Social Justice Report 2003: Chapter 4: Responding to petrol sniffing on the Anangu Pitjantjatjara Lands: A case study

Social Justice Report 2003

Chapter 4: Responding to petrol sniffing on the Anangu Pitjantjatjara Lands: A case study

In September 2002, the South Australian Coroner brought down his findings in the inquests into the deaths of Kunmanara^[1] Ken (who died on 3 August 1999), Kunmanara Hunt (who died on 27 January 2001) and Kunmanara Thompson (who died on 26 June 2001). Each of these young Anangu was a chronic petrol sniffer (they had been sniffing for at least ten years) in their mid to late twenties living on the Anangu Pitjantjatjara Lands (AP Lands). All three were found to have died as a result of inhalation of petrol fumes.^[2]

Indigenous community organisations on the Pitjantjatjara lands had lobbied hard for the inquests to take place in order to bring public attention to the devastating impact that petrol sniffing was having on the AP Lands and to the lack of government action in addressing the situation. The Coroner identified that socio-economic factors such as hunger, poverty, illness, low education levels, almost total unemployment, boredom and general feelings of hopelessness 'form the environment in which such self-destructive behaviour takes place'.^[3] He stated: 'That such conditions should exist among a group of people defined by race in the 21st century in a developed nation like Australia is a disgrace and should shame us all'.^[4]

The Coroner identified the failure of governments (both federal and state) to provide adequate services on the AP Lands to address these factors as contributing to the problems associated with and leading to petrol sniffing. The findings and recommendations of the inquests provide a blue print for action in addressing issues relating to petrol sniffing on the AP Lands within a systemic and long term framework.

In this chapter, I examine progress in implementing the recommendations of the Coroner in the year since they were released. It is critical for the South Australian and federal governments to respond in a coordinated and timely manner to this most difficult, entrenched and devastating issue. An analysis of how they have approached this task and the processes that they have committed to is also of broader relevance for addressing chronic substance misuse and petrol sniffing issues in other Indigenous communities across Australia. The chapter commences with an overview of research on the extent of petrol sniffing in Indigenous communities across Australia and its impact on Indigenous communities. It then discusses issues relating to petrol sniffing on the AP Lands and the Coroner's findings, as well as considers the adequacy and appropriateness of governmental responses and processes that are currently in train on the AP Lands to deal with petrol sniffing issues.

Petrol sniffing and Aboriginal and Torres Strait Islander communities

a) The impact of petrol sniffing on Indigenous communities

There are two main ways that petrol sniffing impacts on Indigenous communities. First, at an individual level it can be life-threatening and poses significant risks to health. It can also result in increasing levels of disability. Second, it has disruptive and destructive effects on the functioning of families and communities.

The impact of petrol sniffing on a person's health has been described as follows:

Petrol is a mixture of C4 to C12 hydrocarbons, the relative amounts of the various constituents depending on the origin and preparation of the petrol. The unsaturated hydrocarbons have mild anaesthetic properties while the saturated hydrocarbons have a narcotic effect. The principle additive is tetraethyl lead which also has intoxicant properties. Tetraethyl lead and its metabolites are highly neurotoxic.

Fifteen to 20 inhalations of petrol will cause euphoria and intoxication for three to six hours. Prolonged inhalation or rapid inhalation of a highly concentrated vapour, such as when petrol-soaked cloth is held to the nose, may lead to violent excitement followed by a loss of consciousness, coma or death. Organic lead toxicity is regarded as the major long term health hazard of petrol sniffing, although some other components (toluene, n-hexane) may contribute to neurological damage ...

Other long term sequelae of chronic sniffing include nutritional disturbances, anaemia, and cardiac, liver and renal effects. Cognitive functioning may also be impaired and there is evidence that some of these changes are irreversible.^[5]

The South Australian Coroner also describes the risks to the health of sniffers as follows:

Individuals who sniff petrol are at a high risk of pneumonia and chronic lung disease; trauma; burns and injury. In addition there have been some deaths in which sudden death has clearly occurred during acute episodes of inhalation. These deaths may be related to cardiac arrythmias, respiratory arrest because of acute effects on the brain stem or cerebral oedema ...

Lead toxicity of the brain is clearly well established in the literature and has been a major cause of brain damage related to petrol sniffing. However there are significant data now suggesting that aromatic hydrocarbons (eg benzene) are also responsible for neurotoxicity.^[6]

Petrol sniffing can also be a significant cause of physical disablement, necessitating full-time attendant care. The Northern Territory Parliament's Select Committee on Substance Abuse in the Community noted earlier this year that:

The direct impact of inhalant abuse is usually contained to the sniffer and family and immediate community. However, it has implications for the broader community also. The end result of petrol sniffing other than early death is brain damage which leaves the sniffer in a vegetative state. A conservative estimate of the cost to the NT of maintaining an ex-sniffer in this state is $150,000 pa. While there are presently 15 such persons in central Australia, it is estimated that this could escalate to upwards of 60 in the near future, an ongoing (and growing) cost of $9m per annum. These figures argue strongly for action to curb the practice and stem the damage now.^[7]

In his findings of the coronial inquests on petrol sniffing on the AP lands, Coroner Chivell outlines the social impacts of petrol sniffing, specifically on the Anangu population, as follows:

Petrol sniffing poses a range of problems to sniffers, their families, communities and to the wider society. Among the problems which have been associated with petrol sniffing are: serious health consequences including death or long-term brain damage, social alienation of sniffers, social disruption, vandalism and violence, increased inter-family conflict and reduced morale on communities, incarceration of sniffers and costs to the health system in terms of acute care and providing for the long-term disabled ...^[8]

In her earlier work, Maggie Brady states that: 'it is not possible to provide an unequivocal answer to the question of whether "Aboriginal people" define petrol sniffing to be a problem.'^[9] However, evidence to the recent Coronial Inquests on the AP Lands makes clear that the Anangu certainly perceive petrol sniffing as a devastating contemporary problem facing their communities. One community member commented at the Inquest:

...they create endless trouble for us and it just goes on and on. What I would really like to do is to help them stop but - I love them and would care for them but the problem is with their sniffing they start to not be able to understand properly so I can't even intervene because they can't understand what I am on about anyway.^[10]

In his findings the Coroner also stated that:

Many attempts over the years to combat petrol sniffing [on the AP Lands] have been unsuccessful. Anangu continue to try and care for sniffers even when they continue to sniff, and even after they are violent and disruptive to their families and the community. Some Anangu are concerned that if they try and stop sniffers they will harm them, or that the sniffers may harm themselves. They look to the broader community to help them deal with a problem which has no precedent in traditional culture.^[11]

b) Recent concern about petrol sniffing in Indigenous communities

In the year since these Coronial inquests, there has been significant concern expressed about petrol sniffing in Aboriginal and Torres Strait Islander communities at the national level. In October 2003, the Senate Legal and Constitutional References Committee made the following recommendation in the report of its inquiry into national progress towards reconciliation:

The Committee recommends that during the Spring sitting 2004 the Senate refer to it an inquiry on progress in addressing the problems surrounding petrol sniffing in the Anangu Pitjantjatjara lands, including progress as it relates to the COAG whole of government trial conducted there.^[12]

The Dissenting Report of Government members of the Committee questioned such a distinct focus on addressing the issue on the AP Land. Instead, their Dissenting Report proposed that recommendation 20 of the committee (quote above) be amended to:

provide at a later date the Senate refer to it an inquiry on progress in addressing the problems surrounding petrol sniffing in remote Aboriginal communities. Government members believe that petrol sniffing is a problem in many regions of Australia and any inquiry should be able to review strategies employed in different regions to assess their effectiveness.^[13]

In its submission to the House of Representatives Standing Committee on Aboriginal and Torres Strait Islander Affairs' Inquiry into Capacity-building, the Aboriginal Land Rights Movement (ALRM) of South Australia recommended that the Social Justice Commissioner monitor the implementation of the recommendations of the recent coronial inquests on the AP Lands:

It is submitted that a recommendation should be made that the Human Rights & Equal Opportunity Commission, Social Justice Commissioner should monitor the progress of the State and Federal governments in implementing the recommendations flowing from the inquest into the deaths of three petrol sniffers.^[14]

In March 2003, the House of Representatives Standing Committee on Family and Community Affairs also released the report of its inquiry into substance abuse in Australian communities. It noted that the use of inhalants such as petrol and aerosols was relatively rare in the Australian community, but nevertheless was a matter of concern to the committee due to the serious impact of inhaling and its prevalence among particularly disadvantaged groups such as Indigenous people.^[15] The Committee recommended that:

the Commonwealth government take a leading role as a matter of urgency in establishing a national committee to coordinate policy and programs to prevent the use of inhalants and treat dependent users.^[16]

The issue of petrol sniffing in Indigenous communities has also been raised as an issue in recent parliamentary inquiries in Victoria and the Northern Territory (discussed further below).

c) Information about petrol sniffing by Indigenous people

These processes have identified the need for greater attention to be paid to petrol sniffing, including at the national level, and for more urgent responses to it where it exists. The phenomenon of petrol-sniffing is, however, not well-understood and there is no reliable national data on the number of people involved and the extent of resulting damage to individuals and communities. Peter d'Abbs and Maggie Brady have noted that:

The situation today remains in many respects little different to what it was thirty years ago. There are still practically no clear policies at any levels of government; there is no accumulated body of knowledge about the nature and causes of sniffing, or even about the efficacy or effectiveness of different kinds of interventions, and most initiatives are forced to rely on short-term project funding, the continuance of which rarely has anything to do with program effectiveness.^[17]

In fact, petrol sniffing in Aboriginal and Torres Strait Islander communities continues to occupy a marginal position as a drug issue at the national level:

As an issue for Australian drug policy, indigenous petrol sniffing is all but invisible. The National Drug Strategic Framework 1998-99 to 2002-03, endorsed by the Ministerial Council on Drug Strategy in November 1998, makes just two references to the issue. The first is to tell us that we don't know anything about its prevalence (among Indigenous Australians) ... The second reference, in effect, states that petrol sniffing is not good for you ...

Similarly, the National Action Plan on Illicit Drugs 2001 to 2002-03, endorsed by the Ministerial Council on Drug Strategy in July 2000 skirts around the issue of inhalants by stating that they would be covered by a separate 'complementary' strategy ... for Aboriginal and Torres Strait Islander drug issues. A background paper prepared to accompany the National Action Plan includes a section titled 'Illicit drug use among Aboriginal and Torres Strait Islander peoples' which makes no reference to inhalants, volatile substances or petrol sniffing.^[18]

Compared to the information available on other categories of substance misuse, d'Abbs and Brady suggest that "the vast untapped pool of professional expertise" [on petrol sniffing] looks somewhat shallow ...'^[19] Paul Torzillo has commented that 'the lack of any sustained institutional interest in petrol sniffing among government agencies is matched by a dearth of high quality research.'^[20] Consistent with this, there is a lack of systematic and comprehensive data on the extent, location and changes over time in petrol sniffing in Aboriginal and Torres Strait Islander communities.

There are, however, reported instances of petrol sniffing as a significant issue in several Indigenous communities across Australia. In its recent report into the inhalation of volatile substances, the Drugs and Crime Prevention Committee of the Victorian Parliament summarised some published materials as follows:

Petrol sniffing occurs in some Indigenous communities and not others. In 1989 it was reported as occurring mainly in Arnhem Land in the Northern Territory, in central Australia ... and in the Riverina region of New South Wales. In 1994, Brady and Torzillo argued that patterns had changed:

It appears that the intensity of sniffing has increased over the past 20 years, with more users sniffing over longer periods, which has resulted in an increase in reported morbidity and mortality from the 1980s onward.

However, since 1994 a further shift in patterns and prevalence of petrol sniffing seems to have occurred. A little-publicised but positive development of recent years has been the move by many Indigenous communities to use aviation fuel rather than petrol for vehicles. In several communities where a long and established history of petrol sniffing has existed, sniffing has been reduced or even stopped. Conversely, some communities which had previously been free of petrol sniffing are now reporting the practice. It has been reported in the Katherine region of the NT, Cape York in Queensland, south-west Queensland, western NSW and Northern Victoria. There is also evidence that Indigenous children are turning to the use of other volatile substances. Although petrol sniffing remains the primary form of volatile substance misuse among young Indigenous children, there are increasing reports of other forms (particularly glue and aerosol paint sniffing) in urban areas.^[21]

The Victorian parliamentary committee report also refers to studies identifying petrol sniffing by Indigenous youth as an issue in Perth. While acknowledging that there is very little research on the situation in Victoria, it also states that 'it is believed that chroming is a far more prevalent form of volatile substance abuse in Victoria, including among Indigenous Victorians, than petrol sniffing. It may be that this is an erroneous assumption.'^[22]

Petrol sniffing has also been identified as a 'major problem' among young Aboriginal people in recent years on Cape York Peninsula in the communities of Kowanyama, Aurukum, Napranum and Lockhart River; and as existing 'periodically and to a lesser extent' in northern Cape York towns such as Mapoon, Injinoo, Umagico, Bamaga and New Mapoon.^[23] The Queensland government has also stated that 'petrol and aerosol sniffing are two of the most common kinds of substance abuse in Torres Strait Islander communities ... For some families, petrol and aerosol sniffing is an even bigger issue than grog abuse.'^[24]

There are also reports that petrol sniffing is periodically an issue faced in remote Aboriginal communities in Western Australia. Concern was recently expressed that petrol sniffing may have been a contributing factor in three deaths in the past two years at Balgo;^[25] and the Shire of Ngaanyatjarraku and community of Warburton have also recently expressed concerns about 'chronic substance abuse' and difficulties in law and justice responses to it.^[26]

In its interim report on issues of alcohol abuse, cannabis use and inhalant abuse, a Select Committee of the Northern Territory Parliament noted in February 2003 that:

Petrol sniffing and other inhalant substance abuse is known to affect up to 30 remote communities in the Northern Territory. Inhalant substance abuse is most entrenched in the Central Australian region and the Tri State border region of the Northern Territory, South Australia and Western Australia ... [i.e, the Ngaanyatjarra, Pitjantjatjara and Yankunytjatjara lands]...

In remote Central communities it is estimated that there are up to 350 'sniffers'. Sniffing is an endemic practice in at least six remote Central Australian communities.^[27]

The limited research also suggests that there are different patterns of use of petrol and other volatile substances by Indigenous people compared to non-Indigenous people. The Drugs and Crime Prevention Committee of the Victorian Parliament notes the following findings of several studies:

A survey of Indigenous and non-Indigenous students in Perth showed that Indigenous users of volatile substances tended to use much more regularly, often on a daily basis and over a longer period of time than non-Indigenous users; and that petrol was one of the predominant solvents used (unlike for non-Indigenous youth);
Other studies have found that Indigenous youth are likely to use inhalants more intensively and for a longer duration than non-Indigenous urban youth, with one study reporting a mean duration of eight years for petrol sniffing (compared with only a brief period of experimentation for most non-Indigenous youth); and
a further study has argued that there are differences in inhalation culture and practices for Indigenous people depending on locality / remoteness. Relevant factors which influence this include the degree of community cohesion, local traditions, customs and the degree of cultural identification, the number of volatile substance abusers, access to resources and support, and other local factors.^[28]

In 2001, the Australian National Council on Drugs published a report examining the structural determinants of substance abuse. It states that petrol sniffing and volatile substance abuse by young Indigenous people, while clearly having some similarities with non-Indigenous people, must be viewed as part of a broader picture of Indigenous disadvantage:

When combined with an environment stressed by poverty, racism and frequent bereavement, some remote Aboriginal communities have been beset by petrol sniffing among their young people. Indigenous communities with a history of involvement in the cattle industry were found by Brady to have resisted solvent-sniffing problems. This resilience was attributed to the independence, self-esteem and outlet for risk-taking afforded by involvement in the cattle industry. Individuals who had adopted Christianity or who valued other activities such as sport or fishing were also found to be resilient to sniffing solvents. Brady concluded that social and cultural factors are paramount in solving youth health problems such as solvent sniffing in Aboriginal communities.^[29]

d) Defining petrol sniffing in Indigenous communities as a public policy issue

In her landmark 1989 publication Heavy Metal: the Social Meaning of Petrol Sniffing in Australia, Maggie Brady raises the question of how petrol sniffing is defined as a problem. She observes that while '[p]etrol sniffing by young people, often in groups, constitutes a threat, both physically and metaphorically to the social order', it is one among 'many behaviours that lead to impaired health and social functioning'.^[30] Certainly other forms of addictive behaviour such as tobacco and alcohol addiction constitute more widespread sources of death and disease across Indigenous populations.

With Peter d'Abbs, Maggie Brady has recently commented on how petrol sniffing makes its way onto the public policy agenda:

Petrol sniffing erupts periodically into the living rooms or onto the breakfast tables of the public through highly sensational media exposes ... The media portrayal of Aboriginal petrol sniffing is worthy of a study in its own right; in particular, one might ask why acts of petrol sniffing are implicitly - and sometimes explicitly - represented not merely as instances of individual self-harm, but as evidence of a broader community social disintegration in a way that heroin use, for example, is never portrayed. ^[31]

d'Abbs and Brady argue that this is indicative of structural problems in the way governments address issues of petrol sniffing in Indigenous communities. They argue that because of the lack of reliable data and the 'absence of any powerful lobby groups or other agencies with the capacity to ensure that petrol sniffing remains on the public agenda in anything more than a transient manner', petrol sniffing as a public issue 'owes almost everything to media outbursts ... what pressure for action that exists as a result is for quick, short term action'. ^[32]

They argue that due to pressures to deal with other, chronic health issues in Indigenous communities combined with petrol sniffing not being a major contributor to indigenous morbidity or mortality, bureaucrats are more often than not pre-occupied with other health priorities. When there is media attention to the issue, they 'find themselves caught in a crossfire: pressured from outside ... to take action in response to a problem that is not, from where they sit, among their most critical challenges.'^[33] d'Abbs and Brady see three inter-related consequences of this:

first, the agency will take some action but not be willing to divert resources from other areas that are seen as ongoing priorities;
second, the pressure to return to what are seen internally as more important priorities provides an incentive to make a one off gesture and refocus on other issues; and
third, there is unlikely to be within the agency or department much experience or networks of people with an ongoing interest in keeping petrol sniffing high on the agenda of priorities.^[34]

Petrol sniffing is therefore unlikely to become the subject of a long-term, sustained policy focus:

[B]ecause petrol sniffing is not seen as a genuine on-going priority issue that falls neatly into any one department's or even one government's scope of responsibility, governments have tended not to engage in direct service provision, but rather to fund community-based groups and other non-government organisations to provide services. This, of course, also fits with the view of petrol sniffing as a community responsibility .... [I]n light of petrol sniffing's low ranking as a priority, most initiatives have been funded on an ad hoc, short term basis, with virtually no commitment to rigorous evaluation or to providing ongoing funding to those programs that demonstrate successful outcomes.^[35]

In these circumstances, it is difficult to consolidate an evidence base, to build and sustain links with existing expertise, or to maintain extensive corporate knowledge on the subject. By identifying petrol sniffing as an 'Indigenous problem' it has also been marginalised as a policy issue, with the result that it has not received the attention and resourcing that it may have if it had been positioned within mainstream substance misuse policy frameworks. Accordingly, D'Abbs and Brady comment that governments have tended to establish interagency committees as the main response to petrol sniffing:

[I]n the absence of an evidence base, and because petrol sniffing where it occurs straddles political jurisdictions as well as departmental "silos", governments have tended to respond to petrol sniffing crises by convening high level inter-governmental committees involving commonwealth and state/territory officials. In no instances to date, however, have these committees succeeded in implementing a co-ordinated, sustained approach to the prevention or treatment of sniffing.^[36]

Petrol sniffing on the Anangu Pitjantjatjara Lands: A case study

a) Why a case study of the AP Lands?

In the second half of 2003, the Social Justice Commissioner's unit of the Human Rights and Equal Opportunity Commission (HREOC) conducted a research and consultation project into progress in addressing the Coronial recommendations on petrol sniffing on the AP Lands. HREOC staff visited the AP Lands as part of this project in September 2003. Interviews and meetings were conducted in Adelaide and across the AP Lands with various government agencies (including those involved in the Council of Australian Government's whole-of-government community coordination trial on the AP Lands),^[37] Aboriginal organisations,^[38] and community members and elders on the lands.^[39] HREOC also received a whole-of-government response from the South Australian government to the issues being considered.

The decision to conduct a case study specifically on petrol sniffing on the AP Lands was based on a number of factors. The Social Justice Commissioner's office had been considering for some time ways that it might best be able to assist communities on the AP Lands to address problems associated with petrol sniffing. This was largely the result of concerns raised with HREOC by organisations such as the NPY Women's Council about petrol sniffing.^[40]

Similarly, the inquests conducted on the AP Lands in 2002 had provided much impetus for addressing petrol sniffing issues. The recommendations of the Inquests provide 'a blueprint for government to consider as the means best able to address the problems and provide the most likely long-term solutions.'^[41] There is a clear need for expediency in following up the recommendations. This is particularly so given that the tardiness of government and other players in addressing petrol sniffing to date has been identified by the Anangu themselves, as well as by the Coroner, as a contributory factor to the escalation and embeddedness of the situation on the AP Lands.

In the absence of systematic and comprehensive data on the extent and nature of petrol sniffing by Indigenous people, there is also much potential value in provide a discrete focus on the AP Lands in order to secure a higher policy profile for the issue of petrol sniffing. The AP Lands are also one of the areas across the country where there is some data on petrol sniffing and a history of dealing with the issue, as Nganampa Health Council has collated such information since 1984.

As a case study, the AP Lands Coronial Inquest also has currency in light of recent policy debate about the need to address urgent problems in communities (drug and alcohol misuse, violent behaviour) versus the need to focus on the underlying causes of family and community dysfunction (inter-related social, economic, cultural and psychological factors) in overcoming Indigenous disadvantage. While the Coronial Inquest endorses a systematic, concerted approach to the AP Lands situation, indications are that interventions into petrol sniffing will need to be adapted to meet the needs of specific contexts:

An important aspect of the Coroner's findings and recommendations is his recognition that petrol sniffing is such a complex problem or indeed series of problems to be faced by outback communities, that no individual measure will 'fix it', rather there needs to be a series of measures all operating synergistically together to have any prospect of long term success. For that reason alone progress should be monitored.^[42]

The AP Lands experience may also have ramifications for addressing other forms of addiction and at risk behaviour in communities (such as cannabis use, which is believed to have dramatically increased over the last five years on the AP Lands).^[43] In previous Social Justice Reports, the Social Justice Commissioner has taken an interest in developing a human rights framework for monitoring and evaluating progress in addressing Indigenous disadvantage.^[44] Given the Coroner's contextualisation of his recommendations in regard to underlying socio-economic factors and disadvantage, the use of benchmarks based on human rights standards could provide a framework for monitoring progress in addressing the AP Lands situation.

Ultimately, the considerable poverty and socio-economic marginalisation identified as incubating and precipitating endemic petrol sniffing in Indigenous communities raises significant human rights concerns about the lack of equality in the provision of government services to Indigenous people on the AP Lands. It raises concerns regarding rights to adequate food, the highest attainable standard of health, education, decent work and adequate housing, and the lack of reasonable access to police services, in particular protection from self harm or harm to others in the community (rights to personal security, and to equal access to justice).

There are also concerns regarding protection of the right of children. The Convention on the Rights of the Child affirms the right of children and young people to protection against drug abuse and other forms of abuse and neglect; and protects the enjoyment of the right to a reasonable standard of living, health and basic services; the right to education and the right to leisure. Under CROC, children and young people with special circumstances, such as those suffering disabilities or orphaned must be provided for, and there are also requirements concerning cultural sensitivity to Indigenous and other minority groups, and rehabilitative care for children suffering from deprivation. The disadvantage experienced by the Anangu is indicative of the ongoing failure to provide the full measure of human rights to which all Australians, including Indigenous peoples, are entitled. It is worthy of detailing the current situation for this reason alone.

b) The extent of petrol sniffing on the AP Lands

[I]t's the biggest shame that young people today in this part of the world are dying from petrol sniffing. And the neglect that I think has happened, has been going on for some time and that there is a reluctance for the wider community in Australia to take any responsibility or concern about it ... well let's be honest, there's been 30 years of neglect from government in this region across the whole board, not just petrol sniffing. But I do believe that if you address the issues of petrol sniffing, you're addressing the wider issues of the problems on the communities. It goes hand in hand. And you know, we have documented time and time and time again - communities have, the women have - that what is needed. We don't need more reports, we don't need more enquiries, we don't need more meetings with the government to say, 'What do you want'. Anangu have written it down time and time again.^[45]

The Anangu Pitjantjatjara Lands (AP Lands) cover an area of 160,000 square kilometres in the far north-west of South Australia. The area comprises one fifth of the state. The AP Lands were handed back to the traditional owners, the Anangu, under the Pitjantjatjara Land Rights Act 1981 (SA). They form part of the larger remote cross-border region of Western Australia, South Australia and the Northern Territory known as the Ngaanyatjarra, Pitjantjatjara and Yankunytjatjara lands.

It is thought that petrol sniffing emerged as a problem on the AP Lands during the late 1960s. The recent Coronial Inquest found that the extent of petrol sniffing on the AP Lands had diminished in the early 1990s. However, there was also a 'reduction in effort towards tackling the problem' in the mid-1990s. This has led to a resurgence of petrol sniffing from at least 1998, with little achieved since then to restore the situation on the AP Lands to its pre-1995 position.^[46]

Data collected by Nganampa Health Council in 2000 indicates that the number of people engaged in petrol sniffing has increased from 1999 to 2000 (from 111 to 166 people). This represents approximately 6% of the Anangu population and 12% of the population aged between 10 and 35 years of age.^[47]

This is a similar number to that observed on the AP Lands in 1984. This suggests a decline in the proportion of this age group engaged in petrol sniffing, given the overall growth in the total population (from approximately 1,700 in 1984 to 2,800 by the year 2000).^[48]

Available data also indicates that despite the increasing number of new recruits to petrol sniffing in the late 1990s, the total number of sniffers and people recruited to sniffing over the decade declined over the course of the decade. The data also reveals 'a fairly dramatic cohort effect since the 1980s':

[T]he median age of petrol sniffers has increased markedly over this time and that in many communities the number of petrol sniffers over 25 years of age are in the majority. This means that a number of those who took up petrol sniffing 10, 15 or 20 years ago are still sniffing. This cohort effect has major implications for understanding the breadth of problems that occurs as a consequence of petrol sniffing and the different interventions that would be required.^[49]

One of the implications of an increase in the number of long-term or chronic sniffers is a greater degree of visibility of the problem and a higher level of impacts on the public order and functioning of communities. It also indicates a need for intervention at both ends of the problem, in addressing the increase in recruitment of sniffers as well as the issues associated with long term or chronic sniffers, such as rehabilitation and harm minimisation.

c) The findings of the Coronial Inquests into petrol sniffing, September 2002

Coroner Chivell concluded in the Coronial Inquests conducted on the AP Lands that the situation in 2002 is that:

Petrol sniffing is endemic on the Anangu Pitjantjatjara lands. It has caused and continues to cause devastating harm to the community, including approximately 35 deaths in the last 20 years in a population of between 2,000 and 2,500. Serious disability, crime, cultural breakdown and general grief and misery are also the consequences.^[50]

The first recommendation of the Coroner in the inquest reflects the serious contemporary impact of petrol sniffing on the community:

1. That Commonwealth, State and Territory Governments recognise that petrol sniffing poses an urgent threat to the very substance of the Anangu communities on the Anangu Pitjantjatjara Lands. It threatens not only death and serious and permanent disability, but also the peace, order and security of communities, cultural and family structures, education, health and community development.^[51]

A summary of the findings of the Coroner and his recommendations for action have been extracted as an appendix to this report (see Appendix 3). A key finding of the Coroner was that the recommendations of the Royal Commission into Aboriginal Deaths in Custody have not been complied with by the Commonwealth or state governments, and that this 'will, if it is not addressed, lead to severe disability and further deaths, not to mention continuing social dislocation, crime, loss of culture and general community degradation and loss'^[52] on the AP Lands. The concerns of the Coroner regarding this are also extracted in Appendix 3.

The findings and recommendations of the Coroner can be grouped into the following two key issues:

i) Coordination, funding and action by Government: Concerns were expressed about the failure of governments to consult appropriately and significant delay in implementing programs, with a need for governments to move beyond the 'information gathering' stage. The Inquest highlights the need for governments to re-assess their coordination of policy and funding approaches to service delivery on the AP Lands;
ii) Specific interventions for addressing petrol sniffing: The Inquest identifies the need to adopt a combination of primary, secondary and tertiary interventions relating to health and justice issues in order to combat petrol sniffing, combined with strategies to address the significant disadvantage and lack of services on the AP Lands, which forms the environment in which petrol sniffing takes place.

The Coronial Inquest recognised the need for broader government and community responsibility, and made a series of recommendations (Recs 1-7; 8.14, 8.15) urging re-assessment of current Commonwealth and State funding and policy strategies in finding solutions to the problem of petrol sniffing in the AP Lands. The recommendations directed towards the Commonwealth, State and Territory governments included the need to:

recognise the threat which petrol sniffing poses to Anangu communities on the AP Lands (Rec 1);
recognise the role played by broader socio-economic factors in causing petrol sniffing on the AP Lands (Rec 2);
recognise the responsibility of government and the broader Australian community to address petrol sniffing (Rec 3);
move existing intergovernmental approaches beyond the information-gathering stage and to utilise existing knowledge and expertise to find solutions to petrol sniffing on the AP Lands forthwith (Rec 4);
address existing fragmentation of service delivery through improved inter-governmental coordination (Rec 5);
establish a more substantial Commonwealth and state government presence on the AP Lands and develop more stable relationships with Anangu, including greater certainty of funding arrangements (Rec 6);
recruit qualified and experienced staff to the AP Lands (Rec 8.11);
recognise the interdependent nature of program interventions and adopt a longer term, multi-faceted approach to addressing petrol sniffing (Rec's 7, 8.14); and
assess initiatives against the recommendations of the Royal Commission into Aboriginal Deaths in Custody (Rec 8.15).

The remaining recommendations address more specifically the different levels of interventions needed from prevention and deterrence through to rehabilitation. Recommendations which have become the responsibility of health agencies include:

appointing four youth-workers and a youth-work coordinator (Rec 8.1);
Assessing petrol sniffers on a neurological and neuro-physical basis for rehabilitation and disability services (Rec 8.2);
Establishing a culturally appropriate Homelands/Outstations Programme (Rec 8.3);
Continuing funding for the Commonwealth Avgas initiative (Rec 8.4);
Evaluating the role of the Department of Families and Youth Services (SA) in relation to children at risk on the AP Lands, including considering the adoption of a more proactive community development approach (Rec 8.8); and
Urgent upgrading of the level of services for disabled victims of petrol sniffing (Rec 8.9).

Justice issues covered by the recommendations relate to strengthening of the police presence in the AP Lands and the need for greater deterrence of petrol sniffing and related disruptive behaviours. They include:

Increasing the range of sentencing options available to courts sitting on the AP Lands, resourcing non-custodial options such as outstations and a secure care facility, as well as increasing the presence of Correctional Service supervisors to ensure that undertakings, bonds and community service orders can be enforced (Rec 8.5);
Amending the Public Intoxication Act to extend its application to the AP Lands and declare petrol or hydrocarbons a drug for the purposes of the Act (Rec 8.6);
Canvassing support for the establishment of night patrols as part of an overall crime prevention strategy on the AP Lands (Rec 8.7);
Planning for the establishment of secure care facilities on the AP Lands, to fulfil a range of roles including detention, detoxification, treatment and rehabilitation (Rec 8.10);
Immediate establishment of a police presence on the AP Lands, through implementation of the recommendations of the SAPOL review of the Community Constable Scheme (Rec 8.12); and
Improvement to existing levels of policing on the AP Lands, through addressing issues relating to staffing at Marla (Rec 8.13).

Progress in responding to the recommendations of the Coronial Inquest into petrol sniffing on the Anangu Pitjantjatjara Lands

In this section, progress in addressing the recommendations of the Coronial Inquest is considered in relation to the following four themes:

Inter-governmental and inter-agency coordination;
Resourcing issues;
Health related issues; and
Justice related issues.^[53]

a) Inter-governmental and Inter-agency coordination

Fundamental to the recommendations made by the Coroner is the observation that government agencies have been stuck for too long in the information-gathering stage at the expense of taking action to address longstanding service delivery issues confronting the AP Lands:

There is no need for further information gathering, and there is a vast untapped pool of professional expertise to be utilised. What is missing is prompt, forthright, properly planned, properly funded action.^[54]

The Coroner recognised that properly planned and funded action is reliant on the development of an '[i]nter-Governmental coordination of approach ... in order to avoid the fragmentation of effort and confusion and alienation of service-providers'.^[55] He also stipulated that the support of the broader community be enlisted in addressing petrol sniffing on the AP Lands:

The fact that the wider Australian community has a responsibility to assist Anangu to address the problem of petrol sniffing, which has no precedent in traditional culture, is clear. Governments should not approach the task on the basis that the solutions must come from Anangu communities alone.^[56]

The need for interagency coordination or holistic or whole-of-government approaches, and the need to avoid duplication of services and to target Indigenous disadvantage more effectively, have become familiar themes in policy debate on Indigenous service delivery. The necessity of changing the ways in which governments do business with Indigenous communities has particular pertinence in light of the recent focus of Indigenous policy on capacity-building and governance.^[57]

Since the Coronial Inquest, one of the most consistent comments made about the inter-agency approach to the Coroner's recommendations by those whom HREOC consulted with is that it has continued to be piecemeal rather than systematic and has been characterised by a reluctance to take action. In the words of one community organisation member, 'there have been many references to the Coroner's recommendations but a failure to act'. In response, government officials often highlight the difficulties in making progress on petrol sniffing-related issues on the AP Lands, given the long-standing and intractable nature of the problems, and the need to consult properly and effectively with Anangu.

This section of the chapter will address concerns in regard to the question of the degree of responsibility to be exercised by both Anangu and government in responding to the Coronial recommendations.

Government coordination of policies and programmes

It is necessary to begin with some background on the history and composition of the coalitions of government agencies responding to petrol sniffing and related service delivery issues on the AP Lands. Recommendation 4 of the Coronial Inquest identifies the major government avenues for coordination of services and action in addressing petrol sniffing:

The Commonwealth Government, through the Central Australian Cross Border Reference Group [CBRG], and the South Australian Government through the Anangu Pitjantjatjara Lands Inter-Governmental Inter-Agency Collaboration Committee [APLIICC], should accelerate their efforts to find solutions to these issues and get beyond the 'information gathering' phase forthwith. They should use the extensive knowledge, published material and professional expertise that is already available.^[58]

The Coroner had acknowledged that the establishment of bodies such as the Anangu Pitjantjatjara Lands Inter-Governmental Inter-Agency Collaboration Committee (or APLIICC Tier One & Tier 2 committees) and the Central Australian Cross Border Reference Group (or CBRG) was met with a generally favourable response.^[59] He noted, however, that there were concerns that resources are not making a significant difference to the lives of people on the AP Lands. The APLIICC (also known as 'Tier One') was established in August 2000 by the previous South Australian state government in order to facilitate a cross-portfolio commitment of senior executives at State and Commonwealth levels to respond to disadvantage in the region, particularly issues such as the persistence of poor health and impoverished conditions on the AP Lands despite the level of expenditure on services.^[60]

Tier One of the APLIICC comprises a core group of chief executives from the state government, APY Land Council, Nganampa Health Council and the Commonwealth Department for Health and Ageing. Originally, there was a second tier of working groups composed of senior project and policy officers from state and commonwealth agencies based in Adelaide who were responsible for implementing the directives of Tier One. This has since been replaced by a series of task forces that are to implement projects and activities identified as Tier One priorities. There was also a Petrol Sniffing Task Force (PSTF), established in November 2001 by the previous SA Minister for Aboriginal Affairs to tackle petrol sniffing specifically, which has since been subsumed into the activities of the Tier One Committee.

There are two further groups with Commonwealth and state representation to address issues emerging from the Ngaanyatjaraa Pitjantjatjara Yankunytjatjara cross border region which straddles the Northern Territory, South Australia and Western Australia. The Central Australian Cross Border Reference Group on Volatile Substance Abuse (CBRG) was established in response to the findings of a review of Commonwealth Aboriginal and Torres Strait Islander Substance Misuse Programs in 1999. A cross-jurisdictional forum was held in Adelaide on 20 March 2001, which agreed to address the issue of improving coordination in the delivery of volatile substance use through the establishment of a tri-state reference group (the CBRG), who would have carriage of the implementation and monitoring of the framework to address volatile substance abuse in the area.

The NPY Lands Tri-Jurisdictional Justice Group was established in early 2003 to examine legislation and policies that will enable the courts and police to operate across borders in order to establish collaborative mechanisms and infrastructure to police the NPY Lands. The working group includes representatives from police, justice, health, education, Aboriginal Affairs agencies and local government. In addition to commissioning a study on the demographics of the region (population breakdown, movement patterns, offending and prison population data, language profiles and so forth), the group aims to develop a coordinated approach to shared facilities and programs, including culturally appropriate early release and rehabilitation programs (including community detention options), the potential establishment of a low security detention/alternative facility in Alice Springs or on the Lands, and the possible use of the Alice Springs Correctional Centre by WA and SA.

Since the Coronial Inquest, the AP Lands have also been designated as the South Australian trial site for the Council of Australian Government's (COAG) whole-of-government, whole-of-community trials. The APLIICC has been chosen to provide the interface between government and the communities on the AP Lands. In the joint media release announcing the nomination of the AP Lands as a trial site, the SA Minister for Aboriginal Affairs and Reconciliation Terry Roberts states:

This trial will build on positive initiatives already under way on the AP Lands, such as the work of the AP Lands Inter-government Inter-agency Collaboration Committee (Tier One), of which the South Australian Government, the Commonwealth, ATSIC and AP Council are all members.^[61]

The AP Lands were identified by the South Australian government as an appropriate focus for the COAG trial because of the level of need in the area, the existence of the APLIICC as a structure to facilitate the trial and the compatibility of its aims with those of COAG.

In early September 2003, there was a meeting (the 'Shared Responsibility' workshop) in Alice Springs of government and community representatives which sought to set priorities for the COAG trial. The two priorities which were nominated for action were Mai Wiru, a stores policy program addressing issues of nutrition, pricing and stores management training, and rural transaction centres, a project to establish permanent facilities in each major community for banking, government agencies and service providers.

Another significant decision included agreement that an Allocation Committee consisting of nominees from Community Councils, Homelands Groups, Nganampa Health and APY Women's Group be established. This fifteen member committee is to be chaired by the Chairperson of the APY Land Council and is to assist in the disbursement of funds. This decision aims to ensure that all stakeholders will have a clear understanding of the funding situation for the AP Lands, as well as a say in the distribution of monies on the Lands. The Allocation Committee will also work in conjunction with the State Government in considering budget bids for future years. The APY Land Council will be given additional financial support for their role in assisting the Allocation Committee.

To support these new arrangements an Office of the APY Lands has been established within the SA Department for Aboriginal Affairs and Reconciliation, which will include a liaison person on the Lands to work with the APY Executive and then to develop relationships with Aboriginal communities. This initiative responds to Recommendation 6 from the Coronial Inquest which directed Commonwealth and State Governments to establish a presence in the region, 'if not on the Anangu Pitjantjatjara Lands then at least in Alice Springs, of senior trusted officials',^[62] and to criticism made by the Coroner that too much of the bureaucratic activity was Adelaide or Canberra-based. The liaison person is to be well-briefed in order to deal with a range of issues. There is a perceived need to discuss with APY Land Council Executive what appropriate liaison with communities would constitute - to take a partnership approach rather than to impose a structure.

Canberra and Adelaide-based bureaucrats from the Cross-Border Reference Groups have also made attempts to spend time defining their relationship with the APY Executive. Officials also acknowledged the need to learn how to work with local Indigenous governance structures, time frames and ways of doing business, and that maintaining continuity of staff over time was a significant issue, as well as the development of longer-term relationships and processes in order to bring about lasting change on the AP Lands. They noted the need to consult appropriately with Anangu and the need for adequate time in which to conduct culturally-appropriate consultations:

While an appropriate consultation process takes time and can be seen to delay the introduction of urgently needed resources, it is considered vital to successful work in the APY Lands. ^[63]

The South Australian government also has allocated funds to support a series of initiatives on the AP Lands, including $76,000 towards implementing an improvement in road planning projects with ongoing planning assistance; $155,000 to commence a three-year program for redeveloping the arts centres in the region; $200,000 to support programs for the removal of feral animals from Indigenous owned protected areas and to enhance native plants and animals; and programs aimed at developing mining activity on the Lands, particularly in working with traditional owners from APY to identify exploration opportunities on the land, and in facilitating opportunities such as a youth geotechnical traineeship scheme.

It is also anticipated that the allocation of $2 million over four years for the Department of Administrative and Information Services to provide staff housing on the AP Lands will assist in responding to the establishment of a state and commonwealth government presence in the region. Options for duplex style housing have been recommended to the Tier One Committee and have been approved for tender.

A critical issue for the APLIICC / COAG trial process as the major interface between government and AP Lands communities is whether it will have the capacity to overcome some of the previous issues of coordination facing the various committees (i.e, Tier One, CBRG and PSTF) in order to facilitate a more effective approach to tackling the problem of petrol sniffing. That is, whether these interagency structures and processes will be able to provide a different way of working with Anangu.

Related to this question are issues concerning the representation of the Anangu and their level of participation in identifying and progressing solutions. Consideration also needs to be given to the question of whether it is possible to change the way governments do business with communities or whether policy-making and bureaucratic processes inevitably foreclose the potential to make progress on an issue such as petrol-sniffing on the AP Lands.

A different way of doing business?

The COAG whole-of-government trials, of which the AP Lands are a trial site, are being piloted to develop a whole-of-government, whole-of-community approach to capacity-building and governance issues in designated areas across the country. Shared Responsibility, Shared Future, the information pamphlet for participating communities, describes the purpose of the COAG trials in the following terms:

Many people are saying that the relationship between the community and the governments has got to change. It is clear that some of the ways that governments and communities approach their responsibilities needs to be done differently if we are going to move forward together.

Recently, Commonwealth and State and Territory governments have agreed to improve their approach. They have agreed to work together .... And they have agreed to work in partnership with Indigenous communities to support them find and manage sustainable solutions to local problems. This means government have agreed to learn new ways of doing business with Indigenous communities^[64]

Similar comments were made at the Inquest by Albert Barelds, the Executive Manager of the Anangu Pitjantjatjara Lands Project Team, who said that both commonwealth and state governments have acknowledged that there is:

A need for a different way of working with Anangu; there is a clear understanding that what government has undertaken to date has not led to the lifestyle, the improvements that were anticipated. In order to do so, it was felt that a different way of working with Anangu is needed and therefore a number of initiatives were taken to talk with both the Anangu Pitjantjatjara and elected members of all the community councils, as well as the service providers, to communicate directly with the Anangu to see how a new relationship between government and Anangu could be built to improve their situation.^[65]

The broader policy context for the COAG trials is the federal government's emphasis on mutual obligation and the responsibility of all players (government, communities, families and individuals) to address issues of social and economic participation that has featured in its welfare reform package and practical reconciliation approach to Indigenous issues. It is also aligned with an emphasis on self-empowerment and self-management in contrast to the perceived 'failure' of self-determination and the rights agenda to bring about change to Indigenous peoples' socio-economic circumstances.

One of the challenges for this policy framework is achieving an appropriate and equitable balance of responsibilities between all participating parties. The federal Minister for Indigenous Affairs in 2002 described this challenge as follows:

The key to this initiative is that neither governments nor Indigenous communities can do it all on their own. We must work together, work in partnership and share responsibility for improving outcomes and building the capacity of people in communities to manage their own affairs.^[66]

Government departments participating in the COAG trial on the AP Lands have emphasised their need to develop culturally-appropriate structures and processes, and to learn how to work with local Indigenous governance arrangements, time-frames and ways of doing business. As discussed above, the APLIICC Tier One / COAG process has given a substantial role to the APY Executive as the gateway to local Indigenous communities and groups in consultation and decision-making processes, including those relating to the allocation of funds for activities on the Lands. This approach has been taken in the interests of supporting Indigenous self-empowerment and participation, with joint agreement to be reached with the APY Executive on outcomes, and support for Anangu by the bureaucracy with grants and services through this structure.

However, concerns have been raised about the appropriateness of representative structures for Anangu to date in this process, particularly in regard to the level of responsibility given to APY Executive. While government departments and agencies present the APLIICC Tier One / COAG process as a means of self-determination, the perception of community-controlled organisations with a longstanding history of involvement in the AP Lands (such as Nganampa Health Council and NPY Women's Council) is that this process has shifted the focus away from Anangu and how they do business.

These organisations suggest that in marrying the APLIICC Tier One process to the COAG Trial, the intergovernmental approach to addressing problems on the AP Lands has become increasingly bureaucratic, impeding the possibility of responding effectively to substance misuse and other issues. There are also continuing complaints about the distance of bureaucrats from the AP Lands, their level of experience and corporate knowledge in dealing with AP issues, especially those of volatile substance misuse.^[67]

Community-controlled organisations claim that better use could be made of their corporate knowledge and established networks with the Anangu. The response from government officials to this criticism is that APLIICC Tier One was limited to representation by key executives from Indigenous organisations and government agencies in order to be more streamlined in their processes.

The appropriateness of the APY executive as an appropriate representative body for liaison with the Anangu communities has also been raised as a matter of concern. At the Inquest, John Tregenza, a consultant with a background in community development on the AP Lands, commented that there was a general lack of understanding by government about Anangu forms of representation. Whereas governments tend to identify a boss for liaison and negotiations with a community, the concept of democratic representation is alien to Anangu culture -- you represent yourself and your family. Additional issues relate to the capacity of APY Executive to represent Anangu on matters other than those relating to its traditional core business, that of land management.

In his Review of delivery of services to people with disabilities on Anangu Pitjantjatjara lands, Tregenza articulates the case for extending representation beyond the networks of the APY Executive to include those of other organisations as follows:

From time to time a misconception seems to arise among policy-makers and funding agencies that AP [Anangu Pitjantjatjara Executive] is the peak body in all matters. While it is true that AP have responsibility for all matters relating to the administration of the Lands on behalf of all the traditional owners of the lands (all Anangu), responsibility for the delivery of many other services has always been in the hands of other Anangu regional organisations.

The administrative structure on the AP Lands does not parallel State or Commonwealth governments. AP is not the 'parliament' and only decision making forum, and, every other service organisation is not a department tof [sic] AP. AP Council is one of a group of independent, community controlled organisations with their own governing Boards of Management (Councils) elected by the same group of traditional owners. Currently these organisations are Nganampa Health Council (which came into existence at the same time as AP and well before AP Services), NPY Women's Council (1980), Pitjantjatara Yangkuntjatjara Education Council (PYEC). Each of the organisations was established, and has a separate elected governing body, because Anangu considered that the area covered by each was so complex that no single organisations could do all the issues justice ....

It is therefore essential that any consultation and discussions of issues with Anangu representatives from the Lands must include representatives from all the Anangu community-controlled organisations, and not just from AP Council and/or AP Services. Failure to include all the stakeholders in the consultative, planning and decision-making processes will only ensure the long term failure of regional programs and projects.^[68]

The existence of serious governance and service delivery issues in the Executive Board of the Anangu Pitjantjatjara and the Pitjantjatjara Council executive were also identified in a report by Dr Mick Dodson. In August 2002 the Dodson Report found problems with the administration of the Pitjantjatjara Lands Rights Act and the Anangu Pitjantjatjara Board, with Dr Dodson observing that:

I think there are some serious governance issues that need to be addressed. At the moment, it is my strong view that the AP Executive Board is unrepresentative, undemocratic, unaccountable, and seriously confused about its role and future role. I also have had numerous anecdotal commentaries on the possible misuse of Board funds to suggest at the very least it should be explored. From what I have been told I suspect the problem is a systemic one ... ^[69]

The SA Minister for Aboriginal Affairs and Reconciliation has since headed a Parliamentary Select Committee inquiry into the Pitjantjatjara Lands Rights Act , with an administrator now having been appointed to administer the Act. The APLLICC Tier One Committee has also focused intensively on issues of governance and service delivery with the APY Executive over the last twelve months. However, Mr Tregenza's and Dr Dodson's comments would seem to corroborate concerns about the capacity of the APY Executive to represent Anangu effectively and the need to access broader networks of representation beyond its structures.

A further expressed concern is that government is setting the communities up to fail, partly through over-reliance on the APY Executive as a gateway, but more particularly through the expectation that the communities should address their own problems, especially those relating to volatile substance abuse. This is frequently framed not only in the discourse of shared responsibility but also that of self-determination. In their article recent article on the policy response to Indigenous petrol sniffing in Australia, d'Abbs and Brady observe:

Central to these changes in the domain of governing Indigenous Australians is the strategy of enlisting "communities" to the work of governance. Under this strategy, Aboriginal communities are expected to articulate desires and aspirations which are then taken as authentic manifestations of "self-determination" - as long as they accord more or less with what the state wants them to choose.^[70]

A kind of 'moral panic' has emerged in the emphasis on responsibility in the public discourse on Indigenous policy and the expressed need for Indigenous individuals and communities to address problems such as violence, drug and alcohol abuse. This predominantly moral perspective has the effect of narrowing the focus of Indigenous policy debate to obscure the broader systemic factors contributing to the marginalisation and disadvantage experienced by Indigenous families and communities.

It is undoubtedly empowering for individuals and communities to exercise control over and to participate in finding solutions to problems that threaten their security and survival. While there is some evidence that strong governance in communities can have a role to play in addressing substance abuse, as the success of zero tolerance policies in petrol sniffing in communities such as Watarru and Ngaanyatjarra indicates, there are limits to what good community governance can achieve. The level of responsibility by government in providing services and resources, particularly when there is an outstanding history of the failure to provide access to services commensurate with the mainstream population, needs careful evaluation.

In the case of volatile substance abuse on the AP Lands, it seems problematic to suggest that the Anangu through the auspices of the APY Executive (an organisation with a background in land management), should assume responsibility for the carriage of programs and services relating to problems such as the rehabilitation of sniffers - that is, beyond consultation about and participation in determining solutions to these problems. d'Abbs and Brady pose the following question: 'How, one must ask, can communities said to be wracked by disempowerment and social deterioration be expected to "originate and control" actions in response to petrol sniffing?' ^[71]

The Coronial Inquest emphasised the Anangu's need for outside assistance in addressing issues of volatile substance abuse, which has no precedent in their traditiional culture. At the inquest, the father of Kunmanara Thompson likened the introduction of petrol sniffing to the imposition of the Maralinga bomb tests:

There has been petrol sniffing since the 1950s. Who is responsible? The petrol doesn't belong to us. It is not part of Anangu law. It was introduced to the Lands by white people. It is important that Anangu revive their culture and hold on to their culture. The problem with petrol comes from outside, it's like the Maralinga bomb tests, the solution should come from the outside too.^[72]

As Dr Paul Torzillo, the Medical Director of Nganampa Health Council, points out, mainstream communities with higher living standards and more available services and resources would not be expected to solve their own substance abuse problems:

[T]here seems to be a widespread view within government ... that this is a problem which the community should solve, this is their responsibility. This is a community with less resources and ability to control a tough problem than any mainstream community ... that's not a demand that's put on any other community in the country. No-one, no politician and no bureaucracy expects that a suburb like - so the people of Cabramatta are not told that they have to solve the heroin problem and it's up to them to do it. No-one makes that demand of them and they don't make that demand of them because it's a stupid thing to do, it's clearly not possible.^[73]

The implicit danger of the current government discourse on shared responsibility in Indigenous policy is that it will not provide resources which are adequate or even commensurate with those it provides to the non-Indigenous population in addressing the problems surrounding volatile substance abuse.

The bureaucratisation of community development?

There is a conflict of opinion about whether these governmental and bureaucratic processes are appropriate for pursuing self-determination on the AP Lands, and moreover, whether they might in fact impede progress in petrol sniffing-related issues. It is sometimes suggested that the government's current emphasis on capacity-building, which is a feature of the COAG trials, merely amounts to the bureaucratisation of what was formerly called community development.

One concern that has been commonly expressed to HREOC is that the alliance with the COAG trial will merely contribute to an unnecessary degree of bureaucratisation already implicit in the APLIICC Tier One committee process and that an adequate response to the Inquest might be overlooked in giving carriage to the business of the COAG trial and the other priorities nominated for address on the AP Lands.

Despite these reservations about the bureaucratically top-heavy way of doing business that capacity-building and inclusion in the government's COAG trials might represent, there is also some optimism that the involvement of the Commonwealth might be a source of greater leverage to achieve some effective outcomes where the actions of states and territories have been ineffectual in the past.

Responsibility for tackling petrol sniffing lies across several government agency portfolios and as an issue, Indigenous petrol sniffing has a tendency to fall through the gaps in public policy. The COAG trial could have the capacity to make a more concentrated effort in addressing the problems facing the AP Lands as a discrete area, and provide greater impetus for Commonwealth and state governments to make a coordinated and consolidated effort in addressing petrol sniffing. In addition, the national spotlight of the COAG trials has the potential to engender a greater degree of accountability from all levels of government.

b) Resourcing issues

There were three main areas of comment about funding issues in the findings of the Coronial Inquest. The Coroner perceived the need for a greater injection of funding and resources; funding of programmes on a triennial basis, as recommended by the Royal Commission into Aboriginal Deaths in Custody; and the provision of funding for interventions into petrol sniffing, including continued Commonwealth funding of the Avgas initiative through the Comgas scheme (this final issue is discussed in relation to health related issues later in this chapter).

An inadequate level of resourcing

Information presented to the Coronial Inquest indicated that the combined Commonwealth and State funding for the AP Lands is:

approximately $60 million per year for around 3,000 people of whom 2,500 are Anangu, making a per capita funding rate of about $20,000 per year .... When the CDEP and Centrelink funds ($16 million) are excluded, the figure drops to around $15,000 per capita.^[74]

Very substantial increases in government funding are required to deal with problems relating to remoteness, such as access to mainstream services, and, more specifically in regard to petrol sniffing, to achieve the continuum of care from prevention to treatment and rehabilitation.

The issues surrounding Indigenous funding needs, and equity and access to services particularly in remote areas were canvassed by the Commonwealth Grants Commission's Report into Indigenous Funding 2001 (the CGC Report). A significant aspect of the terms of reference set by the federal government for the CGC Report was an approach based on redistribution of funding according to the principle of relative need (that is, between regions) as opposed to absolute need (that is, in contrast to the rest of the population), with the intention of considering redistribution of funds to favour remote areas. However, the CGC's final report found that this approach was flawed in terms of addressing the inequity in this area. It commented that:

Indigenous people in all regions have high needs relative to the non-Indigenous population. An important question is whether new methods of distribution should be applied to existing programs and funds. Any change in methods of distributing existing resources means that some regions would lose funding and others would gain. Large redistributions risk losing the benefits of investments made over long periods of time, including those in developing organisational capacity and people. The real costs of redistribution may be high.^[75]

A further dimension of the funding issue is the significant problem of accountability for service delivery to Indigenous peoples which remains at the state and territory level. There is a longstanding need for clear agreement among the states and the federal government about their respective responsibilities to Indigenous peoples, how they will act to meet these responsibilities and the resources to be committed by all parties. The distribution of state and territory funds for Indigenous service delivery is also the area where there exists the least transparency and greatest cost shifting.

In July 2003 the South Australian government announced a series of additional funding commitments totalling almost $12 million over four years for initiatives on the AP Lands in its 2003-04 budget. In doing so, it 'acknowledged the longstanding social problems created by petrol sniffing on the AP Lands ... and the recommendations of Coroner Chivell's report.'^[76] The four main areas of commitment are:

$8.163 million over four years for Department of Health Services health and wellbeing initiatives that impact directly on petrol sniffing, and for regional office and respite initiatives;
$1 million over four years for policing and justice initiatives on the Lands;
$797,000 over four years to the Department of Aboriginal Affairs and Reconciliation for the introduction of legally licensed electrical operators; and
$2 million over four years for the Department of Administration and Information Services to provide staff housing on the Lands.

Some of the questions that emerge from AP Lands situation concern not only what would be a sufficient injection of funds to address petrol sniffing and its attendant problems, but what kind of funding arrangements, commitments and time-frames could be implemented, in conjunction with the Commonwealth, to do so?

In an article that appeared earlier this year in the Adelaide Review, Chris Charles commented that the findings of the CGC Report could be used by the SA govt to secure a greater share of per capita Commonwealth funding by highlighting the funding needs of the Anangu.^[77] Working with an assumption that the cost difference for delivering services to the AP Lands as a whole will be greater than the 212% difference between NSW and the NT, they put forward the following hypothetical calculation to support their argument for greater funds for the AP Lands:

NT is dominated by Darwin and so lets say delivery to remote areas such as the AP Lands is twice the difference, translating to a dollar figure of $4890 per head. The relative capacity to pay for these services can be estimated from data presented by Mr Chivell which show that personal per capita income of Anangu people is around $7000 per capita (mainly from CDEP, the Aboriginal peoples work-for-the-dole scheme which provides $16 million to 2,500 people). If we add to that some of the value of services delivered to the AP Lands and already under Anangu control, we might double the per capita income, making it 63% of the average South Australian income of about $22000. When the adjustments are made, this comparison says that to bring education, health, law and order and welfare of the 3000 people on the AP Lands up to the standards the rest of us enjoy, we need to spend at least $22 million more, each year, on an accrual basis. Of course, before we spend the money a proper plan and an itemised costing needs to be done but we know that more than the $12.4 million is justified and that more than $12.4 million will be needed.^[78]

It appears that the current allocation of funds by the South Australian and Commonwealth governments combined is not enough to address the needs of the petrol sniffers in terms of intervention and service delivery needs. The SA government's allocation of the $12.4 million will not be sufficient if it is to be a one-off allocation, and continuous assessment of these funding issues is necessary in any future budgetary arrangements in order to make inroads on the issues confronting the AP Lands.

One interesting possibility raised by the choice of the AP Lands as a COAG trial site is whether this may provide leverage for negotiating a greater injection of funds in the future. While the COAG Trials are not primarily a source of funding in themselves, the emphasis on finding better ways for government agencies to work with Indigenous communities, including improvement of service delivery coordination and outcomes, should have the potential to negotiate more targeted funding arrangements.

Another strategy might be the use of the COAG trial to set and ensure compliance with performance conditions on grants to states and territories (for example, specific purpose payments) affecting service delivery to the AP Lands. Given that the COAG Trials have the potential to support sustainable development in Indigenous communities, they could also provide a forum for exploring the implementation of some of the longer-term and more flexible funding arrangements recommended by reports such as the Royal Commission into Aboriginal Deaths in Custody and the Commonwealth Grants Commission.

More flexible, long term funding arrangements

In 1991 the Royal Commission into Aboriginal Deaths in Custody made recommendations for longer term, more flexible forms of funding arrangements which would ensure increased Indigenous participation. In particular, it recommended that Commonwealth, State and Territory governments introduce triennial block grant funding for Indigenous organisation, and that wherever possible this funding be allocated through a single source with one set of audit and financial requirements but with the maximum devolution of power to the communities and organisations to determine the priorities for the allocation of such funds.

In part, Coroner Chivell's rationale for recommending the funding of programmes on a triennial basis relates to the difficulties of implementing bureaucratic parameters in a remote area:

Many of the people in the field complained of the remoteness of bureaucracies, and their incessant demands for written reports on performance outcomes and so forth. It would be better if the bureaucracies appointed trusted representatives who could monitor and evaluate projects and programmes for themselves, rather than insisting that dedicated professionals in the field continue to spend valuable time and resources preparing reports in order to ensure continued funding. ^[79]

The implementation of funding on a triennial basis would also have greater potential to make significant inroads into the problems surrounding petrol sniffing, an opportunity that is not available within the pilot project funding paradigm.

The over-reliance of governments on pilot project funding was singled out for particular criticism in the Coronial Inquest. Anne Mosey, a community development consultant, observed that:

[C]ommunities were very tired of pilot project funding. I think it is still pretty evident that there is still a tendency for governments to rely on pilot project funding. Again, because it is very difficult for them to access recurrent funding for new positions, so the tendency is on government departments to be able to put it in a pilot project because they are able to provide that kind of funding a lot more readily, but they are not able to access recurrent funding in terms of being able to provide ongoing support for that project, so it falls over. It then takes x number of years to get the funding up again, and, often state bureaucrats are as frustrated by that as community organisations are. They would like to be able to provide recurrent funding, they have a great deal of difficulty with the fact that they are so constrained by budgetary processes and by their ... annual accountability processes.'^[80]

Unreasonable expectations often accompany short-term funding allocations such as pilot projects in Indigenous Affairs, particularly in relation to a complex issue such as petrol sniffing. Torzillo comments:

[T]here is a widespread view that if funds are expended the problem should be solved. That is, we gave you people some money but petrol sniffing still exists, therefore you didn't fulfil the requirements of the program. I mean, I'm not aware of any reasonable government anywhere in the world who has that sort of expectation in social policy elsewhere. No-one expects that funds expended on heroin addiction in Australia will cease heroin addiction ... in fact, a consequence of that is that when that doesn't happen there tends to be a response from government that somehow the population has failed to deliver and that sets up a hostile relationship between service agencies out here and government, which is not a productive one if we are going to tackle this problem.^[81]

In short, there is a need to give concerted and focused attention to the issue of coordinating long-term funding arrangements effectively at state and commonwealth government levels to engender the necessary 'prompt, forthright, properly planned, properly funded action' identified by the Coroner.

It is understandable if government departments do not wish to commit to time-frames without appropriate consultation, negotiation and the agreement of Anangu at this stage. However, there remains a pressing need for a long-term commitment from governments to address petrol sniffing on the AP Lands. Such a commitment needs to extend beyond the government's four-year budget cycle, and include a time-frame for progressing issues, including with projected outcomes that enable equitable participation by Anangu and ensure the progressive realisation of their rights. It is disturbing that there remains an absence of a clear commitment from all levels of government to do whatever it takes to address the endemic petrol sniffing issues on the AP Lands.

Community participation agreements, an initiative introduced in the 2001 federal budget and administered by ATSIC, offer much potential from a capacity-building perspective for achieving this. They may ultimately provide the appropriate framework for locking down government commitments alongside directions established by Anangu communities. As I observed in the Social Justice Report 2001 about community participation agreements:

Equitable participation by all partners should be further reinforced by ensuring that the model is applied to meet assessable goals and objectives over a prescribed time-frame .... There would need to be clarity about what form of commitment various partners are prepared to make, particularly in regard to the implementation of the model over a period of time and the level of resources required, and careful monitoring of all partners' participation as well as the flexibility to make any necessary re-adjustments to the model.^[82]

A long-term framework would provide the structure to ensure that the response to Indigenous petrol sniffing is targeted and that adequate resources channelled within APLIICC Tier One / COAG process. Greater evaluation of the resourcing of the responses by government is also necessary, and links should be developed with existing knowledge bases and expertise on petrol sniffing to inform this. The COAG Trial should also be viewed as an opportunity for piloting more flexible, longer-term approaches to funding commitments, as recommended by both RCIADIC and the CGC Report, and as a lever for increasing the level of state accountability on service delivery to the AP Lands.

c) Health-related issues

Part of the South Australian government's commitment to funding initiatives for the AP Lands over the next four years included an allocation of $7 million to the Department of Health Services (DHS) for health and wellbeing initiatives that will directly impact on petrol sniffing and $1.163 million to provide regional office and respite initiatives. $100,000 has been allocated to Nganampa Health Council for supplementary funding for the patient transport scheme. Discussions are currently taking place with key Anangu stakeholders and APY Land Council representatives regarding preliminary proposals by the DHS for improving primary health and safety. At the Shared Responsibility workshop in Alice Springs, Anangu confirmed petrol sniffing programs, nutrition, child health and safety as priority areas.

Representatives from government health departments emphasised the degree of difficulty in responding to the health issues surrounding petrol sniffing, given that the problem is multi-faceted and has become entrenched over several decades. Quick-fix solutions are clearly not possible, and interventions need to be progressed at several levels. Importantly, the Coroner recommended the following to address this concern:

Recommendation 7: Many of the strategies for combating petrol sniffing which have been tried in the past should not be discarded simply because they failed to achieve permanent improvements. Some of them might be regarded as having been successful for as long as they were extant. For any strategy to be successful will require broad Anangu support. Most strategies fail unless they are supported by others as part of a multi-faceted approach. Strategies should be aimed at primary, secondary and tertiary levels, as I have outlined in these findings.^[83]

The three necessary levels of intervention have the following goals:

Primary interventions - to reduce recruitment into substance abuse (targeted at occasional and non-sniffers);
Secondary interventions - to seek to achieve abstinence and rehabilitation (aimed at those who have been sniffing for some time and may be responsive to intervention); and
Tertiary interventions - to provide services to the permanently disabled (chronic sniffers and those who may have sustained brain damage).^[84]

Forms of intervention that could be implemented at the various levels include:

Primary interventions - programs to reduce recruitment to sniffing, such as the provision of sports and recreation activities, and the employment of youthworkers;
Secondary interventions - programs aimed at harm minimisation or cessation including policing, neuropsychological assessment, outstations/homelands, the Avgas scheme, legal sanctions, night patrols, programmes for children at risk, and crime prevention; and
Tertiary interventions - disability services including hospital care, chelation therapy and custodial care.

Paul Torzillo has grouped petrol sniffers on the AP Lands into the following three categories:

25-40 year olds who are long-term chronic sniffers, often with sustained and irreversible damage, sociopathic tendencies and disability issues: disability services are the response to this issue;
an unknown number of young people established on sniffing who might be rehabilitated and need a mixture of interventions; and
new recruits who need sustained, long-term, flexible adaptable activities on an ongoing basis.^[85]

The view of the Nganampa Health Council is that strong support is needed for both youth activities and disability services. This section will examine the responses led by health agencies to these areas of intervention against relevant recommendations by the Coroner.

Primary interventions

At the time of the Coroner's report, matters on the agenda of the APLIICC Tier One Committee relating to petrol sniffing on the AP Lands included the immediate placement of four youth-workers, development of alternatives to incarceration for young offenders, and residential disability services, all of which were highlighted for attention in the Coronial recommendations

Recommendation 8.1 of the Coronial Inquest was that the proposal before the APLIICC Tier One Committee to appoint four youthworkers and a coordinator be implemented immediately. At the time of the Inquest, there was $300,000 ($246,000 was recurrent) set aside by the Aboriginal Service Division within the South Australia Department of Human Services to fund these positions on the AP Lands, initially for a period of twelve months. There have been complaints about the length of time taken to implement this proposal of two-years standing from the previous government, although an Anangu youthwork coordinator was appointed in late 2003.

Some service providers see prevention of the recruitment of new sniffers as the most crucial level of intervention in avoiding escalation of the problem. They also argue that there is more chance to make an intervention at an earlier age. Recruitment into petrol sniffing is perceived to stem from the boredom and futility experienced by young people in response to the degree of poverty and marginalisation on the AP Lands.

The youthworker proposal has been seen as the most substantial form of intervention at the level of primary intervention, including as a basis from which to access other youth programs and funds for Anangu and for the provision of after-school and holiday programs and activities. However, there have been comments made about the lack of adequate planning and consultation that preceded the proposal, as there are issues about its implementation that required more careful thought. For example, no real operational money has been provided to establish a youth council or youth groups, or to set up an office. There have been suggestions that some of the youthworkers be paid on a part-time or casual basis via the CDEP scheme in order to free up some of the funding for these purposes.

The basis of employment is another issue in itself: part-time employment may suit Anangu youthworkers better (particularly women), because of difficulties in factoring their other family and community commitments within a standard 'nine to five' hour day. Other relevant considerations include difficulties working with people from other moiety systems, in travelling into other areas and sometimes also a lack of support for women working beside their husbands. It has been suggested that funding needs to be as local as possible, with a number of workers employed across families on a part-time basis.

There is also a role for longer-term interventions, such as case management. Potentially schools could play a role in terms of working with youthworkers to provide preventative education programs and resources for afterschool activities. If school counsellors were appointed, there would be scope for them to liaise with youth-workers in managing youth at risk where appropriate. Previously, community elders have provided preventative activities, such as taking young people to herd camels or to outstations, but it is hardly a role for which they can assume total responsibility, given their range of other community commitment, including dealing with chronic and disabled sniffers. The reliance on the CDEP Scheme to support interventions such as youthworkers and night patrols is also questionable, especially on a long-term basis, and proper funding for part-time and casual positions and development of potential career pathways should be considered.

Secondary interventions

In accordance with recommendation 8.2 of the Coronial Inquest regarding neurological assessment, an assessment team with a multidisciplinary approach visited the lands and assessed a group of people in terms of the extent of brain damage. In certain individuals, there is no hope of reversing the effects of brain damage; the question now is how to treat them. Options are being considered in terms of how their counterparts in Adelaide would be treated and whether these options would be appropriate in the AP Lands.

In relation to recommendation 8.3 of the Coronial Inquest regarding the establishment of outstations/homelands, the success of outstation programs such as Mt Theo near Yuendumu in providing a 'venue for community respite, recreation, skills training education and the like in the context of abstinence from petrol sniffing' was noted by the Coroner.^[86] During the 1980s, homelands were utilised with some success by community elders on the AP Lands in running diversionary activities for petrol sniffers.

While they provide a significant avenue through which community members can intervene in petrol sniffing and do so in culturally-appropriate ways, they tend to be short-term measures (a reflection of available funding), often personality-driven and difficult to sustain as a long-term intervention. They are not suitable for dealing with petrol sniffers with a high level of security or rehabilitation needs. Outstations and homelands nevertheless provide a valuable option as a harm minimisation strategy and have a place within a multi-faceted approach to petrol sniffing on the AP Lands.

Recommendation 8.4 of the Coronial Inquest calls for the continuation of Avgas (aviation fuel) under the Comgas scheme as a successful harm minimisation strategy. Avgas is supplied to about thirty Aboriginal communities under the Comgas Scheme administered under the Commonwealth's Aboriginal and Torres Strait Islander Substance Use Program in the Department of Health and Ageing. The Scheme ensures that communities using aviation fuel do so at no additional cost. Avgas is not permitted otherwise for use in motor vehicles as it does not meet several of the fuel specifications under the Fuel Quality Standards Act 2000.

Data collected by Nganampa Health Council in the mid-1990s demonstrates:

an unequivocal and marked reduction in petrol sniffing as a consequence of the introduction of Avgas to all communities. Not only was there a significant decline in the number of petrol sniffers for the following three years but there seemed to be a marked decline in fitting among petrol sniffers, probably as a consequence of less frequent sniffing being possible because of limited access to petrol.^[87]

The Avgas scheme is currently being evaluated. It is anticipated that a successful application will be made for a continued exemption under the Fuel Quality Standards Act 2000 before the end of the 2003.

In relation to recommendation 8.8 of the Coronial Inquest regarding the evaluation of the role of the Department of Family and Youth Services (FAYS) in relation to children at risk, a common statement from FAYS, teachers, and health service providers was that just about every child on the AP Lands could be classified as 'at risk'.

More specifically, the lack of employment and education opportunities, and also of sport and recreation facilities and other forms of entertainment and activity, are contributory factors here. Although there is some opportunity to attend a boarding school near Adelaide, there is little incentive to pursue an education or a career on the AP Lands, and a perception that you can always get CDEP later [i.e. The 'lifetime destination']. Afterschool employment of the kind available to youth in mainstream communities (such as packing supermarket shelves) is scarce, and there are limited career paths within service delivery to the communities (for example, healthworker) and many of these positions are filled by non-Indigenous people. A further aspect of this problem is disability employment, the need to provide meaningful employment for youth (and adults) with acquired brain damage from petrol sniffing.

In 26 March 2003 FAYS released Our Best Investment: A State Plan to Protect and Advance the Interests of Children, the Report of the Review of Child Protection in South Australia, which has a chapter on children and youth on the AP Lands. The Review endorses the recommendations of the Coronial Inquest and urges that they be implemented quickly.^[88]

Child intervention and protection is important in regard to volatile substance abuse in terms of protecting children at risk of self-harm or harm by others (such as violent or abusive behaviour by sniffers or others). The current system for responding to children at risk on the AP Lands requires the notifier to contact the Child Abuse Report Line in Adelaide; it was asserted to the Review that in some cases, there were as many as twenty-five notifications but no outcomes.^[89] Visits by FAYS workers to remote areas are infrequent, the caseload for FAYS workers is high, and FAYS is seen as reluctant to use its statutory authority in regard to child protection. There is a perceived need for Anangu ownership and participation in the issue of child protection to give FAYS' work credibility.^[90]

The Coronial Inquest recommended that FAYS' role be expanded into one of proactive community development (and noted in this context service delivery issues such as the need for early childhood centres, after-school activities and holiday programs). Similar comments that have been made in relation to other government agencies were also made of FAYS, such as the lack of corporate knowledge, continuity of staff and skilled workers addressing the issues on the AP Lands, their need for a holistic, regional plan with planned outcomes, and the need to move beyond pilot programs and inflexible service arrangements.

An issue specific to FAYS on the AP Lands is that of child protection and intervention. It is said that FAYS is often reluctant to act in cases of children at risk because of the history of enforced removal, leaving children in situations of abuse and neglect. It is also suggested that the desire to respond to the legislative requirement that Indigenous children be placed within their own culture takes precedence over the wellbeing of the child, as well as concerns about being seen to satisfy the recommendations from Bringing them home. The situation needs to be circumvented through consultation and participation with Anangu in working out solutions for children at risk that may not involve removal from families.^[91]

The Review states that FAYS has recognised that levels of community education and community development with the Aboriginal community has diminished over recent years, and that they could take on key roles with Aboriginal families and communities in this regard, particularly in developing programs that incorporate education and awareness about child protection.^[92]

Tertiary interventions

In relation to recommendation 8.10 of the Coronial Inquest regarding the need to urgently upgrade services for disabled victims of petrol sniffing, an appropriate response to the need for disability services and facilities for petrol sniffers who have incurred a serious degree of disability is currently under review. While the Coroner's report recommends the establishment of secure care facilities with a potentially multifunctional role that might include rehabilitation, the issue being canvassed at present concerns the most appropriate model for treatment and rehabilitation.

d'Abbs and Brady make the following comments about the need to clarify whether elements of the mainstream paradigm, such as the construction of rehabilitation facilities, are correct for Indigenous petrol sniffers:

Calls from various community groups and others for money to be allocated to residential rehabilitation facilities for petrol sniffers owe more to a widespread faith in the efficacy of this form of intervention than to any evidence supporting such faith.^[93]

There are a series of questions concerning the location of the facility on the AP Lands, its potential long-term use, its relevance to other groups of people at risk, and the necessary level of security and its potential enforceability. The South Australian Police and the Department for Correctional Services argue that rehabilitation of disabled sniffers is not appropriate as a function of a secure care facility as intensive personal care is needed, and that it is more appropriately the province of health agencies and disability service providers.

Another suggestion has been the development of disability services across the AP Lands, probably to be located at six centres. The Review of delivery of services to people with disabilities on Anangu Pitjantjatjara lands found support for the provision of disability care in communities across the AP Lands:

The Anangu preferred position is to have Anangu disability care workers based in their own communities supported and trained by a regionally based community controlled professional team.
Given the situation in all the communities across the Lands, and while some communities may be able to deliver services in the short term, none are able to maintain effective and ongoing services to the aged and disabled. They do not have the infrastructure and resources nor capable, qualified and dedicated staff to deliver such services.
While people may prefer to have everything delivered close to home, unless services are delivered by one of the regional agencies it is an impossible task. NPY Women's Council, Nganampa Health Council and AP Council through AP Services for housing and community infrastructure, are the current functional organisations.^[94]

Planning for the proposed petrol sniffing rehabilitation facility is being led by DHS. As part of this planning process, the CBRG has reached agreement on the terms of reference for a feasibility study on different models for treatment. Letters of request have been sent to health agencies (Commonwealth and state / territory jurisdictions), and it is expected that the study will start by the end of 2003 or in early 2004, and will be finalised by September 2004. Agreement on the terms of reference has taken longer than expected because of the number of stakeholders involved and the complexity of the issues. The terms of reference include a survey of the available data on volatile substance abuse, an analysis of the efficacy of available models of detoxification, rehabilitation and treatm

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