Aboriginal health care from an Aboriginal doctor

Sometimes medical students come up with images to convey the immense struggle of staying on top of their subject. It’s drinking water out of a gushing fire hose. It’s eating an ever-growing stack of pancakes that could overwhelm you at any moment.

Dr Robert Blackley has his own analogy, “You’re drowning as you swim towards an island,” he says. “In final year, you somehow reach the beach. Then you look up and see this incredibly high mountain. But by then, you think maybe you can climb it.”

A couple of things made Blackley’s swim unusual. He was 40 when he started his medical studies. He was also powerfully motivated by his years growing up on Palm Island in Queensland, where Aboriginal men like him, had a life expectancy of just 42 years.

“I was actually born in Townsville because babies weren’t often delivered on Palm Island because of high mortality rates,” he says. “They still don’t let babies be born, by choice, in the hospital there.”

Blackley tells his story in an easy flow that touches on remarkable experiences; some lived in a beach shack with no running water, others in the glossy corridors of government power. His voice is calm and his facial expressions subtle, but they richly convey happiness, nostalgia, optimism and, at times, deep sadness.

“Since being a small child in the playground, I thought that there should be a sense of justice and fairness in things, and that’s how I acted, too,” he says. Events in his life soon told him that not everyone thought that way.

Many things shaped Blackley into who he is today; the threat of being removed from his white, schoolteacher father and Aboriginal/Torres Strait Island mother because mixed marriages were unacceptable; the positive time later spent in an Anglican boarding school with the prophetic dormitory motto ‘equal to the task’; being in the bush with strong tribal peoples who gave him his cultural knowledge (“I walk in the world very much as an Aboriginal person, grounded in the Aboriginal cosmology of creation").

Still, it was Palm Island and the needs of its people that most strongly drew Blackley’s path through the world.

As a young man living on the island, he was so appalled by the poor quality of the food sold in the state-run store (“People talk about eating healthy food, but what if it’s just not available?”), he started his own business selling fresh fruit and vegetables from a shipping container. Not long after, that shipping container had a sign out front announcing that Blackley was running for council.

His step into public life gained its own momentum. By the age of 21, and as a new father, Blackley was sitting on the Palm Island Council. He was soon pushed forward to confront government ministers about the poor legislation that governed Aboriginal people.

By 24, he was Palm Island’s mayor, making him Australia’s youngest ever, though thanks to some of the problematic legislation he was working to change, he could only be called chair of the Palm Island Aboriginal Council. He lasted only a year before his push against corruption saw him ostracised. He moved to Cairns.

The events and roles of the following years are too numerous to list here. But two stand out: when the possibility of a medical career first crossed Blackley’s path (“A medical school opened in North Queensland. They said, 'Come and do medicine. Rio Tinto will pay for everything.' It was hilarious”); And he was tapped on the shoulder by then Queensland premier, Peter Beattie.

That tap led to Blackley becoming a ministerial adviser in the double ministry of Aboriginal and Torres Strait Islander Policy and Women’s policy. “I’m twenty-seven. I’m in a suit. I’m in Parliament House. The work was interesting, but we’d drink $200 scotch and talk about managing the drinking of Aboriginal people. I didn’t like what I was becoming."

“One day I looked in the mirror to shave, and I couldn’t,” Blackley says. “I had the razor and couldn’t shave my own face.”

Not long after, Blackley was back on Palm Island and re-engaged with improving things for the people there: environment, education, health care.

The following years were a tug of war between energetically working for his community and fighting a heavy darkness that would drop him into listless despair. On his 34th birthday, Blackley had his last drink, cleaned himself up and embraced some lifelines that had come his way, including his now wife, Marisa.

Again, medicine entered the frame.

“A minister turned up to Palm Island and I could see what was happening. He was thinking, ‘I’m on Palm Island. There’s cameras, the media’s here – I have to announce something.’ So he did.”

The announcement was that two Palm Islanders would be trained as paramedics. Blackley applied, was granted one of the positions and began training with Queensland Ambulances. He studied online while being part of the Palm Island ambulance team.

“It was tough, but I was loving the life,” says Blackley. “Fast-driving the ambulance to all sorts of mad stuff. And all those patients, they all had their own human stories. But I was cutting down friends who had hung themselves from trees. Eventually, I had to ask for a transfer to Cairns.”

With urging from his wife, who herself had two degrees from the University of Sydney and was then finishing undergraduate medicine at James Cook University, Blackley eventually did the exam to study medicine at the University of Sydney, and he was offered a place.

“Become a doctor. It was kind of an outlandish plan,” Blackley says, still slightly baffled by the idea. “But getting that offer in the mail from Sydney Medical School was huge.”

“The University does good things for the Aboriginal students,” he says. “There’s a support team, a little a bit of financial assistance. I was given a public transport travel card – I loved that card. And they gave me a laptop which I’ve only just upgraded.”

Study soon threw Blackley into the deep end, where he had to swim for all he was worth. As others fell by the wayside, to his own amazement, he continued on.

“Clinical medicine, I did really well at because I was already a paramedic and knew how to talk to human beings,” he says. “Then, just before one of the toughest exams, our baby came along.”

Clearing every obstacle, though sometimes just barely, Blackley graduated in 2019. He is now in Darwin Hospital, a 45-year-old Resident Medical Officer reporting to supervisors in their 20s but with a strong goal driving him. He wants to help break down the intergenerational distrust of the medical system that exists in Aboriginal communities.

“In places like Palm Island, there are memories of terrible mistreatreatment and medical experimentation,” says Blackley. “And today, the health care system is still notorious for short-changing the Aboriginal patient.”

The difference that Blackley hopes to make is based on one of his own memories. 

“When I first saw an Aboriginal doctor on Palm Island, I cried,” he says. “And the line outside his door was long.” 

Learn more about our Aboriginal and Torres Strait Islander pathways for the Doctor of Medicine (MD) and Doctor of Dental Medicine (DMD).

Written by George Dodd for Sydney Alumni Magazine. Top photo by Oluwaseyi Johnson on Unsplash.