
like high blood pressure in the body. The lungs and
Australian Aboriginal Studies 2006/2 87
 East Kimberley concepts of health and illnessMcDonald
kidneys are like air and petrol filters in a motorcar.
They clear the dirty air and fluids out of the body
(Young 2001). Some of these ideas have been assim-
ilated to traditional ideas about birlirr, giningi and
jiluwa and this will be the subject of another paper.
For Indigenous peoples who lived through
periods of feast and famine, thin bodies are not
valued. The ability to put on weight during good
seasons enabled people to survive the bad seasons.7
Thinness can indicate weakness, excessive worry, or
ill-health. Indigenous peoples also regard a skinny
body as sexually unattractive (Heffernan 1995:281).
For Aboriginal peoples, fat is a substance and a
symbol of life (McDonald 2003). Shiny skin, fat babies
and well-rounded women denote wellbeing and
happiness. Individuals monitor each others health
by signs such as shiny skin and eyes, plumpness
of body, liveliness and stamina. These signs are the
physical manifestations of a persons life experiences
(Mobbs 1991:301). Mobbs appearance was inspected
on her return to an Aboriginal community in order to
understand her circumstances while she was away.
Aboriginal persons told me that when I arrived in East
Kimberley my face was thin and worried looking; but
after some months of living on Aboriginal land and
engaging with East Kimberley community members,
my face had become rounded and smooth.
East Kimberley peoples consider healthy food to
be a gardiya (whitefella) concept. They prefer to talk
about strong foods which generate bodily growth
and vitality. Meat is strong food par excellence. Old
persons say that animal food is the best medicine for
those who are weak and sick. Meat replenishes human
blood, strengthens the body, revives the spirit and
enlivens the organs and senses (see also Wiminydji &
Peile 1978); Gija and Jaru women told me:
Our bush-tucker comes from ground and animal. Meat
is the strongest tucker. Kangaroo, emu, turkey, goanna.
When we feel weak we drink kangaroo blood. Cook
kangaroo in ground and drink warm juice from blood.
Kangaroo blood is ngarrangkarni [ancestral] blood.
People and animals got ngarrangkarni blood in their
bodies.
Good blood comes from strong food. Blood should
be bright red in colour. Its consistency should be not
too thick and not too thin. It should flow steadilynot
too fast and not too slowthrough the jiluwa. It should
be cool and it should not dry up.
Periods of feast and famine still exist for
Indigenous peoples in northern Australia. Aboriginal
use of food reflects their work practices, concepts of
88 Australian Aboriginal Studies 2006/2
time, and forms of reciprocity. Although Australia is a
post-industrial society, Indigenous peoples have not
become atomistic, future-oriented individuals who
adhere to an ethic of delayed gratification.8 A survey
of Indigenous groups living in Kakadu National
Park found that food coming into the household was
consumed relatively quickly, and a large proportion of
the population had gone without food for a 24-hour
period in the preceding week. The perceived rewards
of immediate food, alcohol and tobacco consumption
outweigh the more distant adverse health outcomes in
the medium and long term (Turner & Graham 2005).
Causality
Relational cultures historically preceded and now live
alongside atomistic cultures. Notions about causality
are different in atomistic and relational cultures. In
Western atomistic world-views, reality is composed of
independent atoms separated by a vacuum. Individual
atoms affect each other by direct action. There is no
action at a distance. Even when combining with other
atoms, individual atoms retain their own distinc-
tive nature. Atomistic world-views have a mechani-
cal conception of causality (Edge 2000). In relational
world-views, relationship is prior to individual bodies
and atoms. In an interconnected world in which all
life-forms coexist, reciprocity and moral balance are
important concepts. Many religious and philosophi-
cal traditions espouse a notion of moral causality (the
necessary connection between actions and their con-
sequences). In Hindu and Buddhist traditions, the
law of karma (the moral effects of human actions) is
believed to contribute to good actions and just rela-
tionships (Kobayashi 2002).
Traditional medicines such as Traditional Chinese
Medicine (TCM) and Ayurvedic medicine were
developed within relational world-views. These health
practices are based on the notion of harmony and
balance, that is, living in harmony with nature and
striving for balance in all interactions. Although they
developed within relational cultures, these medical
practices have been influenced by atomistic world-
views. They have adopted individualised diagnos-
tic procedures and treatment regimes. Ayurvedic
medicine is based on an analysis of individual body-
personality types. Each person is believed to have
a unique constitution, that is, a unique balance of
mindbody energies which interact with environmen-
tal factors. TCM seeks to harmonise and rebalance
an individuals mindbody constitution (Bailey 2006;
Mills 1987).
 East Kimberley concepts of health and illnessMcDonald
Aboriginal cultures are relational cultures that
emphasise interconnectedness. Relationship is prior
to morality and is the criterion against which human
actions are judged. East Kimberley peoples espouse
a relational-moral aetiology of illness. Sickness is
perceived as coming from malignant outside forces
or antisocial actions. Today, sickness is believed to
come from war zones, where peoples actions create
a moral imbalance and obstruct the flow of reciproc-
ity in the interconnected world (McDonald 2006). In
health programs, it is helpful to view chronic diseases
as coming from outside forces such as Western coloni-
sation, and to speak in terms of tools for overcoming
these effects. Cultural understandings and images can
be developed to promote a sense of control over the
disease (Heffernan 1995:284).
Sickness
In East Kimberley traditions, sickness is some kind
of obstruction to the healthy flow of life energies
through the body.9 Aboriginal speakers refer to this
obstructing debris as rubbish. Rubbish can refer
to any object that has become useless and unable to
perform its proper function in the social body or the
human body (see Young 2002). The rubbish in the
body may be a foreign objectan object whose proper
place is elsewhere (in the country, for example),
but which has found its way into the human body
through ancestral intervention or sorcery.
Debris can block the bodys organs and channels.
Rubbish in the jiluwa (bodily channels) mixes with
the blood, causing it to become thick and congealed.
Today, whitefella substances such as alcohol and
tobacco have taken on the characteristics of rubbish
in the body. Alcohol and tobacco mix with the blood,
making it dirty and thick so that it is unable to flow
properly. This thick mixture blocks the giningi (heart
and respiratory organs), making the person short-
winded. Diabetes can have a similar effect in the
body. Sugar mixes with the blood. Both mix up and
get thick. Too much sugar stops the blood flowing
properly (Gija woman).10 When the blood is thick
and congealed, the birlirr (spirit) can only breathe
slowly and blood flows sluggishly through the body.
The person feels heavy, drowsy and lacking in vitality.
Rubbish blocks the senses (of seeing and hearing, for
example) so that sufferers are unable to watch, listen
and understand. When you dont have any rubbish
inside, your eye will be clean again. You can see long
way (Gija woman). Inactivity also causes the blood
to thicken and flow sluggishly. Walking makes your
blood flow. If you lay down all day, blood gets thick
and cant move around (Gooniyandi woman).
If the body becomes overheated through sickness
or some other cause, the blood congeals and the spirit
becomes weak and drowsy. Love potions (jeeri) burn
a persons body right through from throat to kumbu
[urine] (Gija woman). Sorcery cooks the body inside,
congealing the blood and turning it black. Sorcery also
acts on body organs, causing them to become con-
stricted or narrow, twisted or doubled up. It can eat
away the organs altogether (Peile 1997:139).11 Love
potions and sorcery are extreme forms of rubbish in
the body. Their treatment requires the skills of tradi-
tional healers. When the body is clogged with rubbish,
the blood flows sluggishly and the spirit is drowsy,
good medicine and a cooling wind can wake up the
spirit.
Medicine
Aboriginal peoples use of bush medicines can give
insights into how Western medicine is believed to work
in the body. Men on long-distance hunting trips used
bush-tobacco (ngunju) as a medicine. Hunters chewed
tobacco to make themselves strong and keep them-
selves going. The tobacco spread through the body,
dulling pangs of hunger and thirst and inhibiting
sleep and drowsiness. Bush-tobacco was used both as
a stimulant and a depressant. It was used to alleviate
physical stress, mental weariness and general pain,
symptoms of headache and dryness of the throat and
mouth (Peile 1997:227). It was also used as a relaxant
at the end of long and exhausting days.
Aboriginal peoples smoked the body with
medicinal plants to clear the body of rubbish and
infuse medicine into the body. Medicinal plants are
chosen for their qualities and potencies. The konker-
berry shrub (Carissa lanceolata) is a smoking medicine
par excellence for Gija and Jaru. Babies are smoked
soon after birth so that they will grow straight (judu)
physically, socially and morally. Konkerberry wood is
used to make children grow tall and strong like trees,
and to make them walk quickly.12 The konkerberry
shrub is a tough, hardy, drought-tolerant shrub. The
wood is dense, heavy hardwood. The childrens legs
are smoked to make them strong and hard like konk-
erberry wood.
The mothers body is smoked after childbirth to
dry up secretions and to make the milk flow into her
breasts. A Walmajarri woman told me that there is
special thing like milk inside the tree. Tree he work
like us. The heat from the smoke dries up the blood of
Australian Aboriginal Studies 2006/2 89
 East Kimberley concepts of health and illnessMcDonald
childbirth, and the milky sap in the leaves causes the
milk to flow in the mothers breasts. The milky sap
of many tree types is called ngaburlu (milk). All parts
of the konkerberry shrub were used medicinally. The
leaves were smoked for diarrhoeal and respiratory
complaints, and wood pulp infusions were made for
respiratory problems. Wood smoke was used to repel
mosquitoes and interfering spirits. A general tonic
was made from infusions of crushed bark, leaves and
twigs. The sap was used as a liniment for rheumatism
and the roots were ground up and soaked to wash
skin sores (Reid 1977:26).13
The konkerberry shrub has an oily sap, aromatic
leaves, and pungent white flowers. Sweet black
berries appear after a good wet season. Strong-
smelling leaves are believed to contain strong
medicine. When Aboriginal peoples smoke the body,
the strong medicine in the leaves enters the body
through the nose, ears and the pores of the skin; they
expect to feel the medicine working in the body. A
Gija woman told me:14
You can feel the jiluwa working, feel the blood flowing
[during a smoking treatment]. I was heavy before,
just like sin. Im fresh and light now. We can feel the
medicine going into us. Feel cold coming through
the body. When we take gardiya tablets, we dont feel
anything.
Western medicine
East Kimberley communities have a pragmatic
relationship to Western health services. Efficacy is
important. One woman told me of her grandparents
deci-sion to accept Western medicine: My jaja
[mothers mother] said, Well try im out gardiya
medicine. He might be work for us, make us feel
better. In pre-colonial Australia, patients and healers
shared common understandings of health, illness and
appropriate treatment, but this is no longer the case.
Western doctors refer to micro-level bodily functions
that can be measured by scientific instruments.
Aboriginal persons in remote communities speak in
terms of macro-level bodily functions, fluids and life
energies, reciprocity and balance, flow and blockage.
An Aboriginal participant in a Port Lincoln medicines
survey came to the conclusion that Aboriginal and
white people have different bodies and therefore
need different medicines (Kowanko et al. 2003:24): I
dont believe in it [Western medicine], but thats my
belief, that our body structures differentyou know,
they are treating us like white people which is wrong.
90 Australian Aboriginal Studies 2006/2
Aboriginal peoples do not accept a hierarchcal,
authoritarian relationship between doctor and patient.
Medical debates about patient compliance are inap-
propriate in a post-colonial era (Humphery et al.
2001). The medical compliance model derives from a
paternalistic era when doctors assumed authority and
patient preferences were not negotiated.15 The compli-
ance model views patient non-compliance as a form of
deviance or moral weakness (Donovan & Blake 1992;
Trostle 1988). In the health providerpatient relation-
ship, Aboriginal persons see themselves as having a
choice, and tend not to discuss their concerns about
Western medicine with medical practitioners. Doctors
are believed to be fallible, and sometimes not to have
the interests of their patients at heart; a Jaru man
said: Doctor talk liar sometimes. He dont want to fix
im up. Some fella he leave for dead. He [doctor]
might be get sick of it. Too much humbug [constant
demands] everyday.
Rather than health practitioners assuming the role
of instructors and patients being required to comply,
Aboriginal and non-Aboriginal health practitioners
and researchers can work together to develop common
conceptual frameworks around health and illness
within which providers and patients can negotiate
comprehensible treatment programs.
Good medicine should clear the rubbish out of
a sick body, revive the spirit from its drowsy state,
and make the person walk again. Blocked heart is a
common disease description in East Kimberley. When
someone has a blocked heart, Western medicine is
taken to melt the congealed blood. Diabetes medicine
is taken to render the sugar weak and clear it out of
the blood. Asthma medicine clears the thick phlegm
out of the giningi and jiluwa so that a good breeze can
flow through the body. Some complain that Western
medicine does not clear all the rubbish out of the
body. They argue that Aboriginal traditional healers
should be employed to clear the rubbish away from
sick bodies, and that this can be followed by Western
medicine.
Good medicine is strong medicine but it should not
be too strong for sick bodies. When the body is weak it
may not be able to tolerate strong medicine. Aboriginal
patients frequently complain that Western medicine
prescribed for diabetes and cardiovascular disease is
too strong for them. Their body loses condition, their
blood dries up and their spirit becomes drowsy. They
feel heavy and sluggish rather than light and alive.
When the body is weak and sick, weak or diluted
medicine should be given until the body builds up
its strength again. Conversely, some East Kimberley
 East Kimberley concepts of health and illnessMcDonald
persons claim that they are stronger than whitefella
tobacco and therefore cigarettes cannot harm them.
Aboriginal concepts of strength and weakness need to
be taken seriously in health education programs.
Aboriginal individuals rely on their feelings
(liyarn) to assess the health of their bodies and the
effect of medicine on their bodies. Feelings are body
faculties which permit human and animal engage-
ment with the world. Body faculties include sight,
hearing, smell, taste, touch, feelings and dreams. They
are taken as reliable indicators of what is happening
in the body and in the world around them. Feelings
are relational, not individualistic. They are kin and
country-oriented (Roe 2000). Westerners, in contrast,
believe their feelings to be intensely private. They
have been taught to rely not on their feelings in
matters of bodily health but on scientific evidence.
When East Kimberley patients feel that Western
medicine is too strong for them they may stop taking
it for a while to give their bodies a rest. Others only
take Western medicines when they feel weak and
sick. They dont take it when they feel strong. A
Wangkajunga woman suffering from multiple chronic
diseases described her medicine-taking: When I feel
proper sick I take gardiya medicine. When I feel
better, I stop taking it. When I stop taking that tablet,
I feel weak again. This woman also goes out bush
to collect bush medicines to alleviate her symptoms.
She eats nyandi (bush gum) and goanna fat to settle
her stomach down, that is, to alleviate stomach pains
which doctors say are caused by too much acid in
her stomach from take-away food. She smokes her
afflicted body with konkerberry wood and leaves.
Gija and Jaru women not only carry Western pill con-
tainers in their possessions, they also keep branches
of bush medicine trees in their bedrooms and bottled
bush medicine in their kitchen cupboards.16
East Kimberley peoples say that bush medicine
has been in the ground from ngarrangkarni (Dreaming)
time. It was put there by the ancestors for Aboriginal
use. Christians say that their god put bush medicine
in the ground. However, doctors do not tell Aboriginal
clients where Western medicines come from.17 If
a Navajo is told to take digitalis every day he will
probably swallow a few tablets and then forget about
them; if the doctor expresses knowledge of herbal
medicine and tells his patient that the medicine
comes from foxglove leaves, he is more likely to have
his instructions carried out (Leighton & Leighton
1941, cited by Peile 1997:131). Health profession-
als can go further than this and engage in intercul-
tural dialogue (a process of information sharing
and negotiation), rather than a one-way transfer of
information. Collaborative approaches to preven-
tion and treatment of illness can be developed which
satisfy both Western and Aboriginal understandings
of good health. Preventive and treatment programs
can include the use of Aboriginal healing practices,
including local bush medicines.18
Health programs
In many Aboriginal health services, health practition-
ers are white, and the medical perspective is Western.
Medical facilities tend to be white intellectual spaces
which do not reflect Aboriginal cultural values. Space
is sharply demarcated to protect medical practi-
tioners from the masses and to allow for privacy in
the providerclient relationship (McDonald 2004).
The biomedical model of health and illness tends to
strip away social contexts of meaning, and diminish
awareness of the sociopolitical causes of disease.
Complex social and moral processes are reduced
to narrow cause-and-effect relationships (Riessman
1989). Diseases are interpreted in terms of a mechani-
cal aetiology. Health professionals, who work within
a biomedical framework, tend to ignore relational-
moral causalityfor example, the effects of economic
globalism, world trade agreements, and neoliberal
politics on Indigenous peoples health. In many doctor
patient consultations, Aboriginal clients are treated
not as relational selves (people defined by social rela-
tionships who demonstrate relational autonomy) but
as atomistic individuals (people defined independ-
ently of relationship who demonstrate self-efficacy
and self-regulation). Treatment regimes are tailored
to the requirements of atomistic, self-motivating indi-
viduals. Self-management programs are articulated
in terms of future-oriented, goal-directed individuals
who adhere to an ethic of delayed gratification (Edge
2000; Pajares 2002).
In relational cultures, disease processes and
healing practices are not privatised. An important
cultural factor in Aboriginal healing practices is not
privacy or patient confidentiality, but community wit-
nessing. Healing events require witnesses to ensure
that the healer performs his or her task correctly and
does not harm the patient. If things go wrong, and the
patient is harmed, the witnesses will be implicated in
the blame because they did not intervene to save the
patient. Both healer and witnesses are required to con-
stitute the healing performance (McDonald 2004;
Sansom 1980).19 In northern Australia, rather than
focusing solely on individual consultations, medical
Australian Aboriginal Studies 2006/2 91
 East Kimberley concepts of health and illnessMcDonald
practitioners and allied health professionals can deve-
lop treatment regimes, education programs, and dis-
ease management programs within group sessions.
Health services directed at the level of family
and significant others are more likely to be successful
than initiatives focused only at the individual level.
Sansoms (1982) study of life-threatening illness in
an Aboriginal town camp focused on the community
of suffering (those who mobilise around the sick
person). Illness is believed to take over peoples
bodies, depriving them of volitional control. Sick
people are rendered passive and unable to speak for
themselves.20 The healing process is seen as the com-
munitys responsibility, and caring and supportive
relationships are crucial to recovery. Observation and
feeling are important forms of communication, and
empathy and sociality are valued aspects of the thera-
peutic relationship (Mitchell 1996). People who suffer
from minor illnesses that are not life-threatening,
however, are required to exhibit personal stoicism.
The chronic diseases of post-industrial societies
do not fit Indigenous categories of life-threaten-
ing illness (requiring community mobilisation) or
minor illness (requiring patient stoicism). The notion
of incurable disease, which is not life-threatening in
the short term but which requires constant surveil-
lance in order to prevent life-threatening complica-
tions, is foreign to Indigenous peoples (Heffernan
1995). Family and significant others tend to catego-
rise people with diabetes, cardiovascular disease and
chronic airways disease in the same way that they
categorise people with minor ailments, that is, the
patient must learn to live with the disease, and not
demand special attention or become a burden on the
community.
It may be better to categorise chronic illness as a
life-threatening illness, not in the sense of requiring
immediate community mobilisation and state of
alertness, but in the sense of requiring a community
of suffering (those who provide support, empathy
and sociality). People with chronic diseases and their
close kin can be encouraged to form support groups
which meet to think about chronic disease processes,
their effects on community life, and ways to combat
their life-threatening complications. Such groups will
need ongoing support from health professionals.
Occupational and cultural therapies and physical
activities can be developed within these support
groups (McDonald 2006).
Chronic conditions self-management (CCSM)
programs, which have been introduced to northern
Australian Indigenous communities, were developed
92 Australian Aboriginal Studies 2006/2
by the Division of Family and Community Medicine
in the School of Medicine at Stanford University in
California. Program evaluation reveals improvement
in health status, and reduction in health-care utili-
sation and costs (Lorig et al. 1999, 2001). Self-man-
agement programs are based on the premise that
clients are future-oriented, goal-directed and self-
motivated individuals. CCSM programs utilise self-
efficacy theory which derives from social cognitive
theories within the discipline of educational psychol-
ogy (Bandura 1986, 1997). Self-efficacy theory is used
to help clients improve cognitive skills and increase
behavioural competencies by setting challenging
goals, planning strategies, and executing action plans.
CCSM courses teach patients to monitor and manage
symptoms, use medications appropriately, develop
nutrition and exercise programs, and manage stress
and negative emotions (Pajares 2002).
Bandura has expanded the conception of human
agency to include collective agency. This conceptual
extension is believed to make the self-efficacy theory
applicable to collectivist societies. Collective systems
develop a sense of collective efficacya groups
shared belief in its capability to attain goals and
accomplish desired tasks (Pajares 2002:5). However,
this notion of collective efficacy assumes that collec-
tivist or relational societies are future-oriented and
adhere to an ethic of delayed gratification. Notions
of social, relational and family efficacies need to be
developed to facilitate behavioural change in collec-
tivist or relational cultures. Relational efficacy and
social support received from significant others have a
strong influence on human motivation, wellbeing and
personal accomplishment in relational cultures (Kim
& Park 2005).
The notion of relational autonomy has recently
gained prominence in Western thinking as a reaction
against liberal understandings of autonomy that
assume an atomistic model of human agency. In non-
atomistic models of human agency, relationship with
others always mediates individual actions and obliga-
tions (Edge & Suryani 2002:68). In a liberal, atomistic
model, individuals are seen as acting in isolation from
others, and moral agents are believed to be limited
only by their own values and capacities (Donchin
1995). Recent feminist work has moved away from
a focus on individual independence towards a view
of human action made meaningful through social
engagement. Feminist scholars have reconceptual-
ised the notion of autonomy, embedding it within
social relationships and interdependencies. An under-
standing of relational autonomy requires a focus on
 East Kimberley concepts of health and illnessMcDonald
the importance of supportive social conditions for
fostering human action (MacDonald 2002; Sherwin
1998).
Family-based health programs can mobilise family
support, empower families, and encourage families to
collectively generate health strategies (Teufel-Shone
et al. 2005). Health programs need to engage with
Aboriginal peoples value systems. Many Aboriginal
peoples subscribe to a temporal system in which
the rewards of immediate consumption outweigh
future adverse health outcomes. Aboriginal cultural
values, work practices, concepts of time, and forms of
sociality can be incorporated into family-based health
programs. Physical activity and exercise regimes
that are unrelated to Aboriginal social purposes are
unlikely to be successful. Family members can be
encouraged to develop health strategies that cohere
with family and social requirements. Family-generated
behavioural change has been shown to contribute to
improved glycaemic control in patients with diabetes.
Respectful familyhealth professional partnerships
can address prevention, treatment and disease man-
agement processes (Cousins et al. 1992).
If health education is taken out of a narrow bio-
medical framework, it will become more accessible
to Aboriginal communities. Chronic diseases can be
discussed within a larger sociopolitical framework;
for example, their origins in agricultural practices
and their intensification in industrial and post-indus-
trial practices.21 Health programs can be developed
within a framework of community empowerment to
explore the relationship between globalisation and the
increasing incidence of chronic diseases in econom-
ically deprived regions (McDonald 2006). Healthy-
eating programs are undermined by the global food
industry that monopolises food production, distribu-
tion, and retail markets. Food marketing is frequent-
ly targeted at children and adolescents (Hawkes 2002;
Morelli 2003). Community empowerment programs
can explore ways to offset the negative impacts of glo-
balisation on community life.
Conclusion
Western medicine is a colonial enterprise that has pen-
etrated Indigenous domains worldwide (Paul 2000).
Powerful biomedical treatments displaced tradition-
al healing practices at a time when infectious diseases
were taking their toll of Indigenous populations.
Today, when Aboriginal peoples are falling prey to the
chronic diseases of post-industrial societies, tradition-
al healing practices are making a modest comeback
(McDonald 2006). In some regions of Australia, tra-
ditional healers provide motivational resources to
help restore patients sense of purpose and to support
their social and emotional wellbeing (McCoy 2004).
After 28 years of linguistic, ethnobotanical and health-
related research with the Kukatja people of the Great
Sandy Desert, Peile (1997) found that abstract bio-
medical knowledge and contextualised Indigenous
knowledges need not be incommensurable, and called
for an integration of Indigenous and biomedical
practices in health services. Sheldon, a psychiatrist
working in Central Australia, found Western models
of clinical examination and assessment to be deficient
in relation to Aboriginal patients. In his practice he
consciously blended Indigenous and Western thera-
peutic practices. He worked with traditional healers
and adopted Aboriginal language concepts for mood
and behaviour disorders. His work is being continued
by the Sheldon Foundation (Sheldon 1997).
In some Fourth World contexts, intercultural
health services have been established. An intercultur-
al approach promotes empathy, respect and synergies
(attaining results that could not be achieved independ-
ently). Intercultural health programs can contribute to
the decolonising of Western medicine in Indigenous
communities (Garcia 2002). Western health profes-
sionals working in intercultural health services need
to acknowledge their countrys colonial history. They
need to acknowledge and work with Aboriginal
cultural values, relational personhood, forms of reci-
procity, and ways of expressing social and emotional
needs. Indigenous modernities, both urban and rural,
maintain distinctive meanings of family, child-
rearing practices, work practices, concepts of time,
processes of decision making, and forms of sociality
(McDonald 2004).
Aboriginal peoples concepts of the body, health
and illness can be utilised, rather than ignored, in
chronic conditions management programs. Aboriginal
understandings of the body derive from the expe-
rienced body: the living, breathing, pulsating body,
not the dead body of the anatomists. Indigenous
understandings of the connections between walking,
breathing and blood flow can be used in health
programs on physical activity, obesity, diabetes, and
respiratory and cardiovascular health. The idea that
good blood derives from strong food can be incor-
porated into health programs on nutrition, obesity,
diabetes and cardiovascular diseases. East Kimberley
concepts of health and illness have particular
relevance for cardiovascular and respiratory diseases.
Indigenous notions of strength (versus weakness),
Australian Aboriginal Studies 2006/2 93
 East Kimberley concepts of health and illnessMcDonald
movement (versus stasis), coolness (versus heat),
and flow (versus blockage) can be used to humanise
Western physiology and produce health programs
that are meaningful to Aboriginal Australians.
Acknowledgments
I thank Ngoonjuwah Aboriginal Council for permis-
sion to conduct this research with East Kimberley
elders in the Halls Creek region. I thank especial-
ly Vera Cox, Doris Fletcher, Maggie Long, Doreen
Quilty, Doris Ryder, Barbara Sturt, Lulu Trancollino,
and Lorna Thomas for contributing their cultural
knowledge to this paper. This paper in prelimi-
nary form was presented at the AIATSIS seminar
series, Health and Society: An Australian Indigenous
Perspective, 27 October 2003, Canberra. I thank the
two referees for their critical comments.
NOTES
1. Including those by Reser (1991), Mitcalfe (1994), Devitt &
McMasters (1998), Trudgeon (2000), Cass et al. (2002), and Fenwick
& Stevens (2004).
2. Individuals living in small-scale societies with a high degree
of population mobility have different health requirements from
those who live in densely populated sedentary environments. The
serious health problems faced by Aboriginal peoples in remote
communities arise from a complex conjunction of pre-colonial
sociocultural factors with colonial and neo-colonial factors (Sutton
2001, 2005). Indigenous kin-based economies, concepts of time, and
forms of sociality are not congruent with agricultural, industrial and
post-industrial work practices. Permissive child-rearing practices
do not cohere well with institutions that are highly regulated
and disciplinary, which promote an industrial work ethic, adhere
strictly to the notion of working days and working hours, and
run on clock time (McDonald 2004). However, rather than trying
to turn Aborigines into whites, Western health professionals can
learn to value and work with relational cultures. This valuing has
already begun in some theoretical disciplines (Sherwin 1998).
3. A Gija woman translated this phrase as Im healthy. However,
East Kimberley peoples generally consider the term healthy to be
a gardiya (whitefella) concept and tend not to use it. Central Desert
communities also consider being healthy a whitefella notion and
dislike being constantly told to be healthy (Wiminydji & Peile
1978). Traditionally, Aboriginal healers did not instruct people
on ways to be healthy. They instructed people on how to live the
right (that is, ancestral) way. If people followed the right way, their
bodies would be clean and strong. In Europe also, health only
became an issue and a topic of debate when it could no longer be
taken for granted, that is, with the development of city-state life
and sedentary occupations.
4. The New Public Health (Baum 2002; Knight 1999) is informed by
an ecological understanding of health, and is referred to by some
researchers as the human ecosystem model (Knight 1999:1467).
For Lowe and Spry (2002), white researchers are beginning to catch
94 Australian Aboriginal Studies 2006/2
up with Indigenous understandings of health. Some researchers,
both Indigenous and non-Indigenous, have moved beyond a
human-centric to a planet-centric model of health (Arabena, this
issue).
5. In East Kimberley traditions, body organs are not collections of
specialised tissue that perform specific functions in the body. They
are containers and channels for the flow of body fluids and life
energies. The term jiluwa refers to blood and lymph vessels, spinal
cord, sinews, tendons and ligaments. It also refers to the roots of a
tree or plant.
6. In Europe, the heart was found to be a kind of pump, and blood
flow to be circular, only after vivisections were performed on
animals. William Harveys Exercitato Anatomica de Motu Cordis et
Sanguinis in Animalibus, describing the circulation of the blood, was
first published in 1628.
7. The evolutionary purpose of insulin (which relates to a hunter-
gatherer way of life) is to store excess nutrients during times of
plenty to enable individuals to survive during times of scarcity.
Our hunter-gatherer bodies have not adapted well to industrial and
post-industrial societies (Rosedale 1999).
8. Boustany (2000), a medical practitioner in the Northern Rivers
region of New South Wales, writes of Goori people engaging
in gratification-thinking. Immediate survival is given a higher
priority than future outcomes, and this may mean having another
smoke or drink in order to cope with the next ten minutes.
9. East Kimberley peoples do not see sickness in terms of discrete
disease entities, each with its own label, collection of symptoms,
possible complications, and prognosis. This way of classifying
sickness requires literacy, recording procedures, systemisation and
other disciplinary techniques that were developed in militarised
city-state societies.
10. East Kimberley peoples say that cane sugar is too strong for
Aboriginal people. It makes them weak (with diabetes). Cane sugar
is really gardiya food, not Aboriginal food; gardiya grow it and they
can eat it without ill effect. Sugarbag (bush-honey) is Aboriginal
food; it makes them strong and energetic.
11. Cane sugar acts like sorcery in the body. It not only thickens the
blood and blocks the body organs and channels, it also eats away
the body organs.
12. In an analysis of Mardu childrens foraging efficiency, Bird and
Bird (2002) show that height is a far better predictor of hunting
success than age. Height and walking speed are closely correlated.
13. The leaves of the konkerberry shrub contain triterpenes, and
the roots contain carissone (Lassak & McCarthy 1983:82). The
leaves and stem contain cardiac glycosides (Reid 1977:26). Cardiac
glycosides are cardiac stimulants (also found in the foxglove plant),
used in Western medicine to strengthen cardiac contractions and
regulate heartbeats. In an effort to identify novel antibacterial
compounds to replace the dwindling pool of effective antibiotics,
Lindsay et al. (2000) carried out a phytochemical analysis of Carissa
lanceolata. They isolated three antibacterial agents (eudesmanes
carissone, dehydrocarissone and carindone) from the wood of the
plant. All were found to be biologically active against Staphylococcus
aureus, Escherichia coli and Pseudomonas aeruginosa.
14. In East Kimberley, healing is experienced in terms of cultural
understandings of hot and cold processes and their effects in the
world and in the body. In hot climates, excessive and prolonged
 East Kimberley concepts of health and illnessMcDonald
heat can lead to desiccation and even death. Coolness is desirable
and life-sustaining.
15. Today, in contrast, patient autonomy and the quality of life
chosen by patients are important ethical issues in medical decision
making. However, Western democratic medicine assumes a liberal,
atomistic concept of autonomy (individuals are seen as acting inde-
pendently of others) and does not acknowledge relational autonomy.
16. This is not dissimilar to many Western womens pharma-
ceuticals. My own bathroom shelves contain Western medicine,
herbal medicine from various locales, and bottled Australian bush-
medicine: tea tree oil and eucalyptus oil.
17. Individuals who have had some training at the Jungarni-Jutiya
Alcohol Centre say that Western medicine comes from bush-
medicine in other countries.
18. Documentation and analysis of Indigenous herbal medicines are
becoming more widespread.
19. In matters of sexual health, however, Western codes of privacy
and patient confidentiality are valued.
20. In Gija traditions, birlirr and juwarri, ancestral life-forces, infuse
the body with energising and motivating power. Birlirr is the life-
force associated with water and wind, and with breath and blood
flow in the body. Juwarri is the motive life-force associated with
executive power, vital energy, and endurance. When a person is
overwhelmed by sickness, their juwarri may be dislocated and
displaced. It may leave the body altogether.
21. Papers in Ferreira and Lang (2006) reframe diabetes as a
sociopolitical disorder.
REFERENCES
Bailey, B 2006, Traditional Chinese medicine, Piedmont Acupuncture
and Oriental Medicine, Winston-Salem, viewed 11 December 2006
<www.piedmontacupuncture.com/prod1.html>.
Bandura, A 1986, Social foundations of thought and action: a social
cognitive theory, Prentice Hall, Englewood Cliffs, NJ.
1997, Self-efficacy: the exercise of control, W.H. Freeman,
New York.
Baum, F 2002, The new public health, 2nd edn, Oxford University
Press, South Melbourne.
Bird, DW & Bird, RB 2002, Mardu childrens hunting strategies in
the Western Desert, Australia, presentation to Ninth International
Conference on Hunter-Gatherer Societies, Edinburgh, 913
September.
Boustany, J 2000, Cultural awareness workbook for GPs, Goori Cultural
Awareness Training, Northern Rivers Division of General Practice,
viewed 6 December 2006 <www.medicineau.net.au/clinical/
abhealth/abhealt3506.html>.
Cass, A, Lowell, A, Christie, M, Snelling, P & Flack, M 2002, Sharing
the true stories: improving communication between Aboriginal
patients and health care workers, Medical Journal of Australia
176:46670.
Cousins, JH, Rubovits, DS, Dunn, JK, Reeves, RS, Ramirez,
AG & Foreyt, JP 1992, Family versus individually oriented
intervention for weight loss in Mexican American women,
Public Health Reports 107(5):54955., viewed 6 December 2006
<www.pubmedcentral.nih.gov/picrender.fcgi?artid=1403697&
blobtype=pdf>.
Devitt, J & McMasters, A 1998, Living on medicine: a cultural study
of end-stage renal disease among Aboriginal people, IAD Press, Alice
Springs.
Donchin, A 1995, Reworking autonomy: toward a feminist
perspective, Cambridge Quarterly of Healthcare Ethics 4:4455.
Donovan, JL & Blake, DR 1992, Patient non-compliance: deviance or
reasoned decision-making? Social Science and Medicine 34:50713.
Edge, H 2000, Extraordinary claims in a cross-cultural context,
presentation to Third Symposium of the Bial Foundation, Aquem e
Alem do Cerebro, Vivencias Exceptionais, Porto, Portugal, pp.159
80.
Edge, H & Suryani, LK 2002, A cross-cultural analysis of volition,
Florida Philosophical Review 2(2):5672.
Fenwick, C & Stevens, J 2004, Post operative pain experiences of
Central Australian Aboriginal women. What do we understand?
Australian Journal of Rural Health 12:227.
Ferreira, ML & Lang, GC (eds) 2006, Indigenous peoples and diabetes:
community empowerment and wellness, Carolina Academic Press,
Durham, NC.
Garcia, H 2002, An intercultural approach: a tool for enhancing the
quality of health services, Direction of Traditional Medicine and
Intercultural Development, Secretario de Salud, Mexico, trans. J
Gapella, John Curtin School of Medical Research, Canberra.
Hawkes, C 2002, Marketing activities of global soft drink and fast
food companies in emerging markets: a review, in Globalization,
diets and non-communicable diseases, World Health Organization,
Geneva, pp.95181, viewed 6 December 2006 <whqlibdoc.who.
int/publications/9241590416.pdf>.
Heffernan, MC 1995, Diabetes and Aboriginal peoples: the Haida
Gwaii diabetes project in a global perspective, in PH Stephenson,
A persistent spirit: towards understanding Aboriginal health in British
Columbia, Department of Geography, University of Victoria, British
Columbia, pp.26196.
Humphery, K, Weeramanthri, T & Fitz, J 2001, Forgetting compliance:
Aboriginal health and medical culture, Northern Territory University
Press, Darwin.
Kim, U & Park, YS 2005, Factors influencing academic achievement
in relational cultures: the role of self, relational, and collective
efficacy, in F Pajares & T Urdan (eds), Self-efficacy beliefs of adolescents,
Information Age Publishing, Greenwich, CT, pp.26786.
Knight, J 1999, Models of health, in J Germov (ed.), Second opinion:
an introduction to health sociology, rev. edn, Oxford University Press,
Melbourne, pp.13855.
Kobayashi, M 2002, Views of moral causality from cross-cultural
perspectives, Japanese Research of Moral Psychology 16:15.
Kowanko, I, de Crespigny, C & Murray, H 2003, Better medication
management for Aboriginal people with mental health disorders and their
carers: final report 2003, a collaborative project of Flinders University
School of Nursing and Midwifery and Aboriginal Drug and
Alcohol Council SA, viewed 6 December 2006 <nursing.flinders.
edu.auresearch/reports/QUMfinalreport.pdf>.
Australian Aboriginal Studies 2006/2 95
 East Kimberley concepts of health and illnessMcDonald
Kunitz, SJ 1994, Disease and social diversity: the European impact
on the health of non-Europeans, Oxford University Press, New York
& Oxford.
Lassak, EV & McCarthy, T 1983, Australian medicinal plants, Reed
New Holland, Sydney.
Lindsay, EA, Berry, Y, Jamie, JF & Bremner, JB 2000, Antibacterial
compounds from Carissa lanceolata R.Br., Phytochemistry
55:4036.
Lorig, KR, Sobel, DS, Stewart, AL, Brown, BW, Bandura, A, Ritter,
P, Gonzales, UM, Laurent, DD & Holman, HR 1999, Evidence
suggesting that a chronic disease self-management program can
improve health status while reducing utilization and costs: a
randomized trial, Medical Care 37(1):514.
Lorig. KR, Sobel, DS, Ritter, PL, Laurent, D & Hobbs, M 2001,
Effect of a self-management program on patients with chronic
disease, Effective Clinical Practice 4(6):25662, viewed 6 December
2006 <www.acponline.org/journals/ecp/novdec01/lorig.pdf>.
Lowe, HJ & Spry, FM 2002, Living male: journeys of Aboriginal
and Torres Strait Islander males towards better health and well-being,
Northern Territory Male Health Reference Committee, Darwin,
viewed 6 December 2006 <www.health.nt.gov.au/health/comm_
health/mens_health/pdf/living_male_discussion_paper.pdf>.
Lowell, A 1998a, Communication in Aboriginal health care: an overview,
Indigenous Health and Education Research Program review paper,
CRCAH, Darwin.
1998b, Cultural education programs for service providers in
Aboriginal health care, Indigenous Health and Education Program
review paper, CRCAH, Darwin.
Marmot, M 2001, Inequalities in health, New England Journal of
Medicine 345(2):1346, viewed 6 December 2006 <www.mindfully.
org/Health/Inequalities-In-Health-Marmot.htm>.
2004, Status syndrome: how your social standing directly affects
your health and life expectancy, Bloomsbury, London.
McCoy, BF 2004, I believe more in maparn: the contested site
of desert health, presentation to AIATSIS Conference, Indigenous
Studies: Sharing the Cultural and Theoretical Space, 2225
November, Canberra.
MacDonald, C 2002, Nurse autonomy as relational, Nursing Ethics
9(2):194201.
McDonald, H 2001, Blood, bones and spirit: Aboriginal Christianity in
an east Kimberley town, Melbourne University Press.
2003, The fats of life, Australian Aboriginal Studies 2003/
2:5361.
2004, Culture in health research and practice, presentation
to Social Determinants of Health Workshop, Cooperative Research
Centre for Aboriginal Health, 56 July, Adelaide.
2006, Australian Aboriginal traditional healing practices,
in T Dunning (ed.), Complementary therapies and the management
of diabetes and vascular disease, John Wiley and Sons, London,
pp.27290.
96 Australian Aboriginal Studies 2006/2
Mills, P 1987, Local physician dispels notion that east and west shall
never meet, The Muncie Evening Press, viewed 11 December 2006
<www.mugjoint.com/ayurveda/veda_papers/local.htm>.
Mitcalfe, P 1994, Listen to us, we got ideas: issues in program development
and delivery for Aboriginal people in remote communities, Department of
Community Services and Health, and Northern Territory Childrens
Services Resource Advisory Committee, Darwin.
Mitchell, D 1996, Sickening bodies: how racism and essentialism
feature in Aboriginal womens discourse about health, Australian
Journal of Anthropology 7(3):25874.
Mobbs, R 1991, In sickness and health: the sociocultural context of
Aboriginal well-being, illness, and healing, in J Reid & P Trompf
(eds), The health of Aboriginal Australia, Harcourt Brace Jovanovich,
Sydney, pp.292325.
Morelli, C 2003, The politics of food, International Socialism Journal
101:4564.
Pajares, F. 2002, Overview of social cognitive theory and of self-efficacy,
viewed 6 December 2006 <www.emory.edu/EDUCATION/mfp/
eff.html>.
Paul, D 2000, Casting shadows: persisting colonial influences and
Aboriginal health, Balayi: Culture, Law and Colonialism 1(1):113.
Peile, AR 1997, Body and soul: an Aboriginal view, ed. P Bindon,
Hesperian Press, Victoria Park, WA.
Reid, E 1977, The records of Western Australian plants used by
Aboriginals as medicinal agents, Western Australian Institute of
Technology, South Bentley, WA.
Reser, JP 1991, Aboriginal mental health: conflicting cultural
perspectives, in J Reid & P Trompf (eds), The health of Aboriginal
Australia, Harcourt Brace Jovanovich, Sydney, pp.21891.
Riessman, CK 1989, Women and medicalization: a new perspective,
in P Brown (ed.), Perspectives in medical sociology, Wadsworth,
Belmont, CA, pp.190220.
Roe, J 2000, Waraja Ngarlu Wanduna: one spirit, one feeling, one mind,
all working together, Northwest Mental Health Services, Broome,
viewed 6 December 2006 <www.pallottine.org.au/waraja_ngarlu_
wanduna.htm>.
Rosedale, R 1999, Insulin and its metabolic effects, presentation to
BoulderFest Seminar, Designs for Health Institute, Boulder, CO,
viewed 6 December 2006 <www.biblelife.org/rosedale.htm>.
Sansom, B 1980, The camp at Wallaby Cross: Aboriginal fringe dwellers
in Darwin, Australian Institute of Aboriginal Studies, Canberra.
1982, The sick who do not speak, in D Parkin (ed.),
Semantic anthropology, Academic Press, London (ASA Monograph
22), pp.18395.
Sheldon, M 1997, Psychiatric assessment in remote Aboriginal
communities of Central Australia, dissertation for Fellowship of
the Royal Australian and New Zealand College of Psychiatrists.
Sherwin, S 1998. A relational approach to autonomy in health care,
in S Sherwin (ed.), The politics of womens health: exploring agency and
autonomy, Temple University Press, Philadelphia, PA, pp.1947.
Sutton, P 2001, The politics of suffering: Indigenous policy in
Australia since the 1970s, Anthropological Forum 11(2):12573.
 East Kimberley concepts of health and illnessMcDonald

2005, The politicisation of disease and the disease of Young, W 2001, Unpublished papers, Jungarni-Jutiya Alcohol
politicisation: causal theories and the Indigenous health Education and Counselling Centre, Halls Creek.
differential, keynote address, National Rural Health Conference,
Alice Springs, 1013 March, viewed 6 December 2006 <www.nrha.
net.au/nrhapublic/publicdocs/conferences/8thNRHC/Papers/
KN_sutton,%20peter.pdf>.
Heather McDonald is a nursing sister and a social
Teufel-Shone, NI, Drummond, R & Rawiel, U 2005, Developing anthropologist. In the 1970s and 1980s she worked with
and adapting a family-based diabetes program at the USMexico
border, Preventing Chronic Disease 2(1):19, viewed 6 December
Aboriginal communities in north-western Australia
2006 <www.cdc.gov/PCD/issues/2005/jan/pdf/04_0083.pdf>. and the Northern Territory in the field of community
health. She studied social anthropology at the
Trostle, JA 1988, Medical compliance as an ideology, Social Science
and Medicine 27:12991308. University of Queensland and the Australian National
University and gained her doctorate in 1998. She is the
Trudgeon, RI 2000, Why warriors lie down and die, Aboriginal
author of Blood, bones and spirit: Aboriginal Christianity
Resource and Development Services, Darwin.
in an east Kimberley town, winner of the 2002 Stanner
Turner, JV & Graham, J 2005, Targeting Aboriginal health in Award. In 2005 she completed an AIATSIS research
Aboriginal terms: lessons from the Top End, presentation to Eighth
fellowship in Indigenous social health, investigating
National Rural Health Conference, 1013 March, Alice Springs.
factors facilitating or inhibiting health and health
Wiminydji & Peile, AR 1978, A desert Aborigines view of health delivery in East Kimberley, especially in relation to
and nutrition, Journal of Anthropological Research 34(4):497523.
cardiovascular and respiratory illnesses.
Young, D 2002, The colour of rubbish: a short paper about how
things become rubbishy on the Nanango Pitjantjatjara Lands in <heathmcdon@hotmail.com>
Central Australia, presentation to Ninth International Conference
on Hunter-Gatherer Societies, Edinburgh, 913 September.

Australian Aboriginal Studies 2006/2 97