Promoting Aborginal and Torres Strait Islander Cultural Safety

As stated by Singh & Keitsch (2016), the culture of valuing motherland and family at forefront provides the understanding of the deep-rooted beliefs in values and understanding and love. However, society also poses some superstitions activity that reflected upon the patriarchal society of the country. The festivals celebrated are Dashain, Shivaratri, Tihar and Sankranti (Tamang, 2018). In addition, the Buddha Jayanti is celebrated with the most priority as the major population is believers of Buddhism in Nepal. The cultural practices and beliefs guide the perception and thinking of individual belonging to this community.

PART 2: My understanding of Aboriginal and Torres Strait Islander people:

The UN has officially identified the Aborigines and islanders of Torres Strait as ‘indigenous’ to Australia. Their cultural beliefs and traditions are different from each other making them two distinct groups of people. Their trends of expressing themselves to others by their home islands and name represent their kinship for their motherland and cultural traditions. The culture, identity and kinship are different among the Aboriginal and islanders of Torres Strait. These people are focused on the relationship between people, water and land and they are strict about their originality with social kinship and rights. As described by Fisher et al. (2017), these people are concerned with their social culture that emphasised on the law of environment in addition to rights to continue business, fishing, communal gathering and hunting. European colonisation has affected in negative political concepts regarding the ignorance of cultural rights.

Colonial policies have impacted the cultural safety of these indigenous people as they promoted the dispossession, settlement, cheap labour and forceful transformation of cultures. As explained by Prout (2018), conflicts have been raised with the continuing issues of social and culture related laws. The colonial conflict due to cultural differences and ignorance to recognition potentially exacerbated conflicts between colonists and indigenous people. On the other hand, Lathouras & Ross (2017) stated that the differences between the different cultural groups in traditional practices and beliefs also generated conflicts significantly. The destruction of natural resources and desecrated significant sites due to transformation of land of agriculture resulted in conflicts among indigenous people.

The denial to access to sustainable resources for maintaining cultural, social, spiritual and economic well being impacted on Aboriginal people negatively and instigated them against colonial invasion by European. Hutt & Onta (2017)opined that the political turmoil and forceful surrender of indigenous people in Australia resulted in the loss of equitable recognition and cultural safety. Moreover, the cultural resilience within the communities of Torres Strait Islanders and Aboriginal people, adequate cultural needs are addressed that were lost during colonisation period. The influences of parents and land impacted the understanding of these indigenous people and reflect upon their thinking and cultural practices. Nonetheless, the decline in cultural strengths and increasing multicultural aspect of the society has heightened the needs for cultural safety to restrict the occurrence of lateral violence. As proposed by Gadsden et al. (2019), revitalisation of cultural practices and beliefs is essential to maintain community resilience. Cultural awareness and active fulfilment of cultural needs are now provided with the aid of government support.

PART 3: Reflection on understanding

Historical events: Closing the gap and its impact on Torres Strait Islanders and Aboriginal people

Closing the gap is a strategy implemented by the Kevin Rudd government that aims to decrease the disadvantages among the islanders of Torres Strait and Aboriginal people. Increasing life expectancy, education, child mortality and employment outcomes are some of the chief focus of Australian government to mainstream the indigenous people in the society and provide basic human rights effectively.  This is implemented to ensure the bridging between indigenous and non-indigenous people in Australia. As mentioned by Parter, Wilson & Hartz (2018), the government has renewed the social practices and management of service availability for people indigenous to Australia. The development of COAG committee has finalised ‘Closing the Gap Refresh’ in order to provide the forum to support engagement and facilitation of social rights to indigenous people.  In addition, the Joint Council of Closing the Gap has represented the Coalition of Peaks, including Commonwealth, and ministers of state and territory (closingthegap.pmc.gov.au, 2019).

Figure 1: Target priorities of ‘closing the gap’

(Source: closingthegap.pmc.gov.au, 2019)

The draft of ‘closing the gap’ involved priorities of family and social interaction, health, education, economic development, housing, justice and land and water. Cross-system priorities are also promoted through this scheme of Australian government. The significant achievements in these priorities are expected to gain by 2030 with successful integration of these people by closing the gap between the inhabitants of Australia. The campaign of ‘closing the gap’ has identified themes to prioritise and categorise the activities to achieve success in integrating indigenous people in society. As commented by Fisher et al. (2019), the representation of the needs and development of strategies to mitigate them can help in supporting the campaign. Moreover, commitment of task force is required to voice the choices to bridge the gap successfully.

Figure 2: Themes of ‘closing the gap’

(Source: humanrights.gov.au, 2019)

The strength-based and community-led approach has helped in driving the activities to achieve target with accountability. National Indigenous Health Equality Council and National Indigenous Reform Agreement have supported the targets set with the focus on increasing life expectancy, achievement of 50% of the targets by 2020 with 12 attainments per year rate. As mentioned by Thompson et al. (2018), investment is needed to be measured as done in this campaign to promote growth and reduce the political influence over the growth and social integration. The indigenous-specific programs in Australia amount for $3.5 billion per year (Altman, Biddle & Hunter, 2018). Moreover, the operation of the Racial Discrimination Act 1975 supported the campaign and redefined the ‘income management’ scheme effectively.

Figure 3: Impact of close the gap scheme

(Source: ctgreport.pmc.gov.au, 2019)

The conversation with Mr. Mike, the Aboriginal musician, it came out that opportunities are provided with ‘closing the gap’ scheme for Torres Strait Islanders and Aboriginals that helped in sustaining government efforts for equality and living quality life. Georges et al. (2017) stated that implementation of this program has reduced child mortality rate by 2.9%, increased preschool enrolment and employment by 7% and 4% respectively. The healthy life target was enacted by the national policies and resulting in an increase of life expectancy rate by 1.8% for male. However, the rate is still low for female population. The rate of occurrence of chronic diseases affecting the mortality rate among indigenous people is reduced by 20% (ctgreport.pmc.gov.au, 2019). The health policies for basic care rights has helped in achieving this target efficiently. Moreover, safety in the community has been obtained with the aid of string legislative framework and family-focused case management to reduce violence in society. Nonetheless, the implementation of this scheme in the management of cultural practices among indigenous people has supported the growth and integration of them in society. Moreover, the wellbeing is stimulated with the support from territorial government and experts along with other stakeholders to prioritise the needs of the Aboriginal and Torres Strait Islanders effectively.

PART 4: Impact of historical approaches on Torres Strait Islander and Aboriginal people

❖           The impact of European Citizen in Aboriginal and Torres Strait Islander people:

 The forced resettlement on the reserves has affected the Aboriginal culture with the impact of the absorption of new Western culture and social services. However, the major discrimination practices have resulted in differential practices and loss of cultural trends significantly. As explained by Gannon (2017), the traditional authorities and the culture has been conducted with European pastoralists. Moreover, the non-recognition of the Aboriginal customs influenced the conflict between the cultures. For instance, the Aboriginal customary laws have been affected by the social rights newly implemented during the colonisation. It had been recorded that Aboriginal people obtained 50% of income of non-Aboriginal people, 12.5% did not attend primary education; life expectancy is only 49 years and 77% affected with chronic illnesses. Moreover, 54% of Aboriginal children are often considered under substitute care arrangements and the imprisonment cases are focused on Aborigines significantly.

Figure 4: Impact of European colonisation

(Source: Hutt & Onta, 2017)

Alcohol introduction and losing of hunting ground and land for agriculture had resulted in hostility. The respect for friends, family and water are adversely affected by the European culture. Moreover, diseases and foreign concepts to social functionalities resulted in social conflicts regarding kinship, sex, tribe and religion. Government intervention also affected the economic and social infrastructure and beliefs and provided legal difficulties explicitly. As accounted by Finizio (2018), aboriginal justice has been demolished and discrimination has been one of the leading concerns of the society. With European colonisation, communicable diseases such as Smallpox, Tuberculosis, and chickenpox are introduced among these indigenous people. The settlement has impacted the life of indigenous people, which can be seen reflected upon the future generation.

❖           Impact on health and disease:

The arrival of European colonists affected the health and environment of the indigenous people resulting in the increasing loss of health. Historical trauma is a major issue that has resulted in the loss of the lives of indigenous people. The occurrences of trauma have ensured substance abuse degenerating health. The increased rate of occurrence of drug abuse, alcohol consumption and degeneration of cultural perception with the influence of Western culture, the lives have been jeopardised effectively. Moreover, the occurrences of mental health issues are increased. As stated by Townsend et al. (2018), the issues after European colonisation regarding health, nutrition, mortality rate, antenatal care services resulted in the increasing occurrences of mental health problems. Moreover, the influxes of diseases such as tuberculosis, pox, cholera just like epidemic diseases occurred with higher frequency.

❖           The impact of racism, and discrimination, including past and present power relations.

The occurrence of discrimination due to skin complexion, race and ethnic background is prominent among the indigenous and non-indigenous people of Australia. The differences in religion, cultural background, nationality and descendants reflected upon the social unjust. For instance, the imprisonment of Torres Strait Islanders and Aboriginal people is as high as 79% and they have limited chance to get bailed. On the other hand, Thompson, Talley & Kong (2017) commented that the health care facilities are often discriminated and not provided for these people due to prejudice and unfair means. The negative impact of this racism culture can be seen in education and employment also. The annual income is always halved for indigenous people against non-indigenous people. In relation to the discrimination of power, social barriers have taken strong roots affecting the health, emotional status and well being of these people adversely. This can be seen that the occurrence of suicidal incidents is 6.7% higher than the people of different origin.

❖           The importance of law and kinship in Aboriginal and Torres Strait Islander communities.

Torres Strait Islanders and Aboriginals are concerned about three aspects of the society such as culture, land and law. Laverty, McDermott & Calma (2017) stated that the cultural safety can be acquired with the implementation of the factors most prioritised among Aboriginals and Torres Strait Islanders that is law, land, culture and family. On the other hand, kinship is the integral part of social organisation. Social interaction between indigenous and non-indigenous people can support the growth and minimise the adverse effects of colonisation, discriminatory practices against indigenous people. On the other hand, Kingsley et al. (2018) commented that language orientation and cultural interaction are most important to develop interpersonal relationship effectively.

Figure 5: Reforms in Australia for Aboriginal and Torres Strait Islanders

(Source: Influenced by Finizio, 2018)

The Aboriginal and Torres Strait Islander Act 2005, Aboriginal Land Act 1991 and Aboriginal and Torres Strait Islander Communities (Justice, Land and Other Matters) Act 1984 are implemented to empower Aboriginal and Torres Strait Islanders and to guarantee them housing, food, education and employment for social and personal well being. Land Commission, special fund, traditional rights and policy for betterment of life has been facilitated. As commented by Markham, Jordan & Howard-Wagner (2018), closing the gap provided a refreshment towards this legislative action implemented by Australian government. Nonetheless, the self-sufficiency and self-government are promoted to bring justice and reduce discrimination against these people.

PART 5:

The issues faced by Torres Strait Islanders and Aboriginal people included health issues, social justice and education that are needed to be improved with the efficient approach of knowledge sharing by their participation which can be seen on those brochure and booklet.. As commented by Markham, Jordan & Howard-Wagner (2018), the approach by ‘closing the gap’ can sustain suitable practices to increase the scope of knowledge sharing and improvement of social and personal life of people indigenous to Australia. Moreover, the management of knowledge sharing is needed to be facilitated with better education programs and management of cultural practices without discriminatory perceptions and racial prejudices. Human-based approach to provide healthcare and educational services has supported the growth of Aboriginal people extensively.

Non-discriminatory and commitments to address the inequality in the society for indigenous people can support the conservation of culture and provide safety regarding health, social participation and educational opportunities. Altman, Biddle & Hunter (2018) mentioned that prioritising the targets and acting on the policies can help in subsidising the issues and differences to promote growth in this community effectively. Moreover, substantial operations to improve health status and educational perspective, significant improvement can be encouraged. As seen after the implementation of ‘closing the gap’ campaign, the mortality rate has been decreased for children until five years of age by 1.5% and increased enrolment in primary education by 3.07%. In addition, consistency in social participation and reduction in health disparities can be observed.

The malpractices taken into effect due to European colonisation such as drug abuse, health problems and such can be decreased with increasing awareness about these practices. Townsend et al. (2018) significantly pointed out that addressing health and educational inequalities and reducing the barrier to social integration can support the growth and acquisition of cultural safety among Torres Strait Islanders and Aboriginal people effectively. Sharing information through participatory approach about the advancing technology and beneficiary practices supports the movement of targets by 2030 as depicted by ‘closing the gap’ approach.

PART 6: Effectiveness of health service and cultural safety

The Accreditation with standards that are nationally consistent and implemented for culturally safe clinical care services support the improvement of health outcomes for indigenous people in Australia. As described by Lathouras & Ross (2017), health care services are important to [protect the cultural aspect of service users to promote health status. The healthcare policies in Australia promote empowering services that adhere to engagement of service users and boosts cultural safety. The clinical care practices are needed to be conducted in a culturally safe environment to promote overall improvement in health in addition to the substantial development of community practices.

The collaboration between Western biomedical praxis and indigenous holistic attention to the overall development of health can help in the growth of the individual along with community. Integration of cultural safety in care practices promotes equity in healthcare services in service access and availability of appropriate intervention strategies. As stated by Lawrenchuk & Harvey (2017), cultural adaptation and change perception can help in providing care services that encompass cultural safety to reduce the mortality rate and promote healthy wellbeing. Reducing barriers such as discriminatory practices, racial differences in participation and educational negligence can help in promoting health and safety in community life maintenance.

Cultural safety in the care service with Indigenous-led model helps in redressing the dynamics between clinical effectiveness and inherent power balance. This is essential to deal with healthcare practices and service delivery to promote physical as well as emotional and mental health development and support. Gadsden et al. (2019) commented that the systematic implementation of skills and knowledge as per cultural safety principles, health issues can be dealt with efficiency. The occurrence of chronic diseases such as diabetes, cardiovascular diseases and tuberculosis among indigenous people can be provided with professional care. However, the community plays critical role in providing culturally safe environment to apply care practices and services. The presence of expertise and acceptance to indigenous people can improve system responsiveness. Moreover, the reinforcement through education and acceptance to society can help in demonstrating significant culturally safe practices for indigenous people.

Conclusion

It can be said that the cultural safety for Torres Strait Islanders and Aboriginal people are essential to bring and facilitate equality in the society. The cultural differences and traditions are needed to be safeguard to provide services that promote the growth of these communities in Australia. By analysing the interpersonal relationship of indigenous people of Australia with non-indigenous people and social status, it has been observed that the impact of differences in the tradition and culture has affected highly in health status, education, and employment. Moreover, the historical event of ‘closing the gap’ has affected in advancing the social position ahead of discrimination and social injustice. Enhancement in education, health service accessibility and increased rate of employment has been facilitated with this scheme of the Australian government. Nonetheless, the impact of European colonisation has affected the discriminatory activities and increased occurrences of epidemic diseases. The law and kinship are also affected by European settlement greatly. Nonetheless, it can be said that the sharing of information and the delivery of healthcare services with respect to culturally safe environment can help in promoting the health and community growth for these indigenous people. Moreover, cultural safety is needed to be guaranteed to facilitate community development and advancing non-discriminatory practices effectively.

REFERENCES:

• Altman, J., Biddle, N., & Hunter, B. (2018). How realistic are the prospects for’closing the gaps’ in socioeconomic outcomes for Indigenous Australians?. Canberra, ACT: Centre for Aboriginal Economic Policy Research (CAEPR), The Australian National University.
• Australians Together | Indigenous kinship. (2019). Retrieved from https://australianstogether.org.au/discover/indigenous-culture/kinship
• Bilbil, M., Collins, L., Swan, C., Sultan, M., and Wilson, A. (1991). The history of past government policies and their effect on aboriginal people. How can aboriginal people make current government policies work for them?,35-37. Retrieved from: https://search-informit-com-au.ezproxy.laureate.net.au/documentSummary;dn=072969271461987;res=IELAPA
• Clarke, A., &Waterton, E. (n.d.). A Journey to the Heart: Affecting Engagement at Uluru-Kata Tjuta National Park. LANDSCAPE RESEARCH, 40(8), 971–992. https://doi-org.ezproxy.uow.edu.au/10.1080/01426397.2014.989965
• closingthegap.pmc.gov.au, (2019). About. Retrieved from https://closingthegap.pmc.gov.au
• ctgreport.pmc.gov.au, (2019). Close the gap report 2018. Retrieved from https://ctgreport.pmc.gov.au/sites/default/files/ctg-report-2019.pdf?a=1
• Finizio, A. (2018). Aboriginal justice: The true cost of aboriginal incarceration-the case for justice reinvestment. Bulletin (Law Society of South Australia), 40(4), 22. Retrieved from https://search.informit.com.au/documentSummary;dn=619520419399354;res=IELAPA
• Fisher, M., Battams, S., Mcdermott, D., Baum, F., & Macdougall, C. (2019). How the Social Determinants of Indigenous Health became Policy Reality for Australia’s National Aboriginal and Torres Strait Islander Health Plan. Journal of Social Policy, 48(1), 169-189. Retrieved from https://doi.org/10.1017/S0047279418000338
• Fisher, M., Baum, F., Kay, A., & Friel, S. (2017). Are changes in Australian national primary healthcare policy likely to promote or impede equity of access? A narrative review. Australian Journal of Primary Health, 23(3), 209-215. Retrieved from https://doi.org/10.1071/PY16152
• Gadsden, T., Wilson, G., Totterdell, J., Willis, J., Gupta, A., Chong, A., … & Maher, L. (2019). Can a continuous quality improvement program create culturally safe emergency departments for Aboriginal people in Australia? A multiple baseline study. BMC health services research, 19(1), 222. [Online]. Retrieved from https://bmchealthservres.biomedcentral.com/track/pdf/10.1186/s12913-019-4049-6
• Gannon, M. (2017). Indigenous taskforce: Aboriginal and Torres Strait Islander people have the solutions to close the gap. Australian Medicine, 29(5), 20. Retrieved from https://search.informit.com.au/documentSummary;dn=719305666211488;res=IELAPA
• Georges, N., Guthridge, S. L., Li, S. Q., Condon, J. R., Barnes, T., & Zhao, Y. (2017). Progress in closing the gap in life expectancy at birth for Aboriginal people in the Northern Territory, 1967–2012. Medical Journal of Australia, 207(1), 25-30. Retrieved from https://www.mja.com.au/system/files/issues/207_01/10.5694mja16.01138.pdf
• humanrights.gov.au, (2019). Close the Gap: Indigenous Health Campaign. Retrieved from https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/projects/close-gap-indigenous-health
• Hutt, M. J., & Onta, P. R. (Eds.). (2017). Political change and public culture in post-1990 Nepal. Cambridge: Cambridge University Press.
• Kingsley, J., Munro-Harrison, E., Jenkins, A., & Thorpe, A. (2018). “Here we are part of a living culture”: Understanding the cultural determinants of health in Aboriginal gathering places in Victoria, Australia. Health & place, 54, 210-220. Retrieved from https://doi.org/10.1016/j.healthplace.2018.10.001
• Kunwar, R. M., Fadiman, M., Cameron, M., Bussmann, R. W., Thapa-Magar, K. B., Rimal, B., & Sapkota, P. (2018). Cross-cultural comparison of plant use knowledge in Baitadi and Darchula districts, Nepal Himalaya. Journal of ethnobiology and ethnomedicine, 14(1), 40. Retrieved from https://ethnobiomed.biomedcentral.com/track/pdf/10.1186/s13002-018-0242-7
• Lathouras, A., & Ross, D. (2017). Benarrawa Aboriginal and Torres Strait Islander Solidarity Group: working to reduce the deleterious effects of racism through structural community development. Community organising against racism:’Race’, ethnicity and community development, 215. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=alI8DwAAQBAJ&oi=fnd&pg=PA215&dq=government+policies+and+their+effect+on+aboriginal+people&ots=_qO5-yI-fs&sig=CRBFSz8j-n44Zvw3-o-4OAq3CrQ#v=onepage&q=government%20policies%20and%20their%20effect%20on%20aboriginal%20people&f=false
• Laverty, M., McDermott, D. R., & Calma, T. (2017). Embedding cultural safety in Australia’s main health care standards. The Medical journal of Australia, 207(1), 15-16. doi: 10.5694/mja17.00328
• Lawrenchuk, R., & Harvey, C. D. (2017). Cultural Adaptation and Change: Aboriginal Peoples in Manitoba Maintain their Differences. In Maintaining our Differences (pp. 71-88). Abingdon: Routledge.
• Markham, F., Jordan, K., & Howard-Wagner, D. (2018). Closing the Gap Refresh: papering over the gaps or structural reform?. Retrieved from https://openresearch-repository.anu.edu.au/bitstream/1885/148768/1/CAEPR_TopicalIssue_2_2018.pdf
• Parter, C., Wilson, S., & Hartz, D. L. (2018). The Closing the Gap (CTG) Refresh: Should Aboriginal and Torres Strait Islander culture be incorporated in the CTG framework? How?. Australian and New Zealand journal of public health. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/1753-6405.12850
• Prout, S. (2018). The entangled relationship between Indigenous spatiality and government service delivery. Canberra, ACT: Centre for Aboriginal Economic Policy Research, Research School of Social Sciences, College of Arts & Social Sciences, The Australian National University.
• Singh, B., & Keitsch, M. M. (2016). Cultural Sustainability and Space–a Comparison of two Cases in Kathmandu, Nepal. Sustainable Development, 24(5), 307-318. Retrieved from https://doi.org/10.1002/sd.1631
• Tamang, S. (2018). Ethnicity and democracy in the eastern Himalayan borderland: constructing democracy. Retrieved from https://www.researchgate.net/profile/Sangay_Tamang4/publication/323519112_Ethnicity_and_democracy_in_the_eastern_Himalayan_borderland_constructing_democracy/links/5a9fc0a245851543e634d001/Ethnicity-and-democracy-in-the-eastern-Himalayan-borderland-constructing-democracy.pdf
• Thompson, G. N., Gee, C., Talley, A. C., & Nicholas, J. (2018). Indigenous health: one gap is closed. The Medical Journal of Australia, 209(1), 14-15. Retrieved from https://www.mja.com.au/system/files/2018-06/10.5694mja18.00483.pdf
• Thompson, G., Talley, N. J., & Kong, K. M. (2017). The health of Indigenous Australians. The Medical Journal of Australia, 207(1), 19-20. Retrieved from https://www.mja.com.au/system/files/issues/207_01/10.5694mja17.00381.pdf
• Townsend, C., White, P., Cullen, J., Wright, C. J., & Zeeman, H. (2018). Making every Australian count: challenges for the National Disability Insurance Scheme (NDIS) and the equal inclusion of homeless Aboriginal and Torres Strait Islander Peoples with neurocognitive disability. Australian Health Review, 42(2), 227-229. Retrieved from https://www.publish.csiro.au/AH/pdf/AH16229