& Oxford University Press and Community Development Journal.

2005
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doi:10.1093/cdj/bsi072
Advance Access Publication 12 July 2005

Starting where the people are:

Lessons on community
development from a remote
Aboriginal Australian setting
Danielle Campbell, Paul Wunungmurra
and Helen Nyomba

Abstract This paper analyses a government health department’s attempt to

implement a community development strategy in a remote Aboriginal
Australian community after identifying deficiencies in one of its health
programmes. The reluctance of non-Aboriginal departmental clinic
staff to share control of health decisions with Aboriginal participants,
together with the deeply embedded power inequalities, undermined
the development process and the achievement of project objectives.
After lengthy critical reflection and supported by the project team
and other community agencies, a group of community members
addressed the priority issue they identified with a community-owned
strategy in opposition to health professionals. This study raises ques-
tions about the capacity of government departments to practise com-
munity development, particularly given the unequal power relations,
and their reluctance to share power between such departments and
marginalized, disadvantaged communities.

Introduction
Community development processes in health involve ‘organising and/or
supporting community groups in identifying their health issues, planning
and acting upon their strategies for social action/change, and gaining
increased self-reliance and decision-making power as a result of their
activities’ (Labonte, 1993, p. 237). Involving local people in constructing
and applying their knowledge to develop locally appropriate and sustain-
able health strategies has the potential to improve health outcomes

Community Development Journal Vol 42 No 2 April 2007 pp. 151– 166 151
152 Danielle Campbell et al.

(Oakley, 1991; Baum, 2002; Butler and Cass, 1993). Participatory processes
can foster individual, small group and community empowerment, which
contributes to improved individual and collective health status as people
gain greater control over their lives (Minkler and Wallerstein, 1997; Baum,
2002). Empowerment consists of personal, group and social aspects of
power and capacity ranging from leadership, resources and strengthened
networks to critical thinking, trusting relationships and increased group
participation (Labonte, 1999).
Community development is considered a useful strategy in addressing
Aboriginal health issues (Feather et al., 1993; Labonte, 1993; Voyle and
Simmons, 1999; Biven, 2000; Ife, 2002; Tsey et al., 2002). It is strongly sup-
ported by Aboriginal leaders and Aboriginal controlled health services
and consistent with Aboriginal demands for greater control over their
affairs (Bell, 1996). Despite this, and the widespread application of commu-
nity development approaches in the ‘developing’ world, equivalent kinds
of fully participatory processes that empower local people remain
unusual in remote Aboriginal Australia. Vertically organized government
departments located in urban centres continue to employ a ‘top-down’
approach to service delivery and few non-government development organ-
izations operate in this setting. The pervasive practice in Australia is one of
non-Aboriginal bureaucrats and service deliverers articulating the rhetoric
of ‘community development’, while trying to solve Aboriginal people’s
‘problems’ for them.
Ife (2002, p. 183) argues that much harm is being done to Aboriginal
people, often in the name of ‘community development’, which has been
used as a euphemism for ‘oppression, domination, colonialism, racism,
and the imposition of Western cultural values and traditions at the
expense of those of Indigenous people.’ Because there is a great need
for Aboriginal community development in one sense of the term, yet
Aboriginal people have been victims of it in another sense, community
development with Aboriginal people is a ‘special case, deserving special
treatment and careful consideration’ (2002, p. 183). Aboriginal communities
continue to suffer the ongoing effects of colonization and dispossession
through marginalization, disempowerment, socioeconomic disadvantage
and poor health (Lodder, 2003). Remote Aboriginal communities are
further disadvantaged by their geographical isolation from centralized
Government decision-making processes and services.
When this research was undertaken, the Northern Territory (NT) Depart-
ment of Health and Community Services (DHCS, formerly Territory Health
Services or THS) advocated using community development approaches to
improve Aboriginal health. DHCS described ‘supporting local health
decisions and actions so that people can increase control over their lives’
 Lessons on community development 153

as one of five key areas in its Aboriginal Public Health Strategy (THS, 1998).
The role of DHCS staff is to support communities to develop local solutions
to health problems, ‘recognising the strengths and knowledge of local
people’ (THS, 1999, p. 49). Although a new NT Government has since
been elected, which has introduced a new community health policy, the
language of recognizing the knowledge of Aboriginal people and
working ‘side-by-side’ with them as active participants in their own
health remains the same (DHCS, 2004).
In 1998, DHCS introduced the Growth Assessment and Action (GAA)
policy and programme in the NT. The focus of the programme was on
Aboriginal children in rural and remote areas because of their disproportio-
nately poorer health status and poor growth (Paterson et al., 2001). Research
suggests that between thirteen and twenty-two percent of Aboriginal
children were underweight (Paterson et al., 2001), compared to three
percent of children Australia-wide (THS, 2000). DCHS health professionals
subsequently identified deficiencies in the GAA programme’s implemen-
tation in Aboriginal communities, including insufficient involvement of
Aboriginal people in the programme, poor understanding by service provi-
ders of social and cultural issues affecting Aboriginal children’s growth,
and a lack of guidelines for promoting community growth promotion
action.
At this time a group of Aboriginal women from Gapuwiyak, a remote
Aboriginal community, discussed their concern about poor child growth
with DHCS health professionals and expressed interest in working in part-
nership on this problem. Together with the Gapuwiyak Council and health
staff from the DHCS-run Gapuwiyak clinic, they agreed to collaborate with
DHCS on a child growth community development project to: (1) improve
growth in the community by increasing community growth promotion
action and (2) inform the GAA programme by documenting Aboriginal
perceptions of child growth and the process of increased community
action. It was anticipated that the community development approach
would also increase community capacity and empowerment. As
Gapuwiyak community members had identified poor child growth as a
concern, the project appeared to be ‘starting where the people are’, which
is key to community development as people are unlikely to act on issues
they see as irrelevant (Wass, 2000). In Aboriginal Australia the importance
of local people owning and defining the problems and solutions in commu-
nity development processes has been repeatedly emphasized (Brady, 1990;
Lawson and Close, 1994; Lee, Bailey and Yarmirr, 1994; Mitchell, 2000).
The commitment of health professionals located both in Gapuwiyak and
in the Department to utilizing Aboriginal knowledge about child growth
and working in partnership also recommended using a community
154 Danielle Campbell et al.

development approach. Valuing local knowledge can be challenging for

health professionals, who are often accustomed to their own ‘scientific
knowledge’ being privileged (Baum, 1990; Cheek et al., 1996). In community
development they must consider how to complement and reinforce what
the community already has in the form of knowledge, skills and other
resources (Baum, 1990; Voyle and Simmons, 1999). This paper outlines the
challenges faced by a health department in implementing a community
development process in a remote Aboriginal community.

The study setting

Gapuwiyak is located in North East Arnhem Land 200 kilometres from
the nearest town centre and 600 kilometres from the NT capital, Darwin.
Gapuwiyak was established as a mission in 1969 by non-Aboriginal Metho-
dists. Yolngu (the Aboriginal people of North East Arnhem Land) were
encouraged to give up their lives of hunting and gathering in family
groups to settle in Gapuwiyak and learn the ‘benefits’ of Christianity and
civilization, and to exchange their labour for rations. The Aboriginal
residents of Gapuwiyak gained some control over their ‘community’ in
1973 when the Australian Government introduced a policy of ‘self-
determination’. The local Aboriginal Council’s degree of control continues
to be limited by its reliance on the Territory and Commonwealth Govern-
ments for funding to provide services to residents. While Gapuwiyak is
now described as a ‘community’, it comprises twelve different patrilineal
descent-groups, or clans, who have many competing and, at times, conflict-
ing interests (Toner, 2001).
Like other remote Aboriginal NT communities, Gapuwiyak’s population
of approximately 750 is characterized by very low levels of income,
employment and education in comparison with non-Aboriginal Australia.
The majority of residents aged fifteen years and over are dependent on
government unemployment or parenting benefits and more than seventy-
five percent have a weekly income of less than $200, which is well below
the Australian poverty line (ABS, 2002). Less than four percent of Indigen-
ous community members aged fifteen and over have completed year twelve
or equivalent study (ABS, 2002). Health is poor in the community and when
the project commenced, thirty-eight percent of children under five years of
age were underweight (THS, 2000).

The project
The Child Growth Project was implemented between February 2000 and
June 2002. The project leader (a non-Aboriginal DHCS paediatrician)
 Lessons on community development 155

consulted with community members over an eighteen-month period prior

to project commencement and subsequently designed the project together
with the project officer (a non-Aboriginal public health doctoral student
with a development background – the first author). In addition to resources
contributed by DHCS, funding was received from the Cooperative Research
Centre for Aboriginal and Tropical Health. An Aboriginal project advisor
and two Aboriginal co-workers were recruited from Gapuwiyak to the
project team on project commencement. The Aboriginal team members
worked closely with the project officer (who lived in Gapuwiyak for the
first year and visited regularly for the remainder of the project) on all
aspects of the project. The project leader provided important support
from Darwin; however, this person left their position at DHCS one year
into the project. The three successive DHCS staff members who were
named as project leaders had limited involvement.
A participatory action research (PAR) framework was used as it has been
described as appropriate in public health research, particularly in the area
of Aboriginal health research, both internationally (Herbert, 1996; Davis
and Reid, 1999) and in Australia (Hecker, 1997; Baum, 2002; Henry et al.,
2002; Pyett, 2002; Tsey et al., 2002). Like community development, PAR’s
emphasis is on a bottom-up approach, locally defined priorities and
perspectives, and the sharing of power between the ‘researchers’ and the
‘researched’ (Baum, 2002). The PAR framework involved an ongoing
spiral of planning, action and reflection. Analysing data and feeding back
key findings to participants throughout the project (through posters,
reports, community meetings, the local radio station, and a video) identified
problems and stimulated ideas for action. Data were collected at different
stages in the project using semi-structured interviews in respondents’ first
language, group discussions, photo-voice (photographic interpretations),
participant observation, and the recording of children’s weights from
their medical charts.1
The key phases of the project in 2000 were informing community members
about the project; facilitating community and clinic involvement in assessing
the ‘problem’ of poor child growth and potential solutions; and supporting
community members to develop and implement a growth action strategy.
This resulted in a committee of Aboriginal community members developing
a strategy they named a ‘Family Centre’. In July 2001 a month-long process of
community members and clinic staff reflecting on the project’s community
development approach was facilitated. In December 2001, the Aboriginal
Committee, with support from the project team, the Gapuwiyak Council,

1 The value of the weight data collected was limited due to poor coverage as few children
presented at the clinic and were weighed on a monthly basis.
156 Danielle Campbell et al.

and the community school, began implementing the first Family Centre
programme. Since then, and beyond project completion in June 2002, the
Committee has continued to implement its strategy.

Discussion
Despite ongoing support for using community development approaches to
improve Aboriginal health, examples of their implementation and out-
comes are rare. This study demonstrates that despite health professionals
committing to a community development approach, after recognizing the
limitations of a top-down approach to child growth, they were unwilling
to share control of health-related decisions with Aboriginal participants.
This is evident in (1) the selection of the issue to be addressed, (2) the defi-
nition of the problem and solution, and (3) the implementation of the com-
munity action strategy. This discussion highlights how this reluctance to
share power, together with the deeply embedded power inequalities that
exist between non-Aboriginal health professionals and Aboriginal partici-
pants, limited the achievement of community action and empowerment
outcomes. While this discussion relates directly to community development
in a remote Aboriginal Australian setting, the underlying themes of partici-
pation, power and empowerment have relevance to indigenous and other
marginalized groups more generally who share a common experience of
disadvantage and marginalization.

Selecting the issue to be addressed

When the project commenced, the team considered that both health
professionals and Aboriginal community members had identified poor
physical child growth as the priority health issue to address and we were
therefore ‘starting where the people are’. Over time, it emerged that poor
physical child growth was of limited concern to Aboriginal participants,
who instead articulated strong concern about the broad development
needs of children being unmet. On reflection, it seems the DHCS agenda
and the interests of health professionals drove issue selection. Although
health professionals believed they were sharing control with local
people, their inexperience in community needs assessment and their lack
of awareness of their power in influencing issue selection meant they set
the agenda.
In hindsight it seems that the ‘community’ concern expressed during con-
sultation was influenced by the clinic’s concern. In early 1998, Gapuwiyak-
based DHCS health professionals identified poor child growth as a major
health problem and secured DHCS funding to establish a health promotion
programme. The four local women employed to work on this programme
 Lessons on community development 157

with the clinic were subsequently those most closely consulted by the
project leader. The possibility that the concern they expressed was a
response to the clinic worrying about and acting on child growth was not
taken into account.
The capacity of DHCS health professionals (including the project leader)
to assess community needs was limited. Health professionals not having
training in participatory methods is likely to have prepared them for a role
of professional dominance in which ‘community participation has at best
an instrumental role’ (Baum, 2002). The project leader being a non-
Aboriginal health professional may have contributed to community
members agreeing to participate. The former described this as the possibility
that as Aboriginal people they were being ‘kind’ to a white person. Key com-
munity members consulted subsequently revealed that they had thought the
project was ‘for Darwin’ and about what the ‘Balanda (non-Aboriginal)
experts’ wanted to do. Therefore, this ‘kindness’ could be reinterpreted as
a willingness on the part of a relatively disempowered group to go along
with a powerful member of the dominant society. The project leader not
speaking a local language and being unable to engage an interpreter
clearly undermined effective consultation. ‘Where the people are’ is likely
to be heavily influenced by ‘where the health professionals are’, particularly
when the former are Aboriginal and the latter non-Aboriginal.
Health professionals driving issue selection resulted in limited commu-
nity participation and ownership in the early stages of the community
development process. ‘Top-down’ issue selection created confusion
about the project’s purpose and the team’s role in Gapuwiyak. During
the first year it was generally assumed that ‘the project was for Darwin’
and we were going to teach people how to look after their children.
However, comprehensive problem assessment implemented with Aborigi-
nal people in local languages resulted in the identification of a priority
community issue. Aboriginal and non-Aboriginal team members collec-
tively analysing qualitative data and feeding back regularly to community
and Committee members resulted in poor child care and development,
rather than simply physical child growth, being identified as the issue.
Subsequently, the project team supported broadening the project focus
to the overall care and development of children, which was after all not
a rejection of the importance of physical child growth or health. Conse-
quently we moved closer to where ‘the people were’ and participation
in the community development process increased. This study suggests
health professionals may drive issue selection due to their inherent
power to make health-related decisions. It also shows that through
comprehensive problem assessment it is possible to identify local health
priorities.
158 Danielle Campbell et al.

Deciding on an appropriate action strategy

The reluctance of health professionals to share control over health-related
decisions with Aboriginal participants was a key issue in the development
of the action strategy. Problem assessment revealed that Aboriginal respon-
dents and non-Aboriginal clinic staff had significantly different perceptions
of both the problem and the solution. Aboriginal respondents repeatedly
articulated concern about the inadequate care of children adversely affect-
ing their overall development. This ‘new’ problem of inadequate child
care was attributed to parents spending their time and money gambling
and taking drugs, and parents not knowing how to look after children
‘these days’. Community members stressed the importance of caring for
children well so that their broad range of social, emotional and physical
needs were met. The range of actions described as constituting good child
care included spending time with children and not leaving them alone,
washing them and their clothes, feeding them good foods, having a clean
house, and teaching them law and culture. This is consistent with the ‘hol-
istic’ view of health widely documented in the Aboriginal health literature
(Anderson, 1999) and indicates a broader view of child growth than that of
physical growth that the project was designed to address.
Non-Aboriginal health professionals expressed strong concern about
poor physical child growth. ‘Sickness’ was the most common reason
given by these respondents for poor growth, which included illnesses
such as worm infestations, ear infections and colds. The Aboriginal
Health Workers also described illness as affecting child growth, which dis-
tinguishes them from the other forty-three Aboriginal respondents, only
one of whom identified sickness as a contributing factor. This highlights
the unique position of the Aboriginal staff in having both local knowledge
and an understanding of the ‘clinic story’. Non-Aboriginal clinic staff also
identified poor nutrition, due to children not being fed ‘enough food’ and
‘often enough’ as adversely affecting their physical growth. This was
largely attributed to the high food prices in the community shop, combined
with the low incomes of most Aboriginal community members. Conversely,
no Aboriginal respondents identified structural factors such as these as
contributing to the poor health of children. They focused on the failure of
families to care for children.
Following problem assessment, the Aboriginal Committee, with support
from the project team, met fortnightly for three months and developed a
‘Family Centre’ strategy. Meetings reflected local Aboriginal organizing
principles and were informal gatherings where members collectively
negotiated a strategy based on local knowledge. The Family Centre is
a multi-faceted strategy aimed at promoting child care and develop-
ment through the following programmes: a playgroup; early childhood
 Lessons on community development 159

education, including learning Aboriginal law and culture from the elders,
and preparing children for mainstream schooling; growth monitoring and
promotion activities run with clinic staff; education for parents from Abori-
ginal elders and clinic staff about how to care for children; ‘after school’
sport and recreation programmes for teenage children. A central aspect of
the strategy is drawing on both Aboriginal and health professional knowl-
edge and the two groups working in partnership. During its development
and throughout the second year of the project, Committee members did
extensive work outside of meetings to secure support from family
members, clan leaders, Council members and Council staff for the Family
Centre. Utilizing local decision-making processes, which are consensus
based, the Committee was confident that the Family Centre was a ‘commu-
nity’ solution.
It is significant that one senior Aboriginal Health Worker was a highly
active member of the Committee and the other Aboriginal clinic staff
strongly supported the Family Centre strategy. Conversely, non-Aboriginal
clinic staff generally did not support the locally developed strategy. Three
non-Aboriginal staff members (the only such staff resident in Gapuwiyak
for the duration of the project) questioned how the local strategy addressed
the problem of poor physical child growth, which suggests they remained
focused on this narrower issue. They retained their concern about ‘illness’
preventing child growth and argued the Family Centre might increase the
risk of transmission of diseases. Further, these health professionals saw
the Family Centre as Aboriginal people taking less responsibility for their
children and asserted that they should care for them at home, as they had
done traditionally. Rather, they favoured growth promotion strategies
such as the clinic educating people about nutritious foods. This was
despite their awareness that many young parents were reluctant to come
to the clinic due to their discomfort in being in a space dominated by
non-Aboriginal health professionals.
The non-Aboriginal health professionals’ lack of support for the Family
Centre can be comprehended given that the Aboriginal understanding of
the problem was significantly different to their own and they were unwilling
to relinquish control. Unlike their own biomedical understanding, which
some staff considered was based on ‘research’ and ‘science’, the Aboriginal
understanding, with its origins in ‘tradition’ and ‘culture’, was perceived as
being less relevant to the contemporary issue of child growth. Further, these
health professionals considered that their health training put them in a pos-
ition to repeatedly question the local strategy. The tendency of health pro-
fessionals to discount ‘lay perspectives’ is described in the health
literature as a way of preserving the power of those operating from
medical discourses and excluding others from control of health care
160 Danielle Campbell et al.

(Cheek et al., 1996; MacDougall, 2001). In this study, non-Aboriginal health

professionals privileged their own knowledge to the extent that they were
unable to ‘complement and reinforce’ local knowledge (Baum, 1990).
These health professionals also resisted Aboriginal people taking control
of a health-related decision because as Aboriginal people they were ‘too dis-
empowered’ to develop useful strategies and they have a ‘welfare mental-
ity’. The Family Centre strategy was considered evidence that Aboriginal
people had been ‘disempowered’ by white people because it required finan-
cial support from the government. This suggests a view that poor people
should solve their problems without any additional resources. One health
professional, who had previously supported the community development
approach, asserted that while such approaches are useful in the ‘Third
World’, they do not work in the ‘Fourth World’. When it came to sharing
power with Aboriginal participants, their lack of power generally was
used by non-Aboriginal health professionals as a reason not to do so.
In this project, the DHCS strategy and community development principle,
that health professionals recognize the strengths and knowledge of local
people and support local decisions, was not realized. Health professionals
were supportive of marginal Aboriginal participation in order to improve
their own programme and practice, not substantive and structural partici-
pation, which have the potential to shift power relations and contribute to
empowerment (Baum, 2002).

Implementing the community action strategy

The resistance of non-Aboriginal health professionals to sharing power with
Aboriginal community members undermined community action and
empowerment outcomes. Health professionals repeatedly questioned the
value of the Family Centre Strategy during the remainder of the project
and beyond. The Committee’s initiative of inviting these staff to present
their concerns at a Committee meeting in late 2000 failed to secure their
support. On this occasion the Committee responded to the list of concerns
presented by the non-Aboriginal health professionals, but remained con-
vinced that their strategy was appropriate and anticipated that the clinic
would support them to implement it. The project team made repeated
attempts to reconcile the Committee and clinic staff by talking with both
groups and encouraging discussion between them; however, this proved
unsuccessful. The non-Aboriginal clinic staff did not support the implemen-
tation of the local strategy and continued to express their doubts in a range
of public forums, including in the presence of potential funders.
The ongoing opposition to the local strategy made it very difficult for
Aboriginal participants to proceed with implementation. In the year after
 Lessons on community development 161

the decision was made to pursue the strategy little progress was made.
Although a range of factors contributed to this, interview data revealed
that fear of upsetting the non-Aboriginal clinic staff was central. While
some respondents considered health was the clinic’s business and had
never participated in the project, others who were closely involved were
concerned that the project and the decision to pursue the Family Centre
was upsetting these staff. They were concerned that it might look as
though community members were trying to ‘steal their work’. One senior
community and Council member asked: ‘Whose part of work is child
health? Is it DHCS? Is it taking work from the clinic? Are the clinic
unhappy about that?’ In response to the clinic staff questioning the value
of the Family Centre, one Committee member argued, ‘We are not taking
away responsibility from the clinic, we are not making ourselves doctors
and nurses.’ This demonstrates how the routine delivery of health services
from the ‘top-down’ can undermine community participation in commu-
nity development processes (Wisner, 1988).
Ultimately, Committee members and several community leaders main-
tained that they as local people had the capacity to design locally appropri-
ate solutions and should make decisions about community action. For much
of the community development process, Aboriginal participants articulated
a strong desire to work in partnership with the clinic. Their strategy
attempted to utilize both Aboriginal and clinic knowledge. Over time,
some Aboriginal participants became frustrated with the non-Aboriginal
clinic staff questioning their strategy. This appeared to be partly due to
the unequal power relations that have existed between Aboriginal and
non-Aboriginal people in Gapuwiyak for many years. Aboriginal partici-
pants perceived the questioning as white people still trying to ‘tell them
what to do’. In turn, these community members challenged the knowledge
and capacity of non-Aboriginal health professionals to address community
problems because they were not Aboriginal and ‘only visitors’ to
Gapuwiyak. The ongoing critical reflection facilitated by the project team
contributed to the Committee’s decision that they did have the capacity
to make health-related decisions. This critical reflection, together with
support from Aboriginal and non-Aboriginal team members, encouraged
Committee members to believe in their capacity and eventually they
began implementing their strategy.
The Committee began implementing the Family Centre in partnership
with the Council and the school, and by mobilizing local and external
resources. The first programme started in December 2001 when they
secured government funding to employ two Aboriginal playgroup
workers. In August 2002 they received further funding for a Family
Centre coordinator. Two years since project completion, the Committee
162 Danielle Campbell et al.

has continued to meet regularly and implement its strategy, which indicates
sustainability of this community-owned solution. Achievements to date
include securing the use of a Council building for the Family Centre and
government funding for extensions to the building; establishing a pro-
gramme of Aboriginal elders and Aboriginal health workers educating
young mothers in child care; and, organizing for the delivery of child
care training to community women. Once fully implemented, this strategy
has the potential to improve child growth, health and development.
By valuing local knowledge, the Committee challenged the clinic’s
monopoly on health knowledge. This resistance to the clinic’s attempts to
use its knowledge and authority to affect the conception of the problem
and solution is evidence of changed power relations. This constitutes
empowerment from a post-structural perspective, which views knowledge
itself as power (Cheek et al., 1996). Community participation in problem
assessment, collectively developing and implementing a strategy, mobiliz-
ing resources and forming partnerships are all important indictors of
individual and small group empowerment, which may contribute to
improved community health in the future (Laverack, 2001).
While it is significant that a group of Aboriginal community members
were able to take control over implementing a strategy to improve child
development, the full potential of the community development process
was not realized. In terms of community action the first programme of the
Family Centre started two years into the project and most aspects of the
strategy commenced after project completion. This confirms that
community development is a long-term process and outcomes should not
be evaluated prematurely (Baum, 2002). Unfortunately, some DHCS
health professionals judged this community development process a failure
because the community action did not contribute to a measured improve-
ment in child growth during the project period. Consequently, the lessons
the Department hoped to learn about supporting community action
have not informed its GAA Program. In terms of empowerment, the
project contributed to individual and small group empowerment, but not
‘community’ empowerment. A limited number of community members
participated in taking action in opposition to local health professionals.
The Aboriginal Committee gained increased control by implementing
their community-based strategy to improve child development outside of
the clinic, but they did not influence or take control of the delivery of
child health services in Gapuwiyak by DHCS. No attempt was made to
change the way the clinic deals with child growth or health. Thus, while
there were changes in power at the micro level, the structures that limit
the control Aboriginal community members have over their health services
were not challenged.
 Lessons on community development 163

Conclusion
The power inequalities inherent in the relationship between government
departments and marginalized groups means there are intrinsic challenges
when they seek to do community development in partnership. However,
the evidence of the futility of top-down government-led interventions
means they cannot simply opt out of doing community development. In
Aboriginal Australia this is particularly pertinent as government efforts
have failed to narrow the gap between Aboriginal and other Australians
in health outcomes, as well as income, employment and education.
Australian Governments are increasingly calling on Aboriginal people to
take responsibility for themselves and participate in solving their problems
in partnership with Government. Recently this ‘Shared Responsibility’
policy resulted in a remote Aboriginal community signing an agreement
with the Government whereby community members undertook to maintain
their children’s hygiene (among other things) in return for the provision of a
petrol pump (Dodson and Pearson, 2004). The Gapuwiyak Project demon-
strates that government does not need to bribe Aboriginal people to ‘take
responsibility’. In this case the determination of Aboriginal people to make
decisions and act to improve the health of their children was so great that
they did so without support from and in opposition to non-Aboriginal
health professionals. Given the limited control Aboriginal community
members generally have in addressing their problems, it is significant that
Aboriginal participants designed and implemented a health action strategy
that has been sustained several years after project completion.
While these are important community development outcomes, the poten-
tial for community development processes to contribute to measurable
health improvements and community empowerment could be increased.
Government departments and staff must be willing to share power in
decision making, not just responsibility. Shifting the blame for problems
to disadvantaged groups without giving them the power to determine
appropriate solutions will only compound these problems and contribute
to further disempowerment. Secondly, the capacity of governments to
support community development would be strengthened by training staff
in community development. In particular, non-Aboriginal staff working
in remote Australian settings require an understanding of the complexities
of working in this unique setting, including the ongoing impact of colonial
race relations and their associated power inequalities. Thirdly, governments
should support disadvantaged groups by funding and facilitating
community development processes over adequate timeframes and by
providing resources to implement community solutions. Community
development is neither a quick nor a cheap way to get poor people to
164 Danielle Campbell et al.

‘sort themselves out’. Rather they need encouragement together with targeted
financial and technical support (Berner and Phillips, 2005). Finally, the value
of community development implemented by government departments
would be increased by its routine application rather than as an add-on
to an otherwise ‘top-down’ approach. It is unrealistic to expect active com-
munity participation in the occasional community development process
when people are routinely marginalized by government-led attempts to
solve problems. This study demonstrates that community development pro-
vides a way for Aboriginal people to address their problems. The potential of
community development to achieve significant outcomes will be greatly
enhanced by governments fully supporting such processes.

Danielle Campbell was a PhD student with the Cooperative Research Centre for Aboriginal and
Tropical Health. She is now a Community Development Worker with the Warlayirti Artists
Aboriginal Corporation. Paul Wunungmurra and Helen Nyomba were the Yolngu community-
based researchers who worked on this project.

Address for correspondence: Dr Danielle Campbell, Warlayirti Artists Aboriginal

Corporation, PMB 20 Balgo, Via Halls Creek, W.A. 6770, Australia. email: culture@
balgoart.org.au

References

ABS (2002) 2001 Census of Population and Housing, Australian Bureau of Statistics,
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