Sustainability of a successful health and nutrition program in a remote Aboriginal community

OBJECTIVE: To assess the long term effect of a nutrition program in a remote Aboriginal community (Minjilang). DESIGN: Evaluation of nutritional outcomes over the three years before and the three years after a health and nutrition program that ran from June 1989 to June 1990. Turnover of food items at the community store was used as a measure of dietary intake at Minjilang and a comparison community. SETTING: A community of about 150 Aboriginal people live at Minjilang on Croker Island, 240 km north-east of Darwin. A similar community of about 300 people on another island was used as the comparison. RESULTS: The program produced lasting improvements in dietary intake of most target foods (including fruit, vegetables and wholegrain bread) and nutrients (including folate, ascorbic acid and thiamine). Sugar intake fell in both communities before the program, but the additional decrease in sugar consumption during the program at Minjilang "rebounded" in the next year. Dietary improvements in the comparison community were delayed and smaller than at Minjilang. CONCLUSIONS: The success of the program at Minjilang was linked to an ongoing process of social change, which in turn provided a stimulus for dietary improvement in the comparison community. When Aboriginal people themselves control and maintain ownership of community-based intervention programs, nutritional improvements can be initiated and sustained.

Survival tucker : improved diet and health indicators in an Aboriginal community

The poor nutritional status of Aboriginal Australians is a serious and complex public health concern. We describe an unusually successful health and nutrition project initiated by the people of Minjilang, which was developed, implemented and evaluated with the community. Apparent community dietary intake, assessed by the ‘store-turnover’ method, and biochemical, anthropometric and haematological indicators of health and nutritional status were measured before intervention and at three-monthly intervals during the intervention year. Following intervention, there was a significant decrease in dietary intake of sugar and saturated fat, an increase in micronutrient density, corresponding improvements in biochemical indices (for example, a 12 per cent decrease in mean serum cholesterol, increases in serum and red cell folate, serum vitamin B6 and plasma ascorbic acid), decrease in mean systolic and diastolic blood pressures, a normalisation of body mass index, and a normalisation of haematologic indices. The success of this project demonstrates that Aboriginal communities can bring about improvements in their generally poor nutritional status, and that the store-turnover method provides a valid, inexpensive and noninvasive method for evaluating the resultant changes in community diet. Although the project was undoubtedly effective in the short term, further work is in progress to assess individual strategies with respect to sustainability, cost-effectiveness and generalisability.

Aboriginal dietary intake and a successful nutrition intervention project in a Northern Territory community

This paper summarises the development and testing of the 'store-turnover' method, a non-invasive dietary survey methodology for quantitative measurement of food and nutrient intake in remote, centralised Aboriginal communities. It then describes the use of the method in planning, implementation and evaluation of a community-based nutrition intervention project in a small Aboriginal community in the Northern Territory. During this project marked improvements in both the dietary intake of the community and biological indicators of nutritional health (including vitamin status and the degree and prevalence of several risk factors for non-communicable disease) were measured in the community over a 12-month period following the development of intervention strategies with the community. Although these specific strategies are presented, emphasis is directed towards the process involved, particularly the evaluation procedures used to monitor all stages of the project with the community.

Diabetes, hyperinsulinemia, and hyperlipidemia in small aboriginal community in northern Australia

A small rural Aboriginal community in northern Australia was surveyed for diabetes, impaired glucose tolerance (IGT), hyperinsulinemia, and lipid levels. Of the 122 adults >17 yr of age who participated (95% response rate), 11.5% had diabetes, 7.4% had IGT, and the remaining 81.1% had normal glucose tolerance. Both diabetes and IGT were strongly age related. This high frequency of diabetes occurred, despite the population being relatively lean. Although the body mass index (BMI) increased with age in both men and women, only 25% of the population overall had BMI >25 kg/m2. There were wide ranges of insulin responses to glucose, with the upper fertile of 2-h insulin levels being more than seven times higher than the lower fertile (144 ± 13 vs. 19 ± 1 mLI/L). Hyperinsulinemia was associated with IGT, elevated triglycerides, and lower high-density lipoprotein cholesterol levels. Lipid abnormalities were much more frequent among men than women. Cholesterol levels were an average of 0.55 mM higher and triglycerides an average of 1.05 mM higher in men than in women, and both increased with age. In conclusion, this small isolated Aboriginal population from northern Australia had an unexpectedly high frequency of diabetes (in view of their relative leanness) in association with a high frequency of metabolic abnormalities indicative of insulin resistance (hyperinsulinemia, IGT, hypertriglyceridemia).

Publishing, postage, and prizes : classic Australian children’s literature in the public eye

2012 saw the publication of competing and complementary lines of Australian “classics”: “A&R Australian Classics” (HarperCollins) and “Text Classics” (Text Publishing). While Angus and Robertson were key in establishing a canon of Australian children’s classics in the twentieth century, it was the Text Classics line which included a selection of young people’s titles in their 2013. In turn, Penguin Australia launched a selection of “Australian Children’s Classics”. In so doing, these publishers were drawing on particular literary and visual cultural traditions in Australian children’s literature. Public assertions of a particular selection of children’s books reveals not only contemporary assumptions about desirable childhood experiences but about the operation of nostalgia therein. In encouraging Australian adults to judge books by their covers, such gestures imply that Australian children may be similarly understood. Importantly, the illusion of unity, sameness, and legibility which is promised by circumscribed canons of “classic” children’s literature may well imply a desire for similarly illusory, unified, legible, “classic” childhood. This paper attends to public attempts to materialise (and legitimise) a canon of classic Australian children’s literature. In particular, it considers the ways in which publishing, postage stamps, and book awards make visible a range of children’s books, but do so in order to either fix or efface the content or meaning of the books themselves. Moving between assertions of the best books for children from the 1980s to today, and of the social values circulated within those books, this paper considers the possibilities and problematics of an Australian children’s canon.

Tensions between policy and practice : reconciliation agendas in the Australian curriculum English

In various parts of the world, Indigenous and non-Indigenous peoples are actively working towards Reconciliation. In Australia, the context in which we each undertake our work as educationalists and researchers, the Reconciliation agenda has been pushed into schools and English teachers have been called on to share responsibility for facilitating the move towards a new national order. The recently introduced Australian Curriculum mandates that Aboriginal and Torres Strait Islander Histories and Cultures be embedded with “a strong” but “varying presence” into each learning area (Australian Curriculum, Assessment and Reporting Authority, 2013). In this paper we consider the tensions between policy and practice, when discourses external to education are recontextualised into the discipline of English. We do so by applying an analytical framework based on Bernstein’s (1990, 1996,2000) sociological theories about the structure of instructional and regulative discourses. Our findings suggest that the space to exert Reconciliatory agendas in the Australian Curriculum English is ambiguous and thus holds the potential to not only marginalise Indigenous knowledges but also to create tensions between policy and practice for non-Indigenous teachers of English.

Celebrating and sustaining Indigenous knowledges through higher education

In its intervention at the 10th session of the United Nations Permanent Forum on Indigenous Issues 2010, the World Indigenous Network Higher Education Consortium (WINHEC) acknowledged that despite a history of protracted but limited attempts by Governments globally to address the low participation and graduation rates of Indigenous peoples from higher education at post graduate level, this continues to be an area of considerable concern. This paper speaks to the development of an innovative academic process that profiles the ground breaking work of WINHEC and a cohort of Indigenous academics in developing academic programs designed to address this systemic failure. The concept of these programs was endorsed in 2006 at a WINHEC conference where Indigenous representatives from across the world met to discuss in part, historical and contempory impediments to Indigenous success within higher education. The goal of WINHEC has been to develop a nested suite of inventive postgraduate awards founded within the scholarship of Indigenous Knowledge which encapsulates an epistemological approach. This has been a ground breaking process that has included collaborative and intellectual contributions of Indigenous academics from diverse cultural nations across the globe and, in particular, Australia. In 2012 the culmination of this dream and the suite of courses developed, honours and embrace the uniqueness of Indigenous Knowledge and the cultural integrity of Indigenous Leadership.

Digital technology and public apology : responses by Indigenous Australians to a government saying sorry

Australia has had two recent public apologies, one to the ‘ Stolen Generation’ of Aboriginal and Torres Strait Islander Australians and the second to the ‘Forgotten Australians' – people who had been removed from their parents as children and institutionalized. Both acts occurred in time when there was no Internet and peoples’ stories took years to collect and decades for their weight to carry the public momentum required to gain a public apology. Now, in a digital age, the reports and the testimonies held within them are available for all to read on the Internet. We all now know what happened and formal public apologies ensued. Both public apologies also draw attention to an emerging intersection between digital technologies, personal historical stories and public apology. Research has identified the potential of digital narrative, such as digital storytelling3 and videoed oral histories to assist in the production of digital narratives that can help to present the multiple voices and viewpoints of those affected by these subjects co-creatively (Burgess et al, pp.152-153). Not all Australians however have access or the skills to use digital tools so as to benefit from these technologies ⎯ especially Indigenous Australians. While the Federal Government is committed to helping Australians enjoy digital confidence and digital media literacy skills, experience inclusive digital participation and benefit through online engagement (Department of Broadband, communications and the Digital Economy, 2009) there are many initiatives that can also be undertaken locally by State funded institutions, such as libraries to assist. This paper highlights the outcomes of recent empirical projects undertaken at the State Library of Queensland (SLQ) in particular focusing on digital initiatives in Family History practices by Indigenous users, and a digital story project in response to the public apology to the Stolen Generation instigated by SLQ.

Beyond the dotted drawings : the Aboriginal Health Worker and health promotion practice

Aboriginal and Torres Strait Islander health workers' roles have changed over the years as the profession has shifted far beyond the mere provision of a cultural brokerage service. Important achievements have been made in enhancing the biomedical role of the Aboriginal and Torres Strait health worker, even though this is not the only area of expertise they need to possess.

Crossing lines: Sport history, transformative narratives, and Aboriginal Australia

In this collaborative article, we seek to unsettle the dominance of Western, reconstructionist accounts of Indigenous Australian sport history through reflections on our past research in the Queensland Aboriginal community of Cherbourg. That research focussed on a statue of legendary 1930s cricketer, Eddie Gilbert, and on sport exhibitions in Cherbourg's Ration Shed Museum. Here, we are less concerned with unveiling the ‘true’ account of Australian Aboriginal sporting history, or even a ‘true’ Indigenous representation of events. Rather, we are interested in analysing various perspectives in order to generate a more inclusive and complete account of Aboriginal sport history and the narrative implications of these for Indigenous and non-Indigenous Australia. Central to this endeavour is the positioning of Indigenous knowledge and understanding at the centre of history-making. The article is in two sections: reflections on our past work from the perspectives of the researchers themselves and an Aboriginal academic colleague, followed by a discussion of how those experiences and reflections will inform our pending project on the 1950s and 1960s Cherbourg marching girls teams.

Review: Let's talk kinship: Innovating Australian social work education, theory, research and practice through Aboriginal knowledge

Review(s) of: Let's talk kinship: Innovating Australian social work education, theory, research and practice through Aboriginal knowledge, by Christine Fejo-King, published by Christine Fejo-King Consulting, ISBN: 978-0-9922814-0-3.

The con-stitutional re-cognition (s)cam-pain: The campaign for the hidden recognition of first nations peoples' racial inferiority

The constitutional recognition campaign has received party-wide support and its efforts have been promoted by Prime Minister Tony Abbott as being something that would ‘complete our Constitution.’ The broader rhetoric surrounding this campaign suggests that it will result in a just, albeit delayed, recognition of indigenous peoples in the Australian legal system. However, beneath the surface of this seemingly benevolent gesture, is a reaffirmation of the colonial subordination and erasure of the several hundred original nations’ peoples and ways of being.

“We don’t tell people what to do”: Ethical practice and Indigenous health promotion

Health promotion aspires to work in empowering, participatory ways, with the goal of supporting people to increase control over their health. However, buried in this goal is an ethical tension: while increasing people’s autonomy, health promotion also imposes a particular, health promotion-sanctioned version of what is good. This tension positions practitioners precariously, where the ethos of empowerment risks increasing health promotion’s paternalistic control over people, rather than people’s control over their own health. Here in we argue that this ethical tension is amplified in Indigenous Australia, where colonial processes of control over Indigenous lands, lives and cultures are indistinguishable from contemporary health promotion ‘interventions’. Moreover, the potential stigmatisation produced in any paternalistic acts ‘done for their own good’ cannot be assumed to have evaporated within the self-proclaimed ‘empowering’ narratives of health promotion. This issue’s guest editor’s call for health promotion to engage ‘with politics and with philosophical ideas about the state and the citizen’ is particularly relevant in an Indigenous Australian context. Indigenous Australians continue to experience health promotion as a moral project of control through intervention, which contradicts health promotion’s central goal of empowerment. Therefore, Indigenous health promotion is an invaluable site for discussion and analysis of health promotion’s broader ethical tensions. Given the persistent and alarming Indigenous health inequalities, this paper calls for systematic ethical reflection in order to redress health promotion’s general failure to reduce health inequalities experienced by Indigenous Australians.