The Rural Health Education Foundation is pleased to present comment on issues related to our work and reviews of relevant film, television and DVD programs of particular interest and applicability to Australian rural and remote health professionals.
If you would like to comment on these matters, please email me, Don Perlgut.
Thanks for your interest.
Free: The New Business Model
I am a great fan of Chris Anderson. In July 2007 I presented a conference paper at the Australian and New Zealand Communications Association conference in Melbourne about it his book The Long Tail, where I analysed the Rural Health Education Foundation’s “long tail” effect of watching and listening to our programs online.
Anderson has just published a new book, called Free: The Future of a Radical Price. As with The Long Tail, Anderson has done a great job at capturing a certain “cultural moment”, in terms of how we relate to information, entertainment and our connected world. His basic concept is that if give people lots of real value free items, there are a number of business models that will allow you to make money. Anderson summarises it thus in his book (page 3):
Therein lies the paradox of Free: People are making lots of money charging nothing [Google being the prime example of this]. Not nothing for everything, but nothing for enough that we have essentially created an economy as big as a good-sized country around the price of $0.00. How did this happen and where is it going?
In the Prologue of his book (pages 1 & 2), he points to the example of the Monty Python team: claiming to be exasperated as to the amount of digital piracy of their programs, in November 2008 they posted lots of their high quality archival video material free on YouTube. But they asked for:
…. something in return. None of your drivelling, mindless comments. Instead, we want you to click on the links, buy our movies & TV shows and soften our pain and disgust at being ripped off all these years.
And according to Anderson, they were wildly successful, with their DVDs climbing “to number 2 on Amazon’s Movies and TV best-sellers list, with increased sales of 23,000 percent”.
The point that Anderson is making is that providing free information and entertainment is the way the world now turns - having the “force of economic gravity”, and that organisations will need to adapt to make money off of the “free”. Giving away lots of free samples will encourage purchase, provide training instead of selling software, sell merchandise and concert tickets and don’t worry about the free downloading of music, but instead charge for extras and add-ons and up-sells. He makes the point that the difference between something which costs and something which is free is enormous, even if the cost is small. An example: Amazon’s offer of “free shipping” for orders greater than $25 (alas, not available in Australia, but that’s a whole other discussion) is wildly successful.
“Give a product away, and it can go viral”, Anderson writes. I know this to be true. At the Rural Health Education Foundation, we give away large numbers of health and medical educational DVDs (about 22,000 in 2008/09 alone, and that was not an unusual year; click here for the latest free DVD offers). But when the Foundation offers the same product/s for sale at a price, even at extremely low prices, the orders fall away dramatically. The business model of the Foundation is, interestingly, also based on “free”, although not the commercial model which Anderson discusses. The model is to receive funding up front to produce and distribute the educational programs and then give as much of it away free as possible (with as little cost). When the “free” is digital (Internet delivered) or via television (satellite or national broadcast), it’s pretty cheap to add lots of users - although in the Foundation’s experience it is not exactly zero: there is a cost to free giveaways.
It is important to note that, like his “Long Tail” concept, Anderson builds directly on the work of others, updating it to the very current present and near future. This sort of futurist writing - explaining what we have just done and are about to do, can be very exciting, and Anderson is a master of this, even if he is often so excited about his concepts that sometimes he sounds more like an evangelist than anything else.
The context here is important: print editions of newspapers are disappearing in the USA, the Google search (and advertising) model is killing many of them (see the July 14, 2009 article by Peter Osnos entitled “What’s a Fair Share in the Age of Google?” at the Columbia Journalism Review or the Century Foundation. (Drawing on my work with the Rural Health Education Foundation, I recently presented a paper on new media business models in Brisbane in July 2009 at the Australian and New Zealand Communications Association conference, which I will write about soon.)
In his article, Osnos discusses the concept of “information wants to be free”, noting that it originally came from Stewart Brand - who said it at a computer programmer’s convention in 1984 and later detailed in his book 1987 The Media Lab: Inventing the Future, writing the following:
Information Wants To Be Free (note: capitals by the author). Information also wants to be expensive. Information wants to be free because it has become so cheap to distribute, copy and recombine - too cheap to meter. It wants to be expensive because it can be immeasurably valuable to the recipient. That tension will not go away. It leads to endless wrenching debate about price, copyright, “intellectual property”, the moral rightness of casual distribution, because each round of new devices makes the tension worse, not better.
And remember this was written more than 22 years ago.
Esther Dyson (see http://www.edventure.com/ for her latest activities) was also another pioneer of thinking in this area, particularly with her December 1994 article (from Release 1.0) entitled “Intellectual Value” (available at Wired magazine archives). Dyson wrote at the time:
Chief among the new rules is that ‘content is free’. While not all content will be free, the new economic dynamic will operate as if it were. In the world of the Net, content (including software) will serve as advertising for services such as support, aggregation, filtering, assembly and integration of content modules, or training customers in their use.
Discussing media and entertainment, she accurately predicted the rise of Google:
The payments to creators are most likely to come not from the viewers, readers, or listeners, but from advertisers…. The challenge for advertisers is to make sure that their advertising messages are inextricable from the content.
That was fifteen years ago. Like Brand, she too was an early evangelist. And her predictions were wildly optimistic: they were not wrong, just way too early. As Nobel Prize winner Paul Krugman pointed out in the New York Times on June 6, 2008:
The predictions of ’90s technology gurus are coming true more slowly than enthusiasts expected - but the future they envisioned is still on the march. In 1994, one of those gurus, Esther Dyson, made a striking prediction: that the ease with which digital content can be copied and disseminated would eventually force businesses to sell the results of creative activity cheaply, or even give it away. Whatever the product - software, books, music, movies - the cost of creation would have to be recouped indirectly: businesses would have to ‘distribute intellectual property free in order to sell services and relationships.’
There is an interesting rule here: the predictions of “technology boosters” (Dyson, Brand et al) are almost always overly optimistic (has broadband reached all of rural Australia yet?), but most do come good … eventually, however only if you wait long enough.
Mark Cuban has an interesting (July 5, 2009) blog post on the topic of “Free” entitled “When you succeed with Free, you are going to die by Free”, where he points out that “The problem with companies who have built their business around free is that it is far from free to remain successful.”
Cuban’s point is that the more success there is, the harder it will be to stay on top. All “freemium based content plays” will have a company that replaces them, their “Black Swan” (from the Nassim Nicholas Taleb book of the same name) competitor that will appear and replace them: Myspace to Facebook, even Google:
We don’t know who their Black Swan company will be. But we all know it will happen don’t we? The only question is when. Of course Google knows it as well. Which is exactly why they invest in everything and anything they possibly can that they believe can create another business they can depend on in the future.
Do you think Cuban is wrong? Remember AOL (also known as America Online)? Some years back it was so big it bought Time Warner, movies and all. And where is AOL now? (See post below on April 14, 2009.)
Reportedly, Anderson’s book Free is tied for 11th best-selling book on the New York Times list. And Anderson truly “puts his money where his mouth is” (as they say) - offering it, as they say, totally FREE, through SCRIBD. According to Anderson, by late July 2009 the free digital version had already been downloaded “between 200,000 and 300,000 times”. And yet people were buying it as well, helping Anderson to prove his point that “free” can be an effective business model.
By the way, Free is NOT available “free” in print form for those of us who live in Australia - and presumably in most other places outside the USA. Go to the “Free” download page on SCRIBD and you will be given the following message: “Sorry, this content is geographically restricted. Due to our agreements with our publishing partners, the document you requested is only available to users located in the United States.” So “Free” is not necessarily … free after all. It was also offered free for a brief period on Amazon’s Kindle (not available in Australia), Sony Reader and iTunes. You can, however, download the audio book free (I have done this, so it works, note 285 MB zip file) by going to Wired magazine of 17 July 2009. As far as I can tell, there is no preview available on Google books.
By the way, SCRIBD has a little sting to its website tail. Once you are on it, the site will not let you go back to your previous website if it was in the same browser window. It’s irritating. So open a new window every time you go there. You’ve been warned.
“Samson and Delilah”
(by Don Perlgut, posted 11 June 2009)
The astute observer of Aboriginal and Torres Strait Islander affairs in Australia will have noticed that there is quite a bit of attention being paid to the rural and remote Indigenous issues, not only politically, economically and socially, but culturally as well.
The May 7th release of the Australian movie Samson and Delilah, by Indigenous director Warwick Thornton, has certainly focussed attention on what is going on in remote Indigenous communities. This movie features stand out performances by young Aboriginal actors Rowan McNamara and Marissa Gibson, and was filmed in a number of locations in remote Indigenous Australia. It also had its premiere screening in a highly unusual place: an outdoor amphitheatre in Alice Springs.
The film is starting to make some significant cultural impacts, in part because of its selection in the official section “Un Certain Regard” at the Cannes Film Festival, where - astonishingly - it won the coveted “Camera d’Or” prize. Previous winners of this prize include Jim Jarmusch (Stranger Than Paradise), Mira Nair (Salaam Bombay), Miranda July (Me and You and Everyone We Know) and Steve McQueen (Hunger).
Since the film’s limited opening in Australia (it started in only two or three cinemas in Sydney), it has gradually been widening its release. (Click here for details of where the film is currently screening.) By the end of the June long weekend (8th June), it had already grossed $1,721,406, and was only playing on 38 screens. It was number seven in the Australian box office, behind no less than six Hollywood juggernaut blockbusters: Terminator Salvation, Night at the Museum 2, I Love You Man, State of Play (starring Australia’s Russell Crowe), Angels and Demons and Star Trek. The ultimate impact of this film on Australian cultural consciousness is yet to be determined, but it is likely to have at least the same effect as Rabbit Proof Fence, and possibly more. We watch this film with great interest.
Nicholas Rothwell’s “Fourth World”
(by Don Perlgut, posted 11 June 2009)
As noted below - back in 2007 - Nicholas Rothwell, the Northern Australia correspondent for The Australian, has been one of the most acute observers of Indigenous Australia. In a May 30, 2009 feature article in The Australian called “Our Fourth World”, he develops the concept of how Indigenous remote Australia lives in a totally different place. I include an excerpt of his article below:
Crafting a future for Aboriginal remote communities requires above all else a clear sight of what they are now. The communities are a welfare state and, thanks to Cape York activist Noel Pearson, the rotting effects of passive welfare provision in the Aboriginal realm are plain, and the virtues of work-for-welfare programs are accepted across the board. But the communities form a welfare zone with unusual, complicating characteristics. They have Third World living conditions but they are not in the Third World.
Rather, they are in a much stranger place: a place quite hard to see and understand. We might call it the Fourth World: a deeply deprived space contained within the borders of a modern, prosperous First World state. Absolute poverty is not the limiting economic problem: a controlled, regular, yet inadequate supply of transferred money is, along with its inevitable outcome, relative poverty - a fate both grinding and comforting for those locked out of the productive economy. Capital formation is impossible under such circumstances, unless land use can be traded.
The inhabitants of this zone are welfare pensioners, who have subsisted for decades without strong incentives to acquire skills or seek jobs. In this Fourth World of the communities, there is a strong awareness of positional disadvantage: the men, women and children there know they are at the bottom of the social pyramid of Australian life, but they have no idea of how to change their status. The younger generation’s members are encouraged to share the expectations of the wider society but geography and the lack of educational pathways prevent them from taking part in the outside world on even terms.
Rothwell is highly critical, but his insights cannot be ignored. His comments complement and extend Warwick Thornton’s view of remote Indigenous Australia, and are worthy of consideration.
Nicholas Rothwell’s new book Red Highway was published in May 2009 by Black Inc.
Google and the future of the Internet
Getting worried about the omnipresence of Google in your life? You are not alone. In an April 14, 2009 post on “The Daily Beast“, Peter Osnos (Senior Fellow at The Century Foundation), asks “Is Google the next AOL?”
Osnos points out that:
AOL, as it came to be known, was so formidable that in 2000 it effectively swallowed Time Warner, one of the most glittering enterprises in global media and entertainment. The combined companies had a stock value of about $225 billion…. And then, poof, it was over. In what now seems like a nanosecond, AOL declined until it was synonymous with business failure and irrelevance. Its name, which once rode astride the corporate headquarters on New York’s Columbus Circle, was ignominiously removed. Today, Time Warner is desperate to offload AOL.
An interesting thought. Things change fast in the Internet world. As Osnos writes:
The rise, dominance, eclipse, and fall of infotech and Internet identities is a major part of the story of these past two decades. At various times, CompuServe, Prodigy, Netscape, MSN, Yahoo, among others, were in the spotlight, only to fade as Google brilliantly rolled out innovations and amassed resources that make it now far-and-away the most powerful presence in Internet culture—not a monopoly, but with many characteristics of one.
Microsoft, Apple, AT&T and even IBM have survived. As Google flexes its muscles (witness the book digitisation project), we must keep in mind that (as Osnos writes) “The Internet is dynamic and things can change very fast. The cautionary message of America Online is that people were willing to pay billions of dollars for its output—and then they were not.”
In his Media Studies lecture at LaTrobe University on April 8, 2009, ABC Managing Director Mark Scott talked about “the phenomenon some describe as macromyopia or Amara’s law - the tendency to overestimate
the impact of technological change in the short term and underestimate its impact in the long run”. It’s an interesting concept: we are both changing slower than we think, but more profoundly than we are aware. I am sure Google understands that, but the history of the Internet is evolving every day, and we are all along for what has already been a very wild ride.
(posted 20 April 2009)
Clay Shirky and the Future of Broadcasting
(By Don Perlgut, posted 5 April 2009)
Clay Shirky is a commentator on the Internet, new media, networks and related matters. His article Power Laws, Weblogs, and Inequality is widely credited with being a key inspiration for Chris Anderson’s book The Long Tail: Why the Future of Business is Selling Less of More. Shirky’s latest book - just published in Australia - is Here Comes Everybody: How Change Happens When People Come Together (Penguin, 344pp., $26.95 in Australia). (The American subtitle of the book is “The Power of 
Organizing Without Organizations”.)
In the book, Shirky tells a number of fascinating stories which illustrate his key thesis: that in this Internet-driven age of revolutionary information technology, systems of information have changed profoundly. As Richard King, reviewing his book in The Australian Weekend Review (April 4-5, 2009, p. 14) puts it:
The telephone put enormous power in the hands of individual users, but it didn’t create an audience. In contrast, broadcast and recorded media created a vast audience, but concentrated power in the hands of a few. Now these phenomena are coming together, with the result that the world is set to change, and indeed is changing, out of all recognition.
Want to know how true this is? To date (April 2009), the Rural Health Education Foundation has run two simultaneous interactive live webcasts and broadcasts - the first in December 2008, and the second in March 2009. I can’t be 100 percent sure, but I am pretty certain that these are the first simultaneous webcasts/broadcasts that have taken place in Australia. And the number of people who watched via the Internet have probably exceeded the numbers who usually watch some of the SBS Television marginal free to air television programs (such as foreign language new services). This is nothing particularly new, but it does show the power of how a small organisation - the Rural Health Education Foundation - can effectively become a powerful mini-broadcaster, all without the necessary overhead of a major television station.
Interested in the result? Click here to view an edited version of the March 10th webcast/broadcast entitled “Birthing in the Bush”. (Note that user registration - which is free - is required to access the archived video webstreaming.)
The Future of DVD in this Digital World
(Posted on 13 March 2009) The Rural Health Education Foundation is a major distributor of educational programs on DVD. Each year we produce up to 20 programs, with many of them available free of charge for Australian rural and remote health professionals (click here the latest free DVD offers if you are interested).
But what is the future of DVD? Does anyone still remember VHS video, which has virtually disappeared as a format? And oh, by the way, what about the old Sony Betamax video, a far superior videotape format that was overwhelmed by VHS because of superior licensing and marketing? But Sony did get one little thing wrong: its first tapes only ran for one hour, meaning that no-one could record a full movie on it (see Jack Schofield’s article in The Guardian of 25 January 2003 for more details on this).
Many may not be aware that DVD has been a financial saviour to Hollywood studios: just when theatrical movie-going started to level off and decline, DVD came to rescue - and unlike VHS video, many of us are actually purchasing these disks. Sandy George writes on the Screen Australia website that “there has been a spectacular rise in the DVD format. Introduced to Australia in the late 1990s, by 2001 DVDs were earning more per year for distributors than the VHS format they have now almost entirely replaced.” George gives lots of reasons for this success, but I will add another that has fuelled it: almost every new computer you can buy nowadays can play a DVD. Some of the latest “digital ready” TVs also include a built-in DVD player. So how’s that for an accessible format?
How about the value of DVD sales in Australia? In 2007, DVD sales in Australia were $1,335 million (or $1,335,000,000, to use all of the zeros; go to the Screen Australia “Get the Picture” website for details). Put this in perspective: that was way more than Australian cinema box office revenue that year at $895.4 million. (But if you really want to compare markets, you should also look at gaming sales - $1,328.3 million in 2007, but that’s a whole other story. Click here for Australian “interactive media” sales details.)
In a February 19, 2009 article in Time magazine, long-time film critic Richard Corliss reviewed the next video format: Blu-ray. He bought a player and watched “a couple of dozen current and classic” movies. His conclusion: “less than a revolution but more than a gimmick”, certainly not the qualitative advance over DVD which that format was over VHS videotape. Technically, pretty exciting, and with a “very practical advantage:: DVDs can be played on it”. Compare that to all previous format “upgrades”, which never allowed you to play the “old” stuff on the new.
In its September 2008 edition, Choice magazine (Australian Consumers Association) has also analysed the Blu-ray/DVD matter. (Ironically and strangely, you cannot find this article direct from Choice on the web, but try the “Access My Library” website page to read it; I read it via an American library service in New Jersey not far from where I used to live. As they say, go figure). They make some good recommendations for Australian consumers about which ones are best “buys” (but note, technology changes things quickly in this “space”).
I hereby officially announce the death of VHS (I am a little late on this, but what the heck). But how about DVD? Is there much life left in it? Sure, particularly because of all of those computers that will be playing DVDs for some years to come. How much longer will it last? That I can’t guess, but I can’t imagine us sitting down to “watch a DVD” in the year 2029. Think about it.
Desperately Seeking Doctors
Starting on Tuesday January 6 SBS Television began screening its three-part documentary series Desperately Seeking Doctors, broadcast at 7.30pm on Tuesday January 6, 13 and 20. The SBS describes this Australian-UK co-production thus:
Australia has a chronic shortage of doctors and nowhere is this more evident than in the bush. Country towns right across the country are so desperate for a GP they’ve recruited doctors from lands as far away as India, South Africa and the UK. Overseas trained doctors have now become commonplace throughout the land – but how do these foreign doctors cope once they’ve arrived in the middle of nowhere? And, just as importantly, how do the locals in the middle of nowhere cope with them?
Episode 1 (January 6, 2009): ”Unfamiliar Territory” - How prepared are medical students to take positions in the bush, and how do the residents of rural communities feel about the future of their health care? In episode one, Dr Mary Fortune leaves her home, family and friends in Scotland to answer the cries for help from the mining town of Kalgoorlie, in W.A. Despite knowing she will miss her son, and husband of 22 years, Dr Mary is excited about the challenge of moving to Kalgoorlie and optimistic about what the experience will be like.
Episode 2 (January 13, 2009): “Out Of The Frying Pan” - In tonight’s episode, as Nabilah’s mentoring proceeds in Wagin, it is clear she is not meeting Dr Majid’s expectations. Already feeling the pressure, Nabilah is pressed even further when a patient at the hospital dies. Meanwhile in the small town of Dallwallinu, news of Dr Mary Fortune’s arrival in Kalgoorlie reaches local doctor, Dr Simon Wamono, and he makes a plea for help. Arriving in Dallwallinu, it becomes immediately obvious to Dr Mary that Dr Simon is completely exhausted and in desperate need of a break. Dr Simon has been on-call 24 hours a day for the past two years.
Episode 3 (January 20, 2009): “Unexpected Territory” - Having left Kalgoorlie to help Dallwallinu’s only doctor, Dr Mary finds herself busier than she had ever expected. Although stipulating in her contract that she would not work 24/7, it doesn’t take long for her to realise that without adequate support, a contract in the bush can be very difficult to enforce. For Nabiliah’s good friend Jen Martin, completing her rural placement was always going to be a challenge. For this city slicker, the small town of Katanning will be an eye-opening experience. Will it be an experience though, that will entice Jen to take a place in the bush once she’s finished her degree?
For more information, go to the SBS TV “Documentary blog”.
Update 18 January 2009:
Ian Cuthbertson has reviewed the series in The Australian (Saturday, January 18, 2009, Weekend Review, page 28) as follows: “If you are the only doctor in a small Australian country town, it means being on call 24 hours a day, seven days a week. In no other profession would anyone be expected to endure such conditions…. (The series) does offer a terrific insight into what makes doctors tick, how much is demanded of them, and why they are unlikely ever to flock to rural Australia in the required numbers.” For the Rural Health Education Foundation’s Strategic Plan summary of the rural health workforce numbers, click here.
Australia the Film
By Don Perlgut, 1 January 2009
The November 2008 release of Baz Luhrmann’s film Australia is the biggest Australian film in many years, and certainly the most expensive Australian film ever made.
Set in the Northern Territory in the late 1930s and early 1940s and presented as a classic “Western” love story between its two major stars - Nicole Kidman (playing Lady Sarah Ashley, an English aristocrat) and Hugh Jackman (simply known as “The Drover”), within the opening credits Australia the film rapidly identifies its major theme: of Aboriginal reconciliation and the “stolen generations”. This term refers to those Indigenous Australian children who were removed from their families as part of systematic policies of forced assimilation by Australian state and national governments. This destructive policy lasted from 1909 to 1969 and resulted in the decimation of tens of thousands of Indigenous Australian families, the impact of which is still being widely felt throughout Australian Aboriginal and Torres Strait Islander communities. For more information about the ”stolen generations”, go to the following resources:
- The Stolen Generations Fact Sheet, by Reconciliaction
- The Stolen Generations Alliance
- The original 1997 Bringing Them Home report resulting from the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from Their Families, available from the website of the Australian Human Rights Commission and from the Indigenous Law Resources Reconciliation and Social Justice Library
The “stolen generations” have been the subject of other Australian films in the past, notably Rabbit Proof Fence (2002), directed by Phillip Noyce, and adapted from the Doris Pilkington novel Follow the Rabbit Proof Fence (1996). (For a review by Fiona A. Villella of that film, click here.)
Australia (the film) explores this theme particularly through the character of Nullah, played by Brandon Walters, an Aboriginal boy from Broome in his feature film debut, who was 11 years old at the time of the film’s production. Walters gives an astonishingly natural and touching performance; his interaction with Nicole Kidman’s character becomes the real emotional core of the film, eclipsing the much-promoted Kidman-Jackman romance. According to Baz Luhrmann, Walters will be “Australia’s next leading man”.
When he first began planning the film some years ago, there was no way that Baz Luhrmann could have known that Australia’s (then) new Prime Minister, Kevin Rudd, would (on February 13, 2008) issue a long-sought apology to the Indigenous peoples of Australia for the Stolen Generations. (Click here for the complete text of the apology and Prime Minister Rudd’s speech; note pdf document of 41kb.)
The fact that the most expensive Australian film ever made has the Stolen Generations as one of its central themes is astonishing. Although, to be fair, Australia the film has at least seven themes operating. In addition to the Drover-Lady Ashley romance and the Indigenous mistreatment, there is the robber cattle 
barons (played by Bryan Brown and David Wenham), the challenging cattle drive to Darwin, the coming of age of Nullah - including his relationship with his grandfather (played by David Gulpilil), the disapproving Darwin “society” and - notably - the World War II impact on Australia, including the bombing of Darwin in February 1942 (more on this last theme shortly). (Spoiler alert: this review will now reveal some plot points, so stop reading NOW if you have not seen the film and want to be surprised when you do.)
The Indigenous themes of Australia extend beyond the plight of Nullah (who is indeed forcibly removed and taken to a mission on an island off Darwin, based on the Tiwi Islands). Hugh Jackman’s character The Drover has an Aboriginal best mate, who, we discover is his former brother-in-law: he was indeed previously married to an Aboriginal woman, who died when she was refused treatment in a hospital.
Despite Luhrmann’s best and well-meaning efforts, he has endured some withering criticism for his film’s Aboriginal concerns. Writing in The Guardian (UK) on December 18, 2008, Australian expatriate social commentator Germaine Greer takes issue with the praise of the film by Marcia Langton (Aboriginal studies professor at University of Melbourne: click here for Langton’s Melbourne Age response to Greer) and notes that Luhrmann has “created a new myth of national origin”. She goes on to say that “Luhrmann’s fake epic, set in 1939, shows Aboriginal people as intimately involved in the development of the Lucky Country; the sequel would probably show Nullah, the Aborigine boy who narrates the film, setting up an Aboriginal corporation and using mining royalties to build a luxury resort on the shores of Faraway Bay.”
Sarcasm aside, Greer is on firmer ground when she points out that:
The camera does not travel to where the Aboriginal workers would have lived with their extended families in a collection of humpies - shelters made of bark and branches - with no clean water, no sanitation and no electricity. As the humpies were not intended for continued habitation they would have been verminous and filthy; the workers would have been issued with a single set of work clothes, ditto. Despite the appalling infant mortality rate, there would have been dozens of children of various shades. The Aboriginal workers would not have been paid, but simply given poor-quality rations, because the station owner claimed the whole community as dependents. Aborigines did virtually all the heavy work, fencing, mustering, castrating, branding, slaughtering, digging dams, making roads, gardening, washing and cleaning. No attempt would have been made to educate Nullah or his mates.
It is these problems - poor living conditions, desperate poverty, illiteracy, institutionalised racism, remoteness and few chances of economic betterment, combined with family destruction - that still bedevil Indigenous Australia, with achingly slow progress.
In a discussion on ABC Radio National’s Movietime program on November 27, 2008, Daniel Browning(producer-presenter of Radio National’s Indigenous arts and culture program Awaye!) was equally as scathing, calling Luhrmann’s Australia a “post-reconciliation fantasy”.
These criticisms were, perhaps, inevitable, and one of the key fantasies of Australia - that somehow an English lady in 1930s Northern Territory would become a surrogate mother to an effectively orphaned Aboriginal boy - presents such an unlikely scenario that it threatens to re-write the history of Aboriginal-white relations.
(Luhrmann also re-wrote history when he showed a Japanese army landing party on an island off Australia just after the bombing of Darwin: the Japanese did not, repeat, DID NOT, ever land on Australian soil and shoot Australians. For more information on the bombing of Darwin, go to the Australian Government’s Culture and Recreation Portal article or the National Archives of Australia fact sheet, which notes that “The air attacks on Darwin continued until November 1943, by which time the Japanese had bombed Darwin 64 times. During the war other towns in northern Australia were also the target of Japanese air attack, with bombs being dropped on Townsville, Katherine, Wyndham, Derby, Broome and Port Hedland.”)
And yet. And yet. Luhrmann does succeed in presenting a vision, fantastical as it may seem, of an Australia where whites and blacks do get along. Racism is there in his film, and it is palpable, and the results are obvious and explicit. It’s just not realistic, and far from complete. It’s only a movie, and a Baz Luhrmann movie at that. From Strictly Ballroom to Romeo + Juliet to Moulin Rouge! , Luhrmann has never been a “realist” director. Why ever would he start being one now?
Postscript 7 January 2009: The Sydney Morning Herald and other media reported:
In the 5½ weeks since its premiere, Australia has taken $28.8 million…. Locally the film has been a hit in the very place it romanticises, regional and rural Australia. Greater Union’s national film manager, Bill McDermid, said yesterday that the film had done particularly well in Canberra, Toowoomba, Cairns and Mackay. “Positive word of mouth in our regional cinemas is driving excellent attendances.”
Australia was filmed in a number of outback locations, including Darwin (NT), Kununurra and various East Kimberley locations (WA) and Bowen (QLD), as well as at Fox Studios and various historic houses in Sydney. The film had four simultaneous premieres in Australia on November 18, 2009: one in each of the cities above.
Update January 18, 2009: Michael Bodey reports in The Australian (Friday January 16, 2009, page 5) that Australia (the film) was far and away the biggest Australian film at the box office in 2008, earning $26.9 million by the end of the year (representing more than 75% of all Australian film box office takings last year - a sad moment for Australian film-making generally when all the other 32 films only grossed $8.6 million - and as of January 18th Australia had earned $31.1 million. This means it will soon pass Happy Feet “to become the third highest grossing Australian film here on record (in figures unadjusted for inflation), behind Crocodile Dundee and Babe.” Effectively this will make Australia the second biggest film of the year, behind The Dark Knight, which stars the late Heath Ledger (who recently received a posthumous Golden Globe acting award, and may very well receive an Oscar as well). Although Australia has not done particularly well in North America, it has been quite popular in both Europe and Asia.
Update 27 January 2009: The film has received one Academy Awards (Oscar) nomination - for “Best Costume Design” for Catherine Martin. The film has also received four Film Critics Circle of Australia nominations: for Best Film, Best Supporting Actor (young Aboriginal actor Brandon Walters), Best Cinematography (Mandy Walker) and Best Score (David Hirschfelder).
Update 6 February 2009: Australia the film is still playing in Australian cinemas and has become the second highest grossing Australian film (unadjusted for inflation). The Australian Teachers of Media (ATOM) along with Twentieth Century Fox Film Distribution has prepared a study guide for the film, which can downloaded for free from http://www.metromagazine.com.au/studyguides/study.asp (note that this free download opportunity may not be available indefinitely).
Update on April 5, 2009: An article by Natasha Robinson in this weekend’s Australian newspaper entitled “Baz Luhrmann’s Australia’s takings are still growing steadily” (page 5) reports that the film Australia has now grossed $US206 million (A$287 million, at current rate of exchange) at the worldwide box office. This amount will (more or less) pay for the film’s production cost of US$100+ after distributors fees are subtracted. The DVD has just been released this week, while the film is still playing in a few cinemas. Responding to the claim of one British critic that the film left “no cliche unturned”, Luhrmann responded this comment misunderstood the nature of melodrama, which “has been the bulding block of storytelling in cinema since the form was invented”. Take that, you doubters.
Other Articles
Insights into Remote Australia: On Reading Nicholas Rothwell
By Don Perlgut, 16 August 2007
As anyone who has worked or travelled in remote Australia knows, it is indeed another country. The vast distances and sparse population density are almost inconceivable for metropolitan dwellers. Aside from a few highly popular locations such as Uluru-Ayers Rock - where it is possible to fly in and out direct from Sydney or Melbourne on modern Boeing 737 jets - most Australians and visitors to Australia rarely visit the remote and very remote communities.
Only two percent of Australians live in remote communities and another one percent live in very remote communities. But the health of these Australians is far worse than their city cousins - or in fact those of their “inner regional” or “outer regional” compatriots, with death rates a full 50 percent higher in very remote communities and life expectancy dramatically declining as “remoteness” increases. In each case it is worse for Indigenous people, who make up almost one-half of the residents of Australian very remote communities. The reasons for these worse health outcomes are many and complex, and include substantially higher accident rates - often related to remote occupations and lengthy driving on isolated roads, poor nutrition and lack of access to health resources. (The Australian Institute of Health and Welfare provides detailed background of these).
I am not certain why it has taken me so long to discover the writings of Nicholas Rothwell (pictured), the Darwin-based northern Australian correspondent of The Australian. Rothwell spent much of the 1980s and early 1990s as a foreign correspondent for The Australian in the Americas, the Middle East, and Western and Eastern Europe. But it has been his recent years - as a senior writer for The Australian when he has travelled the length and breadth of northern and central Australia - that he has come into his own with a unique place in journalistic reporting and analysis of issues facing those living in northern and remote Australia.
Dr Stephen Torre, Executive Director of James Cook University’s Foundation for Australian Literary Studies, describes Rothwell’s “writings about northern Australia as helping (to) define the distinct literary tradition of this part of the country.” Along the way, he has become knowledgeable in Aboriginal languages (see his 2004 “Lingua Franca” ABC Radio interview with Jill Kitson). In his book In Wings of the Kite-Hawke: A Journey into the Heart of Australia (Picador, 2003), he reflected on his travels in the outback, following the tracks of explorers Ludwig Leichhardt, Charles Sturt, Ted Strehlow and Ernest Giles. Gillian Dooley from Flinders University describes the book thus:
What wonderful, unexpected writing to find in a book about the Australian outback! Imaginative without being contrived, this book is full of memorable and wonderfully written vignettes, passages of great beauty and sadness, and descriptions of strange, surreal encounters. (Read the full transcript of her “Radio Adelaide” book review of 17 May 2003).
In 2006, Rothwell along with Ashleigh Wilson won a prestigious Walkley Award for Journalism (Coverage of Indigenous Affairs) for their writings on the Aboriginal art industry. Interviewing artists, art dealers and gallery owners, they exposed widespread exploitation of Aboriginal artists, a story which prompted national coverage and a Senate inquiry.
Earlier this year (2007), Rothwell published Another Country (Black Inc, $32.00; being reprinted in November 2007 for $24.95; distributed by Penguin Books Australia). Part auto-biography, part journalism, part travel writing and part philosophical observations on landscapes and people of northern Australia, Another Country is an up-to-date and lyrical exploration of the northern part of Australia as we barrel well into the 21st century. In his chapter entitled “The Perfect Trap”, he powerfully tells the story of a small desert Aboriginal community on the fringes of the Pitjantjatjara lands where child abuse was rife in the mid-1990’s when he visited. Many years before the recent publicity on Indigenous remote community family breakdown, Rothwell was there, observing and reporting.
And now Rothwell is making his intelligent presence felt with descriptions and analyses of the Northern Territory Indigenous “National Emergency Response” by the Commonwealth Government. In a series of articles in The Australian, he has provided some of the best and clear-eyed analysis of the current activities and their long-term implications. (A particularly good example is his 11 August 2007 article “Desert Sweep“).
We who work for the improvement of rural and remote Australia are lucky to have such an objective and insightful chronicler at a time of great change.
Crossing the Line
Review by Michelle Watson, 2 May 2006
During medical school many students take clinical placements in rural and remote regions of Australia. Crossing the Line is a documentary produced in 2005 about two young medical students from the University of Tasmania undertaking such a placement in their fourth year of study.
This story is about their placement in an Aboriginal community on the remote Mornington Island, located off Cape York Peninsula. They leave their secure middle class world behind them to be confronted dramatically by the destitution and harsh reality of a remote Indigenous community. Like many health professionals in Australia, they have never experienced or been exposed to the realities of Aboriginal health in its real realm.
Throughout their eight week placement, Amy McCormack and Paul Joffe are confronted with ‘real life’ issues they have only heard about and faced in the lecture theatre. It is very frustrating and difficult for them to come to grasp with seeing the real effects of alcohol abuse, domestic violence and youth suicide experienced in such communities each day. The frustration comes from the reality of being unable to help significantly and not making a difference in such a community.
Crossing the Line stretches both Amy and Paul beyond their professional roles to make real connections with individuals in the community. Although this is rewarding, it is also dissatisfying as they both fight an inward struggle at knowing how to keep their personal feelings and experiences separate from their professional practice. How far should one go before ‘crossing the line’ of professionalism and being human? Medical students and health professionals are faced with this question every day: “How far can you go?” Medical professionals are faced with such challenges and moral dilemmas daily.
In some circumstances, especially in Aboriginal communities, trying to make a difference is very frustrating and overwhelming, as Paul and Amy found out. By understanding the experience and taking it with them, it enables them to be better doctors in the future and use the experience as a tool rather than a negative. The experience was an eye opener for both students in which they were required to stand back with reluctance and difficulty as they wanted to ‘give more’. This brought about feelings of guilt, hopelessness and frustration.
After listening to many devastating and tragic stories that have no happy ending taught them both not just to listen to people and patients, but to ‘hear’ what they say. The biggest lesson learnt here was the difficulty in learning where to draw the line and to find the right balance in regards to the doctor-patient relationship. How do you maintain an appropriate professional distance without becoming too cynical or sympathetic? Where is the right balance? The number one thing is to care for yourself first so you can care for others also. Crossing the Line challenges the very essence of why and how far we can go to help people as health professionals and where is it okay to draw that line.
More about Crossing the Line
Crossing the Line (2005, 56 minutes) was directed by Kaye Harrison, and produced by Rod Freedman and Kaye Harrison, Change Focus Media. It has screened on ABC Television, and is available on DVD and video in Australia from Ronin Films.
The Ronin Films website provides additional reviews and a complete study guide for this film.
Michelle Watson is a final year Medical Student at the University of Tasmania. She was born in Tasmania and lived there until she was 18 before travelling and working for several years around Australia.
She gained a Bachelor of Applied Science (Human Movement) at Deakin University, Melbourne and then started a MBBS (UTAS) in 1999. During this time she also lectured Pathology at the Australian College of Natural Medicine, Perth while on a year off.
During her years at University she was extensively involved in rural health through RUSTICA, the rural health club. She is both a John Flynn Scholarship and a Rural Australian Medical Undergraduate (RAMUS) recipient.
She is now in her final year medicine and plans on training in general practice in Northern NSW and becoming a rural GP. She is married and has a two year old son.
Four Corners: Far From Care
Review by Dr Sue Page, 5 June 2006
In Far From Care, the recent ABC TV Four Corners program (5 June 2006), reporter Matthew Carney takes a look at rural health, with a focus on cancer and obstetric services in rural NSW.
Before I viewed this program, I had received several comments to the effect it was “over the top” and exaggerated the desperation of rural health services. It clearly has not, so perhaps this relates to the inherent dilemma in describing the rural health environment creating mixed messages: it needs to be painted truthfully if things are ever to change, and yet we still need to make it sound attractive for young clinicians.
It was also interesting to be able to write this review after several letters had been posted to the ABC’s website as it shows viewers were well able to identify the key concepts:
I do know that as fellow humans, we are duty bound to make real and practical efforts to behave honourably, honestly and with justice and compassion. We’re not, when it comes to how we spend money on health in rural Australia. A Primary School kid could tell you that. (quote from ABC viewer)
The most fundamental consideration for rural health equity is just that, equity. If you don’t have equity of funding, equity of service delivery and workforce are also unlikely. This is where comments like: “Hey if you want to live in the country, don’t expect to have the same terms as living in the suburbs… If it is unfair, then move to the cities“, while common, are inherently flawed.
With so much of Australia’s export dollar reliant on agriculture and mining we clearly cannot afford, literally, to have all our population living in our capital cities, yet these are currently the only places where the full variety of health services are offered. I think this interplay of rural industry is an aspect that could have been emphasised in the program, as could the role of small hospitals as a major employer. Many rural families rely on the steady income of the nursing spouse to offset the vagaries of farming cash flows, particularly in the current drought.
It is unrealistic to expect that we can continue to increase our overall health expenditure, which in NSW health is already 27% of the total state budget, so resolving the health disparities is more about achieving an equitable distribution of the massive resources we already put in.
Country people are ever pragmatic and nobody expects that every service will be available in every backyard. But with all the growth in health expenditure and technology, neither do they expect that services they used to have will be taken away, with the gap between the highest and lowest quintiles of health outcome steadily widening across the nation.
Farmers have accidents, we have road trains carting to the new mines on the coast, and carting grain to the port, we have tourists, and we have very narrow roads, all ingredients for a disaster, with only two health clinics with in a 100km radius. (ABC viewer)
Consider the inequities of Medicare funding. On the basis of population and HIC figures for 1999-2000, it has been estimated that the average per capita Medicare benefit paid in metropolitan areas was $125.59, compared to $84.91 in other parts of Australia. This suggests that approximately $221,009,162 of the Medicare levy collected in non-urban areas flowed back to subsidise metropolitan services. (Wagga Wagga City Council calculation 2003).
Given such disparities in health outcome, any program looking at rural health will have difficulty in choosing which aspects to focus on without losing the audience in the myriad of potential issues. While the show has received criticism for not paying sufficient regard to issues of Aboriginal health or to the prevention of chronic disease through access to Primary Health Care services, I agree that maternity and cancer care were logical choices to highlight. Both require strong rural hospitals being supported to deliver services that are essential to have close to home even when not cost-effective in number.
There are many studies showing poorer outcomes of maternity cases in very small hospitals and this has been one of the main reasons for closing maternity units with less than a critical number of births in a year. (ABC viewer)
This correspondent is appallingly incorrect, and reflects perhaps one major criticism of the program. This furphy that “high volume” and “specialist” automatically mean better outcomes is the largest single barrier to achieving equitable distribution of resources and needs open challenge. Dr Coleman may have likened rural services to Third World, but he meant in terms of access and not in quality. The outcomes of rural birthing units are the best in Australia - the babies of case-matched low risk mothers are three times less likely to die in units of 100-500 size than in hospitals delivering being >2000 per year.
As another viewer points out: “The health departments base their decisions on stats but it is a vicious circle of if they keep closing sections in our hospital how do we keep the stats up.” And these comments are echoed around Australia by clinicians who report the bureaucratic barriers that restrict their practice, and then the reduced practice is used to downgrade services further. Examples include failure to replace inadequate and outdated equipment, nurses denied access to regular educational updates, delays in advertising vacant positions, and bed closures. This war of attrition is far more deadly than an abrupt closure when the community ire can be rallied in support, as happened in Atherton. Just how many more roadside births, and deaths, do we want?
I was also disappointed by the default position of Dr Craig Underhill that unless your cancer care is provided by someone with “formal qualifications in chemotherapy delivery“, there’s a risk that the “quality of experience and outcomes is gonna be inferior“. While I am all for training and standards where they can be demonstrated to improve patient outcomes, many rural units have been administering chemotherapy for over twenty years. To assume a lack of formal qualification (naturally one defined by the specialty unit in your state’s capitol city) is automatically associated with a poor outcome is to also be blind to the thousands who die each year from a lack of access to any service at all. Closing rural chemotherapy units will be a disaster when rural people already access chemotherapy at half the rate of their city counterparts, and as we heard in the program the city “experience” is hardly a quality one.
I would have liked the program to debunk that other great myth that all things can be fixed by a good air retrieval service. Having waited anxiously for a helicopter to attempt a mid-cyclone collection of a hemorrhaging woman at 27 weeks gestation, I could at least feel secure that we then only had an hour in the air. Many sites are 4-6 hours from the nearest base, and examples such as this viewer are unfortunately likely to become more common:
Today was the announcement that our ambulance has closed as from last night, and the Royal Flying Doctors cannot land on the local airport due to no pilot having night flying license or time up. (ABC viewer)
Do we really believe emergencies only happen in daylight?
Overall however, I would highly recommend viewing the program or reading the transcript as being both poignant and factual. I would also recommend the Further Resources section of the ABC website. I hope watching it will change thought processes and attitudes, but like this viewer I do have a certain degree of cynicism:
Perhaps if there were some refugees involved, the eager beaver lawyers and civil libertarians would be jumping up and down demanding action but alas it is only Australians who are suffering and they do not count. (ABC viewer)
Dr Sue Page is immediate Past President of the Rural Doctors Association of Australia and is Senior Lecturer and Director of Education at the Northern Rivers University Department of Rural Health.
Recently appointed as Chair of the North Coast Area Health Care Advisory Council, she is on the Board of Northern Rivers Division of General Practice and is a rural GP VMO at Ballina District Hospital and St Vincents Hospital in Lismore.
A Fellow of, and Supervisor for, both RACGP and ACRRM, she has post graduate training in the Early Management of Severe Trauma, a Diploma in Shared Care Psychiatry (Eating Disorders) and a Diploma in Obstetrics through the Australian and New Zealand College of Obstetrics and Gynaecology.
Her practice includes primary health care within an Aboriginal community, and used to involve obstetrics at Ballina Hospital until the unit was closed due to workforce shortages.
Remote Area Nurse
Review by Narelle MacPherson, 21 January 2006
The Remote Area Nurse program (Thursdays 8.30pm on SBS) gently tells of both the joys and challenges of living and working in a remote community as a remote practitioner.
RAN closely aligns itself to remote medicine and puts remote area nursing in the public arena hopefully assisting it to gain professional recognition as a specialty, through the public medium of television.
The positive promotion and delivery of safe cultural care to remote Aboriginal and Torres Strait Islander communities is the underlying theme of the series.
This program focuses on the peoples inhabiting the islands of The Torres Straight, their culture and spirituality struggling against negative modern influences, and people who would try and take advantage of them, whilst coming to terms of keeping good cultural practices and challenging those that do not promote the health and benefit of the community.
This not something one can forget when you have lived and worked in a remote community and get to know the people living there.
Various issues are addressed well, at the forefront of remote care: of the difficulties of a solo practice promoting proactive primary health care, mental health and midwifery services, based on prevention, early detection and intervention, and obtaining specialist care for chronic disease sufferers and delivering same to patients in isolated communities.
The characters of the health care workers, where RANs are placed in difficult situations at times and where team collaboration between doctors and nurses need to aim towards a more balanced comprehensive remote health service is shown.
Some just don’t get the concept of keeping people in their communities with community-based care for as long as possible. In some cases sending people away for inappropriate care has a rebound effect of people not seeking treatment, having the fear of being “sent away”.
Warning of pitfalls of health care workers being involved or drawn into forming political allegiances is only too well-noted, as is the peril of not adopting and living within the confines of the high cultural and moral mores of the community.
The Remote Area Nurse series is definitely well-worth watching, and will promote lively discussion amongst health professionals about both the issues and innovative ways to increase the delivery of safe, high quality health care to both isolated and remote communities.
These issues include delivering remote medical care under occupational stress and at times questionable staff safety in sometimes Third World conditions; being hampered by the lack of resources; and dealing with the overwhelming workload of patients and paperwork whilst attempting to engage the multi-disciplinary health team.
The serious inequities are well-documented, where health infrastructure and resources in remote Indigenous communities are much poorer than they are in non-Indigenous communities.
Narelle MacPherson was born and bought up on a remote cattle property in Queensland and had the privilege of having Aboriginal people as her friends.
She has thirty years experience as a nurse, and did her training and the majority of her career working in tertiary teaching hospitals before returning to the bush (rural/remote) five years ago.
Her qualifications include a BSc, General Registered Nurse, Midwife, Infant and Child Care, Community Health, Immunisation Certificate, FLEC and in the future Masters Remote Nursing.
She is a member of the Council of Remote Area Nurses of Australia (CRANA), the Queensland Nurses Union and the NSW Midwives Association.
Comment from Don Perlgut:
The Remote Area Nurse SBS television series is a gentle, carefully paced, frequently humorous and thorough look at an Australian remote community.
The series is set and was filmed on the Torres Strait island of Yorke (traditionally known as Masig), with a population of about 300 and the main industry being commercial fishing.
The series is notable for a number of reasons, including its primarily Torres Strait Islander and Aboriginal cast, its complete location filming and its in-depth illustration of the challenges of remote health professionals.
Aside from Susie Porter (Paradise Road, Mullet, Better Than Sex) in the lead role of nurse Helen Tremain, my favourite characters are Charles Passi as the island Chairman Russ Gaibui, Luke Carroll (AFI award winner for Australian Rules, The Alice) as Paul Gaibui - Acting Health Centre Manager and one of Russ’ sons, and Norah Bagiri as the clinic’s meddling and gossipy health worker Lucy. Noted Australian character actor Bruce Spence (Mad Max 2, Matrix Revolutions) also features.
The characters are all rich and interesting - as only a full-on six-hour television series can let you into so many lives.
From a remote health perspective, the Remote Area Nurse series illustrates a number of key issues facing remote communities, including lack of opportunities for exercise, poor food choice, alchohol availability in the community (and who controls it) and the nature of community control of health.
In episode two, it slowly becomes apparent that the health service in the series is a Queensland Health (state government operated) clinic, so the residents of the island have only limited control over its procedures, policies and practices. This is brought into sharp relief when someone dies (drowns bringing in illicit alchohol) and his body must be refrigerated and kept until a doctor can be flown in for an official autopsy. The testy relationship between the doctor who flies in from the mainland (played by Felix Williamson) and Helen the full-time resident nurse is indicative of the types of conflicts which can arise in rural and remote health care, and is carefully developed without melodrama.
Series producer Penny Chapman (former Director of Television of the ABC) has done an extraordinary job of showing a unique part of Australia, and illustrating its unique challenges, all without descending into stereotypes. A remote community and its health challenges has never been this well illustrated on the Australian screen.
The stories in rural and remote Australian health are strong ones, and it is a great pleasure to see them brought to life in this way.
It should be noted that the Rural Health Education Foundation has satellite viewing sites on both Horn Island and Thursday Island in the Torres Strait, along with more than 100 other viewing sites in Queensland.
Don Perlgut is the Chief Executive Officer of the Rural Health Education Foundation, and a member of the Film Critics Circle of Australia. He is also a PhD student in the Department of Media at Macquarie University.
Website of the TV series
This lovely and very detailed series website includes extensive details about each episode of Remote Area Nurse, profiles of the characters, background on the cast and crew members, an extensive photo gallery of the series, “behind the scenes” of the production, background on the island and remote nurses, an interview with Susie Porter and a great study guide for teachers and students prepared by the Australian Teachers of Media (ATOM).