At CareSearch we acknowledge and respect the Kaurna people, the traditional custodians whose ancestral lands on which CareSearch located.
Naa Marni? This greeting in Kaurna language translates to ‘Are you all good?’
I recall once walking through a university corridor on my way to give a tutorial, and overhearing some students complaining that they couldn't understand why they had to spend so much time in their course on Aboriginal Health. I was quite shocked by this, because to me the reason was obvious – Aboriginal and Torres Strait Islander people die at least 10 years earlier than non-indigenous Australians. How had they missed this vital point?
One of the key goals of the Close the Gap campaign for Indigenous health equality is to reduce the gap in life expectancy and healthcare access between Aboriginal and Torres Strait Islander peoples and the non-indigenous Australian population.
CareSearch has a commitment to providing evidence-based resources to improve the health care of all Australians, including the first Australians, Aboriginal and Torres Strait Islander people. To that end we have developed a series of ‘knowledge hubs’ which are discrete sets of content and resources designed to meet the information needs of a particular group or to accumulate the content base around a particular issue of care. They are organised to help the health professionals in this area to easily and quickly find context-relevant information.
Jennifer Tieman and I are currently leading the development of an Aboriginal and Torres Strait Islander hub. The purpose of this hub is to build cultural responsiveness in the provision of palliative care services, by providing easily accessible health information to support health staff working with Aboriginal and Torres Strait Islander people. This is a natural extension of the work undertaken in 2014 when CareSearch collated all of the various Aboriginal and Torres Strait Islander resources relevant to palliative care to make this information easier to access.
Similarly, in developing targeted resources for Aboriginal and Torres Strait Islander people or for the health professionals that care for them, we have to acknowledge that past policies and practices have had very negative impacts on Aboriginal and Torres Strait Islander people, and systematic racism effects how they seek healthcare. The Australian Aboriginal and Torres Strait Islander people are strong, richly diverse peoples, with a living culture made up of both contemporary and traditional practices, with a diversity of people, nations and language groups. This highlights the vital need for recognising that people and their culture are inextricably linked, so acknowledging and being respectful of cultural differences is required when providing palliative care. Central to this is person-centred palliative care, involving culturally-responsive and respectful conversations with patients and their family about their concerns, needs, beliefs, and choices (perhaps with the assistance of Aboriginal Health Workers or Liaison Officers). For example, for some Aboriginal and Torres Strait Islander people, being able to ‘die on country’ will be extremely important, but for others this may not be a priority. Ensuring Aboriginal and Torres Strait Islander patients and families feel culturally safe and receive culturally responsive health care has been seen as a key strategy in improving the quality and effectiveness of care provided to Aboriginal and Torres Strait Islander peoples. The position statement by Palliative Care Australia highlights many of these issues: https://palliativecare.org.au/wp-content/uploads/2015/08/PCA-Palliative-care-and-Indigenous-Australians-position-statement-updated-16-8-11.pdf as does the Cultural Considerations Flipchart created by the Program of Experience in the Palliative Approach (PEPA) https://pepaeducation.com/support-and-education/cultural-considerations-providing-end-of-life-care-for-aboriginal-peoples-and-torres-strait-islander-peoples/.
As with all of the CareSearch hubs, it is important to make sure that we have the appropriate advice and support. Expert advisory groups provide an important function in overseeing projects and we are lucky to have an expert advisory group comprised of Aboriginal and Torres Strait Islander people representing leading organisations within the health sector across Australia. This specialist group is the Aboriginal and Torres Strait Islander Reference Group for the Palliative Care Education and Training Collaboration. To date, the reference group have provided advice on on the visual design and organisational structure of the Hub, as well as guidance regarding suitable content and resources for the Hub. They are also providing advice on culturally sensitive issues such as the presentation of materials and the use of images, and suggesting ways we can promote and disseminate the resources within the Hub. In addition to the Reference group, we have also received substantial practical support from PEPA’s Indigenous Program, including assistance in writing new sections for the Hub webpage.
The Aboriginal and Torres Strait Islander Hub will include five sections:
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Cultural Safety and Cultural Responsiveness in caring for Aboriginal and Torres Strait Islander People;
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Information for Aboriginal Health Workers and Practitioners
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Information for Health Professionals providing care for Aboriginal and Torres Strait Islander People
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Information for Aboriginal and Torres Strait Islander patients and their families; and
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Finding Research and Evidence.
In conducting this work I have developed a deeper understanding of the importance of recognising Aboriginal and Torres Strait Islander peoples as the original inhabitants of Australia and the traditional custodians of the land. We need to acknowledge the deep relationship of Aboriginal and Torres Strait Islander people to country. No work undertaken for or about the care of Australian Aboriginal and Torres Strait Islander people should start without this, much as we do at meetings and conferences. An Acknowledgement of Country is just one small way we can show respect towards the traditional custodians of the land we live on. At my children's school, the Acknowledgement of Country now takes its rightful place alongside the national anthem at school assemblies. I hope that this change that younger generations are experiencing in how we respect Aboriginal people will help bring about a better, richer and more inclusive future life for all Australians.
The Aboriginal and Torres Strait Islander Hub is scheduled to be released in August 2016. In the interim, you can find resources in the Aboriginal and Torres Strait Islander section of CareSearch.
If you would like to find out more about the project, or have any suggestions for resources that could be included in the new hub, please email caresearch@flinders.edu.au
Lauren Miller-Lewis, PhD. Research Associate, CareSearch, Flinders University