A senior doctor at Alice Springs Hospital has described the expiration of intervention-era alcohol restrictions in Central Australia as "like a light switch being flicked", when it came to the number of domestic violence-related presentations to the emergency room.
WARNING: Aboriginal and Torres Strait Islander readers are advised that this article contains the names of Indigenous people who have died, used with the permission of their families.
This story also contains graphic details that some readers may find distressing.
Dr Richard Johnson was called to give evidence at the coronial inquest into the death of 34-year-old Kumanjayi Haywood, who was killed in a house fire lit by her partner at an Alice Springs town camp in November 2021.
The doctor said he had lived in Alice Springs for 12 years and loved the town and his work, but had "questioned what we do" after a 77 per cent increase in domestic violence-related assaults at the end of last year.
"The level . and the ferocity of the assaults we saw as emergency clinicians . was devastating," Dr Johnson said.
"That's the first and only time I've questioned what we do, what we can do [and] what we are capable of . the impact it had on staff was traumatic."
Intervention-era alcohol restrictions in Central Australia were lifted in November 2022 and police statistics shown to the coroner indicated a sharp increase in domestic violence reports followed.
Dr Johnson said the number of reports reflected what emergency staff experienced.
"The morale and ability of staff to cope with what they were seeing on a day-to-day basis was significant, and it was a difficult period," he said.
"Most people are here because they care, most people are here because they want to make a difference and they feel like they are making a difference."
New alcohol restrictions were introduced in Central Australia in February 2023 and the statistics seen by the coroner showed an average 37 per cent decrease in monthly domestic violence-related reports after that.
However, Dr Johnson told the court the impact of the spike was ongoing, particularly when it came to recruitment.
"I think it is really challenging to recruit to all parts of the health service in Central Australia, at least in part due to the media cycle effect," Dr Johnson said.
"Notwithstanding the actual effect of the presentation of those results of violence we saw in the emergency department."
The coroner has previously heard both Kumanjayi Haywood and Kumanjayi Dixon had been drinking prior to the house fire lit by Mr Dixon in November 2021.
But Dr Johnson told the coroner alcohol was not a cause of domestic and family violence.
"Alcohol is an enabler to what we see, it is not the cause," Dr Johnson said.
"Alcohol lowers the threshold [and] . lowering that threshold may turn someone who wouldn't get to that point of violence into somebody who is violent.
"But the actual background of the cause of the violence are the social determinants of poverty, overcrowding, disenfranchisement, generational trauma, generational lack of access to education and resources, and it's the long term and intergenerational impact of colonialism in this population."
Detective Superintendent Kirsten Engels, an Alice Springs-based officer leading a NT police audit of domestic violence responses, told the inquest there were several aspects of police training which needed improvement.
The coroner heard NT Police recruits received about a week of domestic violence training at police college but had limited ongoing DV-specific training.
Superintendent Engels was asked to comment on a series of triple-0 calls played to the coroner on Thursday, in which Ms Haywood was heard asking for police assistance.
On both occasions, one about six weeks before Ms Haywood was killed and another just two days earlier, Ms Haywood was heard asking for police assistance because Mr Dixon was threatening her and in breach of a domestic violence order.
Police were not immediately dispatched to respond.
"It's important to understand we don't need to look for chaos in the call to understand there's domestic violence," Superintendent Engels said.
"There's a level of control he was exerting over her."
The officer told the inquest that on both occasions, she would have dispatched officers urgently.
"Every aspect of policing needs that domestic violence lens put on it," Superintendent Engels said.
The coroner has previously heard domestic and family violence reports make up "well over" half of all call outs to NT Police.
In closing remarks to the coroner, counsel assisting Dr Peggy Dwyer told the court the investigation into Ms Haywood's death had unravelled an "urgent crisis" in funding for domestic violence services and shown what a "horrendous tragedy" Ms Haywood's death was.
"We have focused on the last four to six weeks of Kumanjayi Haywood's life [and] have only a small snapshot, in this court, of what she actually experienced," Dr Dwyer said.
"[Ms Haywood] was acutely aware that the risk to her life had increased in the four to six weeks before she passed away, [as] she was trying to access services.
"She was also aware, almost unbelievably, that she was going to die. She was trapped in a cycle of violence she could not escape from."
Coroner Elisabeth Armitage said the evidence of missed opportunities and flow-on effects of failings by services designed to protect domestic violence victims was a "genuine indictment" on agencies and services.
The coroner's series of investigations into the deaths of four Aboriginal women at the hands of their partners will continue in Darwin on Monday, when the inquest into the death of Ngeygo Ragurrk begins.
"[Ms Haywood's] story and others . underline the urgency of this inquest process, of hearing about these four deaths, so that we can understand what these deaths have in common and also so we can work together so we can achieve change," Dr Dwyer said.