‘I have no idea. Some permaculture thing Tanya is doing, probably.’ I frowned at the mound of earth near the hole, freshly planted with banana and paw paw trees. I felt myself colour as Oliver chuckled to himself.
‘That’s good, if she’s getting into the garden. Not much else to do.’
I waved as Oliver backed out of the driveway and then clumped up the front steps, the whole building shaking under me. I could hear the children shout, ‘Papa’s back!’ and loud footsteps flew across the tiles.
•
After the children were in bed I remembered the hole.
‘What’s wrong with grass? Nice, green, respectable lawn, like the neighbours have?’
‘I wanted to capture the water when it goes flooding down the hill so that all our topsoil doesn’t end up on the road. And I thought it would be great to have some tropical fruit! And then we don’t have to mow . . . and the kids don’t play in the front yard anyway.’
I knew I had already lost this one. ‘Just . . . can’t we make it look less messy?’
Tanya grinned. ‘So tell me about Gurrumu.’
As I spoke, Tanya typed, her fingers flying over the keys as my words came tumbling out. Mostly she just typed but once in a while she would ask for clarification. She thought that if she took down every detail, every name and date and each event, one day we might make some kind of sense of it. We might be able to figure out how to create a new program from scratch without the desperate sense of hopelessness.
Besides, I processed my thoughts by speaking them out loud, sometimes for hours on end, often repeating the same things through days and weeks until it made Tanya’s heart sink when I began again on one of my well-rehearsed tracks, inching painfully towards a clear path. When she typed it gave her something to do and felt like a meditation. I felt listened to and it meant she didn’t have to respond.
When I had finished describing the week in Gurrumu I told her I would be back for a week and was then off to Groote. I watched Tanya carefully as I suggested again that we do the healthy skin day there but she didn’t look up from the keyboard.
‘Just go and see what you think. We can decide after that.’
15
LEARNING ABOUT CRUSTED SCABIES
Rukula had returned to Yalambra after the funeral business and, as promised, she came to see Eva and me for her first treatment. I had immersed myself in crusted scabies research in every spare minute since I first met Rukula and developed a two-week crusted scabies intensive treatment program specific to her situation. It was based on the Royal Darwin Hospital treatment protocol. Eva had seen the possibility that effective crusted scabies treatment could make a real difference, so had offered to supervise the treatment in Rukula’s own home, with the clinic manager’s blessing.
Eva had an able assistant in a practical minded medical student on rotation in Yalambra. The medical student was someone who instinctively looked for ways to be useful, and she created a mini hospital ward in Rukula’s home.
I was not convinced that it would work because we also needed to treat Yinarri and all the others living in the house for scabies as well as treat all the bedding and rid the house of any residual scabies. I felt sure that each day after we had applied the treatments and departed, any mites left in her household environment or on her household contacts would reinfect her, making eradication impossible with home-based treatment.
Richard Walleran, the medical parasitologist I had met at the Cairns conference, had examined mites on crusted skin and seen them march like armies, moving in their thousands at a rate of three centimetres an hour across his laboratory slides. So Rukula’s house, particularly her bedding and clothes, would be covered in mites.
But I did not know Rukula.
Rukula was the head of her house. She was determined not to go to hospital and she had sensed, just as I had, that she had just one opportunity to pull herself and her family out from under the pall of scabies. We were both desperate to find a solution that worked, so we formed an unlikely but formidable team. While I obsessed about the medical issues, she undertook the arduous task of washing all the clothes and bedding, treating everyone in the household and dragging mattresses outside into the sun every single day without fail.
She and Eva remained faithful to our treatment plan and I continued to check up on her.
•
I had been getting into the habit, whenever I wasn’t away at a healthy skin week, of going to Yalambra, Yirrkala and Gunyangara regularly to visit families with crusted scabies and slowly I got to know them. Most warmed to me over time when they saw that I would not push them to talk about their illness or have treatment but just asked how they were, listened to their ideas about what had worked and what might work, and often stayed for a chat about going hunting for mussels. If it was clear it was not a good time, I left.
Nick Connor and I confirmed nine cases of crusted scabies in the surrounding communities. Three of the other people on the list were immediate contacts of some of the nine, so they had been recurrently exposed to extreme loads of scabies but did not in fact have crusted scabies themselves.
Eight of the nine confirmed cases had active crusting at the time I first saw them, which normally would have landed them straight in hospital. I spoke about options and consequences and only three agreed to undergo hospital treatment at my first visit. I continued to answer questions as they arose and over time, as word of the results from my first patients spread, I had more and more takers.
The fact that nearly all of the patients with confirmed crusted scabies had crusting at the time I saw them told me they were likely to relapse soon after returning from hospital. The initial treatment would prove to be the simplest part of the equation; ongoing management was my biggest concern.
My fears were confirmed when I went to visit a man from Gunyangara who had spent almost 12 months of the past three years in hospital having treatment for crusted scabies. This man had few supports and lived in a family member’s house so he went to the clinic as soon as he had a recurrence. His family did not want him at home infecting others and so he was a rare patient who found hospital isolation a welcome respite. At least there he was not continuously blamed for spreading his disease to his family.
During one of his hospitalisations I worked with the clinic to treat his family and bomb his house with insecticide so that he would return to a scabies-free environment. Before he was discharged I confirmed with Nick Connor that he was fully scabies-free.
When I visited him the day after he was discharged from hospital what I saw stayed with me, a frozen image in my mind. There he is at home sitting on a chair, family all around. Gripping my patient’s fingers with pudgy hands and standing on bandy, unsteady legs on my patient’s lap is a sixteen-month-old infant with the unmistakable rash of scabies.
There was no way my patient could refuse to hold his baby nephew and so, after a two-week hospital treatment and thousands of dollars of clinic and hospital resources, he was instantly reinfected. Within fourteen days—the breeding cycle of the scabies mite—the plaques would start to appear.
It was little wonder people grew sick of trying and failing to manage the mite. Nonetheless most people appreciated the time I was spending with them. And since there were no other options, and I was offering simple solutions that made sense to them based on treatment they were already used to and that they could now take control over, we began to trial an individualised treatment regime that we developed together.
But one woman at Yalambra did not warm to our work. Dhimurra, who travelled internationally as a musician and artist, wanted nothing to do with the scabies program. In fact she denied she had any issues with her skin, wearing knee-high socks and long-sleeved shirts and long pants in the sweltering heat.
On one of my visits, Dhimurra took me outside to show me what happened when she had notified the shire about her blocked toilet. She pushed open the door to the toilet and I stumbled back, trying not to gag.
The toilet was caked full to the brim with hardened faeces. Dhimurra explained that it had been more than six weeks since she had made a report to the local shire officer responsible for housing maintenance. The householders had to walk 100 metres to a family member’s house to use their toilet, which caused friction in that already overcrowded house as well.
‘Why haven’t they fixed it?’ I gasped.
‘I don’t know. If you really want to help, then get them to fix it for us. We have three families living here without a toilet.’ She said it dryly, hoping it would convince me not to return.
Most of the houses were so chronically overcrowded that the hardware just couldn’t keep up. It was a fact of life that toilets were forever blocking and taps were forever leaking. The houses belonged to the Northern Territory Department of Housing who worked with their own contractors. No private contractor would touch these houses as it would be without the ‘owners’ permission, so there was no way to get anything repaired other than to go through a brilliantly convoluted process of reporting.
First you would report the fault to the local shire officer. The shire officer would pass the fault report to the Northern Territory housing maintenance office in Nhulunbuy, who would pass it to Darwin for approval. Once approved by Darwin, the job would be given to a third-party private contractor who would put it on their list to fix when they next travelled to the community.
If things went smoothly you could be waiting weeks for repairs but jobs could get lost or held up at any one of these steps and although everyone was doing their best, there were hundreds of repairs waiting for approval or allocation and many more that had simply fallen through the cracks.
I called Oliver and told him about the toilet. He gave me the name of the maintenance manager in Nhulunbuy and, most importantly, he directed me to the maintenance manager’s PA, who received fault report forms for approval and allocation to contractors.
A contractor went out and repaired the toilet the next day.
When I told Tanya what had happened she congratulated me. ‘It must be such a relief to have their own toilet again!’
‘Yes. And the patient sounded slightly less disengaged. But . . .’ I shook my head. ‘It’s no long-term solution, that’s for sure.
‘And the thing is this person is no shrinking violet. They know their way around the balanda world. They tried for six weeks to be heard. What does it mean to my patient, and to all of their household—to all the kids who watched how nothing got done no matter how hard any of them tried—until a balanda swept in and got the shire to fix things in one day?’
Tanya grimaced. ‘Yeah. You’d grow up thinking there was no point trying.’
I remembered reading about learned helplessness. I had used the term successfully in an essay and never thought of it again, until I got a glimpse into what it must be like to live with no voice.
Dhimurra called me over the following day. I was reticent to go near that toilet again but she threw open the door with silent pride on her face—I don’t know how she did it but the toilet was sparkling.
I asked to see her washing machine and she took me to her laundry and banged proudly on the side of a big old machine that looked as though it was a survivor from the 1960s. There was a small yellow sticker on it that I had seen on several of the big, sturdy looking machines around Yalambra and Yirrkala, so I asked where she got the machine from.
‘Got a good one from Bruce. He said if it breaks down to bring it back to him and he’ll fix it again.’
‘Bruce?’
‘Banana farm Bruce.’
Dhimurra described Banana farm Bruce’s unique compost system: the secret of his delicious bananas. She had a throaty chuckle when she remembered taking a new teacher from Melbourne down to meet Bruce.
‘You should have seen the look on her face when she saw that compost, doctor Buddhi. I’ll never forget it.’
When it was time for me to leave I picked up my bag and slapped her lightly on the back.
‘It was good to finally meet you.’
‘Yaaaah,’ she said, shooing me away with mock severity.
I left Yalambra and drove the ninety minutes straight to the Yirrkala banana farm to meet Bruce. I had an idea that maybe the washing machine part of the program wouldn’t have to be a white elephant after all. Maybe setting up a repair service rather than a one-off donation would provide lasting value.
16
THE BANANA FARM ELECTRICIAN
Bruce was the manager of the banana farm in Yirrkala and a former missionary. Frances and Nick Connor had spoken glowingly of Bruce. He had partnered with the Yolngu to improve whatever he could over the decades. Frances and Nick described his commitment to the region, the fact that he worked for very little and his eccentric solutions that had a lasting impact in difficult remote conditions.
Oliver had also mentioned that the Yolngu often turned to Bruce to repair their broken washing machines.
Bruce and his wife were the only local commercial food producers in the area and boxes of their bananas were delivered all over the Gove peninsula. While bananas sold for $12 a kilo in Woolworths, imported from southern farms that had been badly damaged by a cyclone the year before, Bruce’s Yirrkala banana farm remained steady, selling produce to those who could afford it for about a third of the supermarket price, subsidising his donations of the rest of his produce to the local schools, health centres and homeland organisations. They often had papaya or limes available as well, so people would drive up to his ramshackle shed with empty boxes and come away with whatever they could carry.
I drove down a dusty road, past a tractor from a bygone era, to the shed that served as the retail arm and warehouse of the operation.
It took a bit of nosing around before I managed to find a wiry man walking towards a giant cement mixer that looked as though it hadn’t moved in years. The cement mixer had been cannibalised from the back of a truck and converted to run on biodiesel sourced from local eateries. Bruce bent over to unscrew the fuel cap and poured more grease into the machine, old cotton nighties filtering out the fish and chip particles. As the mixer began churning slowly, he caught sight of me.
‘G’day, Bruce, I hear you have a magic compost recipe?’ I grinned up at the cement mixer.
Bruce bent down and picked up a baby buffalo carcass.
‘She’s been hit by a car I’d say. Long dead though. Not going to hurt you.’
He tossed the bloated, stinking creature into the cement mixer and wiped his hands on an old rag, nodding.
‘Best compost you’ll ever find.’
My eyes widened. ‘You use road kill for compost?’
‘Not just road kill, anything organic. Better in there, breaking down to improve the soil, than rotting on the road.’ He held out his hand. ‘Bruce.’
‘Buddhi.’
‘Oh. Are you the bloke trying to do something about scabies? I’ve heard about you. Had you pegged as another fly-by-nighter but maybe youse’ll be different.’
‘Hope so. It’s a long road, though.’
‘They always are. The ones worth travelling on, anyway. Now what can I do for you?’
‘I heard you fix washing machines and I’ve been trying to find a way to get a model that could survive and be easily serviced up here.’
‘Oh right. You gotta wash all the sheets and that to get rid of scabies, don’t you? Well I can tell you this: for the cheap junk most people are buying, the shipping costs more than the machines. They last about three months up here, six if you’re lucky. There’s just too much sand around. And the Yolngu do big loads—lots of people.
‘People like to wash their blankets and they put in way too much washing powder. I’ve seen a half-kilo box dumped straight in, plus bleach. Well, all the suds come up and moisture gets into the electronics and then it’s $200 for a new motherboard. So if you’re looking into washing machines forget about the electronic crap. Get a manual, mechanical machine. The old-style ones, simple, easy to fix, st
urdy. That’s what you want.’
I scribbled a quick note. ‘And do you think you could train some young blokes if we paid them to fix the machines? Is that something that might work?’
‘Yeah, mate, I’d be happy to do that. I reckon I could train up a couple of young Yolngu fellas who had a knack for repairs in half a day. If you get the right model there are only a few parts that need replacing. Come and have a look.’
We walked up to the house that Bruce and his incredibly patient wife lived in. The yard was full of mechanical parts Bruce had salvaged from throughout the region. Washing machines, tractors, boat engines, axles, generators, fridges and half a dozen cars, and then there were a million parts sorted in a shed. It looked like a scene out of Mad Max.
But what looked like chaos to my untrained eye, was a vast mechanical parts store to Bruce and the tip was his free shopping centre.
Most commercial machines used electronics that allowed touch pad operation, noise reduction and tight control of water to meet environmental ratings. However, the lid switches were a safety feature that easily broke. Plastic had replaced the old steel struts that held the bucket so now the bucket had to be made from a much lighter metal that eroded quickly when exposed to salt water and humid conditions. Each extra feature was just another part that would fail in east Arnhem conditions. Bruce had a few of these models sourced from the tip on display, apparently for the sole purpose of explaining his preference for old-fashioned mechanical washing machines to people like me.
Then he showed me the second love of his life—his Westinghouse washing machines. The ten or twenty washing machines he had around the yard were all Westinghouse and he had found them all at the tip, some twenty and even thirty years old, finally discarded by a mining family leaving town or after they broke down.
He turned one over and started to explain that while these looked like any another machine on the surface, they were actually very different.
They had simple mechanical timers. When they failed after a decade or two, they could be replaced for about $20. Then he showed me the drum. Thick steel. He had never seen a drum rusted and leaking on one of these, at any age.
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