Unwanted flirt and unwanted bunny

13 August, 2010
Lunchtime today I got a call from Mutitjulu Community at Ayers Rock, from one of the aunties to the kids I know. “There’s bin bad luck <death>. Can you go over there and find out?”. Really, who? She guessed a couple of young men, describing them by who they’re married to as the names of recently dead should not be uttered. Oh really?! Yeah, police and ambulance was there.

So I got in my car and drove out, fully expecting to find a Sorry Camp in full swing. I pulled up at a neutral place, so as not to disturb anyone’s mourning, and got out. Only to be greeted by happy kids wondering what I was there for? Is everyone okay? Yeah! Really, everyone? Yeah!

My friend Rosie was across at a different location to usual, and waving out to me so I got back in the car and drove over to her. Is everyone okay? Yeah, why? Because I heard there’d been bad luck? Nah, who told you that? <Aunty> rang me up and asked me to come out, she said the ambulance and police were out here and wanted me to find out. Nah, there was accident over there, but it wasn’t us and they all okay, they went to hospital! OH! PHEW!

So we rang aunty and let her know, then I went to leave, and an old patient of mine known as Tiwi was already sitting in the passenger seat of my car, wanting a lift to a place just down the road. Okay, but who’s paying the fine if I get pulled over and you’re holding that beer can in my car? Nah, it’s alright, drop me! Well you’re paying the fine Tiwi! No comment.

Tiwi regularly tells people “Alan always look after me and worry for me, she my Other Mother”. I am old enough to be his mother, which shocked me the first time he said it and I did a quick calculation.

As we drove along he announced “You real old, Alan”. Oh, thanks for that. “Nah, but you look young, but you old!”. Oh, well thanks then..?! You got noone, eh? <A common question – no boyfriend, no ‘usband and no kids. Poor Alan, how dreadful it all must be>. No. Why you got noone? Because I like to be single, I am happy to be single. Well you should get black man because then you can learn all culture stuff. Oh? Yeah, you can learn all culture and language if you get black man. Righty-ho I’ll keep that advice in mind, thanks. “Alan! Stop looking me like that! You always look in my eye! And don’t smile! Just leab it, don’t smile at me, okay?”. Errrrrr….. Awkward!  “I might come and visit you oneday”. Yep, no worries, but only if you’re sober, no drunks at my house. “Nah, I’ll come sober oneday”. Yep, alright, but there’s no rush, okay?

Rabbit Procurement

19 August 2010

I’ve inherited a bloody rabbit !!

Last night a car load of people turned up over the road, making the biggest raucous, god knows what was going on out there but as soon as I heard it (I was on a work call at the time) I knew it was for me.

I answer the door and there’s Molly with son 1 (13), son 2 (10) and daughter (7), and large cage with small furry rabbit looking extremely out of place!

We got nowhere to stay tonight, <ex husband, father of kids, who isn’t averse to hitting Mum> is staying somewhere but look (and brings my hand to a lump on her head). Well, I am working tonight because there’s some sick people we need to talk to, so I can’t look after kids. Oh, well we don’t know where we staying. Well if you stay in the lounge while I do my work. Okay. So we go out to the car and it’s heaving with people, none of whom I could see except ex-husband in the drivers’ seat, who isn’t speaking to me because he knows I called the cops on him recently. She gets whatever she needs out of the car, and from the darkness a voice says “hello Helen”. Mathew! Hello! He gets out and gives me a hug, and says he’ll come to visit me today.

So in the family came, and I won the argument about whether the rabbit was going to stay inside (because it’s warmer) or outside (because I say so). Huge pot of porridge this morning, and off they came with me to work and I dropped them off on my rounds to the temporary accommodation where grandma and grandad stay. Rang the relevant domestic violence organisation and told them that they need to work something out because I can’t play hostess again tonight.

Rabbit remained on my verandah for the day.  When I got home, I read up on rabbits and I really don’t want to give this rabbit back! I’m going to try and get them to let me keep him/her. He/she needs a same-sex companion, and the cage it is in is totally inappropriate, it needs natural ground and mosquito mesh etc. I was feeding it beans, which I’ve just read are a no-no so I hope I haven’t already killed the poor little mite.

If they let me keep it, I’ll get a proper hutch etc. Gawd! But the poor thing, it’ll die otherwise, not because they’d be cruel, but they just won’t research the necessities etc.

28 August 2010

After about ten days on a steep curve, learning how to care for a rabbit, I managed to find someone living a few blocks away whose rabbit recently died, and they came to see Whitey, aka Button, aka Punchinello (he had a few name changes), and decided to take him.  What a relief!  I had him in my bedroom and he took off under the bed, and it was some performance getting him out from under there, to meet his new owners.

When the original owners came back and he was gone, I told them that he had run away.  Far easier than admitting I’d given him away!

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A Dog Act

ImageIt’s almost impossible to think of things to say on a blog with no audience! Obviously I’ve never been one to keep a journal, and I’m not a writer at heart. But I’ll persist for now, and see if practise makes it easier.

I might try and make a post at least once a week, maybe more if I can muster the energy, by way of putting it into practise.

Currently I have a 12yo boy whose parents both died recently, staying with me as a temporary foster child. He’s been with me on-and-off for the past 7 months, but last week it was made an official situation. He’s lots of fun, and incredibly well behaved, gets on well with other kids, goes to school everyday without any nagging from me to wake, eat, shower, dress, etc. He has a lovely nature, and is easy to have around.

That’s my biggest news.

Smaller news, I had a weekend in Adelaide, arriving home this afternoon, and went to see Cirque du Soleil with a friend on Friday night. It was fabulous, literally an other-world of magic, the costumes, the gymnastic skill, the colour and the music. An absolute spectacle!

Stumbling into Domestic Violence

A few days ago while visiting a camp, a woman I know called out to me from across the dust some way, to call an ambulance. I went over to the house and was waved in to the verandah, where I was confronted with the picture of a woman sitting cross legged beside a sheet of tin with some burning firewood on it, whose head was smothered in old blood, hair matted together, left eye unable to open properly, both arms swollen and at least one of them looking probably fractured. She seemed close to tears – hardly surprising.

I asked what happened? Someone bin ‘it ‘er. Who? No reply. What with? Stick like this (pointed to one of the firewoods). A man was standing nearby, as though he was staying around to hear what was said, but I might be wrong about that. Some of the women were hovering as well, and it’s not my place to assume he was the culprit.

I rang the ambulance and they asked me a series of questions including about who did it, etc. I told them what I knew and also stated that I was there alone, and it wasn’t my place to be prying. That’s what police are for.

I sat with her until the ambulance arrived.  They were superb, really kind and gentle with her. She needed help getting up, due to both arms, but once she was up, she walked over to the ambulance.

I contacted some domestic violence people about her a few days later. They went to see her and took a policeman with them, but she would not speak. They attended again the following day with a female officer, and she disclosed the perpetrator who was arrested almost immediately.

Some Town Camp Experiences

I’ve spent a chunk of this weekend watching the complete first season of a show called The Wire,   Set in the housing projects of West Baltimore, it’s a gripping picture of drug dealing, murder, and corruption, linking 16yo drug runners to corrupt politicians, showing the relationships that police have with each other, with their drug addicted informants, the connections between police and politics, corruption within both, and the complex dynamics which can determine the way a case will go, etc.

The town camps of Alice Springs, where I have spent some of my working life over the past ten years, could be compared in some ways to these housing projects.  Only the power that the middle and higher level drug dealers have in America, doesn’t exist in the town camps.  There’s obviously drug dealing in the camps, because marijuana is easily available as is what they call “grog running”, the illegal supply of alcohol to banned drinkers, in what are supposed to be dry areas.

In the past few years I’ve written bits and pieces about my experiences in the camps, which accommodate large, often overcrowded groups of marginalised indigenous people living inside a sub culture that  has a life of it’s own in Central Australia.

Most people who live in Central Australia don’t go into the town camps.  Including services that exist to service them.  A number of health services, for example, have a rule that if they have to service someone who lives in a town camp, then that resident has to be moved to accommodation out of the camp before they can receive the care they need.  My understanding is that the rationale behind this, is due to the perception of “danger” that exists in the camps.  However, in ten years of attending the camps, which began as something I did for work, but evolved into something I also do in my spare time, visiting the children and families that I have developed relationships with, I have not felt in danger once.  I don’t agree with the approach of not servicing inside the camps, given that the perceived threats can just as easily exist at any town address you are unfamiliar with; building relationships with patients in this setting can’t be about the individual and has to include the whole family and community.  I have solid connections with many people in the camps now, which I would not have, had I only serviced individuals who were moved to accommodation for the duration of their treatment.  I very strongly believe that until the brick walls that services build up, are knocked down, no real difference will be made to the health and wellbeing of town camp residents.

Meanwhile, my experiences in the camps have given me many moments of light hearted joy, despite the poverty and self destruction that exists, and I enjoy writing about these experiences, which I’ve decided to add to my blog.

30 June 2010 : Abbotts Camp

I pulled up at my patient’s house and walked into the yard. While I was standing on the verandah with Nerida and her husband Claude (nom de plumes, as always), a very old man who I’ve never seen before, with a huge bushy beard, filthy dirty clothes, walking around in his socks with a walking stick and blind in one eye, walked up to my car, peered into the window, then OPENED the passenger door! I shouted out from the verandah “Wiya! Wanti!” (No! Leave it!). He couldn’t hear me, but he was just opening the door to try and see if anyone was in the car, and when he realised there wasn’t, he shut the door again, but stayed beside the car.

When I came back to the car, he says one word to me, the name of a place in town. I said okay, I can take you there. He got in the car and he couldn’t speak ANY English. He introduced himself by stating his name and offering me a hand to shake – his long and curved fingernails need clipping badly.  Then he told me “Papunya”, so I knew his language must be Luritja, which I don’t speak at all but I said some random words I know in language and he gave me the thumbs up.

Then he started listing, and counting them with his long skinny index finger pressing against the five fingers on his other hand, “Papunya …. <then a few names unknown to me> …. Kintore”, places he’s either from, or travels between. So I said “Oh, have you got family in Kiwirrkurra?” (the next community from Kintore, over the WA border). He couldn’t understand my pronunciation (I don’t roll my R’s as the name requires) so I repeated it a few times and he finally worked out what I was saying! Yuwa, Kiwirrkurra! Then he continued across WA – naming places and pressing a different finger with his index finger with each place name, and finally ending with Port Hedland. I said Port Hedland? That’s a long way! To which he said, very clearly, “It’s a pukkin long way!”.

Abbotts Camp, 8 July 2010

Nerida and Claude again.

I arrived at their house and Nerida announced to me “I bin nearly FIT” yesterday, before offering a demonstration with her eyes rolling back in her head, her head falling back, etc.  Claude joined in with “she bin nearly FIT! Must be that medicine you gib her, eh?”. Which one? “You know that one you bin gib her?”.  I couldn’t really think what he was referring to, but the conversation continued without any confirmation or denial from me.

Claude then said  “One old man from Dokka Ribber bin fix her!”.
Nerida: “Yeah, that man bin tell me, Nerida! Take your shirt off!” <and demonstrated pulling her shirt off>. “He say, Nerida! You sick! And E can see through ‘er, like x-ray, you know? E’s like, you know, Medicine Man, that old man, from Dokka Ribber, and E bin pull out really big STICK from her stomach!”.
Really!? WOW!
“Yeah, it was really big that stick, E pull it out from her, then he put it away, down like this” <demonstrating the stick going down by the Ngangkari’s side>.
What did he do with the stick?
“E bin put it ‘ere like this”.
Okay (I meant, what did he do LATER with the stick but didn’t persist with my questioning!). So I asked, what’s his name? Ummmmmm…. We don’t know, because we don’t really know ‘im, e’s from Dokka Ribber, ‘e’s old man, well little bit old really, like maybe your same age.  I was horrified by this, and protested, which caused a lot of laughter.

 

There are many more stories like this to come, I just have to uplift them from another location, and edit them.

Thinking of things to say

It’s almost impossible to think of things to say on a blog with no audience! Obviously I’ve never been one to keep a journal, and I’m not a writer at heart. But I’ll persist for now, and see if practise makes it easier.

I might try and make a post at least once a week, maybe more if I can muster the energy, by way of putting it into practise.

Currently I have a 12yo boy whose parents both died recently, staying with me as a temporary foster child. He’s been with me on-and-off for the past 7 months, but last week it was made an official situation. He’s lots of fun, and incredibly well behaved, gets on well with other kids, goes to school everyday without any nagging from me to wake, eat, shower, dress, etc. He has a lovely nature, and is easy to have around.

That’s my biggest news.

Smaller news, I had a weekend in Adelaide, arriving home this afternoon, and went to see Cirque du Soleil with a friend on Friday night. It was fabulous, literally an other-world of magic, the costumes, the gymnastic skill, the colour and the music. An absolute spectacle!

An Essay on Indigenous Health

This is an essay I wrote some 10 or 11 years ago, as part of a Bachelor degree course in Nursing. It remains relevant, sadly, to this day.

The health status of Australia’s indigenous people today remains far below that of the general population, with life expectancies comparable to India and Central Africa. Many nurses working in Australia find themselves in remote areas caring mainly for Aboriginal people of whom they have little understanding. It is hoped this paper will provide a basic awareness of indigenous Australians and the reasons for the ill health they experience today.

Indigenous Australians have lived in Australia for over 50,000 years and their culture encompassed over 500 tribes with individual languages and customs, with certain commonalities that could perhaps be compared to the common links between different European cultures.

In the lifetime of a few generations this distinct culture has had to adapt to changes which took thousands of years to spread in other parts of the world.

When Captain Cook landed in Australia in 1770, despite encounters with indigenous people, he claimed that the land was uninhabited and Britain procured ‘legal’ ownership by classifying Australia as ‘terra nullius’, meaning ’empty continent’.

There was both legal and scientific support for a racist attitude towards the indigenous population, who were used by Charles Darwin and the evolutionary scientists as evidence of a “missing link” between man and the animal kingdom. This resulted in treatment such as hunting, rape and massacre of the Aboriginal people on a huge scale.

It is acknowledged that “few doubted at the time that Genocide was official policy. A government report in the 1850s spoke of the success of poisoning Aborigines; 100 of them laid out at a time”. Although the Aborigines resisted, their population was swiftly decimated by violence, as well as a lack of immunity to introduced diseases.

Since European colonisation, Australian governments have dominated the lives of indigenous Australians, who are claimed to be the most legislated people in the world. Reserves and missions were set up and Aborigines were forcibly moved to them, where they lived in crowded, dirty conditions, with high morbidity and mortality rates.

Until the early 1970s an Assimiliation Policy legalised the forcible removal of light skinned children from their darker parents, in an attempt to assimilate these ‘half castes’ into mainstream society. Police were used to find and take the children, with orders not to tell the children or parents where they were being taken. Although there were some exceptions, most parents did not freely give up their children, and usually contact between families was discouraged or prevented. The experiences of these children were varied, from those exposed to various forms of exploitation, to those who found happiness with adoptive families.

Many Australians today will argue that the practises of forcible removal had beneficial outcomes for the children who were taken. Irrespective of the intentions of the policy makers at the time, the National Inquiry into the Stolen Generations found that compared with people who were not removed, these children are in fact not better educated, not more likely to be employed, and not receiving significantly higher incomes. They are twice as likely to have been arrested more than once in the past five years, and twice as likely to assess their own health status as poor or only fair.

In the 1950s the Australian government sanctioned the testings of nine nuclear bombs by the British government on Australian land in Maralinga, South Australia and Monte Bello, Western Australia. These bombs were twenty times greater than the Nagasaki and Hiroshima bombs. It was known at the time that Aboriginal people were living in these areas. The effects included los of sight, skin rashes, radiation poisoning and hundreds of families forced to leave their homelands due to severe contamination.

Other legislation affecting Aboriginal people has included lack of equal pay, segregation and inequality of health care, curfews from certain towns and cities, and alcohol prohibition.

The 1991 census counted the indigenous population at 265,459, or 1.6% of the total Australian population. Their unemployment statistics were almost three times those for non indigenous people. 63.5% of Aborigines reportedly earned less than $12,000 p/a, while 2.2% earned above $35,000. Females die 19 years younger and males 18 years younger than their non indigenous counterparts. Hospitalisation occurs at 70% (males) and 57% (females) higher than the national average. 25% of Aborigines live in remote areas, that is towns with less than 1,000 people, limiting their access to various services including health.

Despite these statistics, there is a belief within segments of Australian society, that Aborigines are not disadvantaged, and even that they live privileged lifestyles on government money.

Alcohol prohibition to Aborigines was enforced in individual states and territories until between 1957-1972. This did not prevent their access to alcohol or other drugs, so they were often arrested for using alcohol. Exemption clauses existed, whereby those who could prove they complied with required standards of hygiene, intellect and good (non indigenous) company, could legally consume alcohol. Like many other indigenous populations throughout the world, some Aborigines now associate ‘drinking alcohol’ with ‘equality and status’. Further causes of alcohol and substance abuse in the indigenous population include low self esteem, depression and alienation.

Growing use of other illegal substances such as petrol sniffing and kava misuse are creating major social problems in some areas. Related causes of morbidity and mortality include accidental or violent injury, toxicity, epilepsy, heart disease, hypoglycaemia, pancreatitis, cirrhossis and pneumonia.

Aboriginal people are placed in police custody at up to 26 times the rate for non indigenous people. They are over represented for offences of disorderliness, assault and drunkenness, whilst being under represented for homicide, robbery, theft, fraud, sexual offences, driving and drug offences.

In 1991 the Royal Commission into Aboriginal Deaths in Custody published it’s final report. Despite evidence showing likelihood that a considerable number of Aboriginal deaths in custody between 1982 and 1991 were the result of violence by police or prison officers, investigations into these cases were not recommended and have not taken place. However, the recommendations made did include vetting police and prison officers, abolishing public drunkenness as an offence, and presuming homicide rather than suicide when investigating future cases of Aboriginal deaths in custody.

Diseases such as obesity, diabetes mellitus, hypertension and cardiovascular disease are causing high rates of premature mortality in the indigenous population. Many Aboriginal people consume large amounts of sugar, meat and tea, which became their staple diet during the days of missions and reserves.

Renal disease is ten times higher in the Aboriginal population than non indigenous Australians. There are a number of reasons, including non insulin dependent diabetes, glomerulonephritis (often resulting from widespread outbreaks of streptococcal skin infections), hypertension and chronic infections.

Malnutrition is experienced by half of the children in some communities. Reasons for this include poor maternal health, low birth weight, diarrhoeal and other diseases resulting in loss of appetite and malabsorption, along with the social issues of family disruption and disintegration.

Although infant mortality has declined since the 1970s, childhood infectious diseases remain rife and are recognised as having a close relationship with standards of living. Diarrhoeal disease is acknowledged as a serious health problem in many Aboriginal communities, especially among infants and children who are at higher risk of associated dehydration and malnutrition. Lack of good quality water, poor hygiene, unsafe sewage disposal and contact with poorly kept animals such as dogs which carry and transmit bacteria and parasites are common reasons. Other conditions resulting from substandard living conditions which are prevalent in Aboriginal children include pneumonia, upper airway infections, otitis media and skin infections.

Trachoma is disproportionately prevalent in the Aboriginal population. This results in a large proportion of avoidable blindness in Aborigines.

Tuberculosis among Aborigines is 15 to 20 times higher than in non indigenous people. Overcrowding and homelessness combined with diseases such as malnutrition, alcoholism, renal failure and diabetes mellitus are all high risk factors for tuberculosis infection.

Sexually Transmitted Diseases (STDs) are very high among certain Aboriginal groups and can be difficult to diagnose and treat. Whilst HIV is thought to be uncommon in Aborigines at present, the infection rate could change rapidly given it’s history of rapid change in overseas populations, and the high risk factors Aborigines are exposed to.

Given the disproportionately high rates of hospitalisation occurring in the indigenous population, the overall health care system which serves these people remains dominated by a western, authoritarian approach. It is vital that nurses and other health care professionals working with Aboriginal people educate themselves in the issues specific to Aboriginal health. Understanding the ways in which Aboriginal people view health and illness will provide the health professional with an understanding of why hospitalisation is resisted by many and only used as a last resort.

Aboriginal people today combine traditional therapies with mainstream health care methods. Traditional healers will sometimes visit patients in hospital to perform or administer therapies, and they are used much more frequently in community settings.

Australians often perceive neglect and vandalism of houses as a form of cultural behaviour inherent in Aboriginal people. However, a publication about health inequalities in Britain noted that bad design of buildings can lead to a lack of respect by some inhabitants. Living in squalid conditions was in turn associated with depression and mental illness.

A study conducted in a remote Australian community in 1994 negated the theory that lack of respect in Aboriginal housing can be explained by ‘cultural’ behaviour. To the contrary, it was found that when functional houses are provided which are adequately maintained, for example plumbing and electrical faults repaired, Aboriginal people do look after their homes. Poor construction was attributable to 70% of the maintenance costs in this study.

A survey in 1992 found that over 300 Aboriginal communities nationwide did not have adequate water supplies and 134 did not have a proper sewerage system. In 1991 one third of the Northern Territory’s Aboriginal population were reported to have no access to a safe water supply. Personal accounts are heard of Aboriginal people spending large amounts of their small income on purchasing bottled water for domestic consumption.

In the 1990s both the Native Title Act and the Wik Decision were passed in Australian courts amidst a frenzy of fear and protest. The Native Title Act overturned the previously held law of “terra nullius” which had stood for 200 years. Indigenous people now had a legal basis to claim ownership of land with which they can prove they have maintained traditional ties. The High Court recognise that Native Title has been extinguished on all freehold and most leasehold land due to dispossession of such land from the indigenous people since European colonisation. As a result, Native Title only applies to a small percentage of Aboriginal people and mainly to remote Australia.

The Wik Decision 1996 was passed on appeal by the High Court of Australia. It concluded that the Wik and Thayorre people of Far North Queensland had native title of the land on which they live, which is an Aboriginal reserve upon hich their people have maintained continuous occupation. Such title is in co-existence with a pastoral lease of the same land which has never been permanently occupied or fenced, and carries a small number of unbranded cattle. The current lease expires in 2004. However, the High Court ruled that native title rights would be subordinate to those of the leaseholder in any cases of conflict.

Despite these facts, and although pastoralists have never had exclusive possession of pastoral lease land, the frenzy in the wake of the Wik Decision led to leasehold pastoralists en masse, demanding freehold title to their leasehold land, which Prime Minister Howard is in support of.

Sheryl Kernot, the leader of the Australian Democrat Party, in 1997 called for an “understanding of the way in which traditional and historical connection to land and water and cultural resources is central to the identity of indigenous Australians, to their community, and to their sense of justice”. Land which indigenous people have maintained traditional ties with should, as a basic human right which we are all entitled to, be inherited by it’s inhabitants. Evidence shows that when such land rights are accorded to Aboriginal people, they become capable of self determination and the resulting positive effects include improved health. To this day, mainstream political support for indigenous land rights remains unattainable.

Conclusion

It is recognised by many that indigenous people themselves need to make positive changes to their circumstances, and take responsibility for their own health status. Aboriginal people are calling for self determination. However, a self determining culture requires the necessary resources, such as educational standards within their own population, and political support, before they can take control of their own situation.

This paper demonstrates the link between Aboriginal culture, Australian history and the ill health of Australia’s indigenous people today. There is an argument for stronger social and political support, for renouncing the dominant ethnocentric view and trying to understand the broader needs of a disadvantaged people. Our association with Aboriginal communities gives health professionals a responsibility to be informed about the wider issues affecting their individual and social health. Nurses have a unique and important role to play in advocating for the needs of indigenous people.

Struggling to write

Hmmmm, well it’s now two weeks since I added anything to my blog. I’m finding it hard to write here, almost a feeling of having ‘writers block’. Hopefully the more I write, the more comfortable I will become with writing.

In the past two weeks, a lot has happened. I have sold one home (an investment property in Darwin), and purchased another here in Alice Springs, which will be the first home I’ve ever owned and lived in, so I am very excited about my new status as an “owner-occupier”!

I spent Easter in NSW with my cousin, Rachel. We spent two nights in the Hunter Valley, staying at a beautiful hotel, the Sebel Kirkton Park, a lovely new but heritage-style complex with stunning Italian style gardens and great views over the valley. We had a day cycling around the wineries, and generally just spoilt ourselves.

Work is going great-guns, I have some very special days where I’m not only busy but also challenged on a number of levels, and it’s certainly never boring. While we only see about six cases of active TB per year, we do a lot of preventive work, which involves treating people who we know are infected with TB, to prevent them from becoming unwell. We also spend a lot of energy looking for active TB, which means talking to people who are contacts of people with known TB, and testing them and following them up. I spend a lot of my time with people who speak the Arrernte language, and am slowly but surely becoming an un-fluent Arrernte speaker!

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