NACCHO Aboriginal & Torres Strait Islander Health News: Decolonising harm reduction: what, how, why

feature tile image: back of person wearing black hoodie with words 'Harm Reduction Saves Lives'; text: wide-ranging benefits to flow from decolonising harm reduction'

The image in the feature tile is from the NZ Drug Foundation webiste. Photo: Charles Mackay, HRI.

The NACCHO Aboriginal and Torres Strait Islander Health News is a platform we use to showcase the important work being done in Aboriginal and Torres Strait Islander health focusing on the work of NACCHO, NACCHO members and NACCHO affiliates.

We also share a curated selection of news stories that are of likely interest to the Aboriginal and Torres Strait Islander health sector, broadly.

Decolonising harm reduction: what, how, why

People and organisations working for harm reduction have been urged to decolonise their work and unpack “the biases, structures, systems that operationalise racism, in our own practices and organisations”.

In a powerful address to the Harm Reduction International conference taking place in Naarm/Melbourne this week, Professor James Ward, Director of the University of Queensland Poche Centre for Indigenous Health, outlined wide-ranging benefits that would flow from decolonising harm reduction. In his address Prof Ward considered why  current harm reduction policies that is not working for Indigenous peoples.

“Beyond Australia, contemporary substance use among Indigenous peoples today is inextricably linked to colonialism, both in the ways land was acquired and in relation to the disruption and trauma that came with colonisation, including the ongoing intergenerational trauma experienced by the younger generations of Indigenous peoples today.”

“The introduction of drugs and substances, to Indigenous peoples has had devastating impacts on our peoples globally. The most common feature of the modern day response to the weaponising of alcohol and other drugs against Indigenous peoples has been to double down on law enforcement and control.

“Indigenous, Black and Brown peoples who use drugs are over-policed, have higher rates of arrest, fatal overdoses, prosecution and incarceration for drug use than other identifiable population. And at the same time they lay bare their bodies to the triple whammy of discrimination, racism and stigma.”

To view the Croakey Health Media article A powerful call to decolonise harm reduction in full click here.

Professor James Ward portrait photo

Professor James Ward, Director University of Queensland Poche Centre. Image source: Harm Reduction Australia.

Biodiversity loss matters to human health

Australia is one of 17 megadiverse countries globally, with many plants, animals and ecosystems found nowhere else on Earth. Unfortunately, over 200 years since European colonisation, Australia has suffered the largest decline in biodiversity of any continent, including the highest rate of extinctions in the modern world.

Now, a comprehensive and sobering report on the state of Australia’s environment (SOE) over the past five years has been released. This shows ongoing environmental deterioration at a continent‐wide scale. Pressures from climate change, habitat loss, pollution, resource extraction, and invasive species are threatening every Australian ecosystem, with 19% showing signs of collapse.

Yet, although we are increasingly hearing dire warnings about our environment, there is a lack of reflection on the consequences for human health among policy makers and the general public. Addressing this, for the first time, the SOE report explores environment–human health linkages, recognising that the state of our environment is highly consequential for the health and wellbeing of Australians.

To view the Medical Journal of Australia article Why losing Australia’s biodiversity matters for human health: insights from the latest State of the Environment assessment in full click here.

word 'save' spelt with wooden letters 's' 'a' 'e' and 'v' is a seedling; globe on soil, trees in background

Photo: Getty Images. Image source: Flinders University webpage – Pandemic exposes biodiversity-health nexus.

Mob face double NDIS disadvantage

A fraction of the estimated 60,000 Indigenous Australians living with a disability are receiving support through the National Disability Insurance Scheme (NDIS). The federal government has outlined plans for serious and systemic reform to ensure the decade-old NDIS’s long-term effectiveness.

The First Peoples Disability Network (FPDN) works with individuals whose needs are more complex than some. “The complications of living in regional, rural or remote areas means often the only disability services available to mob are hundreds of kms from where they live with no allowance made for transportation to access these essential services,” FPDN CEO Damian Griffis said. “The tyranny of distance is enough of an issue, but throw in the lack of cultural safety in mainstream disability services and you have another compounding factor in mob not participating in the NDIS.”

But the most fundamental reform would be to ensure the NDIS was surrounded by increased community and mainstream support services. Mr Griffis said it is vital that the reforms address the under-representation of Indigenous people in the NDIS. “When you get things right for our people and overcome the double disadvantage that disabled Indigenous people face, you invariably improve things for everyone,” he said.

To view The Senior article Indigenous face double NDIS disadvantage, network says in full click here.

young ATSI man in wheelchair with 2 camp dogs

Photo: Karen Michelmore, AAP. Image source: The Conversation.

Major disparity in organ donations

The World Transplant Games in Perth have been used to highlight the disparity faced by Indigenous Australians who face five times the risk of kidney disease and a lower chance of receiving organs. Only a small percentage of First Nations people (9.5%) are waitlisted compared to non-Indigenous counterparts.

The consent rates for organ donation in Aboriginal and Torres Strait Islander families was also significantly lower than non-Indigenous families in 2016, with only 20% providing consent compared to 67%. To address this issue, Transplant Australia is actively promoting the discussion of organ donation within these communities to encourage consent for organ donation.

“Indigenous Australians receive a kidney transplant at about a quarter of the rate of non-Indigenous Australians and that inequality needed addressing urgently. Kidney transplantation is the optimal treatment for End Stage Kidney Failure but there is significant and persistent disparity in transplants to Indigenous and non-Indigenous Australians. Sadly, Indigenous Australians are also five times more likely to suffer kidney disease due to lifestyle, genetic and economic factors,” Transplant Australia CEO Mr Thomas said.

To view The National Indigenous Times article World Transplant Games kick off in Perth, addressing the major disparity in organ donations among First Nations communities in full click here.

World Transplant Games 2023 logo & participant Ken Farmer, Indigenous heart recipient

Ken Farmer, Indigenous heart recipient in attendance at the World Transplant Games in Perth, WA. Image source: National Indigenous Times.

The making of a doctor

Two chance encounters were just the right medicine for Riley Phillips when he was grappling with a major career change. The first was fleeting, meeting an elderly Aboriginal man while working as an employment officer in his home town of Taree, on the mid North Coast of NSW. “I had a lot of older clients and there was this one particular bloke who had mental and physical issues who one day started to cry,” Riley recalls. “He didn’t need employment help; he needed medical help. But he didn’t know what help was available; that there were people called psychologists and mental health care plans. I helped get him in to see a GP.”

The second major influence was Dr Keith Gleeson, also an Aboriginal man, who worked as a locum at Taree’s Biripi Aboriginal Corporation Medical Centre and had begun studying medicine at a mature age. “After meeting Dr Keith, he kept saying to me ‘you could be a doctor’. We had many chats about how I would cope studying as an older student with a young family.”

At 35 Riley was the first in his family to even contemplate university, a path supported by the University of New Englands’s TRACKS Tertiary Preparation Program, which caters to Aboriginal and Torres Strait Islander students looking to prepare for undergraduate studies.

To view the UNE article The making of a doctor in full click here.

Riley Phillips, medical student University of New England

Medical student and future doctor Riley Phillips. Image source: University of New England website.

Room to Breathe Program extends houses

Minister for Housing and Homelands, Selena Uibo, says families in Angurugu and Galiwin’ku have recently returned to their homes, which were extended as part of the Room to Breathe program. In Angurugu, Miranda Lalara and her family received an extension to their home, which included two new bedrooms, plus a separate toilet and bathroom.

The upgrades have reinvigorated the much-loved family home, where Miranda has lived since she was a child with her parents and four siblings. The Room to Breathe program has converted the family home into a five-bedroom residence, allowing Miranda to share her home with her sibling and adult children while ensuring there is room for generations to come.

Galiwin’ku will receive 87 new builds under HomeBuild, and 45 homes will receive Room to Breathe works, which are already completed and underway. The Room to Breathe program aims to improve the living conditions of Aboriginal Territorians in remote communities by extending homes and upgrading amenities. A goal to extend an identified 996 homes in remote communities is underway, with works completed to 392 homes and works currently underway in 209 homes.

To view Minister for Housing and Homelands Selena Uibo’s media release Room to Breathe program improving housing on Elcho and Groote islands in full click here.

2 images - ATSI builders brick laying & moving materials

Images from the NT Government Department of Territory Families, Housing and Communities Room to Breathe webpage.

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