The hidden history of medical incarceration

Medical incarceration can be seen as an example of the role of health care professionals and systems in colonisation writes Melissa Sweet.

In the first decade of the 20th Century, a new medical scheme to remove Aboriginal people from across Western Australia to remote islands was described by government officials as a grand humanitarian venture.

Between 1908 and 1919, several hundred Aboriginal people said to have the non-specific diagnosis of “venereal disease” were taken to Bernier and Dorre Islands, which lie about 30 nautical miles west of Carnarvon in Shark Bay.

“Such a great undertaking of this kind has never before been attempted in any part of the Commonwealth, and it is an emphatic contradiction to the many charges made against the State Government of neglecting the welfare of the aborigines…,” the Chief Protector of Aborigines in WA, Charles Frederick Gale, wrote in 1908.

The segregation of “these unfortunate people” was not only for their own sakes but “for the sake of the community at large”, Gale stated in the annual report of the Western Australia Aborigines Department.

In a briefing note to government colleagues dated 17 September 1908, Gale urged the need for police involvement:

“There may be some Natives who will voluntarily go to a distant land to be cured, but I very much doubt it. The only alternative is to treat them as prisoners, and force them to go; the end justifying the means… It is only by force and practically making them prisoners, that the end we have in view will be accomplished, and this can only be done by the police.”

At least 162 people died at the Bernier and Dorre Island lock hospitals, although this is likely to be a significant under-estimate and also does not include those who died en-route, often on long, harsh journeys in chains, with periods in jail or other lock-ups.

The lock hospitals were racially based

The concept of lock hospitals dates to their use in English garrison towns in the 1800s to protect the health of soldiers by confining women who were thought to be engaged in sex work and to have venereal disease.

Abandoned in Britain following vocal opposition, lock hospitals were continued elsewhere in the British Empire in the 20th century. In Australia they were mainly used to incarcerate Aboriginal and Torres Strait Islander people under racially based laws (health authorities did not support lock hospitals for the general population on the grounds they would discourage people from seeking treatment for venereal diseases).

In Queensland, more than 1,144 Aboriginal and Torres Strait Islander people were admitted to a lock hospital that operated from 1928 to 1945 on Fantome Island in the Palm Island group, 70 kilometres north-east of Townsville.

A leprosarium also operated on Fantome Island from 1940 to 1973. The history of lock hospitals is closely intertwined with the history of the medical incarceration of Aboriginal and Torres Strait Islander people with leprosy at multiple sites between 1884 and 1986.

These included Mud Island and Channel Island in the Northern Territory; Friday Island in the Torres Strait, Peel Island in Moreton Bay and Fantome Island in Queensland; and in Western Australia included islands near Cossack, and other sites at Derby, Broome and Beagle Bay.

As with lock hospitals, some of these institutions housed children. In 1925, a Darwin newspaper recorded that a four-year-old Aboriginal girl was discharged from Mud Island lazaret after being examined by doctors and found free of any trace of leprosy. She had been an inmate since birth, her mother having had leprosy and since died.

Whether people were being removed to lock hospitals or leprosy institutions, they often faced traumatic journeys as well as long periods in prisons or other lock-ups awaiting transport.

A need for acknowledgement

In WA, people were transported from Derby and other places to Cossack, and shipped from Cossack, Derby and Beagle Bay to Darwin in the NT, and then some patients subsequently were returned on trucks to WA from Darwin.

These episodes of medical incarceration can be seen as archetypal examples of the role of health care professionals and systems in colonisation, contributing to intergenerational trauma.

While the situation for medical inmates varied within and between the various sites over time, some general themes can be identified from searches of the academic literature and archival and newspaper sources. These include the unreliable nature of diagnoses and record-keeping, the harmful nature of many interventions, high mortality rates, inadequate staffing, and harsh living conditions.

Although largely portrayed in public debate at the time as benevolent, humanitarian interventions, these episodes inflicted physical, mental, social, emotional, cultural and spiritual trauma over a period lasting almost a century.

They led to the dislocation of multiple generations of Aboriginal and Torres Strait Islander people from their families, communities and country, and were part of a pattern of events and policies that interrupted people’s ability to care for country and to undertake cultural practices and responsibilities. This history of incarceration has ongoing consequences for the families, kin, communities and country of those taken away.

Interviews with dozens of Aboriginal and Torres Strait Islander people have shown a strong wish for wider public acknowledgement of these histories, including by health systems and health professionals, and for healing projects. They also want stories relating to the histories of medical incarceration included in health and medical curricula, as well as wider curricula at all levels of the education system.