Health care and health education seemed essential, but they could be interpreted as assimilationist: for example, teaching Aboriginal people how to think about food and hygiene in a Balanda way, instead of an Aboriginal way. It seemed to me that the immediate necessity of health care was more important than philosophical questions about the imposition of one culture onto another. We had to accept that in some cases, imposing our culture would benefit Aboriginal people. But I had learnt that Balandas would never ever articulate it in those terms. There was a strong taboo in the White community against being an assimilationist. The whole community was founded on the post-Whitlam ideals of land rights and self-determination. In practice, this meant that covert, unintentional assimilation-such as health care-went unspoken.-Mary Ellen Jordan (2005) Background Kearns et al. (2013) reviewed clinical presentations during the first year of life for 320 children living in five remote communities in the Northern Territory, Australia. The median number of presentations was 21 with 14 of these being for infectious diseases including upper respiratory tract infections, ear disease, skin disorders, and diarrhea. These diseases are so common that they have become normalized and are now perceived within communities as common stages of child development (Kruske, Belton, Wardaguga, & Narjic, 2012). The major contributing factors to this high disease burden are poor hygiene and limited housing, which leads to too many people living within a house not built for large extended families (McDonald, Bailie, Brewster, & Morris, 2008). Luby et al. (2010) has shown that hygiene education, hand washing with soap, and encouraging frequent bathing may result in significantly lower rates of impetigo and pneumonia. Stubbs, Hare, Wilson, Morris, and Leach (2005) showed that Aboriginal children living in remote communities are 23 times more likely to have hand contamination with both S. pneumonia and H. influenza than children attending urban childcare centers. Persistent middle ear infection, or chronic suppurative otitis media, is one of the infections for which particular attention has been given, as it can lead to significant hearing 856950S GOXXX10.