In Australia’s red centre, the Indigenous people know two forms of healing. In their communities, there is often a small medical centre with a local area nurse supported by The Royal Flying Doctors Service. The other form of healing comes from the Ngangkaris who use traditional healing techniques passed down through what could be literally hundreds of generations. A recent conference at Sydney University discussed the idea of improving health outcomes for Australian Indigenous people by creating a model that integrates both pathways to healing.

Indigenous health is in a very dismal state in Australia. There’s still a very big gap between health outcomes and life expectancy in Aboriginal and non-Aboriginal people, and I think it’s time we thought through [whether] there is anything else we could be doing… in our health services [to] actually improve health outcomes for Aboriginal people.
– Prof Elizabeth Elliot on The Wire

There’s still a gap between health outcomes in Indigenous and non-Indigenous people.

Who are the Ngangkari?

There were originally around 250 Indigenous language groups across the Australian continent and it was likely that there was a similar number of names for the spirit-healers that are known in the central desert as Ngangkari. The word Ngangkari is somewhat like the word ‘shaman’, which is originally from the Tungusk region in Siberia but is now used to refer to Indigenous medicine practitioners from around the world. In a similar way, the word ‘Ngangkari’ comes from the Pitjantjatjara, Yankunytjatjara and Ngaanyatjarra language groups, but modern use of the term is growing as a description for Indigenous spirit-healers in general across Australia. Other common names in English for the people within Aboriginal tribal cultures who play the role of healer and carrier of spirit lore are ‘the clever people’, ‘clevers’, or ‘feather foots’.

Ngangkari are kind of like a mixture between a general practitioner and a psychiatrist all in one. Their medicine is holistic in nature, concerned with a person spiritually and physically, and this is important to many indigenous people. – Francesca Panzironi CEO of ANTAC (Anangu Ngangkari Tjutaku Aboriginal Corporation)

Ngangkari are kind of like a mixture between a general practitioner and a psychiatrist.

Rare Gifts Almost Lost

The central desert mobs managed to carry through their healing traditions into the modern day in part because of their remote location, whereas other tribal cultures have sadly suffered much more comprehensive cultural severance at the hands of ongoing colonisation. It is important for the world to remember that the Indigenous people of Australia were not even recognised as human beings until the 1960’s, and that more children are being removed from their families today than at any time during the stolen generations, which were designed as a form of cultural genocide.

In spite all of these ongoing attempts to destroy Indigenous culture, a small number of lineages of healing knowledge have remained unbroken or have managed to be revived. We, as a species, came very close to losing every trace of what is almost certainly the oldest continuous healing modality on the planet. Thankfully these featherfoots, after more than two centuries of persecution, are now on the front foot, allowing their presence to be more publicly known.

A small number of lineages of healing knowledge have remained unbroken.

Two Emerging Approaches

In recent years, two main organisations have emerged in central Australia to publicly represent and promote the work of Ngangkari healers, whose extensive tribal homelands are split by a modern colonial state border.

In the past non-Aboriginal doctors would do their work, yet they didn’t know about us traditional healers. Our traditional healers were always busy healing people at home, looking after the entire community, while the doctors did their work in their clinics. But neither knew how the other one worked. – Maringka Burton in The Australian newspaper

The Hand-In-Hand Model

In the north end of South Australia exists the Anangu Ngangkari Tjutaku Aboriginal Corporation or ANTAC, who have chosen to pioneer their Hand-in-Hand model of close collaboration and integration with the western medical system. The Hand-in-Hand approach argues that these practices should be accepted as valid on the grounds of cultural appropriateness and efficacy. In Australia, there is a universal healthcare system that provides science-based western medical treatment to all citizens. ANTAC seeks to create a system of accreditation for the Ngangkari to be formally recognised alternative healthcare providers that can be paid for their services in the same way that western medical practitioners are paid by the government.

Depressed people can feel a lot better within themselves after a Ngangkari treatment. That’s one of our specialities. Their spirits are out-of-sorts, and not positioned correctly within their bodies. The ngangkari’s job is to reposition their spirits and to reinstate it to where it is happiest. – Naomi Kantjuriny in The Australian newspaper

The Hand-In-Hand Model.

The Parallel Model

In the middle of the Northern Territory, in the desert city of Alice Springs, an organisation called the Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women’s Council Aboriginal Corporation or NPYWC is wanting to maintain full autonomy.

Georgina Kenyon describes in her comprehensive article Australia’s Other Flying Doctors that ‘the NPYWC ngangkari tell me they do not directly treat drug addiction or other diseases such as diabetes that they say were unknown in indigenous communities before European settlement brought new social problems and diets high in processed sugar and flour. But they will treat people suffering from mental distress or physical conditions such as injuries and trauma, muscular diseases, and issues surrounding pregnancy.’

Kenyon suggests that while the mob from the South Australian side of the border tend to be more closed to the outside world, but push for formal accreditation and recognition as healthcare providers, the mob from Alice Springs seems to be more welcoming of outsiders but are more closed to the idea of collaborating with government and the western medical system.

The Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women’s Council Aboriginal Corporation

The Ngangkari here are part of an old belief system. They don’t want regulation, but prefer to operate as a parallel health service. Many are happy not to be part of the health system. – Angela Lynch, Programme Manager at the NPYWC

The Hand-in-Hand model seeks to legitimise the practices of the Ngangkari and connect them to the financial stability of the National Health System. Among it’s many goals it also seeks to work with the medical profession in a way that makes it more attractive to Indigenous people, because their culture is not only considered but actually included in the process. While it may seem like an uphill battle to convince the government that spirit medicine needs to be recognised, the numbers don’t lie. If the people at ANTAC can provide evidence for the efficacy of their program, it will be more difficult to ignore, even if the methods of the Ngangkari may seem strange.

The most serious drawback to the Hand-in-Hand approach may well be the ongoing subordinancy of Indigenous practices to the authority of western medicine. While there is no doubt that increasing trust and power balance will occur as relationships between Ngangkaris and doctors strengthen, it seems unlikely that the patriarchal, colonial approach backed by verifiable science would ever truly cede authority to the Ngangkaris perspective.

It seems unlikely that the colonial approach backed by verifiable science would ever truly cede authority to the Ngankaris perspective.

Mainstream recognition

Ngangkaris Andy Tjilari and Rupert Langkatjukur Peter were awarded the Mark Sheldon Prize for Indigenous mental health by The Royal Australian and New Zealand College of Psychiatrists in 2009, as well as the Sigmund Freud Award for distinguished contributions in mental health by the World Council for Psychotherapy in 2011.(Medical Journal of Australia).

One day my grandfather asked me, ‘Do you want us to give you ngangkari power, so that you can live your life as a Ngangkari? You’ll have to help sick people, and heal them, whether they are men, women or children. If you do become a ngangkari, the power will stay with you all your life and you’ll never lose it, or be able to throw it away.’ – Andy Tjilari in The Australian newspaper

“If you do become a Ngangkari, the power will stay with you all your life.”

The Parallel Healthcare Model – Drawbacks and Benefits

Traditional Indigenous Australians aren’t operating without any laws to govern their behaviour and ethics. On the contrary, they are operating in accordance with their own Lore which has existed unbroken for millennia; meanwhile in other parts of the world, empires have risen and then completely collapsed along with the very systems of law that were designed to prevent the kind of chaos that causes civilisations to fall. As long as this system of traditional Lore and ethics has the willingness to refer patients to other professionals more able to assist a person when required, then the parallel model is likely to function in tandem quite well, and this willingness is already being demonstrated.

We are unable to do too much work with renal patients; we never touch their kidneys, they are too vulnerable. But we do help with pain and discomfort. – Maringka Burton in The Australian newspaper

“We help with pain and discomfort.”

Echoes of a Deeper Issue

These two approaches seem to echo a much larger debate in Australia about whether Indigenous people should be ‘recognised‘ and finally included in the constitution of Australia, or whether Indigenous people should stand strong in the concrete fact that they never ceded sovereignty and the legal method for claiming authority by the crown, terra nullius, was actually a lie. This legally makes the crown’s authority on the continent now known as Australia null and void, according to the crown’s own system of law. The truth is that Australia still legally belongs to its Indigenous people and is actually an occupied territory, due to the fact that there is no treaty, no official record of military conquest, and terra nullius – the claim that the great southern land was uninhabited – was and is categorically and definitively false.

Terra nullius is the method the British crown chose to use in order to take possession of the Australian continent according to international law. It is the bedrock that the entire Australian legal system and the very authority of the crown in Australia are built upon, however just like in any other legal matter from murder cases to parking fines, if a crucial piece of evidence turns out to be false (like the fact that the continent wasn’t uninhabited), then the claim, in this case, of possession and authority over the entire continent is legally invalid.  This means that in the practical sense the only authority the crown wields in Australia is the fact that they possess the firearms and the cages.

Terra nullius is how the British crown took possession of the Australian continent.

Indigenous Australians are still sovereign peoples and are the rightful owners of the Australian continent, and they are living under occupation-by-force. They are surrounded by a population who are almost totally unaware that they are descendants of an occupying force and the occupation is still in place. (It should be noted here that Indigenous Australians traditionally held a belief that was more about custodianship than ownership, however, this doesn’t invalidate the fact that according to the terms of the colonisers which involved things such as working the land, the continent was not uninhabited and already occupied.)

The blackfellas who are demanding treaty instead of constitutional recognition, may well be on the correct and true side of history, however this doesn’t mean that the hand-in-hand approach of engagement with a legally illegitimate government, isn’t a prudent path towards preventing suffering and saving lives.

The link between sovereignty and Indigenous health should not to be underestimated. How can we expect there to ever be true healing on the very real and tangible day-to-day healthcare level, if we never rectify the foundational wound of their unrecognised sovereignty?  In my opinion, the healthcare gap between indigenous people will only be finally closed once this fundamental cultural wound is healed. Anything less is just triage on a cultural scale.