Ambivalent helpers and unhealthy choices: public health practitioners' narratives of Indigenous ill-health

We argue that the concepts of self-determination and neocolonialism mark the spaces where universal and particular discourses overlap and clash. Practitioners who seek to escape neocolonialism must inhabit only the discursive space of public health congruent with self-determination, leaving them in a bind common to many postcolonial situations. They must relieve the ill-health of indigenous people without acting upon them; change them without declaring that change is required.