NACCHO Aboriginal Health : A call to acknowledge the harmful history of nursing for Aboriginal people

nurses

 ” While we ourselves did not work there, the societal beliefs interwoven with the professional theories practised at that time are a legacy we have inherited. Those attitudes and practices remain present within our professional space.

Have we done sufficient work to decolonise ourselves?

Decolonising is a conscious practice for Aboriginal and Torres Strait Islander nurses. It involves recognising the impact of the beliefs and practices of the coloniser on ourselves at a personal and professional level, then disavowing ourselves from them.

We talk about this in CATSINaM with our Members. We invite our non-Indigenous colleagues to engage in this self-reflective conversation through many aspects of our work.

janine-mohamed-indigenous-x-profile-picture

Janine Mohamed (right), CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), argues we should.

Is it time for the nursing and midwifery professions to reflect on our historical involvement in the subjugation of Aboriginal and Torres Strait Islanders and consider whether we owe a statement of regret for our failures as part of the wider healthcare system to respond to the needs of Aboriginal Australians?

Do formal apologies mean anything?

We welcome your input on this fundamental issue for Australians – and especially input from Aboriginal and Torres Strait Islander nurses and midwives.

Editorial Nurse Uncut Conversations

In September 2016, the Australian Psychological Society issued a formal apology to Indigenous Australians for their past failure as a profession to respond to the needs of Aboriginal patients.

In the past, the NSW Nurses and Midwives’ Association and the ANMF more broadly have issued statements of apology for our professions’ involvement in the practices associated with the forced adoption of babies from the 1950s to 1980s.

In doing so we recognised that while those nurses and midwives were working under direction, it was often they who took the babies away from mothers who had been forced, pressured and coerced into relinquishing their children and we apologised for and acknowledged the pain these mothers, fathers and children had experienced in their lives as a result.

Following the recent commendable move by the Australian Psychological Society, is it now time for the nursing and midwifery professions to reflect on our historical involvement as healthcare providers in the subjugation of Aboriginal and Torres Strait Islanders and consider whether we owe a similar statement of regret for our failures as part of the wider healthcare system to respond to the needs of Aboriginal Australians?

But firstly, do such apologies mean anything?

Professor Alan Rosen AO (a non-indigenous psychiatrist) makes a cogent argument for an apology by the Australian mental health professions to Aboriginal and Torres Strait Islander peoples:

The recent apology by the Australian Psychological Society to Aboriginal and Torres Strait Islander people is of profound national and international significance.

The APS is believed to be the first mental health professional representative body in the world to endorse and adopt such a specific apology to indigenous peoples for what was done to them by the profession as part of, or in the name of, mental health/psychological assessment, treatment and care.

The APS Board also substantially adopted the recommendation of its Indigenous Psychologists’ Advisory Group (IPAG), whose Indigenous and non-Indigenous members crafted this apology together. This sets a fine precedent.

As some other Australian mental health professional bodies are still considering whether to make such an apology, it is to be hoped that the APS has set a new trend. The APS has provided a robust example of how to do it well and in a way that it is more likely to be considered to be sincere and acceptable by Aboriginal and Torres Strait Islander peoples.

Historically, Aboriginal and Torres Strait Islander peoples have suffered much more incarceration, inappropriate diagnoses and treatments and more control than care in the hands of mental health professionals, facilities and institutions.

This is also true for all First Nations peoples, globally.

Professor Rosen argues that such apologies demonstrate concern for possible historical wrongs, either deliberate or unwitting, by professionals and institutions and the enduring mental health effects of colonialism. The Croakey.org article goes on to describe the purposes and goals of an apology, why they are worth doing and proposes a template.

So, just as we have recognised and apologised for the role our professions played in forced adoptions, is it now time to examine and take responsibility for our professions’ historical contribution to undermining Indigenous Australians’ social and emotional health and wellbeing?

Janine Mohamed (right), CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), argues we should.

Between 1908 and 1919, hundreds of Aboriginal patients were incarcerated in the Lock Hospitals off the coast of Carnarvon, with more than 150 people dying there. The West Australian government established the hospitals for the treatment of Aboriginal people with sexually transmitted infections, but there remains considerable doubt as to the accuracy of such diagnoses – many of which were made by police officers.

The Fantome Island Lock Hospital operated in Queensland from 1928-45 under similar arrangements, detaining Aboriginal people with suspected sexually transmitted infections. There was also a lazaret on Fantome Island (1939-73) for segregated treatment of Aboriginal people with Hansen’s disease.

Aboriginal people taken to the hospitals were often forcibly removed from their families and communities and transported in traumatic conditions, in chains and under police guard. There is also evidence of medical experimentation and abuse.
The NSW Nurses and Midwives’ Association has embarked on the process of developing a Reconciliation Action Plan. As a first step, over coming months we will be working on developing a more thorough understanding of how historical practices have affected Aboriginal and Torres Strait Islander people in our care.

We welcome feedback, especially from our Aboriginal and Torres Strait Islander colleagues.

NACCHO News Alert: Drug and alcohol services Aboriginal Health – funding crisis needs to be resolved.

Picture ABC

 

Any cuts to Indigenous health programs will make access to life-saving medical services more difficult, We are particularly concerned about the future of the Close the Gap Indigenous chronic disease package, which aims to prevent diseases through GP services, medications and tackling smoking,” he said.

Public Health Association’s Michael Moore

All the evidence shows support is needed for preventive health care and timely interventions that reduce the likelihood of expensive hospitalisation. Services provided by the community sector are integral to the achievement of key health and economic goals and maintaining funding is vital to achieving the key targets for Closing the Gap in health outcomes for Indigenous Australians,” .

Janine Mohamed, chief executive of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives

NACCHO looks forward to continuing to work with the Federal Government to achieve this generational change.Funding security for other Aboriginal preventative health programs needed to be the next order of priority for the Federal Government. Funding for specific health programs under the Closing the Gap Indigenous Chronic Disease Package still remain uncertain with some set to cease at the end of March 2015. We look forward to hearing more from the government in the near future on these important initiatives. Aboriginal health program funds currently within Medicare Locals, which are soon to be abolished, should now be transitioned to the Aboriginal Community Controlled Health Sector under the new funding agreements. Aboriginal people respond best to primary health care provided by Aboriginal people.

Matthew Cooke NACCHO chair

Todays Aboriginal Health News Alert comes from the ABC website Sophie Scott reporting

Australia’s key health organisations say thousands of people needing vital drug and alcohol services will be turned away unless an urgent funding crisis is resolved.

The Federal Government has slashed almost $200 million from health flexible funds over the next three years, with the cuts to take effect from the end of June.

Public Health Association of Australia spokesman Michael Moore said the organisations affected provide essential services in rural, regional and remote Australia.

He said the organisations worked to close the gap in health outcomes for Indigenous Australians, manage vital responses to communicable diseases, and deliver substance-use treatment services around the country.

A coalition of 11 peak health organisations is calling on the Federal Government to reverse its planned cuts.

“Obviously it’s of great concern to all the services and organisations potentially affected,” he said.

“To cut the best part of $200 million from frontline services in drug and alcohol, frontline services in Aboriginal and Torres Strait Islander health and frontline services in rural and remote health is inexcusable.”

Alcohol and Other Drugs Council spokeswoman Rebecca MacBean said alcohol and drug rehabilitation services would be severely impacted by any funding cuts.

It comes at a time when drugs such as methamphetamine or ice are creating serious social problems across Australia, particularly for rural and regional Australia.

“To think that funding for these vital services is currently under threat beggars belief,” Ms MacBean said.

She said the foreshadowed cuts would significantly reduce the capacity of non-government organisations and peak bodies to deliver services across the country.

Experienced drug and alcohol workers already quitting

Several drug and alcohol treatment services across Australia contacted the ABC are worried about the impact the funding uncertainty is having.

Brendan Pont, from the Queensland Network of Alcohol and Other Drug agencies, said highly trained drug and alcohol workers were already leaving the sector.

“While we keep hearing about the need for alcohol and other drug treatment services and particularly the ‘ice epidemic’, this uncertainty is meaning that quality clinicians who have years of experience in the sector are starting to look for work elsewhere as they have no guarantee of work post June 30,” he said.

Experts said Indigenous health services were also under threat.

Any cuts to Indigenous health programs will make access to life-saving medical services more difficult, Public Health Association’s Michael Moore said.

“We are particularly concerned about the future of the Close the Gap Indigenous chronic disease package, which aims to prevent diseases through GP services, medications and tackling smoking,” he said.

Indigenous health workers said further funding cuts for non-government health agencies would lead to worse health outcomes.

Janine Mohamed, chief executive of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, said all the evidence shows support is needed for preventive health care and timely interventions that reduce the likelihood of expensive hospitalisation.

“Services provided by the community sector are integral to the achievement of key health and economic goals and maintaining funding is vital to achieving the key targets for Closing the Gap in health outcomes for Indigenous Australians,” she said.

A spokesperson said the Government had committed more than $8 billion over the next three years from the flexible funds for a range of health initiatives, including drug and alcohol services.

The spokesperson said this decision was announced as part of the 2014/15 federal budget.

Mental health services funding cuts

It comes on top of growing uncertainty about the provision of mental health services.

Thousands of Australians seeking help for mental health problems face growing uncertainty because federal funding for hundreds of contracts has not been guaranteed after June 30.

Seventy mental health groups — including Mental Health Australia, Headspace, and the Black Dog Institute — have written an open letter to Prime Minister Tony Abbott and Health Minister Sussan Ley.

The letter reads: “We have not received any definitive advice regarding the future of programs.”

“Some agencies have indicated that without this advice, they will have to give staff notice of termination of employment in a matter of days.

“This ongoing uncertainty is causing a huge disruption to organisations and increasingly, deep anxiety amongst the people they serve.”

The Federal Government said they were hoping to resolve mental health funding as soon as possible.

Opposition health spokesman Catherine King called on the Government to clear up the confusion over funding.

“Minister Ley must immediately end the uncertainty by making an announcement on funding, and explaining how demand will be met for services following the $197 million cut,” she said.

“The flexible funding debacle is yet another example of the chaos and confusion which is a hallmark of this Government’s health policy.”

The ABC has sought comment and reaction from Ms Ley.