Health and water in remote Indigenous communities

by The University of Queensland



A scan of the current status of water, sanitation and hygiene services and challenges in remote Australian Indigenous communities identified challenges and options for stakeholders to respond to these challenges.

Project implemented: July 2017

Project goal

To understand the status of SDG6 in remote Australia- in order to meet the targets.

delivering on

why is this project important?

The population living in remote, discrete Indigenous communities in 2011 was approximately 116,000 in 2011. The 2016 Overcoming Indigenous Disadvantage report identified that health outcomes for remote Indigenous communities were compromised by a range of environmental health factors within homes and communities. Water, sanitation and hygiene challenges such as poor water quality, limited access to safely managed water, hygiene status and marginal living conditions, have been seen as contributing to these continuing health disparities.

A discussion paper from The University of Queensland and WaterAid ( presents a scan of the current status of water, sanitation and hygiene services and challenges in remote Australian Indigenous communities. It was conducted to make explicit the challenges requiring attention and to propose questions to stimulate discussion as to how various stakeholders can respond to these challenges. It was guided by examples of initiatives that have improved WASH services and behaviours.

The results outlined in this report can be summarised as:

  • The status of drinking water was influenced by adherence to Australian Drinking Water Guidelines, which was more likely in areas where centralised utilities operated across the whole state or territory. However, contamination of drinking water remains a risk where monitoring regimes are not rigorous and consistent. The use of bore water is problematic as it may contain naturally high levels of microbial and chemical contaminants. This can also make the water unpalatable, and cause a preference for sugared drinks.
  • The status of sanitation (wastewater treatment) has improved with the increasing installation of centralised wastewater treatment replacing onsite septic tanks. These systems are effectively managed by centralised utilities that have increased service level, decreased response times for repair, and subsidised costs. Where implemented, the approach of ‘fit for purpose, fit for place’ has resulted in wastewater treatment options being technologically, socially and environmentally appropriate. Despite these improvements, concerns remain regarding self-certification of wastewater installations in the NT, irregular wastewater output monitoring regimes, incompatible items flushed down toilets, and high turnover of wastewater management staff in communities. An additional sanitation issue is waste management, where increased availability of waste bins and the regular emptying and cleaning of bins could improve sanitation levels.
  • The status of hygiene and related health issues is the area of greatest need for dedicated programs and funding– especially as chronic infections in early childhood are often linked to vulnerability to other diseases in later life. Significant overcrowding (e.g. 20 residents in a 3 bedroom house) limits the ability of individuals to maintain personal and environmental (clothing, bedding and infrastructure) hygienic conditions, which can negatively affect their health. Some girls are missing school each month– potentially due to a lack of knowledge and products for menstrual hygiene management. Australia is the only high-income country that still has endemic cases of trachoma, a preventable eye infection.

A range of effective contributions have enhanced the status of water, sanitation and hygiene. This includes ongoing programs to fund long-term and well-maintained water and wastewater treatment services; to repair and upgrade health infrastructure in communities; to build new housing in communities with insufficient accommodation; and to ensure functioning hardware in homes to enable effective washing and cleaning.

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