LIFE HISTORY AND REAL LIFE: AN EXAMPLE OF NEUROANTHROPOLOGY IN ABORIGINAL AUSTRALIA
A recent conceptual reworking of the developmental origins of health and disease model that places it within a life history framework is used to interpret some of the history of people living today in the remote Arnhem Land community of Numbulwar. This approach suggests some of the means by which their past circumstances may have had an impact on their current health. A combination of history, ethnography, and the neurobiology of stress and pregnancy provides a neuroanthropological approach for considering the manner in which environmental stressors, particularly those of social origin, may have intergenerational consequences for health.
Neuroanthropology, an emerging subfield that seeks to integrate advances in neuroscience with anthropological theory and practice (Downey and Lende 2012) not only highlights the long asked question of just how the person is transformed by experience but also enables us to better address it. In this article, I do just that, turning to recent research on the neurophysiology of social stress and low birth weight to better understand the disturbing differences in mortality between Indigenous and non-Indigenous Australians. In doing so, I illustrate the utility of neuroanthropology for addressing real problems faced by real people in sociohistorical contexts that contribute to if not create those problems and join others whose work challenges determinist arguments about race and ill health (e.g., Dressler and Bindon 2000; Gravlee 2009; Kuzawa and Sweet 2008). Especially in times when so many media forms create and fan moral panics while perpetuating invidious social constructions and when political responses are often little more than self-interested knee jerk reactions, a considered etiology provides an important corrective for public discourse and policy decisions.
The social determinants of health framework originating in the work of Marmot and his colleagues has, in recent years, promised a particularly powerful way of understanding inequalities in health and wellbeing (Brunner and Marmot 1999). The attempts, prompted by this early research, to understand the mechanisms whereby environmental factors, especially those from the social environment, may not simply affect but transform human bodies and minds has created a new research orientation within the social sciences (e.g., Nguyen and Peschard 2003). Central to this emerging framework is the identification of the “flight-or-fight” circuitry as the principal means by which social factors result in ill health and disadvantage. Also central is a focus on the concept of “stress” (e.g., Sapolsky 1993, 2004). Currently, it is thought that maternal stress is translated into a variety of physiological states that affect fetal and infant development with long-term consequences that may disadvantage the offspring, and even the grand-offspring of the stressed mother (e.g., Dunkel Shetter 2011; Gravlee 2009; Kuzawa and Quinn 2009). But just what people find stressful remains something of an open question. Although major events such as the Dutch Hunger Winter (Lumey 1992) or the 9/11 attacks on New York (Lauderdale 2006) appear to be associated with poor pregnancy outcomes in some populations, just why this is taking place has been far from clear. This neuroanthropological interpretation of some of the recent history of a group of Aboriginal people highlights the necessity of an ethnographic component for understanding the social determinants of health and wellbeing and, at the same time, the utility of considering neurophysiological factors in ethnography.
In great measure, Aboriginal people across the continent of Australia suffer from illnesses associated with an overactive stress system (e.g., Australian Bureau of Statistics 2005). At Numbulwar, the remote Aboriginal community at the heart of this discussion, health clinic personnel identified the “metabolic syndrome” as the main source of adult ill health; obesity, high blood pressure, Type 2 Diabetes and the related conditions of kidney failure and coronary heart disease were, and continue to be, widespread.1 Community specific summaries of morbidity and mortality for remote communities in the Northern Territory of Australia are, unfortunately, nonexistent. However, in Ngukurr, a relatively nearby Aboriginal town to which the people of Numbulwar have long had social connections, Taylor and colleagues (2000:80) have estimated that “there are 4.5 times more deaths … than would be expected if the mortality profile observed for the total Australian population applied.” There is little to suggest that the situation at Numbulwar departs from this estimate in any significant way.2
In the field of Indigenous Australia, the injustices of colonization have been highlighted by anthropologists and others addressing issues of health inequality (e.g., Carson et al. 2007), but statistics such as these invite us to ask precisely how the destruction of a way of life creates a legacy of premature morbidity and mortality and how such consequences might be avoided in the future. To address these questions I have turned to a body of work that views health as a series of ongoing tradeoffs required of organisms by their circumstances (see Ellison 2005). This approach encourages us to ascribe the causes of poor health not so much to physiology as to environment, particularly the sociocultural environment. In taking this position, I am guided by recent conceptual reworkings of what is known most recently as “the developmental origins of health and disease” (DOHaD) model. This reconceptualization places the model within a life history framework, and invites us to consider the mechanisms of our species’ life history strategies (Ellison 2005; Worthman and Kuzara 2005). This reconceptualization also allows us to circumvent a nature–nurture form of dichotomization found sometimes in the social determinants of health arena. For example, Gray and colleagues (2004) present the DOHaD model as an alternative to “the social exclusion” hypothesis. In contrast, the perspective I present grounds this discussion of Numbulwar's history in the neurological, physiological, and social. It becomes possible for us to see “social exclusion,” for example, as a precursor of maternal constraint, that is, the capacity of a woman to nurture a fetus, that may contribute to later experiences of socially generated stress. This approach focuses our attention on aspects of the environment that stress mothers and, later, their offspring, whether such aspects are physical or social. It also allows us to consider the manner in which environmental stressors may have intergenerational consequence for health.
Human life history, that is, our species-specific pattern of birth, development, reproduction, and death, may be characterized as prolonged and plastic (e.g., Worthman 1999). An example of our plasticity may be seen in the fetal capacity to adapt to the uterine environment by modifying its rate and type of growth. Evidence suggests that when a fetus is undernourished, the placental blood supply is directed away from some developing organs to others. Thus, depending on gestational period, blood might be directed away from the developing kidneys to the brain, that supremely vital human structure. This individual's kidneys are likely to have fewer cells than those of a fetus better nourished during development; and kidneys with fewer cells are more likely to fail if later stressed (Barker 1994). As this example foreshadows, plasticity has its costs. It necessarily leads to what have been thought to be permanent changes in individual physiology, including brain physiology, although this view has been challenged (e.g., Gunnar and Quevedo 2007; Wyrwoll et al 2006). These changes may contribute to a greater disease burden in later life. Low birth weight (i.e., a less than expected newborn weight) has become the index of this future cost. Forms of adult ill health associated with low birth weight include coronary heart disease, stroke, hypertension, Type 2 diabetes (and obesity in association with this condition), depressive disorders and schizophrenia (Barker 2004; Eriksson et al. 2003; Thompson et al. 2001; Wahlbeck et al. 2001). All these conditions are found at Numbulwar.
Low birth weight, characteristic of a number of children at Numbulwar (Burbank and Chisholm 1989), is seen in the model I draw on as a consequence of uterine environments where resources are restricted or unpredictable. These kinds of uterine environment are seen, in turn, as the consequence of “poor or uncertain maternal nutrition, poor maternal health, and/or high allostatic load” (Worthman and Kuzara 2005:98). Allostatic load is what we call “stress,” the cumulative biological cost of maintaining stability vis-à-vis changes in internal and external environments (McEwen and Wingfield 2003). Although nutrients in the placental blood supply may be what the fetal-placental unit responds to, more than maternal nutritional status may be responsible for this state (Gluckman et al. 2007). The experience of social stress, such as subjection to the power and control of others, may, in and of itself, diminish a woman's capacity to nourish her fetus although her diet is adequate.
In this model the neuroendocrine architecture, particularly that of the hypothalamic–pituitary–adrenal (HPA) axis, is the mechanism that allocates resources. Worthman and Kuzara (2005) review an extensive literature on birth weight, stress, and health outcomes. Given the pervasive role of the neuroendocrine architecture in body composition and function, they are not surprised to find associations between a birth weight continuum and variation in organ composition and function, body composition, metabolic regulation and functioning of components of the endocrine system. There is a greater likelihood that as low birth weight individuals develop, their bodies will contain, for example, more fat, less muscle, and fewer kidney cells than higher birth weight individuals. They are also likely to have greater resistance to insulin (Worthman and Kuzara 2005). This model suggests that a consideration of the physical, social, and cultural environments in which mothers may be well or ill nourished, in good or poor health, relatively secure and happy or anxious and depressed, is essential background for analyses of the current health environment.
NUMBULWAR AND ITS EARLY HISTORY
The materials for this history are scant in two respects. First, little is known about Aboriginal health prior to European colonization. Reconstructions must rely on the impressionistic reports of early contacts (largely from the southern part of the continent and Numbulwar is located in the north), knowledge of hunter-gatherer health more generally and skeletal remains. Scholars using these, very tentatively, conclude that Aboriginal people surviving the first five years of life were generally healthy and well nourished. They suffered little from infectious and chronic disease. They were more likely to suffer injury or death from accidents and, occasionally, violence (Beck 1985; Franklin and White 1991; Saggers and Gray 1991). Historical materials are also scarce. Most of the material I draw on has been provided by the work of Dr. Keith Cole a historian with close ties to the Anglican Church. Professor John Bern (personal communication, 2006) and Dr. Rosemary O’Donnell (2007), both of whom work at Ngukurr, have also noted the dearth of historical materials for this area. I use this material to suggest the extent to which non-Aboriginal people controlled Aboriginal lives and the circumstances that made this control and subordination acceptable to Aboriginal people.
Numbulwar, then called the Rose River Mission, was established in August of 1952 by the Anglican Church Missionary Society (CMS). In accordance with the Commonwealth's Assimilation Policy, missionaries or other Westerners were in charge of its store, school, health clinic, church, and basic governance (Cole 1982; Young 1981). That the Mission was run in an authoritarian fashion is implied by Cole when he describes “mission discipline” as “strict,” providing an example from the journal of John Mercer:
Sunday 31.8.52 During the afternoon I had to request that a corroboree [a secular gathering for the purpose of dance] be discontinued. This will prove a helpful illustration to tomorrow's address on the fourth commandment. [Cole 1982:30]
This entry suggests the extent of mission control in the early decades of Rose River Mission:
From June 1967 the catering for children was gradually phased out. Up till that time the children had been fed and given school clothes. The teacher at school had supervised showers, teeth cleaning, clothes changes and meals. The clothes had been washed by school laundresses and the older children had helped with serving and washing-up at meal times. As has been mentioned the system came under increased scrutiny by the missionaries. They now decided that the parents should be given the responsibility of washing and mending school clothes, and a greater part in providing meals. [Cole 1982:54, emphasis added]
The subordination of Aboriginal people by these forms of control was likely accompanied and exacerbated by the “Europeans’” attitudes toward Indigenous people. Cole captures what this might have been when he discusses the CMS missions for “half-caste” children in the Northern Territory during his period:
Changes in community attitudes to part-Aborigines has been a feature of the past seventy years. In the early days men and women of compassion cared and acted while the white community despised and governments remained indifferent. Human bodies as well as human souls mattered to them. These people of compassion did what they thought was right. They took them away from meddling whites and unwholesome blacks, and taught them the “better” way of the white man. [Cole 1979:132]
Today Numbulwar is regarded as a “remote” Aboriginal community, inhabited by Indigenous people in an isolated part of the continent, maintained largely by government funding and a local desire, if not need, to reside there. Over the 30 years that I have conducted research in the community, Numbulwar's population has grown from roughly 400 to 1,000, fluctuating as people move between this “town” and other remote communities in the area, those of Bickerton Island, Groote Eylandt and Ngukurr, formerly the Roper River Mission. The language group most strongly identified with Numbulwar, as has always been the case, is that of the Nunggubuyu, speakers of Wubuy. Hunting and gathering still occupies some but does not support the population, there are few jobs to be had, and most of the Aboriginal people living there receive various forms of welfare. In the 1970s, governance of local affairs passed to an Aboriginal Council made up of representatives of the local clans. However, the community has always been assisted by a non-Indigenous town clerk recruited from outside Numbulwar and overseen by various Territory and Federal bodies. Similarly the community's teachers, doctors, nurses and directors of the various structures and programs that sustained it, are, with few exceptions, “whitefellas.”
The Nunggubuyu seem to have been spared the harsher aspects of colonization buffered as they were, and continue to be, at least to a considerable extent, from settler culture by distance and a terrain not easily traversed, even on foot (Eastwell 1976; Thomson 1983). As far as I can tell, premission contact was largely restricted to visits from Macassans from the Celebes (now Sulawesi, Indonesia), who came to fish for trepang (Thomson 1983). These may have been stimulating and enriching encounters, if their traces in dance, loan words, and artifacts are any indication. However, to the west, south and north of Nunggubuyu countries, Aboriginal people were not so fortunate (Bauer 1964; Cole 1979; Merlan 1978; Morphy and Morphy 1984; Reid 1990; Thomson 1983). For example:
The tribes in the Roper River area had been decimated by the depredations of the pastoralists, and their tribal organisation had been smashed. The main tribes in the area, and those now severely depleted, were the Mara, Alawa, Wandarang, Ngandi, Ngalakan, the southernmost members of the Rembarrnga and Nunggubuyu tribes, and some of the Mangarayi tribe. [Cole 1985:57]
Residents at Numbulwar identify not only with Nunggubuyu but also with several other of these language groups, each with a different history of interaction with the colonial environmental. People who speak, or whose ancestors once spoke languages such as Anindiljuagwa, Mara, Ngandi, Ritharngu, and Wandarang are integrated into town life, often through intermarriage with Nunggubuyu people. Just as their language group identities vary, so we might imagine that their stress lineages vary in their potential for intergenerational harm (see Gunnar and Quevedo 2007). Regardless of language group, however, the Aboriginal people who first settled at Rose River Mission were required to adjust to circumstances that may have laid the ground for today's ill health.
STRONG CULTURE, STRONG BABIES
Neuroanthropology directs us to identify sociocultural factors that comprise much of the environment in which bodies become encultured. Because the human brain is so plastic, as are many other of our physiological systems, social arrangements and cultural practices that comprise our “developmental niche” (Super and Harkness 1986) can be expected to actually change our bodies and our minds (Downey and Lende 2012). Depression, chronic stress, and pregnancy anxiety have been identified as major precursors of low birth weight babies as well as those born prematurely (Dunkel Schetter 2011). The identification of sociocultural factors associated with these mental states is a critical step in attempts to reduce these conditions that may predispose the individual to a life of ill health and disability. It is also a critical step for an analysis of the pathways and mechanisms whereby a mother's mental or physical state transforms that of her unborn or newly born child (Kuzawa and Quinn 2009). Anthropology has a long tradition of documenting the unintended, and often deleterious, consequences of social arrangements imposed by those who are dominant in an intercultural setting, that is, one that contains divergent, and not always compatible or interacting, “experience, knowing and practice” (Merlan 2005:174). In this reconstruction of Numbulwar's early history, I trace several interventions into Aboriginal lives that together have created the developmental niches of current and past generations and may well be a major source of today's ill health.
Many of Numbulwar's residents are the children, grandchildren, or great-grand-children of polygynists (Chisholm and Burbank 1991). From the turn of the last century, missionaries in the area opposed this marriage form—along with the premenarcheal marriage age and practice of infant betrothal associated with it—and through a concerted and sustained campaign greatly reduced its practice (Burbank 1988). According to Cole (1977), CMS missionaries had long been concerned about the practice of polygyny, although it was not a concern they felt able to address until relatively late in mission history:
Mission pressures for (what they perceived to be) a more equitable distribution of women mainly to provide wives for unmarried men and so lessen fighting and quarrelling over women, were not felt to any great extent during the period 1908–1939. [Cole 1977:192]
Although the campaign against polygyny began at the first CMS mission at Roper River, according to a missionary present in the early days of Rose River Mission, it may be that activities at the Angurugu Mission on Groote Eylandt had the most immediate effect on marriage practices at Numbulwar (Burbank 1988:62). Describing mission initiatives at Groote Eylandt, Turner says:
In the period between 1944 and 1947 … seven men belonging to Bickerton local groups who were married polygynously surrendered a total of eight wives to eight single Bickerton men. Another man gave up a wife, but after she had been married to the recipient, he reclaimed and kept her. [Turner 1974:51]
At Numbulwar, there was no formal redistribution of wives. However, the Aboriginal inhabitants of the mission were informed that polygyny was not consistent with a Christian way of life. Those that I have spoken with on the topic attribute its demise to the mission, although not always to the mission's policy of “one man, one wife.” One woman told me, for example, that once they were living at the mission, some women simply left their husbands. Of course, if the missionaries felt as compelled to provide “sanctuary” to such women, as they did for girls under the age of 16 who were unwilling to go to their betrothed husbands, the missions may well have made separation possible (Burbank 1988:65–66).
By 2003, with only one or two exceptions, marriages were monogamous. Although the preponderance of monogamy in spite of men's continuing attempts to take additional wives suggests not only women's preference for this marriage form but also their ability to maintain it in their unions (Burbank 1994), their triumph may nevertheless be a source of the ill health characteristic of contemporary times. In a monogamous marriage, one woman may have to bear the reproductive load once borne by several. For at least a time in the recent past, some women have had more children at shorter intervals than did their mothers and grandmothers.
Mercer's stories about the early years of Rose River Mission include mention of the expected birth spacing at the time:
She should not have another baby whilst she was presently nursing a child, not yet walking or able to fend for itself. So you found that aboriginal children were about three years apart in age for mothers fed their babies for two years and they reached three years before they were able to fend for themselves. [Mercer 1978:45]
Genealogies, mission and health records allowing for comparison of birth averages of 31 polygynously and 41 monogamously married women, show a significantly greater number for the monogamous group, 6.05 children compared to 4.61. They also show a significant decrease, from 65.3 months to 39.76 months, in the mean interbirth interval for them (Chisholm and Burbank 1991:296).3 A significant positive correlation between birth interval and birth weight in a sample of 75 children from birth to age five in 1988 has also been found; children born after longer intervals tended to be heavier (Burbank and Chisholm 1989:92).
Monogamy, however, need not be associated with a greater reproductive load for individual women as Western birth rates generally demonstrate. There are other factors to be considered here. A pronatalist ideology is one that may be crucial. At least during the late 1970s, this position appeared to be characteristic of men at Numbulwar:
Some men have a wife and for three or four years she doesn't have a child. “Oh, this girl isn't having my kids. I’ll get another wife.” Then he marries another girl. Might be five or six months and his second wife has a baby. She is going to have a child so she can make a race and a big family. They see when they get old, see their wife having no children. “I’ll have to get another.”[Burbank 1980:104–105]
Several reasons that men might want to have children are suggested by this speaker. First among these might be the expectation that children will care for an elderly father, a reasonable expectation given the principle of reciprocity attached to parent–child relationships (Burbank 2006). I might also note the desire for a “big family” and for a “race” expressed in this text. In 1978, a woman explained to me that when Aboriginal women leave Numbulwar and marry non-Aboriginal men, people are not happy because “it makes not enough people.” That is, a woman bearing children for a non-Aboriginal man is not bearing children for an Aboriginal man at Numbulwar. The possible motive of increasing the “race” is a poignant one, for it reminds us of the colonial violence at the margins of Nunggubuyu lands. The desire also suggests the extent to which the Nunggubuyu ancestors of people at Numbulwar were aware of this violence and passed this awareness on to younger generations. Although few speak of this, at least to me (Burbank 1994:23–24), a general awareness seems likely, especially given the connections of Numbulwar's people to Ngukurr. Should such violence have been interpreted along lines implied by use of the word “race” and the phrase “not enough people,” that is, as genocidal, the pronatalist stance of local people would not be surprising (see also Spiro 1958).
There are also less speculative reasons for thinking that pronatalism has been a factor, at least until recently, in determining family size. Most sources suggest that pronatalism may originate more with men than women. In an analysis of fights occurring between 1977 and 1978 precipitated by the actions of seven men attempting to obtain additional wives, I found that four of these men's wives had no children, one wife had only one, and that two other wives were no longer fertile; in one of these cases, infertility was because of a woman's use of contraceptives (Burbank 1994). This is to say that in all of these cases, infertility might have been at least a contributing factor.4 Conversations and interviews with 30 mothers and fathers in 1988 indicated that men were more likely to want larger numbers of children than their partners; all women interviewed wanted no more than they had at the time of the conversation (between two and four), whereas all the fathers wanted more than they had (between one and six; see Burbank and Chisholm 1992). In this material we can also see a source of gender difference in ideas about ideal family size: a male bias in pivotal social arrangements and a consequent desire for sons:
I’ve got a part to play in ceremony too. I’ve got songs, ceremonial things. Land too. If I get old, I know that I’ve got a son, he might take responsibility of the ceremony and the country. Somebody who will take over and my family will go on and on. Instead of just having a family, we could have just lived on with no kids, that would have been the end of [my] family line. … With our first child we were really happy … and we decided to have another. Our real aim was to have a boy, but we didn't have that until we had three girls, then we had a boy, and I think we’re finished. [Burbank and Chisholm 1992:183]
Circumstances of culture, history, and biology may have conspired with men against women in regard to family size. I have presented an example of fetal plasticity with reference to the number of cells in a kidney. A second example of human plasticity is seen in physiological systems that maintain a balance between a woman's own energy reserves and those dedicated to gestation or lactation. The label “maternal depletion syndrome” identifies a physiological state where this balance is upset. Insufficiently long birth spacing is one source of interference. Maternal depletion is thought to undermine the health of both mother and offspring; in the later case it may lead, among other things, to low birth weight (Ellison 2001; Shell-Duncan and Yung 2004).
Cole (1982) has emphasized the near coincidence of Numbulwar's establishment as the Rose River Mission with the Commonwealth's policy of assimilation, implemented in the Northern Territory's Welfare Ordinance of 1953: “Every endeavour was made to change them from being nomads into people living settled lives in communities. … They were taught health and hygiene and worthwhile trades and occupations” (Cole 1982:15).
In the mission's early years, most adult residents were required to work, although pregnant and lactating women were exempted. Together, the missionaries and their flock constructed an airstrip, sawmill, church, clinic, school, and houses (Young 1981). Indigenous residents were paid for their work according to the Montgomerie 1954 Annual Report: “No rations are issued to the people. They have to work for wages and may buy their flour and rice, etc. at the sales stores” (Cole 1982:34). Yet people were expected to obtain a substantial proportion of their food from the surrounding bush. Until 1958, supplies arrived by boat from Roper Mission only every six months. When they were low, Aboriginal residents were sent “walkabout” (Cole 1982; Young 1981).
Soon, however, food became plentiful. Reviewing early mission materials, Young (1981) paints a picture of this abundance:
When mission construction was completed, attention turned towards increasing local food production, mainly for consumption within the community. This was so successful that it became apparent that Numbulwar could provide a considerable surplus, particularly in fruit, vegetables and eggs. In 1959/60 the market garden produced 4 tons of fruit and vegetables but in 1965/66 this had increased to over 40 tons, approximately a pound per day for every[one] on the settlement …[F]or a number of years Numbulwar exported eggs for workers for the Groote Eylandt Mining Company (GEMCO). In the absence of a market, Numbulwar garden crops were distributed freely throughout the community or, on occasion, were left to rot. [Young 1981:174]
In 1956 over 150 dugong, yielding about 45,000 lbs of meat, were bought by the mission from the fishermen of Numbulwar. [Young 1981:194]
Once the mission became a sustainable community, people ceased moving from place to place in the manner of their hunting and gathering past. By the 1970s, when the outstation movement began and more people again travelled more extensively, they routinely used vehicles and motorized boats to do so.
The hunting and gathering lifestyle of groups like the Kung, or Ju/’hoansi, as reported by Howell (1979), is one associated with a particular pattern of fertility. This is characterized by a relatively late age of menarche, followed by a relatively prolonged period of subfecundity, and a completed reproductive history of four or five births spaced about four years apart by periods of lactational amenorrhea (Lancaster 1986).
Cowlishaw (1981) has argued on the basis of a compilation of biological, ethnographic, and historical material that this was probably the precontact reproductive pattern of Indigenous Australians. In support of Cowlishaw's (1981) argument, Saggers and Grey (1991) count Abbie's (1976) comparison of hemoglobin levels in remote dwelling Aboriginal people and “European” Australians. Only in the latter group was a sex difference found, that is, European women had lower hemoglobin levels than did European men. The absence of a sex difference in the Aboriginal group may be interpreted to mean that these women had “less frequent and shorter menstrual periods,” indicating “less frequent ovulation” and hence lower fertility (Saggers and Grey 1991:24). Saggers and Gray also mention dietary restrictions to which Aboriginal women were subjected, patterns of breast feeding that may have reduced ovulation and the possibility that genital operations such as subincision reduced male fertility, although I am not aware of this operation ever having been a part of the series of male inductions into the religious life of the Nunggubuyu.
In the literature addressing hunter gatherer fertility in general, Bentley and colleagues point out that “forager, horticultural, and agricultural groups are all characterized by a high degree of heterogeneity in their fertility rates, and that it is not possible to predict fertility rates on the basis of subsistence technology alone” (1993:276–277). Nevertheless, following an analysis of “natural-fertility” populations, they concluded that “the intensification of subsistence technology is associated with increases in fertility. … Higher fertility is primarily associated with the intensification of agriculture.” Although the people of Numbulwar have not become agriculturalists, their way of life on settlement at Rose River Mission increasingly became supported by the intensified technology associated with industrial societies.
Currently, women at Numbulwar appear to lead a physically less strenuous life than they or their ancestors did in hunting and gathering days. MacArthur's (1960) observations of subsistence practices in Arnhem Land in the 1940s included a hunting and gathering group on Bickerton, an island just a few kilometers off the coast from Numbulwar with an environment similar to that of the mainland. McArthur remarked of the women's food quest that it was “a job which went on day after day without relief,” although “they rested quite frequently and did not spend all the hours of daylight searching for or preparing food” (MacArthur 1960:92). No comparable drain on women's energy expenditure appears to have arisen since settlement. With much of women's subsistence role rendered unnecessary by the availability of energy rich flour and sugar (see Altman 1984) and with the need to remain near at hand because children are at school, an institution that was established at Numbulwar in 1953, women's daily lives have taken a decidedly sedentary turn.
Bentley and colleagues have emphasized women's subsistence activities as “crucial [for fertility] given the relationship between women's energetic output and gonadal function” (Bentley et al. 2001:210). Factors to consider here would include the distance women travel, the loads they are required to carry (incl. dependent children), and the energy required by daily subsistence tasks, for example, digging for roots. An additional factor is “the level of temperatures to be endured” (Bentley 1985:86). This factor may well have affected the energetics of foraging in a climate that is hot and humid during most of the year. Although this literature makes it clear this is not always the case in a shift from a foraging to a horticultural subsistence strategy, the energetic demands of settled life for Numbulwar's women would seem to have been reduced considerably. Heat and humidity have much less of an effect on someone being driven less than a half-kilometer to the shop than on someone gathering food in areas that may be some kilometers from camp.
Cowlishaw (1981) also observed the increase in fertility, the lengthening of the fertile period and the decrease in birth spacing among women on missions and government settlements. In particular, she noted the association of this new fertility profile with changes in energy expenditure and diet. At Numbulwar, women have been consuming more calories than in the past. In April of 1979, Young surveyed the purchases made by Aboriginal people in Numbulwar's shop. Her survey indicated “excessive” consumption of “flour, bread and sugar” in particular and a daily caloric intake almost double that recommended. Although she admits that the use of shop expenditure to provide information on nutritional intake is very rough, the accuracy of her finding is suggested by increasing rates of obesity to be seen in men, women, and children (Young 1981).
What were the possibilities for women with bodies more receptive to pregnancies they may not have desired and that might have injured their health or that of the developing fetus? Contraceptive use would have been an option, but the mission run health service does not appear to have provided birth control methods, at least on a widespread basis, until the 1970s. An analysis of 232 live births to 73 mothers between 1925 and 1988 shows a decrease in the mean interbirth interval from over 50 months in the period 1925–49 to 26–29 months between 1965 and 1980. By 1988, a reversal of the interbirth interval appeared, increasing to 39 months (Burbank and Chisholm 1989). This increase was likely because of greater access to contraception.
On a recent trip to Numbulwar, I was able to ask a woman with a long experience of the health clinic about the availability of birth control devices:
VKB: When the missionaries were here could women get family planning from the clinic?
AW: In those days, I remember, for family planning, it never never been said. Only in traditional way that I been telling you. But in Western way family planning had not been brought out. The nurse knew and I was learning about it but we never talked to young woman or old woman because they couldn't understand. But now they know it. The nurse never said it. Later in the years, finally it came up. They can take loops [IUDs]. Later in the time when it started, I was interpreting, talking to the older ones. Young ones [use it] today. I had a group of women to discuss it with. Some didn't make sure they wanted it, but some did. Just the loops. They didn't have much to send out. Older ladies got loops because they had nother one coming, nother one coming. Just to have a rest.
VKB: Was that in the old clinic [building] or the new clinic?
AW: In the old clinic. You were in the caravan down with your abuji[kin term for FM, the year was 1978].5
The extent to which women employed traditional contraceptive practices, regarded as “women's business,” is unknown. According to women like this speaker, the result of these is permanent infertility.
To say that until contraception was provided, the missionaries controlled Aboriginal women's fertility, is an exaggeration that nevertheless makes an important point. This kind of control may have had consequences beyond those of contributing to circumstances where women bore more children than was healthy or desired. In this depiction of the early years of Numbulwar, I find two intertwined sources of injury to subsequent generations, both related to HPA activity. First, assuming that Worthman and Kuzara (2005) are right when they suggest that the HPA axis’ role in resource allocation is such that it responds to variations in the prenatal environment, we can posit a connection between the sociohistorical circumstances that may once have given rise to widespread maternal depletion and the poor health seen at Numbulwar today. The elevated production of glucocorticoids that accompanies undernutrition are thought to have lasting effects; included among these are the cluster of health conditions in the metabolic syndrome, so pervasive at Numbulwar today. Greater vulnerability to stress, such as “increased behavioral reactivity and sensitivity to novelty” (Worthman and Kuzara 2005:106), is another possible consequence.
A second source of today's ill health that I posit is the lack of control that women likely experienced because of repeated unplanned and possibly unwanted pregnancies. Elsewhere (Burbank 2011) I have discussed the incompatibility of having large numbers of closely spaced children with the highly responsive form of early childcare—often associated with hunting and gathering peoples—that women at Numbulwar both practice and expect of themselves. Given these expectations, yet another pregnancy, a significant and unwelcome intrusion felt to be completely out of a woman's control, may have been a major source of stress in and of itself (Dunkel Schetter 2011; Sapolsky 2004). The negative feelings experienced along with an unwanted pregnancy likely would have been even more intense when social subordination was experienced in association with an ascribed identity that had been the target of extreme violence, albeit much of this is now past. With this in mind, it is hard to imagine the Rose River Mission as anything other than an environment in which chronic stress was experienced by many of its Aboriginal residents. For pregnant women, fear for an unborn child, if not for themselves and their other children, may have made their experience all the more distressing.
It is becoming increasingly clear that while undernutrition may be the basis of the fetal origins of ill health and disease, this may not simply be because of what women eat. Recent work on the placenta's role in fetal development underlines its importance in many of these processes. Hypertension, for example, one of the components of the metabolic syndrome, may, by interfering with placental function, “severely limit fetal nutrient supply without a corresponding change in maternal nutrition” (Harding 2001:16). Similarly, stress may interfere with the placenta's capacity to buffer the effects of maternal HPA activity on the developing fetus, particularly in the case of “chronically stressed animals … exposed to an acute stressor” (O’Donnell et al. 2009:289). The situation at Numbulwar may be just another example of what research increasingly shows: that psychosocial stress, in and of itself, has the potential to affect fetal development (Dunkel Shetter 2011; Worthman and Kuzara 2005). Thus, it is easy to imagine that the mothers of Numbulwar may be the fourth or fifth generation of women whose bodies and minds have been challenged in this way, if not by maternal depletion then by social disadvantage and other stressful experiences.
I think that the missionaries at Rose River, at least those I have known, were indeed “people of compassion,” concerned with fairness and the wellbeing of Aboriginal people. Nevertheless, in hindsight it is easy to lay at least some of the blame for Aboriginal health at their door. But we would be better off looking not so much at what they did, as at what we are doing now, again with the best of intentions, to Aboriginal people, and others, today. In 2007, for example, the Australian federal government, in the last year of its 11 years of power, responded to a report on the sexual abuse of children in remote communities with the Northern Territory National Emergency Response. “Income management,” the quarantining of welfare payments for essential items such as food and clothing, was one of the results, requiring suspension of Australia's Racial Discrimination Act as only some Aboriginal communities were subjected to it (Austin-Broos 2011). The “intervention,” as the Response is often called, has been continued by the current federal government. A number of Aboriginal women have publically stated that “income management” is a beneficial arrangement. No longer are they subjected to forms of “demand sharing” (Peterson 1993) that may include violence by family members who want to spend their welfare checks on drugs and alcohol. There have also been media reports of improved nutrition for the children in these communities. Income management would seem to be a successful strategy for improving Aboriginal wellbeing. Yet, if we accept the argument I have been making, we must ask about the long-term consequences of imposed control of Aboriginal lives. The dissection of past well-meaning acts such as I have presented here should caution us against instituting other well-meaning but equally damaging forms of assistance. Enabling the people who must live with the consequences of decisions to make and implement those decision themselves is the alternative I would propose to many of Australia's current solutions to the “Aboriginal problem.”
I have been conducting anthropological research in this community since 1977.
Between 2003 and 2005, I conducted research on health and inequality at Numbulwar supported by an Australian Research Council Discovery Grant (#DP0210203) received with Professor Robert Tonkinson and Dr. Myrna Tonkinson, titled “Inequality, Identity and Future Discounting: A Comparative Ethnographic Approach to Social Trauma.” This research included interviews with 20 Aboriginal people, men and women ranging in age from 18 to about 67. By 2007, three were dead, two had recovered from serious illness and two others had lost close kin, that is, over a third had been affected by severe medical conditions or death and none of the ill or dead had reached the age of 65.
The analysis excluded all spontaneous abortions, stillbirths, neonatal and infant deaths, and births in which the father was known to be different from the father of the preceding child.
In her cross-cultural study of “conjugal dissolution”Betzig (1989:662) found infertility second only to adultery in frequency as a reason for divorce.
Rather than IUDs, Implanon appears to be the contraceptive of choice today.