For people living in metro areas, a broken hot water system or washing machine is a nuisance. But it can usually be sorted by a phone call for a same-day repair or a quick trip to the hardware store.

In remote communities, the same repair is slowed by distance and lack of services, often taking weeks or months to fix. When families can’t easily wash themselves or their clothes, the risk of infections, including skin infections, rises.

Compared with non-Indigenous Australians, Aboriginal people are 2.3 times more likely to be hospitalised and 1.7 times more likely to die from illnesses linked to poor environmental conditions.

Illnesses such as acute rheumatic fever and rheumatic heart disease – often driven by untreated skin sores and sore throats – remain common in remote communities. These diseases were once widespread among all Australian children, but have largely disappeared elsewhere thanks to improvements in housing and services.

Read more: How we partnered with local communities to halve skin sores among Aboriginal children in remote WA

There’s been plenty of public discussion about remote housing but the voices of people living with these conditions is usually missing.

To inform this discussion, we yarned with more than 200 people over four years about housing, infrastructure and the services they rely on to stay healthy across nine communities in the Kimberley region of Western Australia. Our results are published in Health & Place.

Long waits for repairs

People told us they had no choice but to live in homes too small for their families. This pushed plumbing, hot water and laundries past breaking point.

Once broken, they were unable to be repaired until the next service trip, often months later. Many told us they relied on relatives or neighbours while their own taps, showers or washers sat waiting for repair.

People told us they knew the environment was making them sick when basic services failed, but they were limited in what they could do about it.

Local Aboriginal environmental health teams – praised by community and able to handle small jobs – were constrained by narrow remits, funding limits and bureaucracy.

Those living in public housing also faced a convoluted process in order to achieve repairs.

One local woman taught herself to fix a broken industrial washing machine behind the art centre so Elders and mums could wash their clothes and linen. When we asked why, she said:

It was for the old ladies. I wanted to help make sure they felt clean.

She has run this unofficial community laundromat for a decade.

What’s causing this?

People framed inadequate housing maintenance and household “environmental health” in remote Aboriginal communities as the cumulative result of successive state and federal policies that have failed to deliver.

Decades of policy fragmentation have normalised substandard environmental health in the home. None of this was new to the people living it. Their stories have been consistently ignored.

These housing and inadequate environmental conditions sit within a longer history of colonisation: dispossession, mission and pastoral control, and later public housing regimes that centralised asset ownership and decision-making away from Aboriginal communities.

When families can’t access secure land and home ownership, they become dependent on government housing systems, with limited ability to assert their rights. Economic exclusion compounds this: distance, wet-season logistics and chronic under-investment drive high costs and long delays.

Homes have often been built without genuine community consultation, leaving dwellings that don’t fit local family structures, climate or daily life.

Read more: We need to design housing for Indigenous communities that can withstand the impacts of climate change

Closing the Gap commits all governments to improve housing. To get there, however, consultation is needed with remote Aboriginal communities themselves, as well as policymakers and experts, including those in preventive health. This should happen before any build or upgrade.

Too often consultation is skipped or rushed to save time and costs, resulting in houses that fail their residents and requiring frequent repair.

What’s the solution?

Addressing these inequities requires clear, measurable standards and accountable delivery:

  • decision-making rights for residents and local communities

  • locally based maintenance with guaranteed response times and transparent reporting

  • sustained funding for new builds, maintenance and remediation

  • community-led housing design that tackles structural crowding and the realities of remoteness and climate change.

Most importantly, there should be increased reliance on local service providers operating in these regions. These teams already have community trust and should be the first call, not the last.

As well as housing, health care should also be co-designed with communities to include a strong focus on prevention, primary health care, community engagement and capacity-building for local health services. This also requires greater funding and support.

Ultimately, listening to communities is the most important way forward. The culture and uniqueness of remote Aboriginal communities thrive despite challenges, but people shouldn’t have to contend with conditions that wouldn’t be accepted elsewhere in Australia.

As a local Elder emphasised during our conversations:

You need to be healthy, kids need to be healthy. We don’t want them to get sick, they’re the future, the future of our communities.

Read more: Aboriginal housing policies must be based on community needs — not what non-Indigenous people think they need

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Stephanie Enkel, The Kids Research Institute Australia; Asha Bowen, The Kids Research Institute Australia; Hannah M.M. Thomas, The Kids Research Institute Australia, and Rachel Burgess, The Kids Research Institute Australia

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Asha Bowen receives funding from the National Health and Medical Research Council of Australia, and Medical Research Future Fund.

Hannah M.M. Thomas receives funding from the Future Heath Research and Innovation Fund.

Rachel Burgess and Stephanie Enkel do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.