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Indigenous health as an important issue in Australia

Perspectives on Nursing Health, Culture And Society. This essay will discuss Indigenous health as an important issue to the Australian community and the problems that Indigenous Australian may experience within the current health care system. This will firstly analysis in depth the historical, cultural, social and political factors that have affected the healthcare for the Indigenous Australians. Secondly, some strategies that may improve the health care system.

Indigenous Australians culture is complex and diverse. The indigenous culture of Australia is the oldest living cultural history in the world dating back at least 50,000years. The reason why it’s survived this long is their ability to adapt and change over time. Aboriginals keep their cultural heritage rich and alive by passing their knowledge, arts, rituals and performances the passing from one generation to the next. The fundamental wellbeing of the Aboriginal people is their land, its environment that sustained by the people and culture, full of spiritual wellbeing. Aboriginal people were hunter-gathers who foraged for uncultivated plant and wild animals. The traditional diet was high in carbohydrates, proteins and nutrients and low in fat and sugars. However, modern Aboriginal diet are heavily westernised and tend to be high in fat and sugar but low in carbohydrate, fibre and nutritional value.

The World Health Organisation, social determination of health (SODH)are defined as ‘the fundamental structures of social hierarchy and the socially determined conditions these structures create in which people grow, live, work and age.” The structural organisation for the Aboriginal people is to settle them with housing, employment, educations and health services so they can live in a well presented environment. Health interventions have a clinical focus on individual behaviours such as diet, condom use, exercise, alcohol, etc despite the fact that when structural issues such as poverty is not addressed. Poverty, as represents most Indigenous people as lower socio economic status shows unhealthy behaviour, smoking, poor diet and physical activity which put a risk for numerous health problems. Indigenous people have been victims of societal and racism since colonial times. The dominant culture promotes exclusion, inclusion, inferior conditions or assimilation (loss of individual, unique culture). Though education is available it is often unmet to the needs of the indigenous children resulting to have low enrolment rate, poor school performance and high dropout rate which increase the vulnerability to child labours. It is important to have tradition Indigenous education to be acknowledged and valued. Literacy for the Indigenous must be proficient in their own languages but also to the nation language. Also education should include the land establishment forms of livelihoods that usual involve the land to understand the tradition competencies. The underinvestment in health care in areas in which Indigenous people live is due to rural/remote nature. There are a number of cultural barriers that prevent access to health care. Indigenous languages are often difficult leading to poor communication between nurse and patient. The may experience discrimination by the staff. The traditional land is vital source of material and spiritual well being serving a crucial resource for their reproduction. The loss of land due to polices of dominant culture creates a social problem. The restored relationship to the land is central to restore sense of identity, social status and political power as well as economic, food security, rehabilitation of land. It is important for health care workers to have a degree of cultural competence and work with traditional healing modalities to make cultural safety.

In 1788 European settlers colonised Australia. Upon settlement, the aboriginal people lost their land, their social and economical structure and in general, their way of life. Since colonisation Indigenous Australians have experienced extreme levels of loss, grief, disempowerment, cultural alienation, and loss of identity (Australian Institute of Health and Welfare, 2002, 2003; Hunter, 1993) The trauma suffered by the stolen generations as a result of the assimilation policies of the Australian Government has direct relevance to the psychological adjustment of indigenous Australians when considered within the framework of attachment theory. Attachment theory is the quality of early parent-child bonding, as well as the infants actual experience of the relationship with their parents has important implications for psychological and emotional adjustment later in life. (Strahan, 1995).

There is enough evidence to suggest that Aboriginal people do not have the same degree of access to many of the health services as other Australians. This implies negative implications for the outcomes of Indigenous health. The access of primary health care is compromised or obstructed as they are more likely to present care later stage meaning more unhealthy state. “I was shocked by the poverty, disadvantage and a medical model of care working “downstream” patching local people up and sending them home again without any longer term, preventative care. The issues are not only health services offering primary health care but also acute care providing in hospitals and specialist’s services. Issues such as distance, transport, affordability, availability, language, and cultural stability are all potential hindrances to access health services. Transport, long waiting time, cost to be some of the most commonly cited barriers. Indigenous people also feel disempowered and are less likely to use health services. It is also very important to note that communication difficulties come from those living in remote areas. However the presence of an Aboriginal health worker can be a strong determinant in whether an Indigenous person will access health services. It is important that primary health care services are run by Aboriginal communities to aim to offer health care in a culturally appropriate setting. This causes to a major source of providing education and training for staff. Indigenous health workers and nurses are to provide primary care services based to interlinked with a holistic Indigenous specific definition of health that states: ‘Aboriginal Health is not just the physical well being of an individual but is the social, emotional and cultural well being of the whole community in which each individuals is able to achieve their full potential thereby about the total well being of their community. It is a whole -of- life view and includes the cyclical concept of life- death-life” (NAHS, 1989) It is also important to build a shared understanding of how community input will inform policy or decision making processes. Numerous attempt to define Indigenous mental health concepts, the common theme has consistently been the holistic nature of health and wellbeing. The word punyu (Ngaringman) encompasses both person and country. In fact caring for the country has been associated with improvements in wellbeing. Suggesting that for Indigenous people ‘our identity as human beings remains tied to our land , to our cultural practices, our systems of authority and social control, our intellectual traditions, our concepts of spirituality, and to our systems of resource ownership and exchange. Destroy this relationship and you damage- sometimes irrevocably-individual human beings and their health'(cited in Burgess et al.,2008,p.2).

On February 13 2008, the Prime Minister of Australia, Mr Kevin Rudd, offered an apology to members of the ‘stolen generation’. The apology attracted words and gestures of gratitude, relief, pride and sorrow. Also for some closure to a painful emotional wound. This let the healing begin it was an act of hope, dignity and respect acknowledging the existence and impacts of past policies and practices of forcibly removing indigenous children from their families. The apology represented that the ‘past of mistreatment and blemished chapter in our country to reconcile indigenous and non indigenous people to a better future. The Prime Minister and opposition leader Brendan Nelson both pledged to close the 17 year life expectancy gap between Indigenous and non- Indigenous Aboriginals by 2030. Promising that Indigenous Australians to have access to same quality health services. As Mr Rudd said “he is determined to make a difference.” Curtin’s University professor of health economics, Gavin Mooney said “it is important that Aboriginal people are involved in the process” It is important to involve the indigenous and ask what they want. As it is important to ensure that the voice of ordinary Aboriginal people to be heard and what it is that they want.

In conclusion aˆ¦.. the services of Aboriginal health aˆ¦.. Aboriginal and Torres Strait Islander people’s health disadvantage needs to be considered in the broader context of social disadvantage, inequality and exclusion, political marginalisation and the historical currents of colonialism. In order to find strategies for health services for the Indigenous Australian need to take account of historical, social, cultural and political factors in order to understand the health disadvantage faced by Aboriginal peoples in contemporary society. This enhances our knowledge of unequal health outcomes between Aboriginal and non – Aboriginal people by focusing on the impacts of social structures and cultural appropriateness of health care services.


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