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The aboriginals are the initial inhabitants of Australia and they boast strong communities and cultural beliefs. They were forcefully removed from their land during the European invasion of Australia in 1788 (Dudgeon et al., 2010, p. 29). The invasion came with new diseases that cleared a very large population of the aboriginal Australians because they had no defence to the deadly diseases. The displacement from their lands by the colonizers led to numerous conflicts that were characterized by mass shootings leading to the death of many Aboriginal Australians (Lawrence, S. and Davies, 2010). To date, the aboriginals are still oppressed and discriminated against in different sectors including health, education, and employment.
Coming from a different country or even continent, one would be forgiven to imagine that Australia is only inhabited by whites. There is also a general notion that whites are always wealthy and one would, therefore, presume that there is no financially struggling Australian. One, however, needs to learn some history regarding the indigenous Australians and the Torres Strait Islander people to understand what these people have gone through over the years. It took me being an international student to realize that there were aboriginal Australians who still practised their cultural beliefs despite the European invasion and being forced to abandon their cultural and traditional beliefs. The notion that all Australians were rich white people was immediately erased when I met and interacted with aboriginal and Torres Strait Islanders who were struggling to make ends meet. They experienced all forms of discrimination in hospitals, schools, and places of employment. There are massive differences culturally and even in health status between the aboriginals and the general population. Cultural beliefs and social health determinants have massively affected the health outcomes of the aboriginals.
It is important to note that Australia is one of the most diverse nations in the world both culturally and linguistically (Piller, 2016, p. 56). It is presumed that all Australians irrespective of the culture, race, religion, or gender are entitled to equitable healthcare. However, aboriginal and Torres Strait Islander people experience a lot of discrimination in healthcare facilities and they are more likely to experience medication errors and incorrect diagnoses as compared to the non-aboriginals (Durey, 2010, p. 89). I can ascertain that most aboriginals have reported experiencing culturally unsafe care from healthcare practitioners.
Despite the changes in aboriginal lifestyle over the 200 years since colonization, the aboriginal Australians have done well in maintaining their culture despite the non-aboriginals attempts to suppress this culture. Their attitude towards healthcare brought by the colonizers has been passively resistive (Gracey, 2014, p. 1141). I believe that the viewpoint of the aboriginal Australians regarding treatment has changed with time. However, I also think that their views regarding the cause of illnesses have not changed significantly. There are some health beliefs that they have retained which continue to provide meaning to events thus helping them in coping with illnesses and death. Their attitude towards illness suggests that the diseases that require the attention of professional health practitioners were brought by the colonizers (Shawande, 2010, p. 18). However, I also realized that they believe that before the invasion they could only fall sick due to bad behaviour and this would require the attention of traditional healers (Shawande, 2010, p. 18).
I additionally learnt that in the aboriginal culture, the family of the patient may sometimes not want their loved one to know the true details of their condition and doctor’s diagnosis. They believe that thinking positively is a way of health promotion and discussing the seriousness of a disease may lead to a faster death of the patient. Aboriginal patients, therefore, tend to accept uncertainties in diagnosis and prognosis easier than non-aboriginals (Stoner et al., 2015, p. 69). Their attitude towards death also differs from that of most non-aboriginals. I can confirm that the aboriginals see death as a natural thing and they believe that there is life after death especially when their loved ones die with composure and dignity. I also noticed that after death, some aboriginal communities do not outwardly express their grief as this is termed inappropriate. Additionally, traditional healers are highly respected among the aboriginal communities. Traditional treatment tries to explain illness and respond to the issues surrounding the illness.
There are several traditional health beliefs held by the aboriginals in Australia. During my participation in this subject, I realized that most of the beliefs regarding the causation of illness among aboriginals are based on spiritual and social dysfunctions. On further research regarding this belief, I realized that the aboriginals believe that the wellbeing of an individual is dependent on effectively discharging obligations to society (Senior and Chenhall, 2013, p. 161). They have classified illness as natural, environmental, supernatural, and illness brought by colonizers. However, I realized that most of the aboriginals believed that supernatural intervention is the major cause of illness. They believe that the death of infants and very old people may be normal but the death of youths and young adults may have supernatural influence (Robbins and Dewar, 2011, p. 2).
During my learning process, I interacted with one aboriginal patient who was born in New South Wales to determine his political and historical context. According to studies, between 1910 and 1970 the government put in place policies that led to children of aboriginals being forcibly taken from their homes. They become known as the stolen generation and were adopted by adoptive institutions and families and prohibited from using their native languages. Currently, approximately 3% of the population of Australia has an aboriginal heritage. According to Jens Korff, (2019), 68% of the entire aboriginal population is found in three cities that include New South Wales, Queensland, and Victoria.
During my interaction with the patient, he revealed to me that most aboriginal families contain at least 5 people. On further research, I realized that the likeliness of aboriginals to have lone-person households was just 14% compared to the non-aboriginals. Additionally, the likelihood of having more than 5 people per household was 23% compared to just 10% among non-aboriginals (Australian Institute of Health and Welfare, 2019). The rates of unemployment were also very higher among the aboriginals than the non-aboriginal Australians. The household income was also lower among aboriginals. He also revealed to me that the aboriginals in New South Wales preferred integration to assimilation.
Patients and their families have a way of making decisions in the aboriginal community. Just like in any other family, the father is the head of the family in the aboriginal community. Patients prefer that decisions concerning medication and healthcare are made by immediate family members. The decision-making process does not entirely rely on the patient (Len Kelly, 2019). His immediate and extended family may be present to offer support and reaffirm the choices of the patient. In some instances, the patient may choose one close member of the family as a decision-maker especially during the consent process. During my learning process in this subject, I realized that healthcare decisions in the aboriginal community are in most cases situational and depend on the beliefs and values of the patient within the context of their family. These relationships are what define the aboriginal identity and as a result, they respond to an individual’s illness as a family or a community.
I believe that everything that I have learnt in this subject will have significant impacts on my future nursing practice. I have interacted with some Aboriginal and Torres Strait Islander people; and I, therefore, believe that I will be more culturally aware when I care for them in the future. Some of the graduate attributes learnt during this study will help in future practice. For example, I will be able to know my skill level. A nurse needs to know their limitations so that they can provide safe care to their patients. Being able to continually develop my skills will ensure that I relate with the aboriginals and Torres Strait Islanders in the right way. Additionally, I will have to be willing to adapt to different areas and cultures. There are very many aboriginal communities some with different cultures. It is thus important to be willing to adapt to improve one’s cultural awareness. It will also be important if I can ask my patients questions and seek feedback. I believe that this is the best way to know my limitations and improve.
UTS indigenous attributes developed during the learning process will also be important in my future practice. I will advocate for and engage the aboriginal and Torres Strait Islander people to reduce the health inequities that are common in most healthcare facilities. I will also observe the nursing ethics and value the diversity of people to ensure culturally safe care. Furthermore, I will exhibit professional cultural competency that is very fundamental to the wellbeing and health of aboriginal Australians. Finally, I will also employ that registered nurse standards of practice such as the provision of safe, appropriate, and responsive quality nursing practice to ensure that my patients achieve safe and quality health outcomes.
Australian Institute of Health and Welfare. (2019). Australia's welfare 2017: in brief, Indigenous Australians - Australian Institute of Health and Welfare. [online] Available at: https://www.aihw.gov.au/reports/australias-welfare/australias-welfare-2017-in-brief/contents/indigenous-australians [Accessed 18 Sep. 2019].
Dudgeon, P., Wright, M., Paradies, Y., Garvey, D. and Walker, I., 2010. The social, cultural and historical context of Aboriginal and Torres Strait Islander Australians. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice, pp.25-42.
Durey, A., 2010. Reducing racism in Aboriginal health care in Australia: where does cultural education fit?. Australian and New Zealand journal of public health, 34, pp.S87-S92.
Gracey, M., 2014. Why closing the Aboriginal health gap is so elusive. Internal medicine journal, 44(11), pp.1141-1143.
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Piller, I., 2016. Linguistic diversity and social justice: An introduction to applied sociolinguistics. Oxford University Press.
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Senior, K. and Chenhall, R., 2013. Health beliefs and behavior: the practicalities of “looking after yourself” in an Australian aboriginal community. Medical anthropology quarterly, 27(2), pp.155-174.
Shawande, M., 2010. Traditional Anishinabe healing in a clinical setting: The development of an Aboriginal interdisciplinary approach to community-based Aboriginal mental health care. International Journal of Indigenous Health, 6(1), p.18.
Stoner, L., Page, R., Matheson, A., Tarrant, M., Stoner, K., Rubin, D. and Perry, L., 2015. The Indigenous health gap: raising awareness and changing attitudes. Perspectives in public health, 135(2), pp.68-70.
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