Leavina Reid was not in a dilemma. She knew precisely what she had to do. She couldn’t afford to have the doctor treat both of them, so she handed over her baby.



Although Reid and her daughter were both ill, the GP would bulk bill for only one of them and Reid, a Weilwan woman from Gulargambone, didn’t have the money to pay for herself.

At that time, 20 years ago, the cost of medical treatment was not just a problem for the Indigenous population of Nambucca Valley, in New South Wales. It was a problem for everyone in the area who had to go through the humbling process of having to ask to be bulk-billed at surgeries that did not advertise their billing policies.

Bulk billing – where the bill gets sent straight to Medicare – was given at the “grace and favour” of local doctors and their staff. If the clinic didn’t agree to it, the patients would have to pay the bill and claim it back from Medicare.

“It was very embarrassing, humiliating, to be put in a position where I had to choose between myself and my child,” says Reid who was at the time an Aboriginal health worker.

She was one of a group of Aboriginal people who decided the solution to the lack of affordable health care was to set up their own bulk-billing clinic and – although she had to work for eight years without pay to do it – today she is the chief executive of a medical service with more than five premises in the region.

The Bawrunga Aboriginal Medical Service, which opened in 2002, has clinics in Nambucca Heads, Macksville, Gilgandra, Dubbo and an outreach service to Gulargambone. It also has the contract to manage the GP Super Clinic in Coffs Harbour and serves more than 13,000 patients.

Reid says 50% per cent of the patients are from the region’s non-Indigenous population. “We wanted to share it with everybody,” she says. “We didn’t want to be put into the category where the community would only see us as an Aboriginal medical service.”

Some of the artists from Tjanpi Desert Weavers, which is a social enterprise in Western Australia. Photograph: Jo Foster/NPY Women's Council

She is particularly proud that the medical service has never received government funding. Bawrunga is one of a growing number of social enterprises founded by Indigenous women.

The program manager of Indigenous business education at the University of NSW, Rebecca Harcourt, says there is a flowering of Indigenous-led social enterprises. “There has always been some incredible commitment and leadership around community organisations,” she says.

“The idea of Indigenous business is not a dirty word any more – whether that is social enterprise or big business. Business and social enterprise is a way in which you can mobilise change.”

A social enterprise is defined as a commercially viable business existing to benefit the public and the community, rather than shareholders and owners. It also dedicates at least 50% of its profits to its mission.

Bawrunga is self-sustaining, is set up as a not-for-profit and has bought its premises at Nambucca Heads.

The service employs 43 people and has about seven Aboriginal people working in ancillary services such as reception, Aboriginal health work and building maintenance. “It does bring the community together,” says Reid. “It gets rid of that [racial] division there. We are working towards trying to close that social gap,” she says, adding that a lot of the doctors were born overseas. “It is also a very multicultural service.”

“[Bawrunga] started from nothing. Not one cent. We started from a passion, a vision, and we started to grow it into an actual profitable service.”

Harcourt says the proliferation of Indigenous owned-and -run enterprises has been assisted by the Indigenous business directory Supply Nation. “I think there has been real momentum and that is through technology and connecting. And it is about a determination to improve and be in the driver’s seat.

“The Indigenous community is mobilising and there are some incredible social entrepreneurs.”

The Tjanpi Desert Weavers is a social enterprise, started 21 years ago by the Ngaanyatjarra Pitjantjatjara Yankunytjatjara women’s council to create a marketplace to sell arts and crafts from women in remote communities.

There are not many opportunities to make an income in the tri-state (Western Australia, South Australia and Northern Territory) border region of central Australia where Tjanpi operates.

Its manager, Michelle Young, says the social enterprise is an intermediary between the retailers and the women living in the remote communities.

Staff travel up to nine hours to the communities to deliver materials (at cost price) and buy their baskets and art works, woven from local grasses.

Leavina Reid is the chief executive of Bawrunga Aboriginal Medical Service, the bulk-billing medical service she set up as a social enterprise in Nambucca Heads. Photograph: Bawrunga Aboriginal Medical Service

Young says it is important that the women are paid up-front, rather than on commission (which is usually the case with paintings). “It supports a number of cultural benefits to the women. It takes them out into country and allows them to also hunt for food and collect bush medicines while they are collecting grass,” she says.

“It allows them to transmit cultural information to younger members in the group as well as maintaining custodial responsibilities to sacred sites. It is getting them out and about and moving and keeping them fit as well.

“It brings opportunities for them to come together. There is a lot of isolation out there in communities.”

Tjanpi provides skill development workshops and engages senior women to teach younger girls. Young says there are up to 800 women involved and, each year, about 400 will produce something to sell.

Nancy Jackson in Warakurna, one of the weavers, makes a basket every day, earning a few hundred dollars a week. “She then uses that money to go to the store and buy food and that would be on the table for dinner that night.”

Some women make only a couple of bowls a year for extra cash, but there are also artists involved in major works and collaborations, creating works for institutions, exhibitions and art awards.

Tjanpi sells the products to galleries and the sales price is split equally three ways between the maker, Tjanpi and the retailer.

“The costs of goods out in communities is extremely high,” says Young. Tjanpi helps them make their money go further by providing bush gear such as crowbars and blankets at cost price.

Young says Tjanpi relies on government and philanthropic funding, but 40% of its income comes from the sale of art works. “Tjanpi will always be somewhat dependent on external funding for its operations, but we also bring much more than simply economic returns – there are social and cultural benefits that we bring into these communities and great health and wellbeing benefits to these women.

“So we are not ashamed of our somewhat dependence on government funding, just because the price point for baskets is quite small and our cost of service delivery is extremely high,” she says.