An ‘accident’ waiting to happen and how to risk manage it.

on friday 14th. i had the distinct privilege and honour to be marching through the streets of collarenebri in 44 degree heat to give recognition and respect to mark mason, snr and the 4th anniversary of his killing by 5 nsw police officers but that report, along with others, will need to wait. >
> the death of this unnamed woman has highlighted the argument put to the nt government of the time that the introduction of the mandatory alcohol rehabilitation program would only lead to such disasters and would not be truly useful in its concept and desired outcome. there are several arrows to this bow so we will address each as they are raised in the article below. >
> the first arrow we need to release is the fact that it took just 18 months for a reported death to be made but only after some two weeks passing of that tragedy occurring. why was such a time lapse allowed to occur? and why the perceived management of the death as being publicly but more importantly, familially acceptable? >
> we are now more and more, as a society, being told that some government actions, along with their consequences, are to be now considered as ‘operational matters.’ these illegal terms, to my mind, and with a wink and a nod to ‘security issues’, are currently being used in the cover-up of the criminal treatment of asylum seekers. do we really want our governments to ‘cherry-pick’ other items of public interest, embarrassing as they may be, to the realms of silence and anonymity for certain lengths of time? i would hope not. >
> the elected leaders of this country have always stressed of australia’s democracy, of australia’s freedoms, of our australian way of life. that apparently places us somehow above or before all other nations thus leading to that horrible obsequious faux patriotic term, ‘the australian way.’ more and more the governments have been restricting that democracy, those freedoms and that way of life. the lives of our fellow citizens and those who wish to become our fellow citizens must never ever become a political pawn of an ‘operational matter’ regime. but it is up to us to do it and not sell our freedoms so lightly merely because the subject target is aboriginal or that dreaded ‘other.’ >
> should the nt government be allowed to withhold such information then as sure as there is climate change that practice will spread to other areas where participants are held against their will as they are in this mandatory alcohol rehabilitation scheme. the move by governments to enforce their will upon the people is but a well-worn path to fascism. >
> the second arrow we must let fly is to join with this poor woman’s family in asking for full public exposure of the health treatment and practices provided by the mandatory program. it must be clearly understood by all that when dealing with chronic alcoholics, as this woman was, you are dealing with people of extreme physical and mental problems. you are dealing with people who have slowly destroyed their own health over many many years. we are not merely talking of a hangover cure or a few weeks off the grog, it is much more than that. >
> these people meet the need for a high level of medical care and an expensive level of care at that. the level of medical treatment has been hidden behind that ridiculous descriptive, ‘commercial-in-confidence’, that is normally used as a smokescreen to cover various inadequacies in any scheme hiding behind such a term. there must never be such an argument used for the allocation and spending of tax payer dollars. the family and the public must be told the medical procedures that were being used on her prior to her death and what medication regime she was receiving. medical experts for the family must be able to test this evidence as to its efficacy. that is a family and public right to know. >
> as is normal in death in custody cases this family must be given the interim and final autopsy reports along with her full medical records from the program, again to allow them to be professionally judged and advised by family appointed experts. >
> the next arrow allows for us to examine the most stupid and cowardly statement of all. let it be made quite clear and plain now; the death of this woman is and must be recognised as a death in custody. for the following easily understood reasons. >
> in 1997 when this association was being formed we made it an integral article of our constitution that we would recognise a death in custody event as those described within the royal commission into aboriginal death in custody enquiry recommendations in situations and events under the control of the police, the gaols and juvenile justice. but further to that level of government instrumentalities control was to be added deaths wherever occurring in mental hospitals, hospitals, government-managed aged care facilities and any and all government-initiated mandatory programs that effectively made the person to be legally under the control of the relevant government. isja still reflects strongly that common-sense understanding today. >
> when this program was first mooted, as this article states, many voices were raised pointing out not only the dangers for the participants but the human rights problems associated with finding the participants to be literally forced to become a quasi-legal volunteer or face gaol as a consequence of refusal. the patients, the volunteers, the inmates, whatever term was to be used had little or no control over their input into the program. it was rehabilitate and be damned or go to gaol! some choice. the macabre semantics used by the nt governments and its departments mirrors the early days of the royal commission when the police, mainly and nationally, argued as to what best described a death in custody caused by them. they had a slight victory when it was agreed by the commissioners that relevant to the police only there would be category 1 and category 2 dic events. but anyone who could add the two categories together would then reach the total of police dic’s. maybe the police just believed it looked better. >
> semantics aside, a death in care equals a death in custody equals a death in care! the term ‘in care’ denotes responsibility and that at least must be recognised. the words of both ms. priscilla collins and dr. john boffa must be heard and reasonably answered to the satisfaction of the family and the concerned public. one serious question that must be asked is to better satisfy ourselves and our ongoing concerns as to the health status of those who have been discharged from this program? what follow up, if any, has been performed of the participants or is it more of being out-of-sight, out-of-mind? >
> we said at the time, along with other bodies, that the process as initiated was a stunt and just another costly attempt to remove aboriginal people from the tourist streets of the grog-soaked alice springs. aborigines die because of this too easily available product but nothing is done to limit the flow of alcohol but instead to limit the number of aborigines by locking them up and removing them from the streets. that must not be allowed to continue. >
> the implementation of this mandatory program, as was stated nearly 2 years ago, was an accident waiting to happen. it was allowing for some anonymous person to face the real and ever-present risk whilst the authority, in this case nt health and the nt government, would manage it. it is called risk management. you take the risk, they will manage it! every worker knows of this process. every one on worker’s compensation knows this. every investor knows this. we all take multiple risks everyday. when we do hospital time or gaol time or any other risk that we steer into everyday. when we give our permission or otherwise to another person or authority we are taking a form of risk. we are putting ourselves into a situation of allowing for an accident waiting to happen to occur. we each do it every day in so many, many ways. we take that life risk and then watch the managers manage it should the risk eventuate. our next arrow. >
> john elferink, the attorney-general of the nt, is very aware of this practice and is among many other managers out there who immediately inform the rest of us that the system is not at fault, ever, the victim is. john’s natural argument is that this woman would have died outside on the streets so the program was merely attempting to save her so hence cannot and will not be held accountable for her death. if the victim was not alcoholic she would have survived. but john is an alcoholic, non-practising to be sure but an alcoholic nonetheless. but he, with good help and care, dried out so if he could do it then why not the victim? ergo therefore, the victim is to blame. she took the risk, the state has managed it. >
> it is the same argument that is put to the dic families by the custodial systems of this country. it is not our fault your loved one died in our custody, it is your fault for allowing your loved one to be in custody. 450+ deaths in custody, 450+ families at fault. now that is risk management on steroids! the words of elferink are definitely weird in their logic that such risks must be taken by someone else or ‘we’ would not have a ‘logical’ custody system. i find that logic to be a sad outcome for those who take the risks that our managers attempt to manage every day. >
> on the 27th and 28th of this month there will be held in alice springs, or more correctly, the old telegraph station, an aboriginal summit that will see leaders and activists gathering to look at the many invasive problems besetting our mobs, including alcohol abuse and deaths in custody or care. these and many more subjects will be discussed. we are fully aware that aboriginal problems and difficulties can only be properly and culturally solved and repaired by our own and not just left to the risk management practices of governments. >
> fkj
> ray jackson
> president
> indigenous social justice association
> prix des droits de l’homme de la republique fraincaise 2013 > (french human rights medal 2013)
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> Aboriginal woman dies undertaking mandatory NT alcohol rehabilitation program > AM
> By Sara Everingham
> Fri 14 Nov 2014, 1:47pm
> An Aboriginal woman has died while taking part in the Northern Territory’s highly contentious mandatory alcohol rehabilitation program.
> It is the first death linked to the scheme that was introduced by the NT Government 18 months ago in the face of warnings from experts that it would target Indigenous people and punish alcoholics. >
> The woman died last month in the Central Australian Aboriginal Alcohol Programmes Unit (CAAAPU) treatment centre in Alice Springs, but the NT authorities have not made news of the death public until now. >
> Her family is now asking questions about the care she was given and how she died.
> The woman’s sister, Elizabeth Raggette Naparula, speaking from her remote central Australian community of Papunya, said she had been worried about her sister’s health and was willing to give the treatment a chance.
> “I thought they were going to keep her to get better, to eat lots of good food,” she said.
> “I wanted them to look after her properly so she could get healthy and not have so much grog.” >
> She said she was informed of her sister’s death by a relative last week. > “All my grandchildren are crying every night for her,” she said.
> “When I cry, they cry too. I can’t understand what happened, I don’t know what happened.”
> She wanted to know what medical services were in the CAAAPU treatment centre, and whether her sister had medication for her seizures.
> “I never went to see her at CAAAPU, I thought everything was alright,” she said.
> “When I last saw her she was looking in the best of health. I can’t understand what happened.” >
> The NT Health Department said the next of kin had been told but would not give any more details. >
> Death in mandatory rehab ‘not a death in custody’
> Under the Alcohol Mandatory Treatment (AMT) program, anyone picked up by police for being drunk three times in two months is forced into alcohol treatment.
> Legal and health groups have warned the untested program would target Indigenous people and cost millions while doing little to treat addiction. >
> Even though people are detained against their will in AMT, the woman’s death will not be treated as a death in custody, authorities say.
> Instead, it is being treated as a death in care and is now before the NT coroner.
> NT Criminal Lawyers Association president Russell Goldflam said the public was usually informed about deaths in custody.
> “In my experience, whenever there’s a death in custody or a death after some sort of engagement with police, the police are very quick to put out a statement,” he said.
> “It’s pretty obvious why, if they didn’t they would be accused of trying to cover things up.” >
> North Australian Aboriginal Justice Agency (NAAJA) chief executive Priscilla Collins was highly critical of the NT Government’s failure to make the death known publicly.
> “The worst thing is we’re only hearing about it two weeks later; why wasn’t this brought up two weeks ago?” she said. > She said it was indicative of the secrecy around AMT.
> She said her questions about medical staff levels, costs and success rates had gone unanswered.
> The worst thing is we’re only hearing about it two weeks later; why wasn’t this brought up two weeks ago? > Priscilla Collins, NAAJA chief executive
> Dr John Boffa, a medical doctor and spokesman for the People’s Alcohol Action Coalition in Alice Springs, said the Government was withholding crucial information about mandatory alcohol treatment.
> “It’s not ethical to put people into a system of care which is not achieving outcomes,” he said.
> “Here we have a death, which is tragic. How many people have actually been helped through this treatment process? We have no idea. > “How many people are leaving and coming back? We have no idea.” >
> The ABC’s AM program put a number of questions about the death and the care at the rehabilitation centre to the NT Health Department. > The department would only confirm there had been a death.
> It said the coroner has been informed and it was not appropriate to make further comment. > The CAAPU treatment centre where the women died did not return AM’s calls. >
> AMT safer than life on the streets: Elferink
> Attorney-General and acting Health Minister John Elferink said the NT Government had no duty to make the death public.
> “It’s not the department’s responsibility to sit there and go through the whole list of extended family and ring them individually,” he said.
> “Once we have given the next of kin the advice of the death, we leave it up to the family to tell other people in the family and the extended family of the death that’s occurred.” >
> He also said many people in AMT would have died but for the Government’s care.
> When the AMT legislation was being debated in Parliament in June last year, Mr Elferink said people would be safer in rehab because they were not on the streets.
> “Currently, they are dying because they are staggering out in front of cars and getting run over,” he said.
> We do not get to see about them in the newspapers because they often go unmarked and unnoticed in their deaths. Their deaths represent the end of an unremarkable life awash with their drug of choice. >
> John Elferink, Attorney-General
> “[They are] dying of diseases such as pneumonia because they are sleeping out unprotected in winter in Alice Springs, and dying because they have renal collapse.
> “One example I can cite is of a fellow who was drunk and asleep on railway tracks and was run over by a train. They are dying now, and in large numbers.
> “We do not get to see about them in the newspapers because they often go unmarked and unnoticed in their deaths. Their deaths represent the end of an unremarkable life awash with their drug of choice.” >
> He said in order to “protect the community” the Government would accept the risk people could die in AMT. > “It is a political risk we engage in,” he said.
> “Unfortunately, when you are in a position where you take people into custody that is a risk you take.
> “However, if you are so adverse to that risk, police would take nobody into custody and [Correctional Services] would hold nobody in prison.
> “The mental health authorities, who also have non-judicial incarceration, would not take people into custody. Why do we do it and accept it so readily in those environments? > “The reason is we need to protect the community and/or the people themselves. > “We take the risk.”
> Absconding from AMT no longer criminal
> Last month the NT Government announced it would no longer be a criminal offence to abscond from the a treatment facility, while also allowing doctors to refer chronic drinkers to AMT.
> It also meant people excluded from AMT because of charges resulting from drinking would be eligible to access the treatment.
> The reform was welcomed by Australian Medical Association NT president Dr Robert Parker, who said it “made sense” that referral to AMT was done through a therapeutic tribunal process rather than a legal one.
> “I am very happy to see that being removed from any sort of criminal act,” he said >
> CAAPU is a not-for-profit organisation that also administers part of the AMT scheme for the NT Government in Alice Springs.
> It was established in 1991 to assist Aboriginal people with alcohol and drug rehabilitation.
> A $6.1 million AMT treatment centre in Katherine was canned this month following community outrage about its industrial location. >
> Key points of NT’s mandatory rehab:
> The legislation came into effect in the Northern Territory on July 1 2013
> Anyone taken into custody for drunkenness three times in two months is assessed for treatment > Means some alcoholics are forced into three months of rehabilitation
> Treatment occurs at rehabilitation facilities in Darwin, Katherine and Alice Springs >
> Draft legislation heavily criticised by Indigenous groups, medical bodies and justice advocates > Critics argue it criminalises drunkenness

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