INDH1006 Indigenous Cultures and Health Behaviours

1. Read the statement below taken from Prime Minister Paul Keating’s 1992 Redfern Speech. Reflect on how this statement may impact on your future role as a health professional.

The fact that British colonisation has brought about a huge amount of negative changes to the lives of Indigenous people of Australia is unavoidable. Paul Keating in his Redfern speech has pointed out how colonisation has snatched away the rights of the indigenous people of their land and their traditional lifestyle (Weiland, 2014). Not only that, the aftereffect of Colonization on the life of Aboriginals in Australia also includes a several types of diseases, excessive alcohol abuse and illegal activities like child trafficking and murder (keating.org.au., 2018).  Weiland writes: “even in this era of civilisation, Aboriginal people are still discriminated and lack basic facilities like food, shelter, health care and education” (82). As per my opinion, the life of Indigenous people was far better to compare to that of today.  I found out that the most immediate consequence of British settlement included the appearance of various kinds of European diseases that includes epidemic diseases like chickenpox, smallpox, measles and influenza (Australian Indigenous Doctors’ Association, 2016). As a healthcare professional, I understand the severity of the diseases in those primitive days and how it might have imposed an impact on the mortality rate of the indigenous people. This has lead to the mortality rate of indigenous people increasing by 23 percent post colonization (Eckermann et al., 2010).

According to a  survey, alcohol abuse rate among Indigenous people has increased by 12 percent after colonization due to several reasons (Abbott et al., 2014). This factor has also contributed to the origin of a series of kidney and heart diseases. The speech given by Prime Minister Keating has made me realise the injustice that has been taking place for a prolonged period of time. Not only that, but the speech has also encouraged me to go through various newspapers and research papers in order to gather the healthcare discrepancies faced by Indigenous individuals. As a healthcare professional, I am beginning to understand the importance of taking immediate action in order to eradicate the gap in healthcare facilities among the Indigenous and the non-Indigenous population in Australia. My future role as a healthcare professional will be to obtain training so that I can develop a better understanding of the language and needs of the local Aboriginal people I will be working with. Along with that, I will provide education and training to my fellow health care service providers so that they can develop respect for the Aboriginal patients. I will also organize campaigns at the Aboriginal localities in order to make them aware of the benefits of availing healthcare facilities and educate them about the adverse impact of alcohol abuse.

2. Critically reflect on the impact of racism on the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples. How might this impact on your future role as a health professional?

The term racism can be defined as the avoidable as well as the unfair phenomenon that leads to inequalities in resources, power as well as opportunities across racial as well as ethnic groups (Department of Health, 2013). The phenomenon of racism takes place due to stereotypes, prejudices and discrimination. The concept of racism is directly associated with the social and emotional wellbeing of the Aboriginals. From the time of Colonization, Aboriginal Australians are excluded from all types of facilities associated with healthcare education and employment. Even after 12 years of “Closing the gap campaign”, Aboriginal Australians still experience substantial disadvantage compared to the rest of the Australians (Department of Health, 2016). (Medical Board of Australia writes: states  that “the two predominant sectors where racism is still clearly visible are in the healthcare sector as well as the educational sector” (118). Considering the fact that Aboriginal Australians have less access to healthcare homes since the majority of the mentioned population resides in remote areas,  this lack of access often gives rise to the feeling of social discrimination. Not only that the high mortality rate due to lack of treatment also results in several mental issues like depression and anxiety which affect their emotional well-being (Department of Health, 2016). Apart from that as per my opinion, lack of education and job opportunities can also be considered as a major fact that is imposing an impact on the emotional wellbeing of the aboriginal individuals (Medical Board of Australia, 2014).  I think the government posses a huge role when it comes to social discrimination. As per my opinion, the chief loophole of the closing the gap policy is that the rule and regulation that has been established through the campaign has not been implemented properly. When it comes to ensuring the social and emotional wellbeing of the aboriginal as a healthcare professional, my future role will include conducting healthcare campaigns at remote Aboriginal localities so that they can have better access to healthcare. Not only that, but I will also incorporate more and more Indigenous staff in the healthcare organization I will be working for. I believe that this will be beneficial in two ways. Firstly, considering the fact that language and cultural difference is a major barrier between the indigenous Australians as well as the healthcare professional, incorporating more Indigenous staff will greatly reduce the barrier. Secondly, this process will also reduce the issue of employment, which is imposing a negative impact on the emotional wellbeing of the Indigenous youths.

3. a. Critically reflect on how you would feel if these laws were applied to your family and how this understanding will influence your future work with Aboriginal and Torres Strait Islander people.

Harman & Grant writes: “The WA ACT passed in the year1905 aimed at the provision of care and support to the aboriginal inhabitants based at Western Australia”(6). It was “an Act that intended to launch reforms so as to enhance the quality of life of the aboriginals.” The law primarily focused on enhancing the living standard of the Aboriginal people and proceeded with the appointment of a legal guardian. The legal guardian was responsible for protecting the rights of the Aboriginal citizens based in Western Australia. However, it should be critically noted here that there was a set of law that was solely designed for the non-Aboriginals and served their interests. One critical aspect of the law was that it provided authority to let the Aboriginal children above sixteen years of age be sent and detained for the purpose of work across various service sectors predominantly at plantation firms and factories (Harman & Grant, 2014,p.8). On critically reflecting on the WA ACT of 1905, I feel that the law was not capable of safeguarding the interest of the Aboriginal community completely. I would strongly feel victimized and violated if these laws were enforced on my family members or me. My consent should have stringently mattered in the decision of sending and detaining my child or other children in the family to work somewhere. In fact, it seems to me that the law was more of providing relief and charity instead of advocating the rights of the Aboriginals (Hendrick et al., 2014.p.16). As a health care professional, my priority of providing care to the Indigenous patients would widely depend on involving them at each step of the decision making process and accordingly planning an intervention strategy.

1. Critically reflect on how these laws impact on your own family and how these experiences will influence your future work as a health professional

If I was an Aboriginal or a Torres Strait Islander who had been subjected to the adversities caused because of the enforcement of this law, it is obvious that I would feel victimized. In addition, my family members would also develop an aversion towards accessing the health care facilities that are available because of the stigmatized societal attitude that they have been encountering for so many years (Hendrick et al., 2014,p.16). This would greatly impact the quality and the standard of life (Harman & Grant, 2014,p.7). As a health professional, my intention would be to provide a positive patient-centred and culturally safe care to  Aboriginal patients so that I can make them feel comfortable about their background and at the same time reinforce a holistic wellness environment (Davis, 2014,p.32). The entire idea is to provide effective care and improve the life expectancy and quality of life of the Aboriginals.

4.Critically reflect on how you will bring the following approach to your future practice as a health professional: An understanding of the importance of person-centred care and empowerment.

After going through relevant studies associated with the healthcare requirements of Indigenous people, I have understood that person-centred care will be more beneficial for the mentioned group instead of the conventional healthcare services (Paradies, 2016). Davis writes: “person-centred care can be defined as the professional care that recognizes uniqueness, individuality, dignity, choices as well as the  rights of the individuals” (56). As per my opinion, a key component of holistic person-centered palliative care is to understand that the Indigenous people and their culture are inextricably linked, so acknowledging and being respectful of cultural differences is required when providing palliative care.  Through research, I have understood that the Aboriginal and Torres Strait Islander people posses diverse cultural practices and beliefs when it comes to diseases and death (Gwynne et al., 2016). Thus what is right for some patients may not be that important to others. Hence, in the future, I will make sure that I as well as my fellow healthcare service providers are well aware of their beliefs, cultural rituals and practices, concerns and choices. However, I think that little theoretical awareness does not possess the potential to develop effective emotional bonding of the Aboriginal people with healthcare professionals. As a healthcare professional, in each and every step of their healthcare intervention I will inform the patient as well as their families (Hendrick et al., 2014). Not only that, in order to demonstrate respect towards the culture of the healthcare service users, I will ensure open, culturally-responsive and respectful conversations between me, patients, and their family about their concerns, needs, beliefs, and choices. As per my opinion, the open conversation will not only ensure empowerment of the healthcare service users but will also create a trusting relationship between the Indigenous patients and myself.  

Reference List

Abbott, P., Dave, D., Gordon, E., & Reath, J. (2014). What do GPs need to work more effectively with Aboriginal patients: Views of Aboriginal cultural mentors and health workers. Australian Family Physician, 43(1), 58-63. Retrieved from https://www.racgp.org.au/afp/2014/januaryfebruary/aboriginal-culturalmentors/

Australian Indigenous Doctors’ Association. (2016). Cultural safety factsheet. Retrieved from https://www.aida.org.au/wp-content/uploads/2015/03/Cultural-Safety-Factsheet1.pdf 

Davis, M. (2014). Australia's Reconciliation Process in Its International Context: Recognition and the Health & Wellbeing of Australia's Aboriginal & Torres Strait Islander Peoples. AILR, 18, 56.

Department of Health. (2013). National Aboriginal and Torres Strait Islander health plan 2013-2023. Retrieved from: https://www.health.gov.au/internet/main/publishing.nsf/content/B92E980680486C3BCA257BF0001BAF01/$File/health-plan.pdf

Department of Health. (2016). Northern Territory health: Aboriginal cultural security framework 2016-2026. Retrieved from: https://digitallibrary.health.nt.gov.au/prodjspui/bitstream/10137/730/8/Northern%20Territory%20Health%20Aboriginal%20Cultural%20Security%20Framework%202016-2026.pdf

Eckermann, A. K., Down, T., Chong, E., Nixon, L., Gray, R., & Johnson, S. (2010). Binan Goonj: Bridging Cultures in Aboriginal Health (3rd ed.). Chatswood, NSW: Elsevier Australia.

Gwynne, K., Irving, M. J., McCowen, D., Rambaldini, B., Skinner, J., Naoum, S., & Blinkhorn, A. (2016). Developing a sustainable model of oral health care for disadvantaged Aboriginal people living in rural and remote communities in NSW, using common impact methodology. Journal of health care for the poor and underserved, 27(1), 46-53.

 Harman, K., & Grant, E. (2014). ‘Impossible to Detain... without Chains’?: The use of Restraints on Aboriginal People in Policing and Prisonsxs. History Australia, 11(3), 157-176.

Hendrick, A., Britton, K. F., Hoffman, J., & Kickett, M. (2014). Developing future health professionals’ capacities for working with Aboriginal and Torres Strait Islander peoples. The Australian Journal of Indigenous Education, 43(2), 154-164.

 keating.org.au. (2018). Honourable PJ Keating - Indigenous Issues. Retrieved from https://www.keating.org.au/shop/category/indigenous-issues

Medical Board of Australia. (2014). Good medical practice: A code of conduct for doctors in Australia.

Paradies, Y. (2016). Beyond black and white: Essentialism, hybridity and indigeneity. In Handbook of Indigenous Peoples' Rights (pp. 44-54). Routledge.

Paradies, Y. (2016). THIS CHAPTER EXAMINES racism as a longstanding phenomenon that hampers development in Aboriginal communities. After considering the nature of racism and its impact on community development, the chapter considers the prevalence of racism against Aboriginal people. It then outlines effective anti-racism approaches, including historical attempts in relation to Aboriginal Australians, before concluding. Mia Mia Aboriginal Community Development: Fostering Cultural Security, 169.

Paradies, Y. (2016). THIS CHAPTER EXAMINES racism as a longstanding phenomenon that hampers development in Aboriginal communities. After considering the nature of racism and its impact on community development, the chapter considers the prevalence of racism against Aboriginal people. It then outlines effective anti-racism approaches, including historical attempts in relation to Aboriginal Australians, before concluding. Mia Mia Aboriginal Community Development: Fostering Cultural Security, 169.

Rickard, J. (2018). Australia: A cultural history. Monash University Publishing.

Weiland, L. (2014). My journey into Aboriginal and Torres Strait Islander health. Australian Family Physician, 43 (1/2), 12-14.