Acknowledgement Firstly I would like to acknowledge the traditional owners of the land on which we gather today, the Wurundjeri people. A gathering point for members of the Kulin Nation, where age old ceremonies of celebration, initiation and renewal took place. I would also like to pay my respects to the Elders both past and present.

Why Acknowledgement? The process of Acknowledgement of Country and Welcome to Country recognises the unique position of Aboriginal people in Australian culture and history. Aboriginal people are the original owners of the land and it is important this unique position is recognised to enable the wider community to share in Aboriginal culture and facilitate better relationships between Aboriginal people and the wider community

Aboriginal and Torres Strait Islander Culture & Patients in Hospital Justice Nelson Aboriginal Hospital Liaison Officer Royal Melbourne Hospital Presentation for International Doctors Education & Support Group 30 th April 2011

Aims of today Introduction Brief history of Aboriginal and Torres Strait Islander people Aboriginal Health Aboriginal Patients Hospital experience Things to be aware of The important role of Aboriginal Health Workers Take home message & what you can do References Thank you & Evaluation

Introduction Justice Nelson Tribal Group: Jaara Jaara Sub Group: Wangerragerra/Gunanga rra gundig Language Group: DjaDja Wurrung Totem/Skin: Waa – Crow

Our History in brief Who are Aboriginal and Torres Strait Islander people? Where did they live? & What were their lifestyles like? Do they all speak the same language? Do they have a flag?

Aboriginal Language Map Australia

Aboriginal Flag

Torres Strait Island Flag

Our history in brief..colonisation effects Assimilation policy = devastating – resulting in destruction of identity & culture Removal = forgetting of language, history, culture, family, group/tribe and connection to country Early expectations = live “ like white Australians ” & be physically absorbed into wider population resulting in the disappearance of a culture

Cardiovascular disease (17%) and mental disorders (15%) are the two leading contributors to the disease burden of Indigenous Australians (NHHRC, 2009). Aboriginal people have the worst health of any section of Australian society and continue to suffer from a range of preventable diseases rare in mainstream Australia (RCH, 2007). Aboriginal Health

Cultural shock Anxiety and fear Isolation and powerlessness Shame and discomfort Withdrawal Reluctance to communicate with non- Indigenous staff Aboriginal Patients Hospital experience

Hospital symbolism Health definition Family, kinship and community Cause of illness Preferred treatment Competing priorities Things to be aware of

Men's & women's business Touch Communication Trust Traditional &/or Christian spirituality Things to be aware of

A cultural interface Social and Cultural Support Provide Education & Advice Act as cultural Interpreter To ensure culturally appropriate care is given Liaison with Aboriginal Community Controlled Health Organisations (ACCHOs) Awareness of Aboriginal networks and Events The important role of Aboriginal Health workers

Become familiar with local Aboriginal history, organisations and people Personal, professional and organisational development and resources Form personal links and be inclusive Positive and direct interaction Watch Movies eg Rabbit Proof Fence & The Tracker TAKE HOME MESSAGE Developing Respect & Understanding

Self awareness Identify Aboriginal patients Liaise with AHLO and other relevant staff Education: –sbs.com.au/first Australians –Koori Heritage Trust, King St, Melbourne –Oxfam ( –NHHRC Report: A Healthier Future for all Australians. Chapter 8 – Closing the Health Gap for Aboriginal and Torres Strait Islander people ( –ICAP ( –VACCHO and VAHS Champion for Aboriginal Health National Apology – ( to-stolen-generations/rudd_speech.html) What can YOU do? Resources

Austin Health pg 5. Cultural Safety- Some Simple Hints Queensland Government al.asp. Australian Bureau of Statistics Australian Institute of Health and Welfare summary booklet Reference: BMJ 2003;327:457 (23 August), doi: /bmj Melbourne Health Policy (3 rd Draft) Acknowledgment of Country Procedure health/#ixzz1KmTk2qEl References

“To us, health is about so much more than simply not being sick. It's about getting a balance between physical, mental, emotional, cultural and spiritual health. Health and healing are interwoven, which means that one can't be separated from the other.” Dr Tamara Mackean Australian Indigenous Doctors' Association

THANK YOU & Evaluation…