Collaborative voices: Ongoing reflections on cultural competency and the health care of Australian Indigenous people

The issue of cultural competency in health care continues to be a priority in Australia for health and human services professionals. Cultural competence in caring for Aboriginal and Torres Strait Islander peoples is of increasing interest, and is a priority in closing the gap in health disparities between Indigenous and non-Indigenous Australians. Through a collaborative conversation, the authors draw on a case study, personal experience and the literature to highlight some of the issues associated with employing culturally appropriate, culturally safe and culturally competent approaches when caring for Aboriginal and Torres Strait Islander peoples. The intent of this article is to encourage discussion on the topic of cultural competency, and to challenge health professionals and academics to think and act on racism, colonialism, historical circumstances and the political, social, economic, and geographical realms in which we live and work, and which all impact on cultural competency.

We’ve had the Redfern Park Speech and The Apology: What’s next?

What really changed for Australian Aboriginal and Torres Strait Islander people between Paul Keating’s Redfern Park Speech (Keating 1992) and Kevin Rudd’s Apology to the stolen generations (Rudd 2008)? What will change between the Apology and the next speech of an Australian Prime Minister? The two speeches were intricately linked, and they were both personal and political. But do they really signify change at the political level? This paper reflects my attempt to turn the gaze away from Aboriginal and Torres Strait Islander people, and back to where the speeches originated: the Australian Labor Party (ALP). I question whether the changes foreshadowed in the two speeches – including changes by the Australian public and within Australian society – are evident in the internal mechanisms of the ALP. I also seek to understand why non-Indigenous women seem to have given in to the existing ways of the ALP instead of challenging the status quo which keeps Aboriginal and Torres Strait Islander peoples marginalised. I believe that, without a thorough examination and a change in the ALP’s practices, the domination and subjugation of Indigenous peoples will continue – within the Party, through the Australian political process and, therefore, through governments.

What health services within rural communities tell us about Aboriginal people and Aboriginal health

There is a growing body of literature within social and cultural geography that explores notions of place, space, culture, race and identity. When health services in rural communities are explored using these notions, it can lead to multiple ways of understanding the cultural meanings inscribed within health services and how they can be embedded with an array of politics. For example, health services can often reflect the symbolic place that each individual holds within that rural community. Through the use of a rural health service case study, this paper will demonstrate how the physical sites and appearances of health services can act as social texts that convey messages of belonging and welcome, or exclusion and domination. They can also produce and reproduce power and control relations. In this way, they can influence the ways that Aboriginal people engage in health service environments – either as places where Aboriginal people feel welcome, comfortable, secure and culturally safe and happy to use the health service, or as places where they utilise the service provided with a great deal of effort, angst and energy. It is important to understand how these complex notions play out in rural communities if the health and wellbeing of Aboriginal people is going to be addressed.

Working on the art of writing

In this short Case story Bronwyn Fredericks shares some of her tips on writing and about the craft of writing. This Case story is contained within the publication titled 'Researching Indigenous Health: A Practical Guide for Researchers', by Alison Laycock, Diane Walker, Nea Harrison and Jenny Brands and published by The Lowitja Institute(pp.266-267).

Nation and Internet : Malaysia and the multimedia super corridor

As part of a development plan-in-progress spanning a total of 25 years (1996 to 2020), Malaysia’s Multimedia Super Corridor MSC provides a unique opportunity to witness a brief and microcosmic unfolding of that process which Lewis Mumford lays out in exhaustive detail in Technics and Civilization (Mumford, 1963). What makes it doubly interesting is the interlocking of national imagining, destiny and progress with a specific group of technologies, information and communication technologies (ICT), of which the Internet is part. This paper casts Malaysia’s development and implementation of the MSC as the core round which an enquiry of the association between the nation and the Internet is woven. I argue here that there are 3 dissonances that occur within the relationship between the Malaysian nation and the Internet. The first of these arises from the tension between the premises underlying techno-utopianism and pro-Malay affirmative action. The second is born of the discordance between the “guaranteed” freedom from online censorship and the absolute punitive powers of the state. The third lies in the contradiction between the Malaysian nation, as practiced through graduated sovereignty and its pro-Bumiputera affirmative action. Together, these three comprise the inflections that the Internet has on Malaysia. Further, I contend that aside from adding to the number of ways in which the nation is understood and experienced, these inflections also have the potential to disrupt how the nation is lived. By lived I mean to denote the realisation of the nation that occurs in and through everyday life.

Researching with the Aboriginal Community, MPH2057- Aboriginal Health Course (Monash University), delivered by the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) & The Burnet Institute at The Burnet Institute, Melbourne, Victoria, 29 September 2010

A copy of the slide presentation titled 'Researching with the Aboriginal Community'. It was presented by Bronwyn Fredericks for the Master of Public Health Program (MPH2057- Aboriginal Health Course) at Monash University. The Monash University Aboriginal Health Course (MPH2057) is delivered in partnership by the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) & The Burnet Institute. The 2010 Aboriginal Health Course was run on Level 3 of The Burnet Institute, 89 Commercial Road, Prahan, Melbourne, Victoria, 29 September 2010.

Aboriginal community control and decolonizing health policy : a yarn from Australia

This chapter outlines: a brief history of Australian Aboriginal health and health policy and then moves on to demonstrate how the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) undertakes its work and is an example of 'decolonizing policy in action'. Moreover, it highlights how Aboriginal participation in the development of policy and in the planning, delivery, management and evaluation of health programs enables policies and programs to respond effectively to the needs of Aboriginal people and to change future health outcomes for them. It showcases how Aboriginal decision-making has gone some way to decolonizing policymaking and has addressed the power imbalance - both of which have been critical in the improvement in Aboriginal health outcomes.

Aboriginal public health and education : has it made a difference in practice?

Over the years, public health in relation to Australian Aboriginal people has involved many individuals and groups including health professionals, governments, politicians, special interest groups and corporate organisations. Since colonisation commenced until the1980s, public health relating to Aboriginal and Torres Strait Islander people was not necessarily in the best interests of Aboriginal and Torres Strait Islander people, but rather in the interests of the non-Aboriginal population. The attention that was paid focussed more generally around the subject of reproduction and issues of prostitution, exploitation, abuse and venereal diseases (Kidd, 1997). Since the late 1980s there has been a shift in the broader public health agenda (see Baum, 1998) along with public health in relation to Aboriginal and Torres Strait Islander people (NHMRC, 2003). This has been coupled with increasing calls to develop appropriate tertiary curriculum and to educate, train, and employ more Aboriginal and Torres Strait Islander and non-Aboriginal people in public health (Anderson et al., 2004; Genat, 2007; PHERP, 2008a, 2008b). Aboriginal and Torres Strait Islander people have been engaged in public health in ways in which they are in a position to influence the public health agenda (Anderson 2004; 2008; Anderson et al., 2004; NATSIHC, 2003). There have been numerous projects, programs and strategies that have sought to develop the Aboriginal and Torres Strait Islander Public Health workforce (AHMAC, 2002; Oldenburg et al., 2005; SCATSIH, 2002). In recent times the Aboriginal community controlled health sector has joined forces with other peak bodies and governments to find solutions and strategies to improve the health outcomes of Aboriginal and Torres Strait Islander peoples (NACCHO & Oxfam, 2007). This case study chapter will not address these broader activities. Instead it will explore the activities and roles of staff within the Public Health and Research Unit (PHRU) at the Victorian Aboriginal Community Controlled Health Organisation (VACCHO). It will focus on their experiences with education institutions, their work in public health and their thoughts on gaps and where improvements can be made in public health, research and education. What will be demonstrated is the diversity of education qualifications and experience. What will also be reflected is how people work within public health on a daily basis to enact change for equity in health and contribute to the improvement of future health outcomes of the Victorian Aboriginal community.

How I became the first Aboriginal person in Australia to lead a national education organisation

In this paper, Bronwyn Fredericks reflects on how, in 1997, she became the National President of the Council of Australian Postgraduate Associations Inc. (CAPA). The paper describes the election process faced by Fredericks, and identifies some of her key achievements during her time as National President. In becoming the National President, Bronwyn became the first Aboriginal person in Australia to lead a national education organisation. The story within this paper is told from the author’s autobiographical memory, drawing on the cultural, social and political context in which the story and the author were (and are) situated (Wojecki 2007). In this way the story teller reveals story lines which have not previously been articulated (Wojecki 2007). Throughout this paper, Fredericks ‘re-stories’ her experiences of leadership.

Rock pools of critical thought : finding a place to think through my higher degree and what a PhD was all about

The rock pools, salt pans, cliffs and bluffs, and the banks of the Coorooman and Pumpkin Creeks within Darumbal and Woppaburra Country are used as a backdrop in this paper, which offers an exploration of one woman’s quest to undertake her PhD and develop as an Indigenous scholar. The paper describes this Country and the use of Country to nourish, develop, stimulate and support the intellect. It draws on Australian and international literature to demonstrate the intellectual growth and development of Indigenous scholars. The paper offers a highly personal narrative of intellectual journeying which shows how we can be agents of change and power in our individual lives, even while power is being exercised over us and we are being oppressed and marginalised as Indigenous peoples.

‘Universities are not the safe places we would like to think they are, but they are getting safer’: Indigenous women academics in higher education

This paper outlines some of the experiences of Indigenous women academics in higher education. The author offers these experiences, not to position Indigenous women academics as victims, but to expose the problematic nature of racism, systemic marginalisation, white race privilege and radicalised subjectivity played out within Australian higher education institutions. By utilising the experiences and examples she seeks to bring the theoretical into the everyday world of being Indigenous within academe. In analysing these examples, the author reveals the relationships between oppression, white race privilege, institutional privilege and the epistemology that maintains them. She argues that, in moving from a position of being silent to speaking about what she has witnessed and experienced, she is able to move from the position of object to subject and gain a form of liberated voice (hooks 1989: 9) for herself and other Indigenous women. She seeks to challenge the practices within universities that continue to subjugate Indigenous women academics.

A participant’s response : recreating the circle with We Al-Li: a program for sharing and regeneration

Personal reflections on the We Al-Li Program