Setting a new agenda: Developing an Aboriginal and Torres Strait Islander women's health strategy

The Australian National Aboriginal and Torres Strait Islander Women’s Health Strategy was developed to reflect the health priorities of Aboriginal and Torres Strait Islander women, as identified by Aboriginal and Torres Strait Islander women themselves. This article describes the process used by the Australian Women’s Health Network to develop the strategy. The women involved in the research used the talking circle method and engaged with Aboriginal and Torres Strait Islander women through a process referred to as ‘talkin’ up’, where women ‘talk back’ to one another about issues that matter to them. In this article, we describe the power of the talkin’ up process, as a way for Aboriginal and Torres Strait Islander women to identify their own issues, discuss them in context and talk in a culturally safe environment. The strategy which emerged from this process is an accurate reflection of the issues that are important to Australian Indigenous women and highlights the improvements needed in Aboriginal and Torres Strait Islander women’s health to strengthen and underpin women’s health, Indigeneity and their sense of well-being as Aboriginal and Torres Strait Islander women.

Oodgeroo : bloodline to country

In 2009, the researcher acted as director and dramaturg for the development of Sam Watson’s play, Oodgeroo: Bloodline to Country, culminating in a season at La Boite Theatre. This project represents the first time notions of Aboriginal politics were seriously questioned. It aimed to illuminate a key divide in the way Australian indigenous people, and the wider Australian community, deal with issues of grief and outrage – the way of resistance and revolution, or the way of reconciliation and education. The work sought to combine specific cultural artefacts belonging to the Noonuccal people and the family of Oodgeroo of the Noonuccal (Kath Walker) with traditional and contemporary ideas and performance forms.

Transforming habitus: Changing self, changing school

Since 2004, Australian Indigenous (Aboriginal and Torres Strait Islander) students at a low socioeconomic area Australian urban secondary school have used participatory action research to investigate issues of disengagement and absenteeism among their peers. Their research revealed that Indigenous students, who made up about 8% to 10% of the school’s population lacked a sense of belonging to the school. The researchers also revealed an apparent official disregard of the academic or sporting achievements of Indigenous students and, more disturbingly, their presence within the school. The young researchers followed up their findings with action to address the issues. These actions have resulted in a positive change of culture across the whole school, with Indigenous students now able to express pride in their heritage and feel some degree of ownership of the school.

Diabetes health program development for Aboriginal and Torres Strait Islander women

According to Australian Health (2008), the area of endocrine, nutritional and metabolic disorders (mainly diabetes) yields the highest cause of death for Indigenous Australian women at 10.1%. Indigenous Brisbane North women’s results reiterate this with slightly higher percentages and are a cause for concern and action due to the noted levels of undiagnosed/unaware Indigenous Brisbane North women with abnormal blood glucose levels, whom participated in the research. A sub-sample of the group (N=17) were piloted to test the feasibility of method of eliciting health information on Indigenous Women within this community. This pilot study revealed the following health information regarding this group of women. 41.2% of Indigenous Brisbane North women were found to have blood glucose levels that were outside normal ranges, however only 29.4% had been diagnosed with diabetes and or endocrine abnormalities. These findings highlight that 11.8% of participants have signs indicating that they may have undiagnosed diabetes or/and pre diabetes juxtaposed to unacceptable endocrine levels compatible with health and wellness. The percentages of Indigenous Brisbane North Women whom have indicated that they have a diagnosis of diabetes have been compared to both National Indigenous peoples percentages and the national percentages for the wider Australian community (all Australians). The rate of diabetes within this population is 9 times that of the wider Australian community and 5 times that of the wider Australian Indigenous community. Data was collected from Indigenous participants on arrival and the attendance numbers of 112 women was recorded for comparison with other current health prevention wellness programs being delivered. Data was also collected through the use of specially designed culturally safe questionnaires undertaken in conjunction with health checks and health service information given to participants.

Does a 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine prevent respiratory exacerbations in children with recurrent protracted bacterial bronchitis, chronic suppurative lung disease and bronchiectasis : protocol for a randomised controlled trial

Background Recurrent protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis are characterised by a chronic wet cough and are important causes of childhood respiratory morbidity globally. Haemophilus influenzae and Streptococcus pneumoniae are the most commonly associated pathogens. As respiratory exacerbations impair quality of life and may be associated with disease progression, we will determine if the novel 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) reduces exacerbations in these children. Methods A multi-centre, parallel group, double-blind, randomised controlled trial in tertiary paediatric centres from three Australian cities is planned. Two hundred six children aged 18 months to 14 years with recurrent PBB, CSLD or bronchiectasis will be randomised to receive either two doses of PHiD-CV or control meningococcal (ACYW(135)) conjugate vaccine 2 months apart and followed for 12 months after the second vaccine dose. Randomisation will be stratified by site, age (<6 years and >= 6 years) and aetiology (recurrent PBB or CSLD/bronchiectasis). Clinical histories, respiratory status (including spirometry in children aged >= 6 years), nasopharyngeal and saliva swabs, and serum will be collected at baseline and at 2, 3, 8 and 14 months post-enrolment. Local and systemic reactions will be recorded on daily diaries for 7 and 30 days, respectively, following each vaccine dose and serious adverse events monitored throughout the trial. Fortnightly, parental contact will help record respiratory exacerbations. The primary outcome is the incidence of respiratory exacerbations in the 12 months following the second vaccine dose. Secondary outcomes include: nasopharyngeal carriage of H. influenzae and S. pneumoniae vaccine and vaccine-related serotypes; systemic and mucosal immune responses to H. influenzae proteins and S. pneumoniae vaccine and vaccine-related serotypes; impact upon lung function in children aged >= 6 years; and vaccine safety. Discussion As H. influenzae is the most common bacterial pathogen associated with these chronic respiratory diseases in children, a novel pneumococcal conjugate vaccine that also impacts upon H. influenzae and helps prevent respiratory exacerbations would assist clinical management with potential short- and long-term health benefits. Our study will be the first to assess vaccine efficacy targeting H. influenzae in children with recurrent PBB, CSLD and bronchiectasis.

The vanishing endpoint of settler colonialism

In this paper, we interrogate the way that narratives about the unfolding of settler colonialism through time are encoded in recent Australian Indigenous policy frameworks. We argue that the postcolonial image of a single transformative moment of radical political break is embedded in Australian policy frameworks, but is deployed in ways that fuse this idea with the moment of colonial completion and in so doing assist the colonial project. By merging the moment of decolonisation and the moment of colonial completion, temporal narratives mobilise conservative and progressive settler voices towards colonial goals. We identify three recent policy approaches: reconciliation, neoliberal contractualism and intervention, and interrogate the narratives of the present and future that they reflect and deploy. We argue these unacknowledged stories of the colonial future must be contested, so that debates about how settler and Indigenous people might live together differently across time are not foreclosed.

Sovereignty, song and 'The Sapphires' (Wayne Blair 2012)

With its foregrounding of the political issue of the denial of Aboriginal Australian sovereignty by British invaders in its big budget, mainstream narrative, 'The Sapphires' (Wayne Blair 2012) is shown to be another example of a "fourth formation" (Starrs 2012) in Moore and Muecke's 1985 model. Blair's feel-good movie features an all-Aboriginal Australian troupe of singers, The Sapphires, who undertake a journey of self-discovery whereby they learn the importance of choosing the protest songs of black Soul over the white coloniser's "whining" Country and Western songs and this is historically contextualised with a discussion of Aboriginal Australians and popular radio. Furthermore, this paper argues the iconic 'Welcome to Country' is twice subverted to reinforce this theme, firstly in the Cummeragunja pub and secondly in war-torn Vietnam. Finally, the prediction is made that a "fifth formation", in which seeking recognition of Aboriginal Australian sovereignty is no longer the goal because it has become the ongoing reality, will soon be the project of Australian film-makers as they celebrate this long overdue societal shift.

eARTh : the dynamics of ontological representation

This Australian Indigenous creactive work and its Treatise promote ways of thinking about practice and research that extend well beyond the current discourse. It invites re-thinking on how research can be practice-led in new ways, and what that might mean for future students. When discussing the challenges of today, this work signifies how "Western Style" thinking and theory is wanting in so many ways. It engages a new dynamic and innovative way of theorising, encouraging future students to apply their full capacity of energy and wisdom. (Extract from examiners' reports.)

Improving retention and graduation of Aboriginal and Torres Strait Islander students in initial teacher education programs

In 2012, the Australian Council of Deans of Education (ACDE), through the Queensland University of Technology, led a MATSITI project focusing on issues related to the retention, support and graduation of Aboriginal and Torres Strait Islander teachers in initial Teacher Education programs across Australia. While some of the barriers that impact on the graduation of Aboriginal and Torres Strait Islander teachers are well, known, this was the first large-scale Australian study to look at the issues nationally and in depth. Thirty-four Teacher Education programs across the country were audited, meetings were held in each state, both Aboriginal and Torres Strait Islander and non-Indigenous Faculty were consulted and approximately 70 Aboriginal and Torres Strait Islander pre-service teachers interviewed. This paper reports on the outcomes of that project, including the evidence that while recruitment into Teacher Education has, in some sites, reached parity, retention rates are well-below expected across the nation. The paper focuses both on the quantitative data and, even more significantly, on the voices of the pre-service teachers themselves, offering insights into the ways forward. As a result of this study, Deans and Heads of School of Teacher Education programs across the country have developed Action Plans alongside their university's Indigenous Higher Education Centres to improve support and retention of Aboriginal and Torres Strait Islander teachers.

The genographic project: Traditional knowledge and population genetics

This article considers the debate over patent law, informed consent, and benefit-sharing in the context of biomedical research in respect of Indigenous communities. In particular, it focuses upon three key controversies over large-scale biology projects, involving Indigenous populations. These case studies are representative of the tensions between research organisations, Indigenous communities, and funding agencies. Section two considers the aims and origins of the Human Genome Diversity Project, and criticisms levelled against the venture by Indigenous peak bodies and anti-biotechnology groups, such as the Rural Advancement Foundation International. It examines the ways in which the United Nations Educational, Scientific, and Cultural Organization (UNESCO) grappled with questions of patent law, informed consent, and benefit sharing in relation to population genetics. Section three focuses upon the ongoing litigation in Tilousi v. Arizona State University, and the Havasupai Tribe v. Arizona State University. In this matter, the Havasupai tribe from the Grand Canyon in the United States brought legal action against the Arizona State University and its researchers for using genetic data for unauthorised purposes - namely, genetic research into schizophrenia, migration, and inbreeding. The litigation raises questions about informed consent, negligence, and larger matters of human rights. Section four explores the legal and ethical issues raised by the Genographic Project. It considers the aims and objectives of the venture, and the criticisms levelled against it by Indigenous communities, and anti-biotechnology groups. It examines the response of the United Nations Permanent Forum on Indigenous Issues to the Genographic Project. It charts the debate over the protection of traditional knowledge in various international fora. The conclusion recommends a number of measures to better regulate large-scale biology projects involving the participation of Indigenous communities.

Editorial: Closing the gap: Nurses and midwives making a difference

Life expectancy at birth is one of the main indicators of health inequality. Current health and social status indicators for Australian Indigenous people demonstrate major discrepancies in comparison to other Australians. For example, in Australia in 2005–2007 the Indigenous life expectancy gap at birth was 11.5 years for males and 9.7 years for females (Australian Bureau of Statistics, 2009). This gap has remained relatively constant over the last few decades (ABS, 2008). While the main causes of death for Indigenous Australians are similar to those of non-Indigenous Australians, the percentages attributed to the different disease categories are significantly different. For example, death from external causes is 16.2% for the Indigenous population compared to 6.3% for non-Indigenous, and diabetes is 8% for Indigenous Australians compared to 2.4% for non-Indigenous (ABS, 2008; AIHW, 2008). The Australian Government’s response to this troubling issue, urged on by unprecedented support from the public, was the Close the Gap initiative which aims to reduce the gap in life expectancy within a generation (Shadow Report, 2010). Since the introduction of the Close the Gap strategy there have been some claims of success. For example, the Honourable Warren Snowden (Snowden, 2010), Minister for Indigenous Health, outlines some of the changes that have occurred as a result of the implementation of the Indigenous Chronic Disease Package, funded at $805.5 million over four years, as: 294 new positions...

‘Enough is enough’: Songs and messages about alcohol in remote Central Australia

This article examines some of the ways in which Australia’s First Peoples have responded to serious community health concerns about alcohol through the medium of popular music. The writing, performing and recording of popular songs about alcohol provide an important example of community-led responses to health issues, and the effectiveness of music in communicating stories and messages about alcohol has been recognised through various government-funded recording projects. This article describes some of these issues in remote Australian Aboriginal communities, exploring a number of complexities that arise through arts-based ‘instrumentalist’ approaches to social and health issues. It draws on the author’s own experience and collaborative work with Aboriginal musicians in Tennant Creek, a remote town in Australia’s Northern Territory.