NACCHO Aboriginal Health : Download The @RACGP Five steps towards excellent Aboriginal and Torres Strait Islander healthcare


 ” The RACGP’s Five steps towards excellent Aboriginal and Torres Strait Islander healthcare has been developed to provide a clear and concise summary of the programs and funding options available to support better care for Aboriginal and Torres Strait Islander patients “

Download 1Five-steps-guide

Download 2. Five-steps-summary-sheet

RACGP Aboriginal and Torres Strait Islander Health produced these resources to help give busy GPs and practice teams practical advice that builds on a foundation of cultural awareness.

The five steps:

1. Prepare and register for the Practice Incentives Program (PIP)
Register for the Indigenous Health PIP Incentive, staff complete accredited cultural awareness training, create a welcoming practice environment.

2. Identify your Aboriginal and Torres Strait Islander patients
Asking whether someone identifies as Aboriginal and/or Torres Strait Islander can cause discomfort in practice staff; however, evidence shows that patients are comfortable when asked if the reasons can be explained.

If patients choose to identify as Aboriginal and/or Torres Strait Islander, they will do so when prompted.

3. Perform a health assessment
Performing a Medicare health assessment for Aboriginal and Torres Strait Islander people (MBS item 715) opens access to an additional five allied health visits.

Conducting a health assessment with a patient is an opportunity to build rapport and trust, and to develop an ongoing relationship. In addition to identifying physical health problems, discussing psychological and social functions is an effective approach to two-way communication with Aboriginal and Torres Strait Islander patients.

4. Register patients with, or at risk of, a chronic disease for the Closing the Gap (CTG) Pharmaceutical Benefits Scheme (PBS) co-payment
Once a practice is registered for the Indigenous PIP (Step 1), it is able to register patients for the CTG PBS co-payment.

5. Use appropriate clinical guidelines and programs from the RACGP, Medicare and Primary Health Networks to enhance access and quality of care
The National Aboriginal Community Controlled Health Organisation (NACCHO)/RACGP National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (the National guide) outlines the activities that are effective for preventive health.

More information is also available in the Australian Indigenous Health InfoNet Indigenous Health service eLearning program.

Other resources in the Five steps towards excellent Aboriginal and Torres Strait Islander healthcare include a Five steps guide, which features detailed information to support GPs and practice teams to access programs and funding options; a quick reference guide to MBS items, policy and programs; and a Five steps visual poster, which is a condensed version of the five steps that can be displayed in a practice.

The RACGP will also be developing supplementary resources throughout 2018 to support GPs to implement the five steps in a way that achieves the best outcomes for practices and Aboriginal and Torres Strait Islander patients.

First published in newsGP. Reproduced with permission of the RACGP.


THE AUTHOR: Mr Paul Hayes Paul is an experienced healthcare journalist and the editor of newsGP.

NACCHO Aboriginal #MentalHealthDay : Australia’s new digital #mentalhealth gateway now live

 ” Today we are launching our new digital mental health gateway – Head to Health.

Head to Health is an essential tool for the one in five working age Australians who will experience a mental illness each year.

The website helps people take control of their mental health in a way they are most comfortable with and can complement face-to-face therapies.

Evidence shows that for many people, digital interventions can be as effective as face-to-face services.

Head to Health provides a one-stop shop for services and resources delivered by some of Australia’s most trusted mental health service providers.

They include free or low-cost apps, online support communities, online courses and phone services.

Head to Health provides a place where people can access support and information before they reach crisis.

The Hon. Greg Hunt MP Minister for Health launching

See full press release from Minister Part 3 below

 ” For Aboriginal and Torres Strait Islander peoples, the strength of personal identity is often connected to culture, country and family.

Like all of us, however, you can have problems with everyday things like money, jobs and housing that can impact your social and emotional wellbeing. On top of that, you might have to deal with racism, discrimination, bullying, gender-phobia, and social inequality ”


 ” Aboriginal and Torres Strait Islander health and wellbeing combines mental, physical, cultural, and spiritual health of not only the individual, but the whole community. For this reason, the term “social and emotional wellbeing” is generally preferred and better understood than terms like “mental health” and “mental illness”.

Addressing social and emotional wellbeing for Aboriginal and Torres Strait Islander peoples requires the recognition of human rights, the strength of family, and the recognition of cultural diversity – including language, kinship, traditional lifestyles, and geographical locations (urban, rural, and remote).”



Read over 160 NACCHO Aboriginal Mental Health Articles published over 5 yrs

Read over 115 NACCHO Suicide Prevention Articles published over 5 yrs Including

NACCHO Aboriginal Health : #ATSISPEP report and the hope of a new era in Indigenous suicide prevention

Our NACCHO CEO Pat Turner as a contributor to the report attended the launch pictured here with Senator Patrick Dodson and co-author Prof. Pat Dudgeon

After almost two years of work, ATSISPEP released a final report in Canberra on the 10th of November 2016.

Download the final #ATSISPEP report here


Part 2 Mental Health Australia campaign

We need to see tackling stigma around mental health as a way to improve the health of the nation, improve our productivity, improve our community engagement, and improve our quality of life.”

“Yes we’ve come a long way to challenge and change perceptions, and paved the way for many to tell their story, but there is still great stigma associated with mental illness.”

“This year, my #mentalhealthpromise is to challenge Australia to look at mental health through a different light. Let’s look at the positives we can achieve as a community by reducing stigma and changing our approach to improving someone’s health.”

Mental Health Australia CEO Mr Frank Quinlan

Today World Mental Health Day – Tuesday 10 October – and Mental Health Australia is calling on the nation to further reduce stigma and promise to see mental health in a positive light.

‘Do you see what I see?’ challenges perceptions on mental illness aiming to reduce stigma.

‘Do you see what I see?’ promotes a positive approach to tackling an issue that affects one in five Australians.

‘Do you see what I see?’ aims to put a new light on the conversation… from dark to bright. Incorporating the successful #MentalHealthPromise initiative, which last year saw both the

Prime Minister and Opposition Leader make a mental health promise to the nation, ‘Do you see what I see?’ will also feature a series of photos from across Australia, shedding light and colour on an issue which is still cloaked in darkness.

“We’ve all seen it before… The stock black and white photo of someone sitting with their head in their hands signifying mental illness. That’s stigma… and stigma is still the number one barrier to people seeking help. Help that can prevent and treat,” said Mental Health Australia CEO Mr Frank Quinlan.

“We have to see things differently, and see the positive outcomes of tackling this issue if we are to see real benefits and reductions in the rate of mental illness affecting the nation.”

“We need to see mental health, and mental wealth through our own eyes, through the eyes of a family member or close friend and through the eyes of those in our community who don’t have that support around them.”

‘What will your #MentalHealthPromise be?

Making and sharing a mental health promise is easy and takes just a few minutes at

Part 3 The Hon. Greg Hunt MP Minister for Health press release Continued

Australia’s new digital mental health gateway now live

As part of our over $4 billion annual investment in mental health, the Turnbull Government is today launching our new digital mental health gateway – Head to Health.

Head to Health provides a place where people can access support and information before they reach crisis.

And it will continue to grow with additional services, a telephone support service to support website users, and further support for health professionals to meet the needs of their patients.

I encourage not only people seeking help and support, but anyone wanting to learn more on how to maintain good mental health wellbeing, to visit the website at:

The Turnbull Government supports the need for a long term shift in mental health care towards early intervention, and the Head to Health gateway will help with this.

We have recently announced $43 million in funding for national suicide prevention leadership and support activity to organisations across Australia such as R U OK?, Suicide Prevention Australia and Mindframe.

This year we are investing $92.6 million in the headspace program to improve access for young people aged 12–25 years who have, or are at risk of, mental illness.

In addition, we have provided $52.6 million to beyondblue, which will partner with headspace and Early Childhood Australia to provide tools for teachers to support kids with mental health concerns and provide resources to help students deal with challenges.

Digital mental health services are an important part of national mental health reform and have been identified in the recently endorsed Fifth National Mental Health and Suicide Prevention Plan.

Building a digital mental health gateway was a key part of the Government’s response to the National Mental Health Commission’s Review of Mental Health Programs and Services.


NACCHO Aboriginal Health and Smoking : Survey #Nosmokes How #socialmedia supports positive health behaviour

How does accessing the NoSmokes health campaign support anti-smoking behaviour in Aboriginal and Torres Strait Islander youth?

What is this project about?

The aim of this project is to explore how the NoSmokes health campaign supports Aboriginal and Torres Strait Islander youth to deal with smoking situations. We will also explore whether accessing NoSmokes supports young people to stay quit or resist starting smoking.

What are the benefits of the project?
This project will help us to understand more about how online technology and social media can be used to support positive health behaviour, particularly in relation to smoking. You may also learn more about your own confidence in dealing with a number of different smoking situations.

What will I have to do?

To participate you must use /view

1.NoSmokes Facebook page.


2. NoSmokes website.


3. NoSmokes YouTube channel.


4. NoSmokes  Instagram page


5.and be 16 years of age or older.

Your participation is voluntary, so you don’t need to take part if you don’t want to. If you choose to take part, you will complete an online questionnaire answering questions about: your experience with smoking; your experience of NoSmokes, your confidence in dealing with different smoking situations. This will take around 20-25 minutes.

If there are any questions in the survey you don’t like, or that you do not feel comfortable answering, then leave that question and move onto the next one. You can complete the survey on your mobile phone or computer. If you change your mind about participating, or are feeling uncomfortable, you can choose to stop the survey at any time by closing the web page or by not pressing the ‘submit’ button. Any data collected before you withdraw will be deleted at the end of the data collection period.

What will happen to my information?

Only the researcher will have access to the individual information provided by participants. Privacy and confidentiality will be assured at all times. The project findings will be used as part of the researcher’s Honours Thesis project, and will be published on the NoSmokes and Ninti One websites. The research may also be presented at conferences and written up for publication.

Only anonymous information will be gathered – you will not be required to provide any identifiable personal information, such as your name or date of birth. No one will know you have taken part in this research from reading the thesis, reports or other publications.

If you are interested in viewing the results of this research, a summary report will be available on the NoSmokes website in December 2017. You can also request a copy of the final thesis by emailing Neeti Rangnath on

Neeti Rangnath
Honours Student
Discipline of Psychology, Faculty of Health
University of Canberra, ACT 2601
Dr Penney Upton
Associate Professor in Health
Centre for Research and Action in Public Health
University of Canberra, ACT 2601
Ph: 02 6201 2638
Data storage
During the project, the anonymous data will be stored securely on a password protected computer, and then stored securely on the University of Canberra network server. The information will be kept for 5 years, after which it will be destroyed according to University of Canberra protocols.

Ethics Committee Clearance
The project has been approved by the Human Research Ethics Committee of the University of Canberra (HREC 17-83).

Queries and Concerns
If you have any questions or concerns about this project you can contact the researchers, whose details are provided at the top of this form. If you are concerned about the conduct of this project please contact

Mr Hendryk Flaegel, Ethics and Compliance Officer at the University of Canberra (p) 02 6201 5220 (e)

There are no anticipated risks associated with participating in this research. However, if completing this questionnaire makes you feel uncomfortable, sad, or angry about your own smoking or the smoking behaviour of someone you know, you are encouraged to visit the following website to find support with smoking-related issues in your state or territory: 

Consent Statement 
I have read and understood the information about the research. I am not aware of any reason that I should not be participating in this research, and I agree to participate in this project. I have had the opportunity to ask questions about my participation in the research. All questions I have asked have been answered to my satisfaction.

Complete consent and start survey here


Aboriginal Health #NAIDOC2017 : New Aboriginal-led collaboration has world-class focus on boosting remote Aboriginal health

“One of the clear innovations that our Centre already offers is acknowledging that the principle of Aboriginal community control is fundamental to research, university and health care partnerships with regional and remote Aboriginal communities,”

Ms Donna Ah Chee Congress CEO said it was satisfying to achieve recognition for the strong health leadership and collaboration that already exists in Central Australia ( see editorial Part 3 below)

  ” The centre’s accreditation this week with the National Health and Medical Research Council proved the “landmark research” by consortium members had “huge potential” to address serious indigenous health issues.

The objective is to evaluate problems and find practical solutions fast, to prevent health problems and give speedy but lasting benefits to patients within community,”

Announcing $222,000 in seed funding, Federal Indigenous Health Minister Ken Wyatt see full story PART 2 from the Australian below

Photo above : Traditional Arrernte owners welcome Ken Wyatt MP to Alice Springs to launch the Central Australia Academic Health Science Centre

An academic health science centre in Central Australia is the first Aboriginal-led collaboration to achieve Federal Government recognition for leadership in health research and delivery of evidence-based health care.

The Federal Minister for Indigenous Health and Aged Care, the Hon Ken Wyatt MP, today announced that the Central Australia Academic Health Science Centre (CAAHSC) was one of only two consortia nationally to be recognised as a Centre for Innovation in Regional Health (CIRH) by Australia’s peak funding body for medical research, the National Health and Medical Research Council (NHMRC).

To be successful in their bid, the 11-member consortium was required to demonstrate competitiveness at the highest international levels across all relevant areas of health research and translation of research findings into health care practice.

With NHMRC recognition, the CAAHSC joins an elite group of Australian academic health science centres that have so far all been based in metropolitan areas including Melbourne,

Sydney and Adelaide. The CAAHSC is also in good company internationally, with long established collaborations including Imperial College Healthcare in the UK and Johns Hopkins Medicine in the USA.

The CAAHSC, whose membership includes Aboriginal community controlled and government-run health services, universities and medical research institutes, was formally established in 2014 to improve collaboration across the sectors in support of health.

Such synergy is vital in order to make an impact in remote central Australia, considering the vast geographical area (over 1 million square kilometres) and the health challenges experienced particularly by Aboriginal residents.

The CAAHSC consortium reflects the importance of Aboriginal leadership in successful research and health improvement in Central Australia.

The Chairperson of CAAHSC is Mr John Paterson, CEO of the Aboriginal Medical Services Alliance Northern Territory, the peak body for the Aboriginal community controlled health services sector in the NT.

With the leadership of CEO Ms Donna Ah Chee, Central Australian Aboriginal Congress was the lead partner on the group’s bid to become a CIRH.

The CAAHSC is a community driven partnership, where Aboriginal people themselves have taken the lead in identifying and defining viable solutions for the health inequities experienced in the Central Australia region.

The CAAHSC partners have a long and successful track record of working together on innovative, evidence-based projects to improve health care policy and practice in the region.

Such projects include a study that examined high rates of self-discharge by Aboriginal patients at the Alice Springs Hospital, which in many cases can lead to poor health outcomes.

This research was used to develop a tool to assess self-discharge risk which is now routinely used in care, and to expand the role of Aboriginal Liaison Officers within the hospital.

Another collaborative project designed to address the rising rates of diabetes in pregnant women involves the establishment of a patient register and birth cohort in the

Northern Territory to improve antenatal care in the Aboriginal population.

CAAHSC Chair, Mr John Paterson agrees, saying the CIRH would serve as a model for other regional and remote areas both nationally and internationally, particularly in its governance, capacity building, and culturally appropriate approaches to translational research.

Mr Paterson said he hoped NHMRC recognition would attract greater numbers of highly skilled researchers and health professionals to work in Central Australia, and that local Aboriginal people would become more engaged in medical education, research and health care delivery.

He also hopes that achieving status as a CIRH will be instrumental in attracting further resources to the region, including government, corporate and philanthropic support.

Mr Paterson said the consortium is now focussed on building a plan across its five priority areas: workforce and capacity building; policy research and evaluation; health services research; health determinants and risk factors; and chronic and communicable disease.

This will include development of research support ‘apprenticeships’ for Aboriginal people and pursuit of long-term financial sustainability.

The partners of the Central Australia Academic Health Science Centre include: Aboriginal Medical Services Alliance Northern Territory (AMSANT); Baker Heart and Diabetes Institute; Charles Darwin University; Centre for Remote Health (A joint centre of Flinders University and Charles Darwin University); Central Australian Aboriginal Congress; Menzies School of Health Research; Central Australia Health Service (Northern Territory Health); CRANAplus; Flinders University; Ngaanyatjarra Health Service and the Poche Centre for Indigenous Health and Wellbeing.

1.Chronic Conditions

Chronic diseases are the most important contributor to the life expectancy gap between Indigenous and non-Indigenous Australians. Given their impact on premature mortality, disability and health care utilisation in Central Australia it is unsurprising that chronic disease has become the primary focus for addressing Indigenous Australian health disadvantage.

The Central Australia AHSC has considerable research and translation expertise with those chronic conditions that most impact the Aboriginal Australian population, including diabetes, heart disease, renal disease and depression.

Some of our focus areas are: understanding the developmental origins of adult chronic disease through targeted multi-disciplinary research focused on in-utero, maternal and early life determinants; understanding and preventing the early onset and rapid progression of heart, lung and kidney disease and diabetes within Aboriginal people, and developing and supporting capacity development of the chronic disease workforce within Aboriginal communities and health services.

2.Health Determinants and Risk Factors

In order to support the health of Central Australians, we recognise the importance of transcending boundaries between the biological, social and clinical sciences. The Central Australia AHSC takes an interdisciplinary approach to understanding social gradients, their determinants, and pathways by which these determinants contribute to illness, and consequently to forwarding policy responses to reduce health inequalities.

The Central Australia AHSC is interested in exploring the role of stress, intergenerational trauma and other psychosocial factors, as well as uncovering the biological pathways by which social factors impact on cardiometabolic risk, mental illness and other conditions of relevance to Indigenous communities.

3.Health Services Research

As a regional hub servicing a high proportion of Aboriginal people spread across an extensive area, Central Australia serves as an exemplar environment through which to address critical issues of national importance – for instance, targeted and practical research focused on the National Health and Hospital Reform agenda, the ‘Close the Gap’ reforms and the Indigenous Advancement Strategy.

Through health services research, the Central Australia AHSC is chiefly interested in developing and equipping primary care and hospital services with the skills, methods and tools by which to improve health care quality, appropriateness and accessibility.

Towards this goal, we are involved in developing, trialling, evaluating and establishing the cost-effectiveness of novel health system approaches to the identification, management and prevention of acute care, chronic disease and mental illness

4.Policy Research and Evaluation

The Central Australia AHSC brings together the expertise of leading clinician researchers, public health specialists and health service decision makers.

The Central Australia AHSC provides the capacity to evaluate the systems that underpin change management in health care through policy, protocol and evaluation research, and to support quality improvement processes through health provider training.

While being locally relevant, our works also informs jurisdictional and national health policy and practice in Aboriginal and remote health and implementation of national health reforms.

5.Workforce and Capacity Building

Central Australia’s health care workforce encompasses health care providers in hospitals, remote Aboriginal communities, and outreach services, including Aboriginal health practitioners, nurses, allied health providers, general practitioners and specialists.

Remoteness and the challenging work environment often translate to high levels of health provider staff turnover.

The Central Australia AHSC’s ongoing focus on professional development and capacity building facilitates health work force sustainability by providing relevant training and support and by attracting new health care providers who are also involved in research.

Workforce and capacity building undertaken by the AHSC partners includes the delivery of education programs (including tailored remote and Indigenous health postgraduate awards for doctors, nurses and allied health practitioners), growing research capacity (supervised formal academic qualifications and informal mentoring), and conducting research to inform workforce recruitment and retention.

Part 2 World-class focus on boosting remote health

Alice Springs mother Nellie Impu is part of a grim health statistic profoundly out of place in a first-world nation: one in five pregnant Aboriginal women in the Northern Territory has diabetes.

Photo : Nellie Impu, left, with Wayne, Wayne Jr and nurse Paula Van Dokkum in Alice Springs. Picture: Chloe Erlich

From the Australian July 5

For pre-existing type 2 diabetes, that’s at a rate 10 times higher than for non-indigenous women; more common gestational diabetes is 1.5 times the rate.

Mrs Impu became part of that statistic almost five years ago when she was pregnant with son Wayne. So the announcement of a new central Australian academic health science centre, led by the Aboriginal community-controlled health service sector and bringing together a consortium of 11 clinical and research groups, is a big deal for her and many women like her.

The diabetes treatment she underwent while carrying Wayne will continue for more than a decade as part of a longitudinal study.

“We know there is a link ­between mums with diabetes in pregnancy and outcomes for their babies as they grow, including ­future possibilities of type 2 diabetes, which work like this can help us track,” said research nurse Paula Van Dokkum, who works with consortium member Baker IDI Heart and Diabetes Institute.

Wayne is meeting all his childhood development targets, and his mother said the ongoing association with the centre would help her in “trying to make sure he grows up healthy and strong”.

Announcing $222,000 in seed funding, federal Indigenous Health Minister Ken Wyatt said the centre’s accreditation this week with the National Health and Medical Research Council proved the “landmark research” by consortium members had “huge potential” to address serious indigenous health issues.

“The objective is to evaluate problems and find practical solutions fast, to prevent health problems and give speedy but lasting benefits to patients within community,” Mr Wyatt said.

The academic health science centre model, well ­established internationally, brings together health services, universities and medical research institutes to better produce evidence-based care.

The Alice Springs-based enterprise will aim to tackle a ­cancer-causing virus endemic in indigenous central Australia, its only significant instance outside South America and central Africa.

The human T-lymphotropic virus type 1 causes a slow death over 20 years with leukaemia, chronic cough, respiratory problems and respiratory failure. It can be acquired through breast milk in early childhood as well as through blood or sexual contact.

A recent study found HTLV-1 infection rates in a central Australian indigenous community of more than 40 per cent. One result, the inflammatory disease bronch­iectasis, is a leading cause of death for young adults at the Alice Springs hospital.

The program will also address the soaring demand for dialysis in remote communities, with indigenous Australians five times as likely to have end-stage kidney disease than other Australians.

Alice Springs hospital is home to the largest single-standing ­dialysis service in the southern hemisphere, with 360 patients.

Part 3 Alice Springs: the Red Centre of medical innovation

London, Boston, Toronto, Melbourne … and Alice Springs.

Although there may be little in common between these major cities and the heart of Australia’s outback, an announcement this week brings the Red Centre into the company of international players in translational health research, including prestigious institutions such as Imperial College Healthcare in Britain and Johns Hopkins Medicine in the US.

This week, the Central Australia Academic Health Science Centre was given the official seal of approval by the National Health and Medical Research Council.

The Central Australia consortium was one of only two centres recognised as a centre of innovation in regional health for its leadership in health research and delivery of evidence-based healthcare.

And now there’s opportunity in the Red Centre to do even more.

It may well be the most remote academic health science centre in the world, and perhaps the only academic health science centre in the world led by Aboriginal people. With such esteemed recognition for this remote, Aboriginal-led, evidence-based healthcare collaboration, it is hoped that public and private support will also follow.

As a model well established abroad and gaining momentum in Australia, academic health science centres are partnerships between health services, universities and medical research institutes whose collaborative work ensures that translational health research leads to evidence-based care and better health outcomes for patients.

For the 11 partners behind the Central Australia partnership, recognition as a centre for innovation in regional health acknowledges the outstanding collaboration that has existed in this region for several years, and particularly the leadership offered by the Aboriginal sector.

Working with the other partners in the consortium, Aboriginal community-controlled health services are taking the lead in identifying and defining viable solutions for the health inequities experienced in the region.

The work of the Central Australia partners is practical and responsive.

Interested in resolving what had become a troubling issue at Alice Springs Hospital, a resident physician researcher initiated a study that found nearly half of all admitted Aboriginal patients had self-discharged from the hospital in the past, with physician, hospital and patient factors contributing to this practice.

The research findings were used to develop a self-discharge risk assessment tool that is now routinely used in hospital care, and to expand the role of Aboriginal liaison officers within the hospital.

Considering the vast and remote geographical area — more than one million square kilometres — and the health challenges experienced particularly by Aboriginal residents who make up about 45 per cent of the region’s population of about 55,000 people, the Central Australia consortium faces unique and significant challenges. In this respect, Alice Springs may be more like Iqaluit in the Canadian Arctic than London or Baltimore.

But in other ways this relatively small academic health science centre may be at an advantage.

With its closely knit network of healthcare providers, medical researchers, medical education providers and public health experts working together, community-driven approaches to identifying issues and developing evidence-based solutions have become a standard approach in Central Australia.

In this setting of high need and limited resources, working collectively is sensible, practical and necessary.

Importantly, there is the possibility to do a lot more.

The consortium hopes such recognition will help to attract top healthcare providers and researchers, to increase educational offerings and to develop local talent, especially Aboriginal people.

The evidence is resounding. A research oasis in the desert, this centre for innovation is fertile ground for investment by government, corporations and philanthropists alike.

Donna Ah Chee is chief executive of the Central Australian Aboriginal Congress. John Paterson is chief executive of the Aboriginal Medical Services Alliance Northern Territory.

NACCHO Aboriginal Health #NAIDOC2017 : Recognising the communication gap in Indigenous health care

 ” The communication gap between health professionals and Indigenous Australians has a significant impact on health outcomes

Limited health literacy is not confined to Indigenous people, but it is greatly magnified for speakers of Indigenous languages in comparison, for example, to non-English speaking migrants from countries where a scientific approach to medicine is practised and where these health concepts are already codified.”

Dr Robert Amery Medical Journal Australia NAIDOC Week 2017


Introduction Press Release

Communication gap puts Indigenous health at risk

The need for health professionals to have a stronger focus on communication with Indigenous people has been highlighted by the University of Adelaide’s Head of Linguistics, who says some lives are being put at risk because of a lack of patient-doctor understanding.

In a paper published (Monday 3 July) in the Medical Journal of Australia coinciding with the NAIDOC Week theme of Our Languages Matter – Dr Robert Amery has raised concerns not just about language but also a lack of cultural awareness that also impacts on good communication with Indigenous patients.

Dr Robert Amery, who heads Linguistics within the University of Adelaide’s School of Humanities and is a Kaurna language expert, says poor communication can lead to “mistrust and disengagement with the health sector” among

Indigenous patients, leading to a lack of compliance with treatment, and ultimately poor health outcomes.

He says there’s a 16-year gap in life expectancy for Indigenous people living in the Northern Territory compared with non-Indigenous Australians. Of these Indigenous people in the NT, 70% live in remote areas, and 60–65% speak an Indigenous language at home.

“While many speakers of Indigenous languages living in remote areas can engage with outsiders and converse in English about everyday matters, they often have a poor grasp of English when it comes to health communications and other specialised areas,” Dr Amery says.

Miscommunication can be subtle, and previous studies have shown that while both parties think they have understood each other, they can in fact come away with very different understandings.

“Miscommunication isn’t just about language. Some of these difficulties also arise from the interface of communication and culture, which are often derived from differences in worldview,” he says.

“For traditionally oriented Aboriginal people living in remote areas, understanding of disease causation is fundamentally different. Serious diseases, even accidents, are often attributed to sorcery. Germ theory and the immune system are foreign concepts.

“Silence plays an important role in Indigenous cultures. Indigenous people often respond to questions after a prolonged pause, a concept foreign to those doctors who see silence as impolite in their own cultures.

They compensate by filling the silence and disrupting Indigenous patients’ thoughts. There is a simple solution: pause and allow the patient to think.”

He also suggests healthcare professionals avoid the use of “intangible” conceptual English words and vague sentences, instead focusing on factual communication; that they demonstrate how a medical procedure works; and use simple diagrams to explain medical issues.

“These examples may seem plain and obvious, but astoundingly, despite the many hours dedicated to communication in medical education, such concepts are not taught,” Dr Amery says.

“An investment of time in the consult will have immense payoffs over the long term.”

 Download MJA paper here MJA Dr Robert Amery

Published with permission from Robert Amery and Medical  Journal Australia

 See website for references or PDF

The communication gap is most pronounced in remote areas where cultural and linguistic differences are greatest. The close interdependence of language and culture amplifies the gap, such that communication difficulties in these communities run deeper than language barriers alone.

Life expectancy for Indigenous Australians living in remote areas is considerably shorter than for those living in rural and urban areas.6 Figures are not available for the life expectancy of native speakers of Indigenous languages as a cohort, but the gap in life expectancy exceeds 16 years for Indigenous people living in the Northern Territory,7 70% of whom live in remote areas, and 60–65% speak an Indigenous language at home. The life expectancy gap is, of course, multifactorial, although most studies focus on causes of death.8 The communication gap as a contributor is under-rated and under-researched.1,9

An understanding of the Indigenous language landscape is critical to improving communication. In the 2011 Australian census, 60 550 people, or 11.8% of Indigenous respondents, claimed to speak an Indigenous language at home, and 17.5% claimed not to speak English well.10

More have difficulty with specialised language, with common terms such as infection, tumour, high blood pressure, stroke and bacteria often misunderstood. Native Indigenous language speakers communicate in over 100 different traditional languages and live primarily in the NT, the Kimberley region of Western Australia, northern South Australia and northern Queensland, including Torres Strait.

None of these languages have more than 6000 speakers, and many are now reduced to a mere handful, yet each of these languages is a vast storehouse of knowledge built up over thousands of years. It can be daunting to enter a large English-speaking hospital if you communicate in a language spoken by so few people.

Speakers of some languages have shifted to dominant regional languages, such as Murrinh-Patha (Wadeye, NT), while others have shifted to a creole language, such as Kriol (the Kimberley region and the Barkly Tableland area of the NT and North West Queensland).

Aboriginal people often speak distinctive varieties of Aboriginal English that differ from mainstream English. For most Aboriginal people in remote areas, their Aboriginal English is an inter-language variety, in the same way that Japanese speakers have their own distinctive accent and turn of phrase in English, which may be a challenge for medical personnel to understand.

Data might suggest that only a small proportion (less than 10%) of Indigenous adults under 60 years do not speak English well, and that communication issues would therefore not be significant (Box 1).

However, while many speakers of Indigenous languages living in remote areas can engage with outsiders and converse in English about everyday matters, they often have a poor grasp of English when it comes to health communications and other specialised areas. In a study on comprehension of 30 common legal terms (assault, bail, guilty, warrant, etc),11 200 Yolŋu people (north-east Arnhem Land) were surveyed with over 95% unable to correctly identify the meaning of these terms (Box 2).

A parallel health study has not been conducted, but it is likely that understanding of common specialised health terms would be no better. Personal experience supports this view. In 1990, I taught a short course in medical interpreting to a group of Yolŋu students. In teaching the difference between idiomatic and literal language, I introduced an example (“He chucked his guts up”) that I thought everyone would understand. The Yolŋu students interpreted this idiom literally, thinking he ripped out his intestines and threw them in the air. Even simple little things that might be said, such as “let’s keep an eye on it”, can be baffling, because these expressions are often taken literally.

Proportion of Indigenous Australians who speak an Indigenous language and who are reported to speak English “not well” or “not at all”, 2006 and 2011*

Yolŋu comprehension of 30 common legal terms*

Misinterpretations also arise from the interface of communication and culture, here derived from differences in worldview rather than linguistics. In the 1980s, I talked with Tjapaltjarri (skin name, now deceased), a senior Pintupi Aboriginal health worker, about the location of a relative’s house in Alice Springs. Tjapaltjarri referred to various landmarks such as trees and rocks. I asked him about prominent street names including Bloomfield Street. We conversed with full understanding, but I could not follow Tjapaltjarri’s directions. I never paid attention to these landmarks, he never noticed street names. This was not a linguistic issue. It was literally a matter of different worldview. Extrapolate from this example to appreciate the difficulties first language speakers of Aboriginal languages might have in following medical explanations, even when they seemingly speak good English.

These communication gaps are confirmed in health settings. A study of Yolŋu patients undergoing dialysis in Darwin2 identified, through exit interviews, significant misunderstanding of test results despite both patient and renal nurse having revealed that they were satisfied with the communication.

Trudgen9 discusses a Yolŋu patient suffering from severe diabetes and renal failure who was able to avoid dialysis once his condition was explained to him in meaningful terms, and goes on to estimate that 75–95% of communication with Yolŋu patients fails, even with an Aboriginal health worker involved. Aboriginal health workers are not necessarily trained interpreters, nor is interpreting their primary role, although they are often expected to interpret.

How do we improve? Surprisingly simple communication methods, which are easy to teach within mainstream medical education, can help. Trudgen demonstrates how to explain to a Yolŋu patient their 2% residual renal function.9 Many Yolŋu and speakers of other Indigenous languages do not understand the concept of percentages. A picture of a kidney was drawn, shading in the 2% still functioning and showing the remainder, which was sclerosed (Box 3). The patient responded in shock and, no doubt, with better dialysis participation.

Box 3

Template to explain residual renal function of 2% (hatched area) in an otherwise sclerosed kidney (dots)

Aboriginal patients may not be as trusting of medical implements as others. Refusal of an ear examination, for example, may be overcome by allowing such a patient to look through the otoscope to understand how it works. Silence plays an important role in Indigenous cultures.9,12,13

Indigenous people often respond to questions after a prolonged pause, a concept foreign to those doctors who see silence as impolite in their own cultures. They compensate by filling the silence and disrupting Indigenous patients’ thoughts. There is a simple solution — pause and allow the patient to think.

Studies1,2,3,4,14 have identified a widespread belief among Yolŋu people that information is deliberately withheld, mirroring culturally based misconceptions that lead many professionals to believe that Aboriginal patients do not want to know or that they do not experience pain.15

However, several studies1,4,14 clearly demonstrate the desire of Aboriginal people, both from the Top End and from Central Australia, for information about their illnesses and treatment. Effective communication methods, including the use of interpreters, are grossly underutilised, and frequently there is a failure to recognise that patients do not understand.

In a study of 41 Yolŋu people, only 11 found explanations about diagnosis and treatment satisfactory.4 Other studies have shown that even when patients are satisfied, gross misunderstandings may still exist.2 Trudgen9 again gives an example of how this may occur. A doctor explained to a patient that he “could not tell conclusively why [the patient’s] heart was enlarged”. The patient subsequently interpreted this to be that the doctor had no idea why his heart was enlarged and decided not to engage in treatment. Had the doctor avoided use of “intangible” conceptual English words and vague unrevealing sentences, instead focusing on factual communication, this error could have been avoided.

A failure to develop an adequate understanding does run deeper than words. For traditionally oriented Aboriginal people living in remote areas, understanding of disease causation is fundamentally different. Serious diseases, even accidents, are often attributed to sorcery.16,17 Germ theory and the immune system are foreign concepts.

Traditionally oriented Aboriginal people typically have detailed knowledge of anatomy from hunting, butchering and observing nature,9,18 but the perceived function of the kidneys, lungs, pancreas and other internal organs may be quite different. Finding common ground between these understandings is no easy task, but it is important to understand that it may play into medical treatments in the same way as having insight into the use of alternative medicines does in other cultures.

These examples may seem plain and obvious, but astoundingly, despite the many hours dedicated to communication in medical education, such concepts are not taught. Some strategies are provided in Box 4. There is an urgent need to pay more attention to communication needs of remote Aboriginal people.

Communication strategies

A refusal to take Aboriginal languages seriously not only results directly in less than optimal medical outcomes, but also in mistrust and disengagement with the health sector and non-compliance with treatment regimens.3

An investment of time in the consult will have immense payoffs over the long term. We cannot expect our medical students and colleagues to adapt without teaching.

Concepts are simple to grasp with knowledge of the languages and cultures. Is effective establishment of the Aboriginal patient–doctor relationship not one of the more teachable aspects of communication for generations of doctors?

Education is the way forward to a practical and high impact population of medical staff who contribute to the health and pride of the people who are Australia’s national treasures.

Aboriginal Health #NRW2017 : @AHCSA_ and @PAFC @AFL to support new @DeadlyChoices Aboriginal health checks in South Australia


” The Deadly Choices program’s intent is to provide a measurable difference in addressing Aboriginal health issues. 

“Aboriginal people have far higher mortality rates than the average population and die at much younger ages. Despite government intentions to ‘close the gap’, the problem isn’t getting any better,

Chronic disease and preventable health conditions are taking a toll on our communities and we need to find innovative ways to move the dial toward better health outcomes.

We hope, with support from the Port Adelaide Football Club, our Deadly Choices initiative will encourage our young people to take responsibility and stop smoking, stay active and look after their own wellbeing, and that of their families.”

Aboriginal Health Council of SA chairperson John Singer

Port Adelaide has signed a memorandum of understanding (MOU) with the Aboriginal Health Council of South Australia Ltd (AHCSA) to deliver Deadly Choices – a program that will build awareness of healthy lifestyle choices and encourage regular health checks.

‘Deadly’ is a common term used to express positivity or excellence within Aboriginal communities, and Deadly Choices is designed to help improve the excellent health choices made by Aboriginal people in South Australia.

Gavin Wanganeen ( right ) won the 1993 Brownlow Medal. Wanganeen is a descendant of the Kokatha Mula people.

The program is based on a successful model used in Queensland since 2009 with the Brisbane Broncos, developed by Adrian Carson and his team and staff at the Institute for Urban Indigenous Health.

That program led to a 1300 per cent increase in Aboriginal and Torres Strait Islander people undergoing health checks.

Deadly Choices provides participants with limited edition merchandise in exchange for taking part in educational programs and undergoing regular health checks.

The merchandise is provided as a ‘money can’t buy’ incentive, with revenue from undergoing health checks used to fund subsequent stages of the program.

Port Adelaide players will support the promotion of the program and encourage participants to take part in the eight-week education program to receive their Deadly Choices footy guernsey.

As part of the program:

  • Education programs will be launched in the Anangu Pitjantjatjara Yankunytjatjara Lands (APY Lands) in collaboration with the Nganampa Health Council in June, in support of Port Adelaide’s WillPOWER program.
  • Curriculum will cover leadership, chronic disease, tobacco cessation, nutrition, physical activity, harmful substances, healthy relationships, access and health checks.
  • Health checks will be provided in the first stage of Deadly Choices by AHCSA-aligned members, which already provided comprehensive primary health care in SA.
  • Long-term partnerships with the South Australian Health and Medical Research Institute (SAHMRI) are being explored to established metropolitan clinics to provide health check services.

Port Adelaide chief executive officer Keith Thomas said the decision to partner with AHCSA is a continuation of Port Adelaide’s commitment to helping forge tangible outcomes for Aboriginal communities in South Australia.

In his CEO Update, Thomas reflected on the fact 70% of Aboriginal deaths are related to chronic disease, while the life expectancy for an Aboriginal person is on average, 10 years less than the wider population.

“We are proud to partner with AHCSA to deliver Deadly Choices across South Australia,” said Mr Thomas.

“The Deadly Choices program perfectly links to the healthy lifestyle messages we promote through WillPOWER and the Aboriginal Power Cup programs.

“We’re very excited to be making a contribution to the health agenda in Aboriginal communities around South Australia.”


NACCHO Aboriginal Health #Smoking #WNTD @AMAPresident awards #NT Dirty Ashtray Award for World #NoTobacco Day

“Research shows that smoking is likely to cause the death of two-thirds of current Australian smokers. This means that 1.8 million Australians now alive will die because they smoked.

The Northern Territory, a serial offender in failing to improve tobacco control, has been announced as the recipient of the AMA/ACOSH Dirty Ashtray Award for putting in the least effort to reduce smoking over the past 12 months.

But it seems that the Northern Territory Government still does not see reducing the death toll from smoking as a priority. Smoking is still permitted in pubs, clubs, dining areas, and – unbelievably – in schools.

The NT Government has not allocated funding for effective public education, and is still investing superannuation funds in tobacco companies.

“It is imperative that Governments avoid complacency, keep up with tobacco industry tactics, and continue to implement strong, evidence-based tobacco control measures.”

Ahead of World No Tobacco Day on 31 May, AMA President, Dr Michael Gannon, announced the results today at the AMA National Conference 2017 in Melbourne.

Previous NACCHO Press Release Good News :

NACCHO welcomes funding of $35.2 million for 36 #ACCHO Tackling Indigenous Smoking Programs

The Northern Territory, a serial offender in failing to improve tobacco control, has been announced as the recipient of the AMA/ACOSH Dirty Ashtray Award for putting in the least effort to reduce smoking over the past 12 months.

It is the second year in a row that the Northern Territory Government has earned the dubious title, and its 11th “win” since the Award was first given in 1994.

AMA President, Dr Michael Gannon, said that it is disappointing that so little progress has been made in the Northern Territory over the past year.

“More than 22 per cent of Northern Territorians smoke daily, according to the latest National Drug Strategy Household Survey, well above the national average of 13.3 per cent,” Dr Gannon said.

“Smoking will kill two-thirds of current smokers, meaning that 1.8 million Australian smokers now alive will be killed by their habit.

“But it seems that the Northern Territory Government still does not see reducing the death toll from smoking as a priority. Smoking is still permitted in pubs, clubs, dining areas, and – unbelievably – in schools.

“The Government has not allocated funding for effective public education, and is still investing superannuation funds in tobacco companies.”

Victoria and Tasmania were runners-up for the Award.

“While the Victorian Government divested from tobacco companies in 2014, and has made good progress in making its prisons smoke-free, its investment in public education campaigns has fallen to well below recommended levels, and it still allows price boards, vending machines, and promotions including multi-pack discounts and specials,” Dr Gannon said.

“It must end the smoking exemption at outdoor drinking areas and the smoking-designated areas in high roller rooms at the casino.

Learn more about the great work our Tackling Indigenous Smoking Teams are doing throughout Australia 100 + articles HERE

“Tasmania has ended the smoking exemption for licensed premises, gaming rooms and high roller rooms in casinos, but still allows smoking in outdoor drinking areas.

“While Tasmania has the second highest prevalence of smoking in Australia, the Tasmanian Government has not provided adequate funding to support tobacco control public education campaigns to the evidence-based level.  It should provide consistent funding to the level required to achieve reductions in smoking.”

Tasmania should also ban price boards, retailer incentives and vending machines, and divest the resources of the Retirement Benefits Fund (RBF) from tobacco companies, limit government’s interactions with the tobacco industry and ban all political donations, ACOSH said.

It should also ban all e-cigarette sale, use, promotion and marketing in the absence of any approvals by the Therapeutic Goods Administration.


Download the app today & prepare to quit for World No Tobacco Day

Queensland has topped the AMA/ACOSH National Tobacco Control Scoreboard 2017 as the Government making the most progress on combating smoking over the past 12 months.

Queensland narrowly pipped New South Wales for the Achievement Award, with serial offender the Northern Territory winning the Dirty Ashtray Award for putting in the least effort.

Judges from the Australian Council on Smoking and Health (ACOSH) allocate points to each State and Territory in various categories, including legislation, to track how effective government has been at combating smoking in the previous 12 months.

“Disappointingly, no jurisdiction scored an A this year, suggesting that complacency has set in,” Dr Gannon said.

“Research shows that smoking is likely to cause the death of two-thirds of current Australian smokers. This means that 1.8 million Australians now alive will die because they smoked.

“It is imperative that Governments avoid complacency, keep up with tobacco industry tactics, and continue to implement strong, evidence-based tobacco control measures.”

The judges praised the Queensland Government for introducing smoke-free legislation in public areas, including public transport waiting areas, major sports and events facilities, and outdoor pedestrian malls, and for divesting from tobacco companies.

However, they called on all governments to run major media campaigns to tackle smoking, and to take further action to protect public health policy from tobacco industry interference.

31 May is World No Tobacco Day Tweet using “Protect health,reduce poverty, promote development”

NACCHO Invites all health practitioners and staff to a webinar : Working collaboratively to support the social and emotional well-being of Aboriginal youth in crisis


NACCHO invites all health practitioners and staff to the webinar: An all-Indigenous panel will explore youth suicide in Aboriginal and Torres Strait Islanders. The webinar is organised and produced by the Mental Health Professionals Network and will provide participants with the opportunity to identify:

  • Key principles in the early identification of youth experiencing psychological distress.
  • Appropriate referral pathways to prevent crises and provide early intervention.
  • Challenges, tips and strategies to implement a collaborative response to supporting Aboriginal and Torres Strait Islander youth in crisis.

Join hundreds of doctors, nurses and mental health professionals around the nation for an interdisciplinary panel discussion. The panellists with a range of professional experience are:

  • Dr Louis Peachey (Qld Rural Generalist)
  • Dr Marshall Watson (SA Psychiatrist)
  • Dr Jeff Nelson (Qld Psychologist)
  • Facilitator: Dr Mary Emeleus (Qld GP and Psychotherapist)

Read more about the panellists.

Working collaboratively to support the social and emotional well-being of Aboriginal and Torres Strait Islander youth in crisis.

Date:  Thursday 23rd February, 2017

Time: 7.15 – 8.30pm AEDT


No need to travel to benefit from this free PD opportunity. Simply register and log in anywhere you have a computer or tablet with high speed internet connection. CPD points awarded.

Learn more about the learning outcomes, other resources and register now.

For further information, contact MHPN on 1800 209 031 or email

The Mental Health Professionals’ Network is a government-funded initiative that improves interdisciplinary collaborative mental health care practice in the primary health sector.  MHPN promotes interdisciplinary practice through two national platforms, local interdisciplinary networks and online professional development webinars.







NACCHO Aboriginal Health debate #changethedate #australiaday : #InvasionDay, #SurvivalDay, or Day of Mourning?


“Many of our people call it Invasion Day … to many Indigenous Australians, in fact, most Indigenous Australians, it really reflects the day in which our world came crashing down,” the prominent Indigenous leader and academic said.

The idea that it’s not appropriate to hold a national celebration on the date the first fleet arrived in Sydney cove in 1788 to begin the process of Indigenous dispossession wasn’t new. It wasn’t even the first time an Australian of the Year had said so. Lowitja O’Donoghue pleaded for a date change after she was honoured in 1984. It’s even more widespread now.

Mick Dodson explained succinctly why he thought Australia’s national day is celebrated on the wrong date after accepting his Australian of the Year award in 2009. See article 3 below from the Guardian

“It is critical that more Australians understand why Aboriginal and Torres Strait Islander peoples often feel that 26 January is an inappropriate day for celebration.

Australia Day has diverse meaning to Aboriginal and Torres Strait Islander Australians; some see it as a day of invasion, a day of mourning and of assertion of sovereignty; some see it as a day of survival.

Considering these meanings, it must be recognised that holding Australia Day on 26 January does not make for inclusion and celebration of our nation and all its peoples possible.”

Reconciliation Australia believes Australia Day must be inclusive, unifying, and be supported by all Australians. It should be a day when we come together as a unified people – a day when all Australian’s rights, histories and cultures are valued as part of a shared national identity

Justin Mohamed, CEO of Reconciliation Australia (former Chair of NACCHO ) Article 2 below

 ” Every year on the 26th of January I wonder a bit about how I am going to refer to the day, Invasion Day, Survival Day or Day of Mourning? Over the years I have referred to it as all of these, and I think the choice I make reflects a bit about the mood I am in at that time, where I am at in life, and where Australia is in general.

Photo above NITV : Each of the names captures an important part of what this date represents.

Invasion Day, for me, reflects an honest truth that needs to be expressed. It speaks of the power of protest. It speaks of a history that has never been reconciled, of justice denied. It reminds how one simple word, ‘invasion’, seems to bewilderingly upset those connected to the invaders more than those who descend from the invaded. It comes largely from the 1988 protests which also brought the slogan “White Australia Has A Black History” to our national consciousness. At the same time, there is a part of me that felt it gives too much energy away and not enough to ourselves. I often think about whether or not we spend too much responding to the moves of others rather than making our own, but at the same time the power of the above slogan always resonates with me and speaks to a battle that is still underway about how we relate to Australian history. I believe we still need to speak these words, and we still need people to attend these events.

 White Australia Has A Black History


It speaks to me of celebration and commemoration. It speaks of amazing resilience and resistance of cultures, communities, families and individuals. At the same time, it feels too comforting for white Australia. It does not feel ‘in their face’ enough. Perhaps this is more to do with how the name has been coopted than what it was originally intended for, I don’t know, but it has never quite sat right with me. So many lives have been needlessly lost in our history, and every day; those who didn’t survive. I am not comfortable about a day that can so easily be misrepresented to gloss over this tragic reality. Still, I believe we still need to speak these words, and we still need people to attend these events.


It speaks to commemorating and acknowledging all we have to mourn since invasion took place. Not just the loss of life, but for all of the loss of culture, loss of land, loss of language. It is one of the oldest names we have for this day, and the significance of the 1938 protests should always be remembered and commemorated. Like the other two days though I have at times felt this lacked the fire of Invasion Day, and the positive outlook of Survival Day. But I know the power and the importance of grieving for people and things lost, and I believe we still need to speak these words, and we still need people to attend these events.

 Aborigines day of mourning, Sydney, 26 January 1938

Aborigines day of mourning, Sydney, 26 January 1938 (State Library of NSW)

It is only in recent years that I have stopped the internal debate each year about which camp I should sit in and come to realise that all three days are important, all three are still needed for different people at different times in their life. All three come are essential pieces of the whole that are needed to fully recognise the significance of this date.

There are times we need to protest. Other times we need to breathe, and to celebrate that we are still here despite the obstacles we have overcome and those we still face. And at other times we just need to mourn, and to heal.

Like many debates in our communities this is one where I believe we do not need to debate but instead we need to support each other regardless of the camp we need to sit in, and respect the reasons why we need to be there. We should be able to freely move between each and let others do the same.

There are times we need to protest. Other times we need to breathe, and to celebrate that we are still here despite the obstacles we have overcome and those we still face. And at other times we just need to mourn, and to heal. I know many people who plan to attend an Invasion Day march in the morning, attend a Survival Day concert in the morning, and then spend a reflective evening commemorating the Day of Mourning.

I have at times heard people opposed to changing the date of Australia Day argue that doing so would be to ignore or try to erase the history of this date. I disagree. January the 26th will always be an important date in our national calendar. It will always be Invasion Day. It will always be Survival Day. It will always be a Day of Mourning. We will never forget what this day represents. The only name I think the 26th of January should not have is ‘Australia Day’. It is not a day that was ever intended for Aboriginal people to celebrate. Even as far back as 1888, when Henry Parkes was the Premier of NSW and was preparing to celebrate the 100 year anniversary, he was asked if he was planning anything for Aboriginal people on this day, to which he replied, “And remind them that we have robbed them?”.

Australia Day, for me, is a day that was only ever intended to be a day for white Australians to come together to celebrate white Australia, and the recent attempts to make it a more inclusive day just feel like an effort to make it a day where all Australians regardless of their race, colour, or religion can come together to celebrate white Australia.

I am not necessarily opposed to the idea of an Australia Day that would allow us all to celebrate together, on the condition that we eventually learn to see the difference between inclusion and assimilation, but I am not entirely sure if there is a date in Australian history that could adequately encapsulate that ideal. That, to me, is the most interesting element about the whole ‘change the date’ conversation. Not the push to see that date changed, but the conversation about what day, if any, best encapsulates the Australia the Australia that we would like to imagine ourselves as.

Is our national identity best commemorated on the day that NSW became a British colony, or the date that Australians stopped being British subjects? Is it the day that the White Australia Policy was enacted, or is it the day it was repealed? Is it perhaps the day, if it ever comes, that we become a republic? Or is it some future day that we can’t even imagine at the moment, some future event that could serve to help ‘bring us together to celebrate all that is great about being Australians’?

But whether the date of Australia Day ever changes or not, the 26th of January will always be an important day. It will always be Invasion Day. It will always be Survival Day. It will always be a Day of Mourning.

So whatever you call it, whatever events you choose to go to or whether you just do your own thing, we do not need to debate what we should call this day so long as we can agree on one simple thing – Australia always was, and always will be Aboriginal land.


Article 2 : Australia Day should be a source of unity, pride and celebration that reflects the identities, histories and cultures of all Australians.


Justin Mohamed, CEO of Reconciliation Australia said today at a breakfast honouring Aboriginal and Torres Strait Islander Australia Day finalists,

“We must find a day on which we can all participate equally, and can celebrate with pride our common Australian identity. I believe that it is critical to reconciliation for all Australians to acknowledge and understand different views around the date of Australia Day. And to ask the critical question: can our national day be truly inclusive if it is celebrated on a day that represents the beginning of physical and cultural dispossession for First Australians?”

Reconciliation Australia  hosted a celebratory breakfast for Aboriginal and Torres Strait Islander Australian of the Year Awards finalists, and finalists who work with Indigenous communities.
The work of the finalists champions #reconciliation and brings Australia closer to becoming a just, equitable and reconciled nation.

Finalists Andrew Forrest, Arthur Alla, Andrea Mason, Tejinder pal Singh, Sister Anne Gardiner AM and Lois Peeler AM, Reconciliation Australia Co-Chair Professor Tom Calma AO, finalists June Oscar AO and Patricia Buckskin PSM, and Reconciliation Australia CEO Justin Mohamed

Article 3 Editorial the Guardian Australia agrees.

This is not a date that unifies Australians.

In fact it’s hard to think of a worse date for a party that is supposed to include us all.

The National Australia Day Council itself acknowledges the problem.

“We recognise that some Aboriginal and Torres Strait Islander people and some non-Aboriginal and Torres Strait Islander Australians may have mixed feelings about celebrating this day. January 26 has multiple meanings: it is Australia Day and it is also, for some, Survival Day or Invasion Day. The NADC acknowledges that the date brings a mixture of celebration and mourning and we believe that the programs presented by the NADC should play a powerful and positive role in advancing reconciliation.”

The national strategy that followed the initial decade-long process to achieve reconciliation recommended the date be changed.

“Governments, organisations and communities negotiate to establish and promote symbols of reconciliation,” it said. “This would include changing the date of Australia Day to a date that includes all Australians.”

But, despite the obvious historical arguments and the growing acknowledgement the date is a problem, there is still deep resistance to the idea that 26 January is inappropriate.

Fremantle council tried to hold this year’s main citizenship ceremony at a more inclusive 28 January event, but eventually bowed to pressure from the federal government. The prime minister, Malcolm Turnbull, insisted Australia would be “sticking with” 26 January.

Back in 2009 the then prime minister Kevin Rudd’s reply to Mick Dodson’s suggestion was even more brusque. “To our Indigenous leaders, and those who call for a change to our national day, let me say a simple, respectful, but straightforward no,” he said.

Some – like the Indigenous leader Noel Pearson – have suggested changing our understanding of exactly what we are celebrating on 26 January.

He sees three defining moments in Australia’s history: “Firstly, 53,000-plus years ago, when the first Australians crossed the Torres Strait land bridge to this continent; secondly, the landing of the first fleet in 1788; thirdly, the abolition of the White Australia policy between 1973 and 1975.”

“I believe the celebration of Australia Day will always be equivocal as long as it is about only one of these three parts,” he said at the National Press Club last year. “If we brought these three parts of the nation together and the day defining Australia spoke to these three parts then less offence and hurt would attach to 26 January. It can’t just be about what was destroyed. It must also be about what we have built.”

When he became Australian of the Year in 2014, the footballer Adam Goodes also suggested broadening what Australia Day is about. “There was a lot of anger, a lot of sorrow, for this day and very much the feeling of Invasion Day,” he said.

“But in the last five years, I’ve really changed my perception of what is Australia Day, of what it is to be Australian and for me, it’s about celebrating the positives, that we are still here as Indigenous people, our culture is one of the longest surviving cultures in the world, over 40,000 years.

“That is something we need to celebrate and all Australians need to celebrate … It’s a day we celebrate over 225 years of European settlement and right now, that’s who we are as a nation but we also need to acknowledge our fantastic Aboriginal history of over 40,000 years and just know that some Aboriginal people out there today are feeling a little bit angry, a little bit soft in the heart today because of that, and that’s OK as well.”

Even these measured comments prompted wild attacks by conservative commentators and were later cited as one of the reasons fans from opposing teams booed Goodes the following year.

But for many Australians, Indigenous and non-Indigenous, the only viable solution remains to #changethedate and public discussion of a new date is growing. The national youth broadcaster, Triple J, declined to shift its much-loved Hottest 100 this year, but given the public pressure the ABC says the date remains “under review”. Indigenous musicians A.B. Original and Dan Sultan released a track advocating for a date change last year, and this week a collection of hip hop artists released another.

The Saturday Paper has argued that boycotting Australia Day celebrations is the best way to try to force a shift.

Guardian Australia also argues for change but we will be covering 26 January.

We’ll reflect the deep concerns about the date in our live blog – which will cover the Invasion Day marches and Indigenous cultural celebrations such as Sydney’s Yabun festival and also the events on 26 January that reflect the best of us, the wonderful citizenship ceremonies around the country, as well as concerts and the Hottest 100.

There are many reasons for Australians to feel proud. We agree 26 January is the wrong day for national festivities, but we think respectful debate – about changing the date or the meaning of the celebration – is the best way to a solution that will allow all Australians to join the party.



NACCHO Aboriginal Ear Health : Tackling Aboriginal ear disease will help close the gap


” We should be embarrassed that Aboriginal Australians have the world’s worst incidence of middle ear infection and the worst deafness rates because of those infections. More than 90 per cent of young Aboriginal children have hearing-aid-level deafness for much of the year and 35 per cent of central Australian Aboriginal children have perforated eardrums at any one time.

The situation is a disgrace.”

Chris Perry is president of the Australian Society of Otolaryngology Head and Neck Surgery as published

Aboriginal children develop ear infections at a younger age and are affected more severely ­than any other racial group in the world by a factor of up to three. They have harmful bacteria colonising their nose and throat very early in life. The ear infections cause a build-up of infective fluid behind the eardrums that frequently burst and result in holes in these eardrums and a purulent discharge from the ears. These eardrum perforations often do not heal and the infection can dissolve the tiny middle ear bones called the ossicles, which conduct sound to the hearing nerves.

The partial deafness from infections is devastating to a child’s language development, ­especially where English is the second language. Children who are partially deaf never fully understand the spoken word. They find it difficult to follow conversations and to listen to what a teacher is saying. They become easily bored and disillusioned at school – that’s why we see the high rates of truancy and illiteracy among them.

Poor educational results lead to poverty and high unemployment levels. If you are illiterate it is hard to move away from an isolated community with high unemployment, violence and substance abuse issues.

Damien Howard, the distinguished academic psychologist from the Northern Territory, has documented the association of deafness in Aboriginal communities with violence, substance abuse, mental illness, suicide and the high rates of Aboriginal incarceration, especially in juvenile ­detention facilities.

Many ear, nose and throat surgeons, whom I represent, pediatricians, audiologists, education­alists and Aboriginal health workers have been involved in the research of this problem as well as the important provision of interventions that help mitigate the far-reaching, devastating consequences of this true pandemic.

Multiple health department jurisdictions, health regions, universities and medical centres across rural and outer suburban Australia are aware of the issue but still today these well-intentioned ­interventions are largely untested, not always evidence-based and are rarely benchmarked.

The terrible images from the Don Dale Youth Detention Centre and the high rates of Aboriginal incarceration have been brought to the attention of ordinary Australians who, through the years, have grown accustomed to tales of truancy, substance abuse, overcrowding and youth suicide.

The association of deafness as an important but remediable root cause has been unaccountably ­ignored, especially in Closing the Gap strategies, and unfortunately this reflects badly on us, the health practitioners and researchers who should be advocating for adequate treatment of this condition.

There is no shortage of surgeons, pediatricians, audiologists, speech therapists, educationalists and health workers wanting to help. States and territories need to come together to finance interventions that work.

Sound amplification systems in classrooms, hearing aids where appropriate, the training of teachers going to communities on how to teach a class of deaf kids, timely and appropriate GP and primary healthcare interventions, and timely surgery and vaccinations within the communities do work. Preventive action and early treatments are extremely cost ­effective when considered against the effects of hearing impairment.

It costs up to $60,000 to lock up a child for a year, and that is often followed by a life of welfare dependency. Australia would save a great deal of money and raise health and wellbeing among ­Aboriginal Australians by making ear health a priority.

A recognition of the consequences of inaction on Aboriginal deafness and the risk this poses to making any progress to closing the gap is essential. It should never be normal for people to have to suffer with ear disease and deafness. I am encouraged that this past year we have had a strong show of support from parliamentarians in Canberra and across several states and territories who have pledged their support to making Aboriginal ear disease a thing of the past.

To close the gap in health, we need a definitive ­national approach to address the Aboriginal ear disease crisis. The Ear Health for Life campaign that will be launched this year will draw together stakeholders from the health, social services, education and government sectors. It will raise awareness of this terrible problem, encourage preventive and early intervention action, and advocate for a co-ordinated national approach.

A nationally co-ordinated, evidence-based, benchmarked and multi-level response to the devastating rates of Aboriginal ear disease will boost Australia’s ability to close the gap. Join us in making this the year of ear health for all.

Chris Perry is president of the Australian Society of Otolaryngology Head and Neck Surgery.