Indigenous Health In Australia

All the determinants of health have a major role in a nurse’s career. “It is critical that nurses understand the impact of these factors on the individuals and groups that they work with, and include these factors in their assessments” (Canadian Nurses Association, 2015). In March of 2008 the Australian Government introduced the Closing the Gap strategy that aims to reduce the disadvantage throughout Indigenous health (Australian Indigenous Health Info Net, 2013). Although the health system is improving there are still major disadvantages with Indigenous Australians compared to non-Indigenous Australians, especially in the Aboriginal and Torres Strait Islander communities. According to Burchill and Higgins (2005), although Close the Gap was
implemented to improve the health outcomes of Indigenous Australians, forty percent of their population is made up of people aged less than fifteen which has made it quite difficult to decrease the gap and meet the needs of early childhood development. Early childhood development is only one of many social determinants that have a major impact on the social and emotional wellbeing and health of Indigenous people in rural and remote areas.
Nurses in Aboriginal and Torres Strait Islander rural communities play a very important role in the improvement of Aboriginal and Torres Strait Islander people’s health through the delivery of culturally appropriate health care and the progress of health services in the Indigenous communities.
Early childhood development is one the most important social determinants of health. Not only does this social determinant maintain a person’s health while they’re young but it also creates a stepping stone for their health as they grow into men and women (Shonkoff, Boyce & McEwan, 2009). Burchill and Higgins (2005) state that a number of problems within the youth of Aboriginal and Torres Strait Islander are still desperately seeking attention. From 1991 to 2010 youth suicide has increased from a low ten percent to eighty percent and has increased in the following years. To add, the juvenile detention rates are twenty-four times higher than non-Indigenous Australians and only twenty-five percent of Aboriginal and Torres Strait Islander children complete school compared to a fifty-two percent rate in non-Indigenous Australians. These statistics show evidence that whilst improving in other factors Closing the Gap isn’t meeting the needs of early childhood development and the negative impact it has on the social and emotional wellbeing of young Indigenous Australians. This can lead to the misuse of health services in Indigenous communities (Burchill et al, 2005).
Most Aboriginal and Torres
Strait Islander people believe that the hospital environment relates to past mistreatment, symbolising death not the healing of themselves or other people of the community (Queensland Health, 2014). Queensland Health (2014) further explains that indigenous families may also experience the following when it comes to health care services;
• Fear and distrust of health services and buildings, which can be threatening or alienating
• Feeling vulnerable, isolation, shame and disempowerment
• Cultural misunderstanding, stereotyping, racism and disrespect
• Financial and accommodation difficulties
Additionally, language is definitely one of the most extensive barriers between Non-Indigenous Australians and Indigenous Australians in rural and remote communities, with many Aboriginal and Torres Strait Islanders considering English as their second or third spoken language (Shahid, Finn & Thompson, 2009). Although, young Aboriginal and Torres Strait Islanders within the rural and remote communities can either be the most easiest or most difficult in the delivery of health care (McBain-Rigg & Veitch, 2011). Children are adaptable by nature, and some Indigenous children will adapt more to modern mainstream society than others. A community nurse can connect with these children and use this connection as a resource to help get the message across to other children in the area as well. This can be especially helpful when attempting to engage with and provide health care to young Aboriginal and Torres Strait Islander children who may be difficult to engage with due to the effects of transgenerational trauma (Korff, 2016). The first generation, after colonisation, men and boys were killed, imprisoned or enslaved, depriving them the ability to provide for their families, which then lead to the raping and prostitution of women. Second generation of Indigenous people were sent to missions where the misuse of alcohol and drug use became a mechanism to deal with grief and loss. Third generation was the stolen generation and since 2007 the fourth generation suffered another level of trauma. The Indigenous men, mainly in the Northern Territory, were accused of being involved in paedophile rings (Korff, 2016). All these aspects have led to mothers, fathers and elders within the communities to become very protective of their children when it comes to introducing them to ‘whites’ or introducing their children to ‘white’ dominated services such as health care. Burchill and Higgins (2005) further state that these factors of transgenerational trauma have a massive impact on children’s health in Aboriginal and Torres Strait Islander communities.
Whilst worrying about a patients/persons health is one of the most important aspects of a nurse’s career, when working within the communities, nurses should first and foremost understand and study Aboriginal and Torres Strait Islander culture, different tribes, different languages, different traditions, different personalities and beliefs to help towards building a professional rapport with Indigenous people.
Additionally, community nurses must not treat every patient the same based on diagnoses, each person in an Aboriginal or Torres Strait Islander community will have individual beliefs. Not all are the same. Moreover, in order for the rural nurse to improve the delivery of health care towards Aboriginal and Torres Strait Islander children, all staff must be culturally capable. Communities nurses must also take in mind the child’s beliefs, not ignoring them or trying to push upon the child their own beliefs. Following these guidelines will result in greater health outcomes (Queensland Health, 2014). The next big stepping stone to improving early childhood development and the social and emotional wellbeing of Aboriginal and Torres Strait Islander people would be to have a better understanding into why Indigenous people misuse the health system when it comes to their children. When speaking to an Indigenous child, the nurses must be considerate of their level of education and English speaking. Don’t give them too much complex information, give the child or guardian
information that they are able to comprehend and understand or collaborate with the child’s guardian about their child’s health in a way that they can understand and then which they can pass on to their child. Just by understanding Aboriginal and Torres Strait Islander culture, tradition and beliefs, the community nurse is already making a dramatic improvement on early childhood social and emotional wellbeing of Indigenous people.
In 2008 as a part of the Close the Gap program the Council of Australian Governments endorsed the Indigenous Early Childhood Development National Partnership Agreement. This partnership agreement was made for Aboriginal and Torres Strait Islander children to have access to quality education. The program was then commenced in 2009 contributing $293 million dollars which provided 35 children and family centres around Australia (Queensland Government; Department of Education and Training, 2011). These centres provide education and care plus parenting and family support. Additionally, the aim of these health centres is to reduce mortality rates in children under five, halve the gap for Indigenous students in reading, writing and numeracy and to ensure four year old children have access to education (Sullivan, 2011). To help address the social and emotional wellbeing of early childhood, the community nurses should collaborate with other allied health teams to encourage parents/guardians or elders to then encourage the children of their communities to attend these centres. By attending these centres, Aboriginal and Torres Strait Islander children will gain more access to education giving them more general knowledge about the world outside of their community. This can also give the children a sense of belonging whilst also improving their social and emotional wellbeing.
The rural nurses could further collaborate with other allied health team members and elders of the community to set up an arts or cultural centre for all ages of the community. Art centres can provide the community with a regular income supply whilst at the same time giving Aboriginal and Torres Strait Islanders a sense of pride and achievement. Young people within the communities then see their elders selling their artworks and heading out to go to major cities for exhibitions. Success like that can rub off and inspire the young people of the community to want to make something of themselves instead of turning to drug or alcohol addiction. The cultural centres will be run and taught by Indigenous people which can help encourage more young people to get involved. They will teach youth about respect, country and cultural protocols (Korff, 2016). If centres like these are implemented throughout rural areas, it can further help with the minds of youth, giving them something to occupy the children that is both educational and enjoyable.
In summary, early childhood development is one of the most important social determinants when it comes to social and emotional wellbeing and health. Community nurses can help address the impacts of this determinant on the social and emotional wellbeing of Aboriginal and Torres Strait Islander people by simply understanding and respecting each communities cultural and spiritual beliefs. Moreover, the implementation and encouragement of attendance to educational centres for youth within the communities can help shape their mind, give them a sense of belonging, guiding them to better life and health decisions. All of these aspects most definitely will help towards improving social and emotional wellbeing of early child development.