Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Hansard source

by leave—Not many Australians are aware that Australia’s closest international border is only a few kilometres away—in fact, 30-odd minutes away by banana boat—from the Torres Strait and that Australia and Papua New Guinea share a unique treaty arrangement that permits free movement between treaty villages on either side. A number of media reports in the last year or two have intimated that there is an influx of PNG nationals arriving, via the treaty, in the Torres Strait and that infection risks for communicable diseases like TB and HIV-AIDS are very high. The inquiry and a delegation of the health committee sought to examine these issues in detail. We hope that this report goes some way towards highlighting the issues in their complexity, tempering some of the unsubstantiated fears and reaffirming why we permit a relatively small number of sick PNG nationals access to health services in the Torres Strait under specific conditions. We do so for humanitarian and practical reasons, because that is what good neighbours do.

The report shows that a range of structures exist and that systems are in place for managing this process from treaty consultation processes through to Queensland Health treatment guidelines. There are costs associated with treating these individuals and, while the numbers treated are small, costs for serious conditions like MDR-TB are not insignificant. It is in everyone’s interests to try to mitigate these.

The committee heard and saw for itself some of the push factors for why treatment may be sought on the Australian side. There are vast disparities between health facilities in PNG and those in Australia. Major challenges on the PNG side include a lack of human resources, equipment and infrastructure, coupled with rugged geography and governance issues that make difficult the distribution of essential supplies and service delivery.

The committee learnt that the problems are not solely due to a lack of money, especially in the Western Province, which is actually one of the richest provinces in the country. Australian aid in the region is substantial, seeking to strengthen health facilities along the border in the Western Province as well as the national health system in PNG and the Solomon Islands. Extra resources are being allocated to the Saibai Health Clinic—Saibai being in the Torres Strait on our side—in recognition that it caters for PNG nationals, in addition to Torres Strait residents. The Office of Development Effectiveness reports indicate that overseas aid effectiveness is a bit of a mixed bag and that it is more successful in some areas than in others. Placing Australian advisers in line agencies, such as the Ministry of Health, to work alongside host counterparts in the Solomon Islands is one strategy that appears to work well.

On overseas aid it is worth mentioning something not well known: assistance flows two ways. It is not well known in Australia that PNG provided aid to Australia for its victims of natural disasters, of the Victorian bushfires and the Queensland floods. So it does flow both ways. Australia works in partnership with the governments of PNG and the Solomon Islands to achieve better health outcomes and determines priorities in both countries, in line with what those governments want. PNG and the Solomon Islands are sovereign nations and Australia can only, and only wishes to, assist. Ultimately, the PNG and Solomon Islands governments are responsible for delivering health services to their own citizens.

In this report the delegation highlighted the problems but also what works or could work better in Australia’s role in facilitating these solutions. For instance, Australia has clearly made a fundamental difference to the water and sanitation situations in treaty villages in the Western Province of PNG through supplying rainwater tanks that provide a minimum level of safe drinking water. The delegation also recommended that this installation program be expanded to provide more than the minimum level of water required. Installing adequate water and sanitation in villages is part of getting the basics right for better health outcomes. We saw that, if you do not get those basics right, the health outcomes that flow through obviously are not as good. We know that a lot of illnesses and diseases are eradicated just by having sanitation in these villages.

The delegation also noted that the PNG government, together with Sustainable Development, have undertaken to improve water supply and would like to see this done as soon as possible. That said, the delegation recognises the very real logistic and practical difficulties that stand in the way of any speedy or comprehensive installation.

In the Solomon Islands Australia has built basic but functional health clinics, complete with solar fridges for cold storage of vaccines where electricity does not exist. The delegation learnt that one-off projects, supply deliveries and volunteer or staff placements can sometimes do more harm than good, despite donors’ best intentions. The committee has recommended that a contact point be established that provides community organisations with basic information on the suitability of their intended donations in particular regions. Similarly, when building new health facilities or offering other goods and services to assist, the Australian government and Australian community organisations must consult donor partners and local communities. New health facilities must be consistent with suitable support measures that will need to be put in place for staff and to maintain that new structure.

The delegation heard from nearly everyone it met with during the visit about the huge benefits of twinning arrangements between health institutions in respective countries, be they hospitals, laboratories, universities or parliaments. Developing and maintaining institutional relationships is not up to governments per se; rather, it is up to the institutions themselves. However, the delegation has recommended that the Australian government do all that it can to encourage and support sustainable schemes and exchanges.

Fostering greater people-to-people links, genuine exchange and sharing of information and training lies at the heart of a new era of re-engagement and underscores true partnership. Myriad benefits are being reaped from the Australian Leadership Awards. There is the relationship that exists between the Solomon Islands parliament, for example, and the New South Wales parliament, and there are courses like those run by the Australian National University’s Centre for Democratic Institutions. Women in politics courses are designed to assist participants from the region get more women elected in their national parliaments. The delegation hopes to see more women parliamentarians elected in the region in coming years and for the Australian parliament to do all it can to support that process—hence our recommendation to the Presiding Officers to establish a parliamentary mentoring program, especially for women MPs. The delegation believes such a program would have reciprocal benefits for and enrich all our parliaments.

This inaugural committee delegation visit to the PNG and Solomon Islands was the first joint parliamentary delegation in recent memory to the treaty villages, and the first parliamentary health delegation in recent memory. The symbolism of such a visit is very important. The delegation visit was warmly welcomed by governments at the highest national and provincial levels, and by institutions and community organisations. Delegates were also made to feel incredibly welcome in the villages and were privileged to spend time in villages that are not easy to get to in either the Western Province of PNG or the Solomon Islands. Wherever the delegation went it experienced and shared the goodwill that exists with the people of PNG and the Solomon Islands.

Of course, governments must go beyond symbolism and in-principle agreements to fund and implement the better health infrastructure and services that are required on both sides of the border. That is something which the Australian and Papua New Guinea governments have both undertaken to do with a new package of measures which is designed to strengthen health services on both sides of the border. This package is in its infancy but already the delegation heard that measures such as installing health communication officers on both sides of the border are proving effective. The delegation has recommended that consideration be given to expanding such positions in the future because their job is so vital and possibly beyond the capabilities of any one or two individuals. The delegation was told that close communication between partners is a key to any program’s success, including that achieved by the national malaria program in the Solomon Islands.

The delegation was fortunate to be able to meet with ministers, parliamentarians, health professionals and communities for discussion on a range of health issues, from TB, HIV-AIDS and malaria to the rise of diabetes in the region and the encroaching impacts of climate change on health. All dialogue was conducted in a frank and very open manner. Delegates were especially impressed, and indeed humbled, by all the health professionals and community workers that we met with in the Torres Strait, PNG and the Solomon Islands. They are so clearly committed to providing the best patient care they can under the circumstances, and often they have limited tools and support. They are the unsung heroes of any health system.

Beyond aid, PNG and the Solomon Islands require robust integrated healthcare systems that incorporate a range of outreach services in outlying areas. Australia has rural and remote areas too that governments find difficult to service. PNG and the Solomon Islands are not alone in grappling with how best to deal with moving a fragmented health system to a less fragmented one. Australia has long struggled with the issue of major health reform, and still we hear the debates as to what level of government—national, state or local—should take responsibility for health services funding and delivery. Major structural reform is again on the agenda here in Australia, so we have something fundamental in common here.

Similarly, we must all deal with the impacts of climate change on health, and we should take note of some of the experiences we learned from each other while we were over there as to what does and does not work. For example, at the hospital on the island of Gizo we saw the effects of climate change on rising sea levels where the water has come right up to the hospital’s border. They had to actually physically move the hospital and they are building a new one. Climate change is a real threat and is already affecting people’s lives. It is already having an impact on health in the Pacific. The delegation’s visit played a role in that sharing and learning process in that we heard from them and they heard from us. Delegates hope to see the parliamentarians we met in the PNG and Solomon Islands back in Australia in the near future to continue our engagement. It is so important for leaders and communities in our respective countries to have ongoing dialogue about the range of health issues that affect our region.

In the few minutes that I have left, I would like to take this opportunity to thank my committee—my deputy chair, Steve Irons, and the secretariat, Sara Edson, James Catchpole and Penny Wijnberg—for their assistance and their help. The secretariat did an absolutely A-class job in getting the itineraries and the meetings all set up for us and in the development of this particular report. But I must say that we were also warmly welcomed and appreciated in both countries. There was generous hospitality and support provided by our host parliamentarians and governments of Papua New Guinea and Solomon Islands, and we were assisted ably by our high commissions in both countries.

We are very grateful to the many people who helped make the visit such a success. In particular, I would like to thank the Governor of the Western Province of Papua New Guinea, the Hon. Bob Danaya, and, of course, the local member for South Fly in PNG, the Hon. Sali Subam. They accompanied us on our visit to the three treaty villages—our closest neighbours in Australia—of Mabadawan, Sigabadaru and Buzi. We were warmly welcomed with full traditional welcomes when we attended these villages. The three villages, as I said, are some of the most isolated villages in the world. There are no roads leading into them. There are no aeroplanes and airports. The only way you can get to them from Daru, the capital of the Western Province, is by banana boat. We were lucky that we went by helicopter. You can see the problems in getting aid into these places, because, as I said, there are no roads or other infrastructure. I really felt for the people when we saw them. They were so welcoming and so happy to see us. I hope this report does make some sort of difference to their lives.

As I said, I thank my committee colleagues on the delegation for their very hard work, and the committee secretariat and parliamentary relations officers for their efforts in coordinating the delegation’s program. I commend the report to the House.

See this speech in context