“As an Aboriginal Educator working in health, I’ve lost count of how many times I’ve been asked to create a contacts/links/services/etc. list for mainstream professionals working with Aboriginal Community. Honestly, I’ve been asked so many times to provide a concise and complete list of all the services and programs available, so people can theoretically streamline their workload by avoiding the perceived tedium of searching for appropriate areas to refer to.’

Relationships are built on a solid foundation of collaboration, communication, and mutual support and respect.

Nathan Leitch is a Quandamooka man from South East Queensland, who has lived most of his life in Victoria. Nathan has a background in visual art, but more recently has worked in Aboriginal education and health; focused predominantly on delivery of Cultural Awareness training, health promotion, advance care planning, and service improvement. Nathan is a resident of Northern Melbourne and is committed to supporting and improving the health experiences of local Aboriginal people.

This article was featured in this months 20 Page NACCHO Aboriginal Health Newspaper available as a lift out in the 1 July Koori Mail

Or download the PDF copy here

Anyone who has ever created one of these lists (many have even poured resources into design and development of websites and other high-end publications) will know the frustration that comes with the endless maintenance and upkeep required just to keep all the information current. With the high turn-over of Aboriginal staff, as well as the constant shift of funding to services, you can bet the whole farm that your list will be out of date and in need of total auditing within a year.

Well, I’d rather not do it anymore. Not in the arbitrary “Can you make me a full list of Aboriginal services, so I don’t have to do as much work?” kind of way. I’m happy to address enquiries and questions on a case-by-case basis, focussed on the best outcomes for a specific client or family, but I have some serious concerns about the ongoing expectation that Healthcare professionals should have all the groundwork done for them and presented on a platter.

The “too hard” attitude toward Aboriginal health is understandable from a daily grind viewpoint, but if you don’t take a long-term approach to it, you are only crushing your own (and that of the Community) chances at achieving any sort of “Gap closing”. There is a crucial necessity for all mainstream health workers, particularly GPs and other senior Doctors and Physicians (Historically seen as trusted pillars and leaders of Western culture), to step away from their habit of seeking networking assistance, and make some actual Community networks and, dare I say it, ‘friendships’ of their own.

Any Aboriginal consultant worth their salt will tell you that the absolute scaffolding and foundation of any successful Aboriginal program is Relationships; Proper consultation, genuine and respectful relationship development and upkeep, an acknowledgement of the importance of Culture in healthcare… A solid dedication to being a part of the whole community.

The silo of the GP practice is an unnecessary and (probably) arrogant condition. These are not our Gods. These are our family doctors in whom we have an automatic level of faith and trust. I would suggest that the trajectory of this ascending respect be levelled out to a parallel, in which the GP (or other mainstream health professional) hold the client in an equal esteem, as co-fixtures in one community. My most humble apologies to those Doctors who already understand all this, and have been delivering excellent healthcare to Aboriginal Communities for many years, I’m sure you will agree with me, regarding the importance of attitudinal change and a priority of Community relationship development and upkeep, especially with Aboriginal Community Controlled Health Organisations. I have read several published articles by Doctors such as these, published over the last ten years, which are essentially saying the same things I am. These are not new or controversial concepts. These are well-known directives and concepts, which have been making their way slowly throughout the medical industry, and can be clearly aligned with the principles of good general practice.

A serious dedication to developing an understanding of the Aboriginal Community will require a willingness to relinquish the Fortitude of Doctorness (an ever-archaic situation in which individual practitioners are allowed to develop habits and systems which serve their own needs more than those of the community. “Doctor knows best” is the common adage), and return to the ground where the clients of said doctor actually are. If anything, the strategy of helping everybody enjoy their optimum level of health becomes so much simpler when a doctor can confidently make recommendations and decisions based on a realistic understanding of an individual and the social and Cultural elements that surround them. There is no single piece of literature that can adequately explain the intricacies of working with Aboriginal Community. There is no single website which will provide all the links and secret pathway through the veritable minefield which is Aboriginal health. What there is, however, is a thriving and generous community of people who just want to be respected and collaborated with.

You won’t need a contacts/links/services/etc. list if you have a local network of people with real knowledge and skills. You won’t even need to ask so many questions about what services and programs are out there, if you have an active presence in the Aboriginal Community, because it would just be normal to know that stuff. This is just one area in which people other than the Aboriginal Community are required to do some heavy lifting to bring true social justice. I would suggest that we (Aboriginal Community) take a proactive approach to making our programs and services fully advertised and “Google-able”, so as to exist equally with our Mainstream service counterparts.

The lack of broad public education on the general topic of Aboriginal and Torres Strait Islander Culture and history is a simple right that the entire Nation has been denied of. In my work, delivering Cultural Awareness to healthcare providers, I’m constantly frustrated (but never surprised) at the lack of general knowledge which should be ubiquitous. Colonialism and a deeply entrenched social ethos of white advancement have left us with a huge deficit, and it’s time everybody acknowledged it. Keeping in mind that GPs are held in such high esteem by the general public, this makes them the prime candidates for reform. This is a golden opportunity for these already-respected pillars to set a new example, and step into the vastly unchartered waters of genuine community participation. There will undoubtedly be some GPs who feel they are already very educated, and are already delivering effective healthcare in their practices, however I challenge these individuals to describe exactly how they are addressing the Gap. To suggest that all Australians have the same access to healthcare and resources, or to say it’s a poor people thing rather than a Black people thing, is purely and totally incorrect. These are opinions borne out of broad ignorance to the true barriers of Aboriginal people attempting to survive in a system we are not historically welcome in.

What I’ve outlined here (for discussion) is just one shared barrier to improving healthcare access for Aboriginal and/or Torres Strait Islander Community. This is a situation of give and take, as all good relationships should be. I call on Mainstream health providers (GPs, nurses, allied health, everyone!) to consider their personal attitude toward Aboriginal Health, and honestly assess the personal attitudes and opinions which may be directing current practices and professional habits. To operate within Cultural Safety, is to apply an honest lens to one’s own practices, where other Cultures are factors (we know that Culture is ALWAYS a factor in health). On a home-team level, I call upon Aboriginal services and staff to try to raise the level of available information, within reason. I encourage you to produce resource and service listings, if deemed necessary, but I caution you as to the dangers of supporting the poor networking habits of your Mainstream peers and colleagues.

We know what it takes to achieve Cultural Safety. We can tell you how to bring great social change and therefore social justice. We have the knowledge and strength to be regarded as our own experts and spokespeople, regardless of Western definitions of education. So here’s the big secret to unlocking the gate in front of “the Gap”;

Nationally

These are necessary education reforms, and not absolute solutions. Seeking legitimate education on Aboriginal and Torres Strait Islander History and Culture has been made the responsibility of the pro-active Australian. (You may have difficulty with these steps if you’re not an influential politician, but keep them in mind when considering barriers to Aboriginal health access. Or, you could suggest these ideas to an influential politician. Just a thought)

• Acknowledge that an insurmountable history of racist atrocities have been perpetrated by the colonisers and subsequent governments of Australia
• Full disclosure of Aboriginal history in all its beauty, complexities and colonial horrors in the National Curriculum, including a National campaign of re-education for the broader public

Locally

• Develop and nurture relationships* and networks with Aboriginal Communities
• Enjoy the support and knowledge you now have access to

*Relationships are built on a solid foundation of collaboration, communication, and mutual support and respect.

If you would like to share your experiences leave comments below