Something in the Water

I first heard Dr. Christine Jeffries-Stokes talk at a meeting of Aboriginal medical students and doctors and their supporters in the nineties. She told us about her work as a paediatrician in Kalgoorlie and the surrounding Western Desert. Some of the Aboriginal babies she cared for were thin and irritable, with watery diarrhoea and terrible, scalded nappy rashes. They were diagnosed with Failure to Thrive — a diagnosis which puts a child’s parenting directly under the spotlight. Their mothers seemed powerless to help them. Health workers had repeatedly explained how important hygiene is when mixing formula, how to wash babies and what creams to put on the baby’s tender skin, how often they needed feeding. What was going on in these babies’ homes? There was talk (and some action) of calling in Community Services workers.

Our neighbour's house on a stormy night in the Western Desert. (c) Claudia Jocher 2016

But Christine wondered if it could be something else. She investigated the babies for lactose intolerance. On a lactose-free formula they became fat and happy. The diarrhoea cleared up. The awful blistering rash healed. Eating food meant for baby cows was what made these human babies so sick. The babies’ mums were no longer threatened with having their children removed.

Indigenous families have struggled a lot with the removal of children from our families. Many of us at the meeting had experienced it directly. A wellspring of gratitude flooded back to Christine as we listened to her. Instead of social workers and child protection officers, what these babies needed was the careful attention of an open and well-trained medical mind.

Since then, I have followed Christine’s work with interest. Born and educated in Tasmania, she moved to the Western Australian Gold Fields region, where she fell in love and married Geoffrey Stokes, a senior Wongatha Wonganarra man. Geoffrey is a pastor known to take the men out hunting. He’s one of those interesting people who lives harmoniously in Aboriginal Lore and Christianity. Geoffrey was a widower. When they married, Christine became mother to five children. I always imagine their household to be loud and lively, with bacon and eggs frying in the kitchen.

The next time I heard Christine speak, she was talking about the benefits of a diet high in protein and natural fats — closer to the Traditional Aboriginal diet — for Aboriginal people. Similar research done with the Native Hawai’ian (Kanaka Maoli) people had found that a diet closer to that of pre-colonial ancestors helped reduce the need for medications and resulted in less sickness -- fewer people with hypertension, diabetes and obesity.

Christine began investigating insulin resistance in young Aboriginal people after noticing at a basketball game that many of the youth had acanthosis nigricans — a darkening of the skin under the arms which is an early indicator of pre-diabetes. It’s the kind of sharp and powerful everyday observation typical of a doctor who builds bridges between the social and scientific aspects of disease.

When I was living and working in Tjuntjuntjara in the remote Western Australian desert in February last year, I came across some beautiful resources Christine had helped to make. Working with the Western Desert Kidney Health Project (WDKHP), she and her team produced inspiring educational materials using superb artwork, photography, videos, recipes and whatever else worked. I called to congratulate her on the excellent work and to let her know I was working just about 700kms up the road. Christine told me that she knows Tjuntjuntjara well and has family there.

Tjuntjuntjara Street Scene. Photo (c) Claudia Jocher 2016

In the course of working with the WDKHP, doing preventative health care in the remote desert towns and communities, Christine and her team noticed that many of the people they tested, including non-Indigenous people, had acidic urine. Protein or blood in the urine, high blood pressure and early signs of diabetes were much more common in some regions than in comparable populations nearer the coast. Christine investigated and has found a possible link between this acidity and the high levels of nitrates — naturally occurring salts — in the drinking water of some of the towns and communities. All this time we’ve been telling people to drink plenty of water to help their kidneys and now it seems that it could be the drinking water that is contributing to the problem.

Years ago, Indigenous mums were told again and again how to prepare the formula correctly, by increasingly frustrated health workers, but their babies didn’t get better until the real cause of their illness was found. A decade or two later, Dr Jeffries-Stokes and her team are onto something important again. A good water purification plant and management system may save many more lives and suffering.