NACCHO Aboriginal & Torres Strait Islander Health News: CTG is possible with proper use of information

feature tile image ATSI mum holding baby; text 'Closing the Gap can only be achieved if service gaps are identified and filled'

The image in the feature tile is from the Strong Mothers, Strong Families webpage of the Carbal Medical Services webpage.

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.

CTG is possible with proper use of information

Ian Ring AO, a Professor in tropical health and medicine at James Cook University says if there was general agreement about anything in the recent Voice referendum, it was that progress in Closing the Gap (CTG) has been unacceptable. Given this, Professor Ring said you would have thought, the key question asked by all might be “Why has progress been so slow – and what needs to be done to turn that around?” According to Professor Ring there are steps that could be taken right now to put the targets for life expectancy and child mortality “on track”. They are not unaffordable, do not require new knowledge and have been sought by Aboriginal and Torres Strait Islander people for a very long time. But they would require governments to heed the voice of Indigenous people, strengthen Indigenous leadership and conduct a root-and-branch overhaul and upskilling of key government agencies – and make proper use of information that has long been available to it.

Professor Ring points to child mortality as an example. He explains that most childhood deaths occur very early in life and are driven by birthweight, and that healthy birthweight is much more likely in those who start to access antenatal services early in pregnancy and receive adequate care for a range of health conditions and effective health promotion strategies for nutrition, smoking and other important factors. The Strong Mothers, Strong Babies, Strong Culture program, first developed by Aboriginal women and health workers in the early 1990s and was followed by various adaptations of this approach has led to improvements in the birthweight distribution and a reduction in perinatal mortality.

In 2014 the Australian Institute of Health and Welfare (AIHW) said “Evidence shows that models of care tailored specifically for Indigenous women result in quantifiable improvements in antenatal care attendance, pre-term births, birth outcomes, perinatal mortality, and breastfeeding practice. These models include culturally appropriate and safe care as well as continuity of care, collaboration between midwives and Indigenous health workers, and involvement of family members such as grandmothers.” Professor Ring says that given this information, it might have been expected that the Commonwealth would conduct a service inventory of existing ACCHO services for mothers and babies, identified service gaps and then developed a forward plan to fill the service gaps across Australia. Sadly, that has not been the case and there has been no significant change in the Indigenous low birthweight rate between 2013–2019, and between 2010–2019 there was no significant change in the Indigenous child and infant mortality rates.

Major changes to improve ACT justice system

The ACT Government has formally announced several major changes to key laws in a bid to improve current performance and trajectory in the justice system, including increasing the age of criminal responsibility from 10 years of age to 14 years by the year 2025.  By raising the age of criminal responsibility the ACT Government is hoping to divert youth away from the criminal justice system and ensure they receive the therapeutic rehabilitative support needed to address the underlying cause of their behaviour. Attorney General Shane Rattenbury said “children in our community, especially those engaging in harmful behaviour, need our care and attention, not to be locked away in prison. Barbara Causon, the current Advocate, Aboriginal & Torres Strait Islander Children and Young People in the ACT, said First Nations’ children “are currently over-represented in the juvenile justice system and this important reform, along with carefully considered, culturally informed, alternative service responses aims to address this concerning issue”.

“The importance of involving our local Aboriginal community in the development and implementation of an alternative service response will go a long way to addressing the significant over-representation of our children in the juvenile justice system and have the potential to improve lifelong outcomes for our First Nations children and young people,” she said.

First Nations leader, Bundjalung man and Joe Hedger said “the issues of over-representation are interconnected, part of a web of poverty, limited access to education, healthcare, housing and cycles of disadvantage. By collaborating closely with First Nations people and organisations, the ACT Government can unlock the tremendous expertise and insights they bring to the table. This not only addresses immediate challenges but sets the stage for holistic reform in areas like education, healthcare, employment, housing and mental health, ensuring a brighter future for all.”

To view the National Indigenous Times article ACT leading the way with historic changes to justice system in full click here.

Joe Hedgers (left) with Alicia Payne, Aunty Violet Sheridan, Noah Allan, Paula McGrady and Katy Gallagher at Parliament House

Joe Hedgers (left) with Alicia Payne, Aunty Violet Sheridan, Noah Allan, Paula McGrady and Katy Gallagher at Parliament House. Photo: Jess Whaler. Image source: National Indigenous Times.

Top End life expectancy research wins award

NT Health research looking at the life expectancy of Indigenous and non-Indigenous people in the NT has won the 2022 Medical Journal of Australia (MJA) Award for Excellence in Medical Research. The research conducted by Dr Yuejen Zhao, Shu Qin Li, Dr Tom Wilson, and Professor Paul Burgess, found that life expectancy for Indigenous people in the NT improved markedly from 1999 to 2018, with fewer lives lost to cancer, injuries and chronic disease.

The MJA Editor-in-Chief, Professor Virginia Barbour said “Their important research has helped contribute to the growing Australian academic literature about Indigenous health and wellbeing. We know that more needs to be done to improve the health outcomes for Aboriginal and Torres Strait Islander people, so the MJA really encourages more research into this area. It is also vital that the research community recognises the importance of research into the health and wellbeing of Aboriginal and Torres Strait Islander people.”

Co-author Professor Paul Burgess, the Senior Director of Health Statistics and Informatics at NT Health, said the team were honoured to receive the award. “We are delighted and humbled to accept the MJA award for Excellence in Medical Research,” Professor Burgess said on behalf of the team. “As public health officials, we generally eschew the limelight — outside the occasional pandemic! However, we think the true recognition for this work belongs to the many Aboriginal and non-Aboriginal people who have volunteered or worked tirelessly over the past 20 years to improve health outcomes across the NT.”

You can read the research in the Medical Journal of Australia here and the InSight+ article Indigenous research wins MJA Award for Excellence in Medical Research in full here.

Aboriginal man's hand being held by health worker in hospital

Image source: The Medical Journal of Australia.

Important others see racism called out

A GP has been banned from registering as a doctor for a year in Australia because of discriminatory behaviour toward an Indigenous doctor he accused of being a “fake Aboriginal” akin to “like a watered down bottle of Grange”. The medical board describedthe decision as a “landmark outcome” as it is the first case to make reference to changes in the Australian Health Practitioner Regulation Agency (Ahpra) national law introduced last year to include a definition of cultural safety for Aboriginal and Torres Strait Islander people.

In the ACT Civil and Administrative Tribunal’s findings, the Canberra-based GP’s name was suppressed but the Indigenous doctor, Yuggera, Warangoo and Wiradjuri man associate professor Kristopher Rallah-Baker, made the unusual request that his name be published. “It was important for me that this outcome wasn’t faceless, for people to see they won’t be brought down if they complain about racism,” Rallah-Baker said. “Racism in the healthcare system contributes to patient harm and premature death.”

The nation’s first Indigenous eye surgeon knows the consequences of racism all too well. He was inspired to become a doctor to stem the cycle that saw his grandmother orphaned at 12. “My nanna lost her own mother from pneumonia after refusing to see the white doctors for medical assistance. She was a member of the stolen generation.” While still at the University of Newcastle medical school Rallah-Baker became one of the founding members of the Australian Indigenous Doctors’ Association,, developed and managed the Indigenous Health Unit in the Logan-Beaudesert Health Service District, as well as developing the Deadly Ears Indigenous Hearing Health Program for Queensland, which has now been adopted as the National Indigenous Hearing Health Program by the federal government.

To view The Guardian article Doctor banned for 12 months after sending racist email to Australia’s first Indigenous eye surgeon in full click here.

Australia's first ATSI eye surgeon Ophthalmologist Kristopher Rallah-Baker in scrubs in theatre

Ophthalmologist Kristopher Rallah-Baker received an offensive email from a GP. That doctor has now been reprimanded over misconduct. Photo: Michael Amendolia. Image source: The Guardian.

Suicide prevention, postvention support

Content warning: This article contains reference to suicide. Please refer to the services at the bottom of this article for support.

The suicide rate among Aboriginal and Torres Strait Islander people is more than double that of the Australian population overall, a terrible legacy of the dispossession and trauma wrought by colonisation. But those supporting Aboriginal people in the Illawarra say First Nations people have a lot of strengths to focus on as work continues to drive down the tragic toll. Suicide rates were especially high among males, and suicide was the leading cause of death for Aboriginal and Torres Strait Islander children.

Kim Reid works with Thirrili, a postvention service that supports Indigenous people and communities after a suicide or traumatic death. Mr Reid said he believed the high suicide rates were the result of generational trauma stemming from colonisation, leading to lower socio-economic status, lower employment rates and poorer health. Racism also takes its toll.

Sharlene Cruickshank, Aboriginal mental health clinical lead with the Illawarra Shoalhaven Local Health District, works with a team of Aboriginal clinicians and mental health workers who ensure Aboriginal and Torres Strait Islander people in the region are supported in a culturally safe and sensitive way. “We need to make sure that people feel safe, they trust the service, they trust the people around them, they feel comfortable,” Ms Cruickshank, a Wandi Wandandian, Wodi Wodi and Jerrinja woman, said.

To view the Illawarra Mercury article Suicide prevention, postvention support for Aboriginal community in full click here.

Kim Reid from Thirrili and Sharlene Cruickshank from the Illawarra Shoalhaven Local Health District

Kim Reid from Thirrili and Sharlene Cruickshank from the Illawarra Shoalhaven Local Health District. Photos: Ainslie.Co. Images source: Illawarra Mercury.

If this article brought up anything for you or someone you love, please reach out to, call or visit the online resources listed below for support:

13YARN – 13 92 76,

Lifeline – 13 11 14,

Beyond Blue – 1300 224 636,

MensLine – 1300 789 978

Kids Helpline – 1800 551 800

Suicide Call Back Service – 1300 659 467

Healing power of art for doctors and patients

Medicine cannot cure all diseases, but one simple yet powerful tool – art – can help patients and doctors alike. It is well known that art is good for patients. “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,” as stated by the 1947 Constitution of the World Health Organization (WHO). The WHO uses art in health promotion and communication. In 2019, the WHO tested the effect of arts in advancing specific health goals, including improving mental health, suicide and blindness prevention, and maternal health. The WHO’s Regional Office for Europe is conducting research on the effect of art in health, in its Behavioural and Cultural Insights Program. Art also helps communicate health messages across different cultures and helps with emergency preparedness.

Indigenous artwork displayed in hospitals is one means to aid a culturally safe environment for Indigenous patients. It is also a reminder to non-Indigenous people in the hospital, to mentally acknowledge the Traditional Owners of the land that the hospital lies on. Engaging in art is instrumental in the wellbeing and healing of Indigenous patients. For many Indigenous people, art is not a commodity but rather as “something akin to a family member”. Engaging in and displaying art, when treating Indigenous patients, could be a valuable part of the management plan. However, it remains widely unadopted. The incorporation of Indigenous artwork into staff uniforms of the Royal Flying Doctor Service in Queensland, which they report has helped improve engagement of Indigenous people in their mental health programs.

Art as a method of healing is still viewed as an accessory tool, rather than a primary tool, in the doctor’s toolbox. This likely stems from a multitude of factors: a lack of education of doctors and medical students in the importance of art for patients and themselves, a lack of time in a busy hospital system for the doctor to remember and use available hospital art services, perhaps a feeling that art is not as important as current clinical practice backed with research, a lack of funding for art services in hospitals, and a lack of research studying the effect of art on the physical and mental health of patients. There are likely many other reasons why today, there are still hospitals in Australia without an arts service for its patients or an Arts in Medicine program for its doctors.

To view the InSight+ article The healing power of art for doctors and their patients in full click here.

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