There is a special place in the hearts of the Northern Territory’s people. It is a place that is a wellspring of sympathy for people who have been afflicted by tragedy and disaster.

That place in Territory hearts is the source of compassion, a desire to help others who are suffering the consequences of disastrous events. It springs from full awareness of what other people might be going through as a result of such events.

In the Northern Territory, there is a very special dimension to those sympathetic feelings, a dimension that is explained by the simple words: We understand, we have been there. We understand because we have been through what you are going through; we know how capriciously tragedy and disaster can strike at a community. We know these things because we live in a region where nature’s forces are especially tempestuous, a region where destruction and chaos can arrive without warning.

Because we understand, because we have shared your experiences, we are willing to reach out to help. In 2024, as we approach the anniversary of Cyclone Tracy, we are reminded of just how much we share the experience of tragedy and disaster. Fifty years ago, on Christmas Day 1974, Cyclone Tracy devastated Darwin. It was the most catastrophic natural disaster to have befallen any part of Australia at that time but it was by no means the first occasion on which widespread destruction and human suffering has been inflicted on the Northern Territory. Natural disasters and manmade tragedies have been a prominent part of our history because the Northern Territory is situated in the centre of a tempestuous environment where both nature and mankind have frequently brought calamity.

That is why the Northern Territory is the home of the National Critical Care and Trauma Response Centre (NCCTRC). Darwin, the Territory’s capital, lies at the Centre of a vast region across north Australia that is prone to cyclones and other extreme natural events. It is at the very northern edge of the continent, it is the part of Australia that is closest to the ‘arc of instability’ that girdles south-west Asia and the Pacific region, an area that is subject to devastating natural events as well as man-made catastrophe.

Above all, the Northern Territory’s distinctive history has created so many cultural connections with the peoples of the region to our north. We are more than just neighbours, we are friends – and family.

When disaster strikes anywhere in our region, on our own soil or in nearby countries, it is instinctive that we should wish to reach out to help our friends, family and neighbours. Darwin is the base from which we respond, from where we can help.

The NCCTRC has not been established for very many years, but already its short history has justified its existence and demonstrated the suitability of its Darwin venue.

The Centre was established following the 2002 and 2005 Bali bombings, which reinforced the point that Darwin had both close proximity to and affinity with nearby countries. Bali was only about as far from Darwin as was Cairns in north Queensland; for decades it has been a favoured holiday destination for Territorians. When disaster struck on Bali in 2002, Darwin was ready to reach out to help.

Dr Len Notaras, in 2002 the Medical Superintendent of Royal Darwin Hospital, and now the Executive Director of the NCCTRC, recalls that Darwin’s outreach after the 2002 Bali bombings led to the establishment of the Centre. He said that the genesis of the Centre was the admission of a patient to the Emergency Department of Royal Darwin Hospital on 13th. October 2002.

“It was a Sunday morning about nine o’clock or half past when I got a phone call from the Director of the Emergency Department telling me that an injured man had presented for admission. He was telling a chilling tale of horrendous injuries to people in Bali, including many Australians, as a result of explosions at the Sari Club nightclub in the tourist centre of Kuta at about 11pm, Bali time, the night before, 12 October.

“The man said he had just flown into Bali earlier that evening. He had gone straight to the Sari Club and then the explosions occurred. The story was disjointed, understandably, but it was clear the man had been injured – he was suffering burns.

“The man had seen that local medical emergency response facilities were quite overwhelmed and so he had gone straight back to the airport and caught the last available flight back to Darwin. When he arrived in Darwin he got a cab directly to the Emergency Department and there he told the terrible story of what had happened. But, for quite a few hours, that account was all we had to go on, we had no further information.

“I immediately spoke with Graham Symons, the then acting head of the Health Department. I said that we should try to get what hard information we could, but in the meantime we should take the report seriously and we should mobilise the resources of the hospital so that we could respond, so that we could be a platform for Australia’s response to the situation.

“I thought it quite likely that we would soon have to deal with a large influx of casualties. Graham agreed. At about 10.00am I called together the hospital’s emergency response team and it was unanimously agreed we should prepare to respond as best we could as quickly as we could. We went through staff rosters, we lined up our equipment, and we arranged that the Darwin Private Hospital would take patients if we needed to clear beds. We got blood supplies ready.

“We were a bit handicapped because we still didn’t know what had really happened, but we were making guesses and doing the best we could. By about midday the hospital was as ready as it could be.

“Then I was called in to a meeting of the NT Counter Disaster Group, the Chief Minister. Clare Martin, and the Police Commissioner, Paul White, and other senior people were there. I still did not have hard information about what had happened and neither had they, but I was asked if we should be doing something. I said, ‘Yes, we should’ and I outlined what had already been done. I said, ‘I think we should be a retrieval platform, we should be ready to receive people who might be flown into Darwin, we should be ready to rescue, retrieve and resuscitate. Then we should sort the people out and be ready to repatriate them to other centres around the country. And we should contact the Prime Minister and the Minister for Foreign Affairs and tell them what we propose.

“’We made the phone calls. Prime Minister Howard and Foreign Minister Downer both said, ‘Yes, we will bring them to Darwin.’ The Defence forces were scrambled and we were told that a Hercules aircraft had taken off for Bali with a small medical team. Then we were asked to make two of our people available to go to Bali. They were both defence forces reservists, Major David Read, a surgeon, and Lieutenant Colonel Sue Winter, an intensive care specialist.

“We gave them satellite phones so they could keep in touch. Then they flew out. It was only when David and Sue rang us at about 6.30pm on the Sunday that we became aware of the scale of the disaster. They told us they couldn’t believe what they were seeing – burns, severe explosive trauma and crush injuries. Already the death toll was about 200, including 88 Australians.

“We spent the next few hours getting ready, ramping up our preparedness. The airlift of casualties to Darwin was the largest aero-medical evacuation by the Australian Defence Forces since the Vietnam War.

“At 1.40am on 14 October the first 13 casualties arrived at the hospital, their injuries were worse than any expectation we could have had. Then there was a deeply moving sight as a convoy of ambulances arrived at the emergency services ramp at the hospital. Over the next 16 hours, 62 casualties were received at the hospital, people with missing limbs, extensive burns, and deep shrapnel wounds and, often, all of those things. Over the next 36 hours we delivered first responses to the injuries, then began evacuating many of the people to the burns units of major city hospitals around Australia.

“It had been a heroic response by the people at the hospital, and by others, such as the ambulance services people. I was tremendously proud of what everyone had done, how they had performed, what had been achieved.

“It didn’t go unnoticed. A few weeks later the Prime Minister came to Darwin. He toured the hospital and met some of the Bali patients who were still with us. Mr Howard thanked the hospital staff for their efforts and then presented us with a cheque for $1.5 million dollars. ‘That is to repay you for some of the financial cost of going well beyond the call of duty, on Australia’s behalf.’

“In October 2004, I had a totally unexpected phone call from Mr Howard. He said, ‘We are grateful for and very impressed by what Darwin did after the Bali bombings. I think we should build on that. What would you need to set up a facility that could stand alone, but would be under the Royal Darwin Hospital umbrella, a facility that could be Australia’s first response to situations like the Bali bombings when they happen again? We will put $50 million towards it.’

“I was a bit lost for words, but I prepared a proposal that covered things like additional surgeons, anaesthetists, burns staff, more beds, communications and stores, memoranda of agreements with other Australian institutions, things like that. Mr Howard accepted the proposals and made a public announcement about it later that same day.

“A few months later Mr Howard came to Darwin and made a presentation of the cheque – the only thing was that the money had been increased to $75 million. The Royal Darwin Hospital was designated as the NCCTRC, with the intent of enabling the hospital to function as a ‘rapid response, forward receiving platform, equipped where appropriate to assess, revive, retrieve and facilitate the transfer of victims of mass casualty events both locally and regionally.’ That initiative began in July 2005.

“On the evening of Saturday, 1 October 2005, there was a second series of terrorist bombings on Bali, again in tourist districts. Three suicide bombs were exploded almost simultaneously, this time killing 20 people and injuring more than 100 others. Four Australians were among the dead. We were able to mount a swift and decisive response. On the Sunday evening casualties began arriving at Royal Darwin Hospital and by the Monday morning a total of 23 people, six of them in a critical condition, had been transferred to the hospital.”