Kalokerinos, Dr A. --- "Neglected Medical Aspects of Aboriginal Deaths in Custody" [1989] AboriginalLawB 3; (1989) 1(36) Aboriginal Law Bulletin 5

• Neglected Medical Aspects Of Aboriginal Deaths In Custody
• The First Experience
• The Death Of Peter Campbell
• Some Neglected Medical Aspects Of Aboriginal Deaths In Custody.
• An Experience In Queensland
• The Seriousness Of Problems Faced By Aborigines Are Not Appreciated By White Australians

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Neglected Medical Aspects of Aboriginal Deaths in Custody

by Dr A. Kalokerinos

The First Experience

In Collarenebri, 500 miles north-west of Sydney, during the 1950s and 1960s one of the policemen was appointed as "lockup keeper". His pay depended on the number of prisoners in the cells. This led to the practice of raiding the Aboriginal reserve, arresting men, drunk or sober, and charging them with alcohol related crimes or aggressive behaviour.

One night there was the usual need for cell inmates. Amongst those arrested was a man who did not drink. In fact, he was asleep when arrested. Later, in the cell, he complained of chest pain. He was ignored. Shortly afterwards, still in the cell, he was found dead. I was called to examine him and perform an autopsy. The cause of death was very clear - a coronary occlusion that had been present for a period long enough to produce visual evidence in the heart muscle. There was no alcohol in his stomach. I wrote and submitted a report. It apparently created problems because the Inspector of Police drove nearly 100 miles to Collarenebri from his base in Moree and woke me from my sleep. "Dr Kalekorinos," he said, "Don't you think, on reconsidering it, that he did have alcohol in his stomach?". "Are you asking me to alter my statement?" I asked. He said "Yes". I refused. He then said "You know, Dr Kalekorinos, we can make life pretty tough for you here." I threw him out!

At the inquest I presented my evidence and my statement (unaltered). There were no questions. No action was taken against anyone.

There were several reasons why this angered me. At the time only specially licensed Aborigines were permitted to drink. Unlicensed Aborigines depended on white "suppliers" who sold them alcohol, illegally, for substantial profits. I had stated that for every Aborigine arrested for alcohol related offences there should be a white supplier arrested also. This was rarely the case. If a local white man supplied, no action was taken. Sometimes, if a strange white man came to town and supplied there was an arrest. When I complained to the police I was told that no witnesses were available.

One day I saw a local white man supply to an Aboriginal adult in the presence of a group of children This made me doubly angry. I immediately went to the police. "You have your witness now," I said. No action was taken.

The death of Peter Campbell

Peter was found dead with his throat cut in his cell at Long Bay. His family was told that it was "suicide". This was not accepted and I was approached for assistance. Together with family members I attended the inquest in the Glebe Coroner's Court. First to give evidence was the doctor who performed the autopsy. I was surprised to find that oral evidence in court was vastly different to his report which was extremely brief, mentioned only one wound (typical of murder cut-throat) and very little else. The oral evidence was more detailed. It mentioned "tentative" wounds (typical of suicide cut-throat).

I was called as the next witness. I expressed the belief that the evidence just presented was incorrect and asked to see photographs of the wound. The answer to this was, "There are no photographs of the wound and it is not routine to take such photographs." This I refused to accept and went on to explain that photographs would enable a diagnosis to be made with confidence and if there were difficulties experts could be found who would solve them.

There was one photograph tendered. It showed the body lying face down on the bed. The right arm was partially visible and I could tell from the distribution of the blood that suicide was impossible.

The verdict was handed down many weeks later. It was "suicide".

Some Neglected Medical Aspects of Aboriginal Deaths in Custody.

While total knowledge does not exist, a great deal is known and not applied in practice. There are obvious interrelationships between the various factors which could be divided as follows –

1. A rapid rise and/or fall in blood sugar leading to disturbed states of consciousness and behaviour (including aggression, depression and apparent "intoxicated" states which can be mistakenly diagnosed as alcoholism).

2. Vitamin and mineral deficiencies leading to abnormal biochemical mechanisms that result in abnormal states of behaviour including aggression and depression. The vitamin and mineral deficiencies are invariably associated with excessive refined carbohydrate (white flour sugar) intakes which reflect blood sugar abnormalities.

3. Biochemical disturbances lead to abnormal tolerances and side effects to administered drugs, particularly sedatives, and alcohol. In this way, drugs that are administered to control aggression or intolerable behaviour may cause further behavioural problems and/or sudden or unexpected death. This is particularly likely if alcohol is part of the picture.

4. It is obvious that vitamins and minerals should be administered in all cases and, often, it is necessary to do this by intramuscular or intravenous injection. This should be done before sedatives are administered. It is important that the methods of administration of vitamins and minerals, and possible side effects, be properly understood.

5. Properly administered and properly controlled vitamin and mineral supplements can result in rapid detoxification and rapid control 'of difficult patients. It is also lifesaving.

An Experience in Queensland

While visiting homes in northern Queensland I came across a young man who was desperately ill with pneumonia. He told me that he had gone to the local hospital during the previous night and the staff thought that he was drunk. So they left him sitting unattended on a bench for many hours while he continually begged for help. Finally he gave up and somehow managed to drag himself home to bed where I found him next morning. I called an ambulance and instructed the driver to take him to hospital and ensure that he received instant attention. The driver said that he did not have the authority to do this. I told him that he did because of his training and position in the community and if instant medical attention was not obtained he must report back to me immediately. Instant medical attention was obtained. The patient survived.

Often patients who are ill are regarded as being "drunk". Diabetic coma is the typical example and diabetes is extremely common amongst Aboriginal people. Or there may be a mixture of a true illness and alcoholism. In all cases proper assessment is necessary.

The Seriousness of Problems Faced by Aborigines are Not Appreciated by White Australians

When I first visited a remote Northern Territory settlement I expressed an interest in eye problems. Almost instantly I found myself surrounded by a group of blind old men. But they were not really "old". They just looked and acted old. There were also blind women who stayed shyly in the background. The young men and boys watched us from a distance. A quick survey revealed that the incidence of blindness was staggering. I began to ponder on its development and this led me to wondering what the young men were thinking. Surely, they were aware of what was happening. They knew that men were ageing and going blind earlier as the years progressed. They knew that there were only three ways to the future. They could sit it out and accept their fate. They could hope that some outsider would come and change things for them. Or they could try to change things for themselves. They knew what happened to those who tried to bring changes - they were slaughtered or imprisoned. They knew that there was one system and one law for whites and another for the blacks. How much worse can you get - the gas ovens?

The depression and hopelessness, the escape to alcohol, the anger, the aggression. It is easy to understand if one cares to look at it. I often think that we could throw away the law and the government and depend on just plain common sense and humanity. For too long white Australians have only seen what they want to see - the final result of utter depression - the drunk Aboriginal in the gutter or the dead one in a cell and I no longer believe that white Australia really cares.

Dr Kalokerinos has worked since 1957 as a General Practitioner in a variety of Aboriginal communities and Aboriginal Medical Services. He will be giving evidence before the Royal Commission in the hearing of Peter Campbell's case.