Central Institute of Technology Cultural Awareness Training

Transcription

1 Central Institute of Technology Cultural Awareness Training Resource Booklet 2012 Kallip Pty Ltd 2010

2 COPYRIGHT: Information presented in this publication may be reproduced in whole or part for study, training purposes and general education subject to the inclusion of acknowledgement of source and provided no commercial usage or sale of material occurs. Reproduction for purposes other than this requires the written permission of Marr Mooditj Health Foundation, Kallip Pty Ltd, Joan Winch and Ken Hayward. Original concept design copyright of Marr Mooditj Foundation INC. Marr Mooditj Foundation INC, Requests for permission should be addressed to Marr Mooditj Foundation INC, 295 Manning Road, Waterford 6152 ORIGINAL DESIGN AND TYPESET BY: Pre-emptive Strike COVER PHOTOGRAPH: Kinship Photo by Nic Duncan ArtyCool Imagery ACKNOWLEDGEMENTS Central Institute of Technology WA acknowledges Marr Mooditj Health College, Joan Winch and Ken Hayward from Kallip Pty Ltd for the developing the material for this booklet. WRITTEN BY: Kallip Pty Ltd Kallip Pty Ltd 2010

3 FOREWORD I welcome you to this cultural awareness workshop. Central Institute of Technology is excited to provide this opportunity to students studying within the Enrolled Nursing and Health Services area. This workshop aims to assist students to improve their knowledge and understanding of the Aboriginal community in which they may work and provide health care. It is by working with the Aboriginal community that barriers to accessing health care can be discussed and solutions planned and implemented. Your interest and participation in the workshop reinforces the importance of everyone working together towards a common goal addressing the inequities that exist for Aboriginal people in our community. Working together is most important however the most relevant action on our part is to learn about Aboriginal Culture. There exists great diversity and variation in life and the lived experience of Aboriginal people is vastly different to most of our students. Enjoy today with an open mind. Thank you Julie Fereday Learning Portfolio Manager Health and Lifestyle Kallip Pty Ltd 2010

4 4. Learning Outcomes 5. Aboriginality Definition 6. Kimberley Regions and Languages 7. Aboriginal Cultural Groups -map CONTENTS HISTORY 8. A Brief History of Aboriginal Affairs in Western Australia 24. Significant Issues and Trends 26. National Aboriginal and Torres Strait Islander Oral Health Action Plan 31. Effects of Government Policy 32. Removal of Children 33. Kimberley History CULTURE 34. Kinship 35. Kimberley Skin Systems 36. Child Rearing 37. Sacred Sites 38. The Dreaming 39. Traditional Medicine KNOWING ABORIGINAL PEOPLE 40. Understanding Aboriginal People 41. Ethnocentrism 42. Aboriginal Terms of Reference 43. General Cultural Comparisons 44. Values of Aboriginal People 45. Sensitivity in Speaking with Aboriginal People and Communicating With Aboriginal People ABORIGINAL HEALTH 47. Traditional Aboriginal Health Concepts and Traditional Healers 48. Causes of Aboriginal Illness 49. Kimberley Aboriginal Medical Service Centre WAYS OF WORKING 50. Nurses in the Field 52. Staff in the Hospital 53. Teaching and learning MAPS AND NETWORKING 54. Maps Aboriginal Communities in Western Australia 55. East Kimberley Contacts 62. Internet Addresses for Australian Aboriginal Issues Kallip Pty Ltd 2010

5 LEARNING OUTCOMES Participants as Members of Society Review your interactions and relationships with Aboriginal people. Gain a greater understanding of interaction between non-aboriginal and Aboriginal Australian individuals, families and groups. Acknowledge your own culture and experiences, in particular, the ways of coping in new cultural situations and enhancing self-recognition of changes in behaviour. Comprehend and gain an appreciation of the effects of life chance. History Learn about Australia Society from Indigenous perspectives within the history of Australia. Relate to the impacts of government policy and the stolen generations, in particular on culture, Indigenous families, and community. Gain an understanding of racism and discrimination Culture Gain an understanding of Aboriginal culture, the importance of law and kinship. Understand the diversity and variation of Aboriginal culture. Discover religious structures and philosophies of Aboriginal society within traditional and contemporary communities. Recognise cultural differences and see where these differences may cause conflict or difficulty, as well as recognising the similarities that make us all human. Communication Acquire information about ways of working in different situations to accommodate local cultures and customs. Learn about the concept of Aboriginal English. Recognise possible barriers in language and communication styles and learn ways to overcome them. Aboriginal Heath Discover how Aboriginal people collect and make bush medicines to treat many ailments. Appreciation of cultural shock and its impact on health and well-being Recognise the factors which contribute to Aboriginal and Torres Strait Islander ill health and common diseases experienced by these groups of people. Working Together for Improved Health Care Knowledge of power relations and its impact on the workplace and communities. Identify strategies to promote and accommodate cultural differences in the workplace. Explore ways to deliver culturally safe and appropriate health care, services and programs. 1

6 ABORIGINALITY DEFINITION An Aboriginal person is a person of Aboriginal descent, Who identifies as an Aborigine and Who is accepted as an Aborigine by the community in which he/she lives Official Government Definition of Aboriginality,

7 Kimberley Region and Languages Picture Courtesy of the Australian Conservation Foundation Pictures by Kerry Trapnell and Justin McCaul 4

8 ABORIGINAL CULTURAL GROUPS The WA Tindale Tribal Boundaries Map is used with the kind permission of DIA 2007, and can be found at please note that this map s boundaries have been corrected by regional groups. 5

9 HISTORY A BRIEF HISTORY OF ABORIGINAL AFFAIRS IN WESTERN AUSTRALIA The following chronology lists the major historical events, government legislative, administrative and policy changes affecting Indigenous people in Western Australia since colonisation. The list refers primarily to State Government matters except when major Commonwealth initiatives have impacted on Indigenous affairs administration in Western Australia Albany settled. This is the first British settlement in Western Australia Colonisation of Western Australia by the British. Governor Stirling establishes the Swan River Colony. The welfare of Aborigines comes under the direct responsibility of the Colonial Secretary Aboriginal Protectors appointed A Superintendent of Tribes was appointed to assist the Colonial Secretary. The first Superintendent was Captain Ellis who died in 1834 from injuries received during his involvement in the massacre of Aboriginal people at Pinjarra Rottnest Island Aboriginal prison established Colonial Government issues direction that Aboriginal people should not be admitted to towns 1854 Role of Protectors temporarily abolished Flying Foam Passage, Nickol Bay killings occurred Royal Commission established to inquire into the treatment of Aboriginal prisoners - the Forrest Report. 5

10 1886 Aborigines Protection Board established under the Aborigines Protection Act. The Board was constituted to provide Aborigines with food and clothing when destitute, provide for the education of Aboriginal children and assist in the preservation and wellbeing of Aborigines. The Board reported directly to the Colonial Secretary. The new Act enabled regulation and control over the entire Aboriginal population in WA Section 70 introduced into the Constitution providing for 1% of gross revenue to be "appropriated to the welfare of the Aboriginal natives" Western Australia attains self-government. British government continues to maintain control over Aboriginal affairs Abolition of the Aborigines Protection Board and establishment of the Aborigines Department under a Chief Protector of Aborigines who was responsible to the Premier Rottnest Island Aboriginal prison officially closed Royal Commission into Aboriginal matters headed by Dr W E Roth, inquired into the administration of the Aborigines Department, the employment of Aborigines, the Aboriginal police system (Police Protectors), the treatment of Aboriginal prisoners and the distribution of relief. The report found many abuses of Aborigines and their rights and recommended the protection of Aborigines by strict controls Aborigines Act (1905) enacted. This gave the Chief Protector the statutory power to institute measures for the relief, protection and control of Aborigines as recommended by the Royal Commission. The Act legalised the removal of Aboriginal children from their natural families; encouraged establishment of reserves and missions; and introduced many restrictive measures ACT The chief prosecutor (AO Neville) was made the legal guardian of all Aboriginal children. The Chief Protector could remove any Aboriginal children from their parent s care and control. No Aboriginal person could marry without the Chief Protector s permission. Any person who wished to employ an Aboriginal person had to have the Chief Protector s permission. The Government had the power to declare prohibited areas for Aboriginal people. Most policemen were made honorary protectors so had wide-ranging powers over Aboriginal people. The Chief Protector had the power to manage the property of all Aboriginal people with their permission or without Royal Commission to inquire into the treatment of Natives by the Canning Exploration Party. Commission headed by C. F. Gale Aborigines Department's name changed to Aborigines and Fisheries. 6

11 1915 Appointment of Mr. Auber Octavius Neville as Chief Protector of Aborigines. Neville was in charge of the various departments responsible for Aboriginal Affairs until his retirement in Carrolup Native Settlement opened Moore River Native Settlement opened 1920 The Department for the North West was responsible for Aborigines living above the 25th parallel and the Department of Aborigines and Fisheries for those below the 25th parallel The Aborigines Department was re-established and became responsible for Aboriginal matters throughout the State The Royal Commission into the Killings and Burning of Bodies of Aborigines in East Kimberley, conducted by Mr. G T Wood, resulted from public outcry over the 1926 Forrest River Massacre Royal Commission into Aboriginal Affairs under Mr. M D Mosely SM established. The Commission inquired into the social and economic conditions of Aborigines; the law relating to Aborigines; the administration of the Aborigines Department; and the specific allegations of ill-treatment of Aborigines As a result of the recommendations of the Royal Commission, the Aborigines Act was amended and became the Native Administration Act (1936). The Aborigines Department became the Department of Native Affairs headed by a Commissioner for Native Affairs. The amendment incorporated the recommendations of the Royal Commission which resulted in greater control of the Aboriginal population, including the imposition of penalties for actions which were not an offence for non-aborigines; the placement of children of Aborigines under the guardianship of the Commissioner; and the imposition of a permit system for entry into certain towns and for employment NATIVE TITLE ADMINISTRATION BILL People of less than quadroon (one-fourth) descent were not allowed to live with people who were classified as natives even if they were related. No Aboriginal person was allowed access to alcohol, and was not permitted in the grounds of any hotel. The Commissioner of Native Affairs was allowed to take any Aboriginal children away from their parents, and place them in an institution to be trained in the ways of white civilisation. All natives still required permission to marry, permits to obtain a job, and permission to travel. The Commissioner of Native Affairs had total control over the lives of all Aboriginal people. The terms native and quadroon were used in the wording of the Acts, and are only used here to illustrate the language used at the time. 7

12 1937 First conference of Commonwealth and State bodies concerned with Aboriginal matters held in Canberra Commonwealth Child Endowment payment extended to children of 'detribalised' parents Commonwealth invalid and old age pensions and maternity allowance extended to Aboriginal people holding 'Exemption Certificates' Natives (Citizenship Rights) Act gave limited rights to Aboriginal people who could prove, among other things that they had adopted a "civilised life" and did not associate with Aboriginal people who did not have citizenship rights. Such 'citizenship', however, could be withdrawn at any time. Commonwealth Unemployment and Sickness Benefits extended to "detribalised natives" living in European conditions First Aboriginal pastoral workers strike in the Pilbara Mr. F Bateman SM was appointed to survey Aboriginal conditions in Western Australia. The Bateman report showed the deplorable conditions in which the Aboriginal population was living and advocated the abandonment of past protective measures in favour of a long-term policy of positive welfare and supported the assimilation of Aboriginal people into the general community. The report resulted in the decentralisation of the Aborigines Department, and the appointment of field officers to deal directly with Aborigines and concomitantly to reduce the Department's dependence on Police Protectors Native Administration Act replaced by the Native Welfare Act, which attempted to overcome the previous policy of strict controls and handouts. Many of the restrictions imposed by the previous Act were repealed. The Department's name changed to the Department of Native Welfare Aboriginal people became eligible to vote. Voting was not compulsory Slow but progressive liberalisation of the regulations affecting Aborigines culminated in the amendment of the Native Welfare Act in which the last restrictive provisions were removed. Some places in the North West, however, were still entitled to restrict the movements of Aborigines and refuse to supply liquor. These clauses were repealed in Commonwealth Referendum. Aboriginal people first granted citizenship rights. Commonwealth Government was given the power to legislate in relation to Aboriginal matters Federal Pastoral Industry Award amendment sanctioned, theoretically allowing for equal wages for equal work. Australian Aboriginal Affairs Council (AAAC), comprising Commonwealth, State and Territory Ministers with responsibility for Aboriginal Affairs, formed Repeal of the Native Welfare Act and the enactment of the Aboriginal Affairs Planning Authority (AAPA) Act. The Department of Native Welfare was abolished and replaced by the Aboriginal Affairs Planning Authority, with some of its functions taken 8

13 over by the newly-created Department of Community Welfare. Rather than having a single department with over-riding responsibilities, housing, health, education employment and welfare programs were channelled to departments such as the State Housing Commission and the Public Health Department. The Authority was established to retain the policy planning, co-ordination, and Ministerial advice and land management roles of the defunct Native Welfare Department. In addition, it provided administrative support to three statutory bodies: the Aboriginal Lands Trust, the Aboriginal Advisory Council and the Aboriginal Affairs Co-coordinating Committee. For the first time a statutory mechanism was in place for Aboriginal people to be involved in the government decision-making process. The Aboriginal Heritage Act was also enacted giving the WA Museum, through the Department of Aboriginal Sites, the responsibility to protect places and objects of significance to Aboriginal people. Whitlam Government provides opportunities for Aboriginal people to advance both economically and socially especially in education and employment A Royal Commission headed by Mr. L C Furnell QC inquired into all matters affecting the well-being of Aboriginal people in Western Australia. Because the AAPA Act and the Authority had only been in existence for 12 months, the report did not consider that any major changes were justified. The report recommended that the most desirable policy towards Aborigines would be to preserve as much tribal Aboriginal identity as possible along with assisting the integration of non-tribal Aborigines. The report affirmed the existing policy of consultation and Aboriginal involvement in decision-making and that Aboriginal communities should be self-managing and able to choose their own manner of living. National Aboriginal Consultative Committee (NACC) established. Perth Aboriginal Medical Service commenced - Bill Forrest, Director 1974 The Federal Labor Government announced its intention of taking on greater responsibility in Aboriginal affairs throughout Australia. As a consequence, following discussions with the Western Australian Government, the AAPA Act was amended and a merger took place between the Authority and the Federal Department of Aboriginal Affairs (DAA). The Commonwealth became responsible for the administration of the AAPA Act Laverton Royal Commission inquired into the 'Skull Creek Incident' between Aboriginal people and police. The Commission concluded that no-one involved acted improperly despite allegations of assault made by Aboriginal people and "unsatisfactory evidence" from police National Aboriginal Conference (NAC) established as a result of a restructure of the NACC. This established the first Aboriginal elected body with direct access to government Aboriginal Communities Act was proclaimed, allowing certain Aboriginal communities to manage and control community affairs. 9

14 1980 The Noonkanbah dispute highlighted the administrative difficulties of the State/Commonwealth merger since officers were required to implement the policies of both the State and Commonwealth Governments, which at times differed. In addition, an expectation was developing within the Commonwealth that the States should resume more responsibility in Aboriginal affairs. The Aboriginal Heritage Act was amended in 1980 in response to uncertainty and disputes (particularly at Noonkanbah), which had occurred in recent years over Aboriginal sites. The amendments tightened the definition of an Aboriginal site, removed a penalty provision and gave the responsible Minister the power to give approval to disturb an Aboriginal site Newly-elected State Labor Government instituted the Aboriginal Land Inquiry, headed by Mr. Paul Seaman, Q.C. The inquiry was established to make recommendations to the Government "for a scheme of legislation for land-related measures for the benefit of Aboriginal people" in Western Australia In July 1984 the formal arrangements by the Commonwealth Government had responsibility for administering the AAPA Act was repealed. The AAPA became independent of the Commonwealth Department of Aboriginal Affairs. The AAPA also became responsible for administering the Aboriginal Communities Act, The Report of the Aboriginal Land Inquiry was submitted to the Government in September The Aboriginal Land Bill was presented to State Parliament and defeated in the Legislative Council. National Aboriginal Conference disbanded For the first time since 1972 a separate Aboriginal Affairs portfolio was created in Western Australia. The Hon Ernie Bridge, MLA, became the first Aboriginal Member of Parliament to be appointed to Cabinet when he became Minister for Aboriginal Affairs. In December 1986 Ms Sue Lundberg was appointed Commissioner for Aboriginal Planning, thereby becoming the first Aboriginal person to head a State Department in Western Australia. Following the failure of the Aboriginal Land Bill and the Commonwealth Government's decision not to introduce uniform land rights legislation, the State and Commonwealth Governments entered into an agreement in support of land initiatives within the terms of existing legislation. $100m was allocated over 5 years ($10m per year per government) for the Aboriginal Communities Development Program (ACDP) On 16 October 1987 the Royal Commission into Aboriginal Deaths in Custody 10

15 was established jointly by the Commonwealth, State and Territory Governments. The Commission investigated the deaths of 99 Aboriginal and Torres Strait Islander people in the custody of police, in prison or in juvenile detention institutions between 1 January 1980 and 31 May In November 1987, the State Ministers for Aboriginal Affairs, Police and Corrective services established an Interim Inquiry into Aboriginal Deaths in Custody in Western Australia. The Inquiry was chaired by Mr. Phillip Vincent and was required to present an interim report by January Commonwealth Government launched the Aboriginal Employment Development Policy to assist Aboriginal people to achieve equity with other Australians in terms of employment and economic status. The policy was established as a result of the Miller Report (Review of Aboriginal Employment and Training Programs) and aimed to promote Aboriginal economic independence from Government and to reduce Aboriginal dependency on welfare in accordance with their traditions, chosen way of life and cultural identity. In December, the Ministers for Aboriginal Affairs and Health co-chaired the first national meeting of a joint Ministerial Forum on Aboriginal Health. This forum agreed to establish a working party to develop a National Aboriginal Health Strategy On 21 January 1988, 32 recommendations from the WA Interim Inquiry, or Vincent Report', were submitted to Government. This report lead to the introduction of the Aboriginal Visitors Scheme. The Royal Commission into Aboriginal Deaths in Custody produced an interim report, also known as the 'Muirhead Report'. On 1 March 1988, the Aboriginal Lands Trust, a statutory body under the Aboriginal Affairs Planning Authority Act, became a sub-department of the AAPA. The Bill to establish the Aboriginal and Torres Strait Islander Commission (ATSIC) introduced into Federal Parliament Royal Commission appoints Patrick Dodson as Commissioner for Western Australia to consider "underlying issues" for Aboriginal deaths in custody. The National Aboriginal Health Strategy was finalised in March 1989 but unfortunately was never fully utilised. In May 1989, State Cabinet approved the establishment of a Cabinet Sub-Committee on Aboriginal affairs. The Aboriginal Lands Trust was reabsorbed into the AAPA. Mr. Cedric Wyatt appointed Commissioner for Aboriginal Planning 1990 The Aboriginal and Torres Strait Islander Commission commenced official operation on 5 March It is Australia s principal, democratically elected Indigenous organisation. Aboriginal Visitors Scheme established on a permanent basis. Inquiry into Service and Resource Provision to Remote Communities conducted by Mr. Peter Alexander examined the delivery of services in remote areas. 11

16 1991 Final 'Alexander Report' presented to State Government. The report highlighted the need to improve communication systems for remote communities and made a number of recommendations aimed at improving planning and co-ordination for better safety in remote and emergency situations. On 9 May 1991, the final Report of The Royal Commission into Aboriginal Deaths in Custody was tabled in State and Federal Parliaments. The Royal Commission made 339 recommendations aimed largely at addressing the disadvantaged position of Aboriginal people in society, which the Commission found to be the most significant factor contributing to the over-representation of Aboriginal people in the criminal justice system and the principle reason for the large number of Aboriginal deaths in custody. The Royal Commission stressed the need to empower Aboriginal society and Aboriginal people s right to self-determination. The State Government announced a special Royal Commission Cabinet Sub-Committee. The Statutory Aboriginal Advisory Council was restructured to establish formal links with the Aboriginal and Torres Strait Islander Commission and to represent a wide range of Aboriginal special interest groups. In August 1991, both houses of Federal Parliament unanimously passed the Council for Aboriginal Reconciliation Act establishing a Council of 25 members. The State Tripartite Forum on Aboriginal Health was formed to bring together the key agencies and health providers in government and community health care On 31 March 1992, Commonwealth and State Governments tabled a cooperative National Response and individual State responses to the recommendations of the Royal Commission into Aboriginal Deaths in Custody. The State Government indicated its full, qualified or in-principle support to all 339 recommendations. The Aboriginal Advisory Council established a special Royal Commission Reference Group chaired by ex-royal Commissioner Mr. Pat Dodson. An Aboriginal Women's Task force was formed as a reference group to the Aboriginal Advisory Council to provide advice to the Authority and to the Minister on matters affecting Aboriginal women and families. The Commissioner for Aboriginal Planning was appointed Chairperson of the State Tripartite Forum. A State Aboriginal Health Strategic Plan was developed. The Commissioner for Aboriginal Planning appointed Chairperson of an Aboriginal Education Strategic Planning Group. The Group was formed under the auspices of the National Aboriginal Education Policy. State Government gave approval for the reorganisation and regionalisation of the Department of Aboriginal Sites in line with the recommendations of a Public Service review of the Department. On 3 June 1992 the High Court handed down its decision in the Mabo v Queensland case. The decision rejected the doctrine that Australia was 'terra nullius' (land belonging to no-one) at the time of settlement with its implication that absolute ownership of land at that time vested in the Crown. Instead, the Court held that the common law of Australia recognises a form of traditional native title. 12

17 In December 1992, the State Government tabled a progress report on the implementation of the recommendations of the Royal Commission into Aboriginal Deaths in Custody. Also in December 1992, the Council of Australian Governments endorsed a National Commitment to Improved Outcomes in the Delivery of Programs and Services for Aboriginal Peoples and Torres Strait Islanders. The major purpose of the National Commitment was to provide a framework for co-ordinated intergovernmental action to redress Aboriginal inequality and disadvantage, confirm the national commitment to established common objectives and that the planning and provision of government programs and services is a shared responsibility across all levels of government. Bilateral agreements are to be entered into between governments for the delivery of specific programs and services. The development of agreements in the areas of housing and health will commence in In April the Aboriginal plan 1993 was published by the AAPA and released by the Coalition Government under Premier Richard Court and Minister for Aboriginal Affairs the Hon Kevin Minson. This was the first time a plan had been produced which provided a clear statement of State Government programs in Aboriginal affairs, listed the departments responsible for them, and the financial resources provided for their implementation. ATSIC legislation was amended in June and provided for a reduction in the number of Regional Councils from 60 to 36 and for Council chairpersons to be appointed on a fulltime basis. Regional Council boundaries were altered at the same time and there are now nine Regional Councils operating in Western Australia. The Social Justice Task Force (SJTF) was established in August to review activities of Government in relation to social conditions and the advancement of Aboriginal people. The AAPA provided information resources, support and assistance in co-coordinating consultation with Aboriginal communities across the State. The Land (Titles and Traditional Usage) Act came into force on 2 December. The Act replaced native title with rights of traditional usage of Crown land and provided for a system of objection, appeal and/or compensation if those traditional usage rights were extinguished or interfered with through the granting of other forms of title to land. In December the Implementation report of the Royal Commission into Aboriginal Deaths in Custory was tabled in State Parliament. Western Australia is the only government to date that has tabled a formal and detailed progress report on the implementation of the Royal Commission's recommendations In April the Report of the Task Force on Aboriginal Social Justice (known as the Daub Report ) was presented to the Government. The Task Force report made 296 recommendations. The major issues considered and recommendations developed by the Task Force can be categorised into three themes: Better management Better lives Better community support On 1 November the Aboriginal Affairs Department was created in response to the recommendations of the Premiers Task Force on Aboriginal Social Justice. It incorporates the roles of the former Aboriginal Affairs Planning Authority, the Department of Aboriginal Sites and Office of Traditional Land Use. The Department s role in 13

18 planning, coordination, target setting and monitoring outcomes in Aboriginal affairs across Government was strengthened. Mr. Cedric Wyatt was appointed the first Chief Executive Officer of the Aboriginal Affairs Department. In November State Cabinet confirmed the transition from interim status to full recognition of the role and functions of the Aboriginal Justice Council. In December three reports were released on the implementation of the recommendations of the Royal Commission into Aboriginal Deaths in Custody Government of Western Australia Implementation Report 1994 vol.1; Aboriginal Contact with the Criminal Justice System in Western Australia vol.2; and Getting Strong on Justice 1995 On March 16, the High Court of Australia handed down its decision on Native Title. As a result of this decision the provisions of the WA Land (Titles and Traditional Usage) Act and sections of the Mining and Land Acts relating to the rights of traditional usage became inoperative. Land and mining titles over most of WA are now processed through the Federal Tribunal system. In June the WA Government s Chief Executive Working Party on Essential Services to Aboriginal Communities under the Chairmanship of Dr Kim Hames MLA published its report. The recommendations in the report have been used as a basis for a review of services and proposals for new legislation. In June, the Human Rights and Equal Opportunity Commission (HREOC) launched its Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families. The Aboriginal Affairs Department s seven regional offices were opened in July. The Commission of Elders was established with representatives drawn from each of the seven regions. The AAD gives secretariat support and assistance to the Elders. The process of setting up regional Aboriginal Justice Councils commenced. The first ones were established in the Pilbara, the Metropolitan region, the Goldfields and the Murchison / Gascoyne In March the State presented its submission to the HREOC Inquiry. In April the Aboriginal Lands Trust Review Team, which was chaired by Mr. Neville Bonner, released its report Review of the Aboriginal Lands Trust. To improve coordination and planning of essential services to discrete Aboriginal communities, the AAD was closely involved in a joint project with ATSIC to ensure remote Aboriginal communities develop town plans. To foster better across-government planning and coordination in remote Aboriginal communities, demonstration projects totalling $3 million were launched in Ommbulgurri in the East Kimberley and Jigalong in the Pilbara. In December the Wik High Court judgement was handed down. Four of the seven judges held that a pastoral lease did not necessarily extinguish native title that in some cases some native title rights can survive the grant of the lease. 14

19 1997 The Legislative Review Reference Group report Provision of services to Aboriginal people in Western Australia an action plan and proposed legislation was released in January In May the HREOC Inquiry brought down its findings in its report Bringing them home: a guide to the findings and recommendations of the National Inquiry into the separation of Aboriginal and Torres Strait Islander children from their families. Immediately following the release of the report, the Premier, on behalf of the State and Parliament, formally offered an apology to Aboriginal people affected by past Government policies and practices for the removal of Aboriginal children from their families and communities. In July the AAD completed a restructure to reflect more closely its functions and responsibilities. In December Cedric Wyatt resigned and Hayden Lowe was appointed as the new Chief Executive Officer of Aboriginal Affairs Department In January a restructure of the Agency began. The Department identified three key roles to achieve the Government s desired outcomes. To assist Aboriginal people to access services and facilities available to the community at large. To facilitate the co-ordination of the operations of mainstream agencies to ensure equitable access to their services by Aboriginal people; and To play a key role in support of Aboriginal people in matters of land, heritage and culture. In March the Royal Commission into Aboriginal Deaths in Custody 1997 Implementation Report was presented to Government. The Premier announced the opening of sixteen regional offices of Aboriginal Affairs Department. May 26 th Sorry Day. This date was chosen as it was a year to the day since the tabling in Parliament of the HREOC report and it was the 30 th Anniversary of the Referendum. In July the Native Title Amendment Act 1998 was introduced. This act implemented the Government s 10 Point Plan in response to the High Court s decision in the Wik case. In November the WA Government s Response to the Report of the National Inquiry into the separation of Aboriginal and Torres Strait Islander Children from their families Bringing them Home report was released In June the Aboriginal Justice Council (AJC) released its 1998 Monitoring Report Our Mob, Our Justice: Keeping the vision alive on the Implementations of the Recommendations of the Royal Commission into Aboriginal Deaths in Custody in WA. In July the Minister for Aboriginal Affairs launched the Aboriginal Heritage Management System. Utilising the latest technology, the system has been developed and implemented to provide information to developers whilst respecting the confidentiality of Aboriginal heritage and cultural sensitivities. As part of the 1999 International Year of Older Persons celebrations and to acknowledge the importance of Aboriginal Elders, AAD and Office of Seniors Interests published Messages for our children: a selection of oral histories from Aboriginal Elders. 15

20 In December the remote Kimberley Community of Pandanus Park made history when it became the first reserve to be handed over under the State Government s Land Transfer Program. The Aboriginal Affairs Department regional expansion program saw five new regional offices open during the year Armadale, Mirrabooka, Broome, Newman and Narrogin AAD continued to boost local presence across the State with regional offices opening in Laverton, Katanning, Merredin, Fitzroy Crossing and Meekatharra. In January, AAD released its Five Year Business plan Delivering better outcomes for Aboriginal people. In April AAD s Heritage Management System won the Government Technology Productivity Silver Award in Canberra. A Memorandum of Understanding between the Eastern Guruma people and Hamersley Iron was signed on future mining activities that protect Aboriginal culture in the region. In August WA s first Stolen Generation conference Healing Within was held in Geraldton and attended by people from all over the state. In December, the dedication took place in Kings Park of Australia s first State war memorial for Aboriginal and Torres Strait Islander people In February, Labor gained power and newly-elected Kimberley Labor MLA Carol Martin became the first Aboriginal woman in WA Parliament. In July DIA launched the video My Body Belongs to Me, which was prepared by a group of Aboriginal women and men from across WA. The video is designed to help raise awareness of sexual abuse in Aboriginal communities. In September, the Yungunora people were presented with the deeds to 260 hectares of freehold land. The Nookanbah pastoral lease is the first freehold property in the West Kimberley to be handed over under the State Government s land Transfer program. October. A statement of commitment to a new and just relationship between the Government of Western Australia and Aboriginal Western Australians was signed. Parties to the agreement ATSIC State Council supported by Aboriginal Peak Bodies Richard Curry was confirmed as Director General of the Department of Indigenous Affairs. In June the Tindale Journals, significant historical records collected by the late Norman Tindale, were returned to their rightful owners. These journals date back to the beginning of last century. They are housed in the DIA Family History Unit. A joint communiqué between the State and Federal Governments and ATSIC issued which should pave the way for a genuine improvement in the level of coordination and partnerships between Aboriginal people, government and the business community. Department of Indigenous Affairs Library Information Paper October

21 2002 THE STATEMENT OF COMMITMENT TO A NEW AND JUST RELATIONSHIP WITH INDIGENOUS WESTERN AUSTRALIANS 2002 On October 2002 the Premier signed the statement to commit the Government to work collaboratively and to work in partnership with Indigenous community. To deliver this commitment the Government will support the development of regional and local agreements. These agreements are developed in partnership with the community and with stakeholders at the National, State and Local level. Department of Indigenous Affairs (DIA) is working to support effective engagement with the Indigenous community. To obtain more information about the statement and DIA s strategies and priorities to ensure the process of change occurs effectively refer to the DIA website: LOST LANDS REPORT Over a number of years, many Aboriginal people have expressed a desire for Government to undertake a review of lands in Western Australia which were once reserved for Aboriginal use but, for one reason or another, are no longer part of the Aboriginal estate. The Lost Lands Report attempts to identify all lands originally set aside for Aboriginal use and benefit but which are no longer available and also provides an informative account of the changing legislative, administrative and social contexts of these reserves. Download a copy from the DIA website: REGIONAL INITIATIVES, PARTNERSHIPS AND AGREEMENTS Regional partnerships Regional Partnership Agreements (RPA) are a Commonwealth instrument to provide targeted assistance to Indigenous people for employment and other requirements. RPAs are delivered through a process of cooperation and are not legally binding on the parties that form the partnerships. DIA is the principal coordinator of the state s involvement in RPAs, linked to Indigenous people and their communities. In 2007/08 a number of partnerships continued or were formed with Government and nongovernment partners. These include: The Ngaanyatjarra RPA, signed on 12 August 2005 and concluded on 30 June 2008, provided a strategic approach for joint innovative action with the Commonwealth Government and othe Indigenous linked partners to jointly work on service delivery and planning outcomes to support the 12 Ngaanyatjarra Lands communities. The RPA attached to the trial sites flowing from the MoU between the Minerals Council of Australia and the Commonwealth Government were signed in June The MoU created a set of high-level principles to work with Indigenous people to build sustainable, prosperous communities. 17

22 2006 DEPARTMENT OF INDIGENOUS AFFAIRS STRATEGIC PLAN VISION A society where there is equality, mutual respect and understanding between Indigenous and non-indigenous people. MISSION To close the gap between the social, cultural and economic well-being of Indigenous and non-indigenous people through strategic leadership of land heritage and culture, and whole of government coordination of Indigenous issues STRATEGIC OBJECTIVES DIA s strategic objectives are targeted to achieve a society where there is equality, mutual respect and understanding between Indigenous and non-indigenous people. DIA s strategic objectives are: To lead and influence the development of policy, planning and improved delivery of services to Indigenous people in Western Australia; To promote Reconciliation and respect for Indigenous history, heritage and culture; and To manage and protect places of significance to Indigenous people in Western Australia and manage the ALT estate. To achieve these objectives, DIA: Fosters relationships that promote the State Government s Statement of Commitment to a New and Just Relationship with Indigenous people; Advises Government on the strategic management of its Indigenous affairs policies; Advises Government on its progress in achieving Indigenous affairs goals; Works with key agencies to achieve reforms in legislative, policy and planning and budgeting systems; Promotes awareness and appreciation of Indigenous culture, history and contemporary issues; Delivers services in land, heritage and culture, community patrols and community engagement; and Develops and promotes agreement and partnerships that address service inequities. REGIONAL OPERATIONS Signed an MoU with the Commonwealth Government for a contribution of $20 million for the construction, over three years, of MFPFsin Blackstone, Burringurrah and Looma and for visiting officers accommodation at Bidyadanga. Created the position of Government Services Coordinator, Fitzroy Crossing. Provided funding to external organisations in the East Kimberley for: 1. Governance Support Oombulgurri, Kalumburu and Warmun; 2. Community Capacity Builder Balgo; 3. Government Services Manager Oombulgurri; 4. Wunan Foundation working with the community councils at Oombulgurri, Kalumburu and Warmun; and 5. A Community Capacity Builder working at Balgo where a new council has been elected. Coordinated the State s involvement in the continued implementation of the Port Hedland, 18

23 East Kimberley and Ashburton/Roebourne Regional Partnership Agreements (RPA). Contributed to the restructure of the East Kimberley RPA to better reflect local needs and constraints. Concluded the three-year Ngaanyatjarra RPA centring on the Ngaanyatjarra Lands and began negotiations on a new agreement. Committed to the Wiluna partnership to renegotiate and restructure the Wiluna RPA to reflect the wishes of the local community as well as mining and Local Government interests. The Hedland RPA exceeded its employment targets. Provided a total of $175,000 to fund Mapping and Gap Analysis (MAGA) projects in the South-West region; the Wheatbelt region; and the joint Shires of Laverton and Leonora. The draft Leonora/Laverton MAGA was completed in March Supported Indigenous patrols operating in 19 locations throughout the State. Provided assistance and support to the Derbarl Yerrigan Committee for the reburial of Yagan s Kaat in partnership with the City of Swan and other key stakeholders. Assisted in capacity development and governance support with Burringurrah and Mungullah communities. These activities were supported by the National Seniors Partnership Volunteer Program (INSTEP) which has supplied volunteers in the Murchison/Gascoyne region since April This partnership between DIA, the communities and INSTEP will continue in 2008/09. Formed the Broome Indigenous Visitors Strategy Steering Committee and completed the subsequent survey. Commenced the Balgo Capacity Builder initiative. This included the establishment of the Balgo Advisory Council and identification of training needs. POLICY COORDINATION Bilateral Agreement on Indigenous Affairs DIA and the Commonwealth Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) jointly coordinate the implementation of the Bilateral Agreement on Indigenous Affairs. The agreement - signed by the Prime Minister and the Premier of Western Australia in July aims to improve and streamline services to Indigenous people. It has six key outcome areas: Law and order and safe places for people; Skills, jobs and opportunities; Healthy and strong people; Sustainable environmental health and infrastructure; Land, sea and culture; and Strong leadership and governance. During 2007/08, DIA has worked with relevant State agencies to establish six Senior Officer Groups. These groups address each of the agreement s key outcome areas. To date, four of the Senior Officer Groups have produced action plans, subsequently endorsed by DGGIA. The remaining two groups continue to develop their plans. The Senior Officer Groups report to the DGGIA quarterly on progress against the plans. 19

24 2007 Stolen Wages In May 2007, the Government established a Stolen Wages Taskforce to examine and prepare advice and policy options relating to the nature and extent of stolen wages in Western Australia. The taskforce included representatives from DIA, DPC, DTF and the Departments of Culture and the Arts, Communities, Child Protection, and the Minister for Indigenous Affairs Policy Officer. In addition, six Aboriginal and Torres Strait Islander advisors were engaged by the taskforce to provide cultural and ethical guidance and support to ensure the cultural integrity of the taskforce s work. The term Stolen Wages refers to wages, savings, entitlements and other monies that Aboriginal and Torres Strait Islander people may have had controlled by Government in Western Australia between 1905 and These controls occurred during times where Government policy and administrative practice allowed extensive controls over the lives, employment and money of many Aboriginal people. In accordance with the taskforce s terms of reference, a project team undertook archival research to understand the nature and scope of Government controls of Aboriginal people s money in Western Australia, including policy analysis for the development of options to address the issue. Extensive public consultation involved 62 community meetings with Aboriginal people in 58 towns and communities throughout the State. Over 500 written and oral submissions were also received. Consultations were also undertaken with Aboriginal organisations, State and Commonwealth Government agencies and other relevant groups. The information provided about the systems of Government controls over Aboriginal people s money and the impact of the system on Aboriginal people s lives, assisted the taskforce to understand the nature and extent of the issue in Western Australia and to shape recommendations and policy options for the Government to consider. The completed report of the taskforce has been submitted to the Minister for Indigenous Affairs for consideration before submission to Cabinet. 20

25 SIGNIFICANT ISSUES AND TRENDS The reform agenda of COAG, in cooperation with Western Australia, will provide an opportunity for leadership and the foundation for achieving real and sustainable improvements to Indigenous outcomes with clear targets and goals. The State s strong resource economy requires an appropriate balance between protection of Indigenous heritage and demand for access to land for development and community infrastructure. The department has a legislative responsibility for the protection of Indigenous heritage and is achieving this balance through the participation of Indigenous people in decision making and by monitoring compliance to decisions granted under the Aboriginal Heritage Act The Commonwealth Government s formal apology to the Stolen Generations has created a greater appreciation of Indigenous history, heritage and culture and has led to the development and implementation of reconciliation initiatives. This will be a key focus in ensuring that the richness of Indigenous heritage is respected and that issues arising from past policies are addressed. Following completion of the functional review process, a reform agenda to re-position the department s role has commenced. This renewed focus will see a significant leadership role for the agency, strengthening the mandate and outcome areas of Indigenous specific services and a commitment to deliver appropriate services to Indigenous Western Australians by harnessing investment and implementing accountability mechanisms. Western Australia s Indigenous population is estimated at about 60,000 people and makes up 3 per cent of the State s total population. The Indigenous population is a relatively young population compared with the State s non- Indigenous population. About half of the Indigenous population is 25 years or younger, compared with 33 per cent of the non-indigenous population. Western Australia s Indigenous population is also culturally diverse. Some 15 per cent of the population speaks an Indigenous language. More than 50 different Indigenous languages were recorded in the 2006 census. Indigenous Western Australians are also more geographically dispersed than non- Indigenous Western Australians, with almost one-quarter (24 per cent) of the population living in the most remote parts of Western Australia, compared with just one per cent of the State s non-indigenous population. Another distinct feature of Western Australia s Indigenous population is that some 17,000 people are estimated to live in discrete Aboriginal communities. There are an estimated 280 discrete communities in Western Australia ranging from small outstations to large town-sized settlements. This is significant when one considers that the number of Indigenous people living in the Perth metropolitan region is close to 30,000. This diverse range of social and economic needs and geographic dispersal of Indigenous people in the State requires varied and specific policy and service delivery responses. Key statistics describing the continuing disadvantage of Indigenous people reflect the complexity of Indigenous affairs and the urgent need for commensurate action. While there are areas showing some improvements, the gap between Indigenous and non-indigenous people in Western Australia remains significant. 21

26 Mortality rates for Indigenous Western Australians are significantly worse than those for the average Australian. On average Indigenous Western Australian men die 19 years earlier than their non-indigenous counterparts. The figure for Western Australian Indigenous women is 16 years. Some progress is being made in improving rates of Indigenous infant mortality, with the rate decreasing from 16.9 deaths per 1000 live births in to 12.9 deaths per 1000 live births in This rate is still very high compared with the non-indigenous rate of 4.5. The proportion of Indigenous people (aged 15 years and over) living in homes owned or being purchased by a household member has deteriorated from 20.9 per cent in 2002 to 16.9 per cent in 2004/05. Overcrowding has worsened with the proportion of Indigenous people living in overcrowded houses increasing from 25.1 per cent in 2002 to 28.8 per cent in 2004/05. Apparent educational retention rates are improving. Indigenous students staying in school to Year 10 has increased from 90 per cent in 2002 to 97 per cent in The retention rate to Year 12 increased from 25 per cent to 31 per cent for the same period. In 2007, results from Year 3, Year 5 and Year 7 benchmark testing still showed Indigenous students having significantly lower literacy and numeracy achievement rates than non-indigenous students. The rate of imprisonment for Indigenous males increased from 4,463 per 100,000 adult population in 2002 to 6339 in 2006, a 20 per cent increase. Likewise the imprisonment rate for Indigenous women increased from 366 to 631 per 100,000 adult population, a 34 per cent increase. There has been some reduction in juvenile detention rates, with rates decreasing from 623 per 100,000 juvenile population in 2001 to 555 per 100,000 juvenile population in However, this is still significantly higher than the non-indigenous juvenile detention rate; with the latest data showing the Indigenous rate to be 44 times more than the non- Indigenous rate. Picture Courtesy of Australian Conservation Foundation Picture taken by Kerry Trapnell and Justin McCaul 22

27 National Aboriginal and Torres Strait Islander Oral Health Action Plan Commonwealth Department of Health and Ageing 2003 ACTION AREA SIX: ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLES The broad population health measures set out in Action Area One (see page 15) are basic to improving the oral health of Aboriginal and Torres Strait Islander peoples, and provide the context for the targeted actions set out below. Outcomes Good oral health for Aboriginal and Torres Strait Islander peoples, commensurate with that of the overall Australian population, which supports good health and quality of life; achieved in culturally supportive ways through: enhanced understanding of Indigenous health issues in the community; Collaborative approaches to oral health planning and delivery; improved public health measures that address oral health; Local and timely access, according to need, to affordable, culturally appropriate dental care; and improved collection, quality and dissemination of oral health information about Aboriginal and Torres Strait Islander people. National Action Implement the National Aboriginal and Torres Strait Islander Oral Health Action Plan (Commonwealth Department of Health and Ageing 2003), including the following actions: In the short term (over the next 2 years) 6.1 Support the proposal to include under Medicare a biennial adult health assessment for Aboriginal and Torres Strait Islander peoples, which includes an oral examination. 6.2 Provide culturally appropriate and accessible oral health services through: partnerships between Indigenous-specific and mainstream health services at a regional level; provision of patient-assisted transport schemes; increasing the proportion of mainstream dental services that provide culturally appropriate services. See also: 1.2 (page 15) Extend fluoridation of public water supplies 7.4 (page 38) Improve recruitment and retention of oral health professionals in public dental services 7.8 (page 39) Develop and implement programs, including dedicated student places and scholarships In the medium term (over the next 5 years) 6.3 Increase oral health promotion activity for Aboriginal and Torres Strait Islander peoples by: 23

28 developing strategies targeting Aboriginal and Torres Strait Islander oral health, both as stand alone and integral to other health promotion activities (eg diabetes, cardiovascular disease, tobacco and alcohol control, nutrition); improving access to oral hygiene materials (toothbrushes, tooth paste, floss); improving access to a nutritious and affordable food supply 6.4 Foster the integration of oral health within health systems and services, particularly with respect to primary health care, by: Inclusion of oral health into health check guidelines for well people, and recall mechanisms for people with chronic illnesses integrating oral health into relevant Aboriginal and Torres Strait Islander health policy 6.5 Improve the collection and quality of oral health information on Aboriginal and Torres Strait Islander people by: developing an agreed national Indigenous oral health data set; consolidating existing data on oral health; regular, standardised collection and dissemination of oral health data In the long term (ongoing up to 10 years) 6.6 Consistent with the National Aboriginal and Torres Strait Islander Workforce National Strategic Framework, increase the oral health workforce available to improve the oral health of Aboriginal and Torres Strait Islander people by: increasing the number of Aboriginal and Torres Strait Islander people working across the oral health professions, including provision of scholarships for Aboriginal and Torres Strait Islander students; clarifying roles and recognising Aboriginal and Torres Strait Islander health workers as a key component of the oral health workforce; addressing the role and development needs of the oral health workforce contributing to Aboriginal and Torres Strait Islander health; Improving training, recruitment and retention measures for oral health staff working in expanding the role of dental therapists, dental hygienists and oral health therapists Rationale Traditionally, Aboriginal and Torres Strait Islander peoples experienced good oral health, with minimal oral diseases. With the change in lifestyle and dependence on new introduced foods, oral diseases are now common in most Aboriginal and Torres Strait Islander communities, comprising one aspect of the many serious health problems experienced by Aboriginal and Torres Strait Islander peoples. Aboriginal and Torres Strait Islander peoples comprise 2.4 percent of the total Australian population, based on 1996 Census figures, with almost 26.5 percent living in areas classified as rural and remote, compared to 2 percent of the total population (ABS and AIHW 2003). Compared to the overall Australian population of similar age, among Aboriginal and Torres Strait Islander peoples: children generally have more than twice the caries experience and a greater proportion of untreated caries; adults have more missing teeth; andperiodontal health is worse, with poor periodontal health evident in younger populations. 24

29 In 2002, a workshop was held on Aboriginal and Torres Strait Islander Oral Health, under the auspices of the National Aboriginal and Torres Strait Islander Health Council and the Standing Committee of Aboriginal and Torres Strait Islander Health. The National Aboriginal and Torres Strait Islander Oral Health Action Plan developed at that workshop (Commonwealth Department of Health and Ageing 2003) is a major step towards addressing the oral health needs of these populations, and forms the basis of this Healthy Mouths Healthy Lives Action Area. Risk factors: Oral health in Aboriginal and Torres Strait Islander communities, particularly in rural and remote locations, is affected by factors that operate from infancy through to old age, including water quality and fluoridation, diet, smoking, alcohol consumption, stress, infection, the cost and availability of oral hygiene items, the availability of dental services, and transport over distance to those services that exist. Emerging evidence indicates that oral conditions share common risk factors with other diseases and that poor oral health occurs simultaneously with a range of chronic diseases. The recent report from the Australian Health Ministers Advisory Council (AHMAC) on oral health identifies associations between oral diseases and cardiovascular disease, cerebrovascular disease, diabetes, preterm and low birth weight babies, aspiration pneumonia, blood-borne disease, infective endocarditis, otitis media, Aboriginal primary health services; and nutritional deficiencies in children and older adults. A number of these conditions notably diabetes and cardiovascular disease contribute to the poor health status of Aboriginal and Torres Strait Islander peoples, and comorbidity with oral disease is common. In 1995, the reported rate of diabetes was four times higher among Indigenous people aged 15 years and over than for the general population; and the differential were substantially greater among those under 55 years (AIHW 2002a). Life expectancy: Many Aboriginal and Torres Strait Islander people do not reach older age in conventional terms with a life expectancy some 20 years less than the Australian average. Poor oral health contributes to this reduced life expectancy as well as to quality of life. Workforce: Recruitment and retention of oral health practitioners, including Indigenous providers, is becoming increasingly difficult in rural and remote regions, where a substantial proportion of Aboriginal and Torres Strait Islander people live. Experience across Aboriginal and Torres Strait Islander health emphasises the importance of involving Indigenous practitioners in health care delivery. There is also a need for non-indigenous workers to be trained to meet the needs of Aboriginal and Torres Strait Islander people. Principles for action The National Aboriginal and Torres Strait Islander Oral Health Action Plan (Commonwealth Department of Health and Ageing 2003) is based on nine principles outlined in the National Strategic Framework for Aboriginal and Torres Strait Islander Health: 25

30 Cultural respect: ensuring that the cultural diversity, rights, views, values and expectations of Aboriginal and Torres Strait Islander peoples are respected in the delivery of culturally appropriate services. A holistic approach: recognising that the improvement of Aboriginal and Torres Strait Islander health status must include attention to physical, spiritual, cultural, emotional and social well-being, community capacity and governance. Health sector responsibility: improving the health of Aboriginal and Torres Strait Islander individuals and communities is a core responsibility and a high priority for the whole health sector. Making all services responsive to the needs of Aboriginal and Torres Strait Islander people will provide greater choice in the services they are able to use. Community control of primary health care services: supporting the Aboriginal community controlled health sector in recognition of its demonstrated effectiveness in providing appropriate and accessible health services to a range of Aboriginal communities and its role as a major provider within the comprehensive primary health care context. Supporting community decision-making, participation and control as a fundamental component of the health system that ensures health services for Aboriginal and Torres Strait Islander people are provided in a holistic and culturally sensitive way. Working Together: combining the efforts of government, non-government and private organisation within and outside the health sector, and in partnership with the Aboriginal and Torres Strait Islander health sector, provides the best opportunity to improve the determinants of health. Localised decision-making: health authorities devolving decision-making capacity to local Aboriginal and Torres Strait Islander communities to define their health needs and priorities and arrange for them to be met in a culturally appropriate way in collaboration with Aboriginal and Torres Strait Islander specific and mainstream health services. Promoting good health: recognising that health promotion and illness prevention is a fundamental component of comprehensive primary health care and must be a core activity for specific and mainstream health services. Building the capacity of health services and community: strengthening the existing health services and building community, expertise to respond to health needs. Thus take responsibility for health outcomes. This includes effectively equipping staff with appropriate cultural knowledge and clinical expertise, building physical, human and intellectual infrastructure, and fostering leadership, governance and financial management. Accountability for health outcomes: this includes accountability for services provided and for effective use of funds by both Community Controlled and mainstream services. Governments are accountable for effective resource application through long-term funding and meaningful planning and service development in genuine partnership with communities. Ultimately, government is responsible for ensuring that all Australians have access to appropriate health care. 26

31 Who will be involved? Aboriginal and Torres Strait Islander people Aboriginal health workers General medical practitioners Oral health practitioners and their professional associations The tertiary education sector The primary and secondary education sectors Rural and remote media State/Territory and Commonwealth governments National Aboriginal Community Controlled Health Organisation Standing Committee on Aboriginal and Torres Strait Islander Health Where will it happen? Aboriginal and Torres Strait Islander communities Aboriginal community controlled health services Schools, preschools and child care settings Maternal and child health settings Dental clinics Health care settings and services Tertiary education settings Linked initiatives National Strategic Framework for Aboriginal and Torres Strait Islander Health National Aboriginal Health Strategy National Aboriginal and Torres Strait Islander Nutrition Strategy and Action Plan The Aboriginal and Torres Strait Islander Health Workforce National Strategic Framework The NHMRC Road Map: A Strategic Framework for Improving Aboriginal and Torres Strait Islander Health through Research National Public Health Partnership Patient-assisted Transport Scheme Primary Health Care Access Program National Rural Health Alliance Evaluation Note: These indicators may need to be adapted to ensure consistency with the National Aboriginal and Torres Strait Islander Health Performance Framework currently under development. Process indicators Percentage of oral health staff in the public sector who have undergone cultural awareness training Percentage of Aboriginal children having general anaesthetics for oral health problems Percentage of Aboriginal communities with access to fluoridated drinking water Percentage of Aboriginal Health Workers who have received oral health training Publication of regular reports from the Indigenous oral health data set Number of Aboriginal persons in oral health courses in Australian universities 27

32 EFFECTS OF GOVERNMENT POLICY Ramifications of Crisis Breakdown of social structures and traditional lifestyle Imposed identity Hopelessness/helplessness Anomie/alienation Desecration of spiritual life Exclusion of sacred life Dietary changes Poor hygiene/housing/health Restriction of movements Sexual abuse Aboriginality denied Breakdown in socialisation Total dependency Cycle of poverty well established Appropriate Response Opportunities to rebuild Own identity encouraged Hope and help from society Develop sense of belonging Rediscover spirituality Rediscover sacred life Re-education on diet Health education Freedom to move Counselling Aboriginality encouraged Rebuilding of social structures Re-establish independence Learn to budget and save Other mid to long term effects of past policy decisions on Aboriginal people: High infant mortality Reduced life expectancy Rapid increase in communicable diseases Re-infections (eye, skin etc.) Malnutrition, malabsorption Vitamin deficiency Diabetes Alcohol and substance dependency Trauma and stress Ken Hayward,

33 REMOVAL OF CHILDREN Adults at 47yrs old and children are starting their own families 1980 s Example of impact from 1940 s to 2000 s (KenHayward1997) 3-4 generations have suffered emotional abuse Adults at 37yrs old and children 7-17yrs old suffering the effects of parents being taken away. Without appropriate guidance may be Dysfunctional problems repeated in the next generation 1940 s Example of 7yr old girl or boy removed from family 1970 s getting into trouble at school or out of school Development stage from child to adult = no love or guidance = loss Institutionalised = lack of loving supportive environment Guidance from authorities = rebellion away from authority and the law 1950 s 1960 s 1990 s Children at adolescent stage 17yrs old, in search of self values = loss of identity Some Aboriginal families had up to 3 generations placed in missions Adults at 57yrs old, children27-37 yrs old and grandchildren 7=17yrs old starting to rebuild the family system and support group starting to rebuild and heal the past and better their future 2000 s White Australian Policy ( ) Assimilation Policy ( ) Children removed from their families between 1905 and 1967, give or take 15years either way 29

34 Y KIMBERLEY REGION In 2004, Kurijinpi Ivan McPhee,Walmajarri explains Kimberley history in the following way before time when guddeeyu came to Australia, people bin practicing their Law and their Culture and looking after their land and also talking about their language. And them days when the guddeeyu started forming a cattle industry, sheep industry and buying all the block of land and starting it into pastoral lease, lot of our Aboriginal people bin still talking language and having our culture and Law really strong. Soon as white man brought all these animals and these new windmills spinning, people bin gettin frighten. Our old people didn t know what was going on. They didn t know what was going on. They don t know anything about the land that was stolen from them (New Legend KALACC 2007, p65). Prior to the arrival of Europeans, the Kimberley was one of the most densely inhabited areas of Aboriginal Australia. Nearly fifty distinct language groups, making up six language families, occupied its desert regions, saltwater territories, river country and rangelands. As in all other parts of Australia, European settlement had many serious consequences for Aboriginal people, yet remarkably the Kimberley remains a stronghold of traditional languages, customary Law and Culture to this day. Almost thirty language groups have survived the pearling and pastoral industries and nearly a hundred years of government policies intent on breaking up communities and preventing the continuation of traditional ways of life. Today, the repercussions of these historical events are further compounded by new pressures that have been places on communities in contemporary life. (New Legend KALACC 2007:65) John Watson, Nykina celebrates Kimberley legend, in like Pigeon [Jandamarra, the Bunuba people resistance fighter], he wasn t a bad man. He mighta killed a police but he was fighting for his own people. He had reason to do that. And many other people got killed and they fought for their own people 2004 (New Legend KALACC 2007:66). What guddeeyu bin doing to us before,you know? You looking back in those years when guddeeyu bin start killing our people. But we wanna try and to make realize. We asking for that recognition Joe Brown, Walmajarri, 2004 (New Legend KALACC 2007:66) Throughout station time and particularly during periods of drought, flood, war and depression, stations were able to subsist because of their dependence on a highly skilled but unpaid labor force. Aboriginal people quickly gained a reputation as talented stock workers, and although stockmen and women rarely received acknowledgement for their efforts they were acutely aware of their importance to the industry and were able to maintain a sense of dignity and selfworth in their contact with Europeans despite the conditions that were imposed upon them. Most importantly, station life made it possible for Kimberley communities to remain close to their traditional lands, and to uphold their customary laws and practices. Although the constraints of working life meant that Aboriginal people were unable to stage traditional Law time ceremonies during the late dry season, cultural leaders adapted to their circumstances by transferring the practice of Law time to the wet season holidays when stations ceased work.( New Legend KALACC 2007:68) Regarding employment, in 2004, Gadjai Frank Sebastian, Yawuru, stated that And then we ve worked for nothing and made them white man millionaires. Even pearling masters here today, they re all millionaire and they don t want to look at blackfella (New Legend KALACC 2007:65). Extract from New Legend KALACC

35 c CULTURE KINSHIP Kinships exist in every Aboriginal community throughout Western Australia. Social structures and organisations also exist within the Aboriginal communities, including social and cultural obligations, traditional laws and cultural values that are binding in all communities. Skin groups regulate this social organisation that involves many family groups. Panaka marries Karrimarra children will be Milangka Karrimarra marries Panaka children will be Burungu Burungu marries Milangka children will be Karrimarra Milangka marries Burungu children will be Panaka Diversity and variation Multiculturalism has bought diversity to the Australian society. There are many cultural differences between Aboriginal people and other cultural groups in Australia. Aboriginal people live in dual domains and as Australians, are Indigenous people with a unique cultural heritage. Our knowledge of land and country provides a traditional spiritual connection to all living things. Aboriginal families who live in urban and rural areas have developed a culture of their own through family, kin, extended families, the community and organisational structures. These structures provide psychological and physical support and security. Aboriginal people also live in rural and remote situations giving rise to a mixture of contemporary situations. Most Aboriginal people who live in remote regions have their skin group affiliation by virtue of birth. Every person in a skin group knows where they fit and with whom they are connected. Sharing the Dreaming, CALM

36 SKIN SYSTEMS Throughout the Kimberley, both the kinship and skin systems are crucial components of customary Law, which determine the organization of society on many levels. Within the skin systems, clearly defined roles and obligations are accorded to different skin relationships, whether or not individuals are related by blood. These associations are reinforced by patterns of behavior, which range from playful familiarity and informal closeness to restraint and respectful avoidance. Mutual obligations of ritual, emotional, educational and economic accountability are also determined on the basis of skin relationships. In this way, the skin system ensures the social and economic welfare of the group as a whole and allows for a wide range of constructive associations to take place between people of different generations. Protocols regarding suitable marriage are also strictly dictated in accordance with the skin system, and family ties between the in-laws are reinforced in a number of significant ways. (New Legend KALACC 2007:20). I m John Watson from Jarlmadangah. Nyikina, Karajarri, Mangala. I got three sides. We only a caretaker here, we works in with all our leaders. Looma [Nyinina Mangala] down to Walmajarri people in Fitzroy side and to Bidyadanga to Karajarri people. We had that connection John Watson, Nyikina 2004 (New Legend KALACC 2007:23) The skin systems continues to be of considerable social importance in modern times as it enables Aboriginal people in the Kimberley to interact closely with people from other groups, by determining the correct way for individuals to behave towards others. Although there is a great diversity of kinship structures and skin names in the region, elders are adept at translating different systems into one another. ((New Legend KALACC 2007:21) The skin system, through which many Aboriginal people are able to understand their place in the physical world and their obligations to maintain its health, balance and well-being, was laso created by Dreaming ancestors and makes up an important part of spiritual and religious Law. This complex and harmonious pattern of associations recognizes spirit as an elemental foundation of life. People, animals, plants, waterholes, Dreaming ancestors, spirits and areas of country are all identifies by their own place within the skin system, and are recognized as members of the same spiritually interconnected family. This interrelatedness has many personal, cultural and spiritual implications for Kimberley Aboriginal people. In the religious belief of many Kimberley groups, a person s spirit exists before they are born, often as a mammal, fish, bird, plant, reptile, or sometimes, even a person. Before a mother knows she is pregnant, one of the parents may kill the animal, identifying the animal as the child s totem. Consequently, the place where a person s spirit is found is also of immense importance to Aboriginal people, and forms a spiritual link between the individual and their totem country, giving rise to further and spiritual responsibilities. (New Legend KALACC 2007:37) Extract from New Legend KALACC

37 CHILD REARING Aboriginal Society State of being From Hunter and Gatherer society Must be autonomous for survival Takes time to deliberate on decisions for survival independence important Has a wider scope to roam from carer Western Society State of doing From Agrarian society Work in a group with a boss to lead Must obey commands immediately for survival industrial revolution Carer keeps child within sight at all times Extended family all responsible for child rearing Helping/reciprocal Conquered society used to bowing to conventions of dominant society Disciplined by being made to feel ashamed of behaviour Allowed to stay with adults and participate in socialisation Very little discipline in childhood the child is left to make many decisions of his own Baby is in constant touch with family and siblings feet never touch the ground Carried around on hips of children Mainly bought up by nuclear family Competitive Dominant society expectations of others and obeying commands Disciplined by command or scolded for bad behaviour Made to sleep in bed and room by themselves at a very young age Strict discipline at a very young age including eating, sleeping, watching TV and the like Baby is left alone in pram or cot. Mostly from a nuclear family. Mother learns skills from a book, TV, etc. Baby always in sight of mother or carer Body language intuitive More of a verbal interaction Joan Winch 33

38 SACRED SITES Sacred sites are an integral part of Aboriginal culture. They are places that bear the marks of the creative ancestral spirits, which continue to have a presence in land formations. These ancestral spirits followed pathways and sites, and form a connection with the land for people from various language groups into a wider community of Aboriginal peoples. There are geographical features (not all of them obvious or interesting to the non-aboriginal eye), which mark episodes in the stories of the ancestral spirits journeys throughout Australia. Sacred sites are the settings of the custodian s most important knowledge and activities. They are fundamental to the sense of self. To destroy or damage a site is a distressing and dangerous act, which threatens not only living and unborn generations, but also the spiritual forces and order of the world. Aboriginal people are descendants of these ancestral spirits, and their task is to take care of sacred sites by performing necessary rituals and singing the songs, which tell of the ancestral spirits deeds. Rituals and ceremonies celebrate and continue the order of life. Religious in nature, sites and songs which are sacred are also secret, and too powerful for disclosure. To reveal details of these sites may in itself be tantamount to desecration. Certain sacred sites are known to be dangerous places, and Aboriginal people work to protect others from harmful contacts with such places. The judicial system in Australia recognises sacred sites as bounded entities which is a useful and definitive tool for protection. There are over 26,000 + sites registered in WA. Thousands of sites are as yet not registered and large numbers of sites are not disclosed due to their sacred nature, while others, due to interference, wait to be reconnected to Aboriginal people. (Ken Hayward 1997) Picture Courtesy of Australian Conservation Foundation Picture taken by Kerry Trapnell and Justin McCaul 34

39 The THE DREAMING The Dreaming is the basis of all aspects of traditional Aboriginal societies. SACRED OBJECTS TERRITORIAL RIGHTS LAND ART RITUALS CELESTIAL BODIES SONGS SPIRIT BEINGS LANGUAGES TOTEMIC SITES THE DREAMING MYTHOLOGY ANIMALS SOCIAL CONTROL PLANTS SOCIAL ORGANISATION HUNTING & GATHERING RELATIONSHIPS TECHNOLOGY PEOPLE DIVISION OF LABOUR 35

40 TRADITIONAL MEDICINE In the past, Aboriginal people had an environmental perspective that was based on the premise that everything in the world was linked and was imperative for life and living. They had to know about plants, animals, sea creatures, herbs and how they affected human life. Natural medicines were used as a primary preventative health care, unlike the contemporary medical model of responding to illnesses. All food was eaten to maintain health and herbs (stimulants), clay and insects (mineral replacement) were used at all times. There was also a spiritual force, which could cause sickness or health. Aboriginals managed to harvest in all temperatures from the tropics, to the desert and in the cold south coast. Decisions regarding harvest and the events of the seasons were dependent on nature and signs such as the phases of the moon. Many berries have high Vitamin C content, although Aboriginal fruits are often not palatable to European tastes because they have a very low glucose content. With palates more accustomed to low levels of glucose, a high incidence of diabetes exists in Aboriginal society today. Early settlers did not take advantage of the traditional knowledge that Aboriginal people had to offer. The destruction of our culture in the South West has caused the loss of a lot of the finer knowledge. In many areas of WA, coldness and dryness of the body is considered a sign of good health, and so treatments that achieve these conditions even including antibiotics are administered. The plants used for medicinal purposes were insignificant in appearance, and frequently used for the same purpose in places hundreds of miles apart. Before Europeans came to our land, boiling was not possible inland as there were no large shells, therefore infusions were used and herbs were ground up and put in a warm bath made from wood. The most important chemicals in Aboriginal medicine are the aromatic oils and tannins. The more potent alkaloids and other toxins, although still important, are less widely used. Aromatic oils give eucalypts, tea trees, native mints and other herbs their strong aroma. Known as essential or volatile oils, these aromatic oils evaporate readily to produce an inhalant vapour. Dr Joan Winch 2001 Quandong WA (Noongar name Wogol of Jerramungup) References: Low, T (1990) bush Medicine, A pharmacopea of natural medicine. Angus and Robertson Book, Harper Collins Publishers, Australia. Reid & Betts (1979) Records of Western Australian Plants Used as Medical Agents, Department of Pharmacy West Australian Institute of Technology. 36

41 KNOWING ABORIGINAL PEOPLE UNDERSTANDING ABORIGINAL PEOPLE A large percentage of Aboriginal people who live in remote and rural locations live according to traditionally-orientated social organisations. Being aware of this is the first step for nursing staff to achieve broader outcomes in health care when working with Aboriginal communities. This is important to comprehend because local community people s way of life determines much of their behaviour towards each other and towards non-aboriginal people. Niyaparli people s culture or life for people in Buddimia culture will determine who a person may or may not speak to; whom they may or may not ask for help, whom they may or may not approach. These customs are very relevant to Aboriginal people who are bound in life by cultural and social obligations. Please take into strong consideration; there are three over-riding emphases in Aboriginal life. They are religious customs, kinship and people s relationship to the land. CODE-SWITCHING Aboriginal people have the capacity to code-switch into a western framework of understanding but this will always be regulated according to specific customs and cultural nuances. Nursing staff will require using techniques of code-switching to the specific cultural domain in order to convey primary health care and medical instructions. RELATIONSHIP TO LAND To Aboriginal people, the land is inalienable. It belongs to the people as much as the people belong to the land. Aboriginal people associate so closely with all aspects of the physical and non-physical. Rituals are inextricably linked to country, including all natural features. Ancestors are identified with the people s country. There are social, cultural and economic relationships that are in essence a sacred relationship between people and land. Aboriginal people s social and religious life is complex. RECIPROCITY Within their kinship ties people will depend on each other for moral and material support and can and do make demands of resources, according to cultural and social obligations. This behaviour for some non-aboriginal people is often seen as a source of irritation and misunderstanding. This physical and material dependence on each other is interconnected with emotional dependence, with a spiritual bond across families, their people and their country. 37

42 ETHNOCENTRISM Ethnocentric Stages 1. Denial of difference: People are treated as objects of curiosity. 2. Defence: We become aware that culture is variable in human interaction. People use negative stereotypes ( our culture is superior to theirs ). We have to do things the proper way ; they have weird ways of being and doing. Or the reverse might happen. Everything from their culture is glorified while own is denigrated. 3. Minimisation: Rejects cultural subtleties in favour of generalised concepts. We are all the same colour under the skin. We are all God s children. Classification categories are too general and unable to accommodate difference. Ethno Relative Stages 1. Acceptance of difference: Crossing the threshold from ethnocentrism to enthnorelativism is usually accompanied by discomfort. We feel uncomfortable with someone from another culture and lack the skills to bridge the gap. We may lack critical awareness of our own culture and information about other cultures. This is a critical phase of development. It is easier to retreat across an enthnorelative/ethnocentric divide. 2. Adaptation: It is possible to cross barriers with their adventuring, pioneering spirit, which allows them to communicate sensitively across the cultural gap and break down barriers to a better understanding. 3. Integration: Requires a healthy self-concept and acceptance of their own cultural heritage warts and all. All cultures have differences and we should have insight into these aspects. The implications of this model are: a. Though it is important to stop people acting in racist ways, this alone will not ensure good cross-cultural communication. b. Though teaching skills are important, this alone will not develop good cross-cultural communication. c. People are likely to become less comfortable with their own attitudes and performances before they develop higher competence. Adapted from Neil Quintrell, Flinders University 38

43 ABORIGINAL TERMS OF REFERENCE Aboriginal Terms of Reference is a set of principles, core values and a process that determines an Aboriginal world view on an issue in a particular context. Aboriginal Terms of Reference are defined in the following terms. Diagram from Sharing the Dreaming, CALM 2002 The concept of Aboriginal Terms of Reference (ATR) encompasses culture but is more than any one aspect of culture in a given situation. ATRs are always devised in relation to a specific context. ATR can be either about establishing Terms of Reference with the non-aboriginal domain or within the Aboriginal domain. They encompass the cultural knowledge, understanding and experiences that are associated with a commitment to Aboriginal ways of thinking, working, and reflecting, incorporating specific and implicit cultural values, beliefs and priorities from which Aboriginal standards are derived, validated and practised. These standards will and can vary according to the diverse range of cultural values, beliefs and priorities from within local settings of specific context. Cultural elements, experiences, understandings and aspirations can be brought together to provide common ground between significant stakeholders to enable them to work cooperatively and introduce positive programs for community development. Aboriginal life relates to symbolic relationships of people and the world encompassing the connection of the individual to one s cultural setting. In contrast, western models of education are based on the dynamics of continued change and progression. Aboriginal world views are interactive and in tune with external senses of perception while the western world view is predominately transitional with a ruling of unending desires causing a detachment from nature. Centre for Aboriginal Studies, Curtin University,

44 GENERAL CULTURAL COMPARISONS Aboriginal Society History is timeless Engage in holistic thinking Time is circular, without boundaries is past and continuous Spiritual views are not questioned Being rather than doing is important fit into circumstances that are there Immediate gratification important Aboriginal society is acceptable as it is Group orientated everything is for all group members Kinship is important in a family unit a person can go from home to home Aborigines expect children to be like them Spontaneous lifestyle do what you want when you want Uncritical of children or society because of respect Personal lifestyle hard to understand an impersonal person Basically listeners do not speak unless it is important Illiterate use symbolic language Little eye contact is impolite to do so Indirect in questioning talk around the point Non-legislative laws are morals and to support the group, not to isolate anyone Accepting others following separation or wrongdoing Age is respected A non-market economy money not important Giving is important Hughes and Andrew, 1998 Wadjulla (Non-Aboriginal Society) History is quantified and specified Engage in empirical thinking Time is linear and quantified with reference to points is future orientated Spiritual views may be questioned Try to change circumstances that are there Deferred gratification important Society needs to change Individual orientated acquisitions are for you Kinship of far less importance Non-Aboriginal children not expected to be like parents Structured lifestyle must plan and be stable if want to succeed Critical everyone is judged Impersonal lifestyle people would rather be alone Basically verbalisers think out loud, must speak Literate use books and very verbal Lots of eye contact it is important Direct questions very to the point Legislative laws are written and offenders are isolated Not accepting of others following separation or wrongdoing Youth respected Market-orientated money important and complex Saving important 40

45 VALUES OF ABORIGINAL PEOPLE Family Shared Responsibility Acceptance Sharing Equality Belonging Ownership Land Respect Time Orientation Person Orientation Laughter Shyness Language Family and extended family takes priority Each person is required to be responsible in one area or another. If this is neglected it becomes automatic for another member of the family or extended family to fill in Each individual is accepted for both strengths and weaknesses Sharing is an honour and is seen as part of our responsibility Each person is respected with the right to be equal Belonging to your people, your land, and your rights are of utmost importance Ownership is a shared experience Land gives us a complete sense of belonging Respect for ones position and responsibilities in all areas Past and present is important rather than the future. For Aboriginal people today is important, not tomorrow Family and human relationships and interactions is a valued factor. Material gain can have little or no interest Laughter may be used as a coping strategy; it is usually a case of laughing at or with oneself Many Aboriginal people use shyness as a means to build a silent trust. Once these barriers are down there is often a genuine openness There are different understandings to Aboriginal Words. The wrong word can offend Body Language Most Aboriginal people communicate through body language Understanding Family Conflict Shame Handshakes Boisterous Behaviour Generalising Behaviour Be aware of Aboriginal teaching and learning styles Be aware of community conflict which may involve different families To be singled out for praise or criticism is often seen as loss of personal dignity Handshakes are often gentle, this represents a politeness and respect not to intrude into your personal space Boisterous behaviour does not necessarily mean unruly behaviour This is a common means to communicate. It helps us discover acquaintances and relating links 41

46 SENSITIVITY IN SPEAKING WITH ABORIGINAL PEOPLE Derogatory Terms: The sayings half caste, full blood, abo, boong, coon, blackfella, etc in most circumstances are not to be used. Question Identity: When meeting someone and establishing a rapport, ask about who their family is not where they work. Cultural Expectations: Remember we aren t all experts in culture and history, take your time to observe, listen and learn. COMMUNICATING WITH ABORIGINAL PEOPLE Touching Discipline Eye Contact Plain Talk Yes Quiet Time Family Business Touching is used as an expression of acceptance, welcoming or direct communication Adult members of the family have rights to discipline the children Aboriginal people may avoid eye contact. It is not polite to gaze into another s eyes Plain talk is the best way to communicate. Too many explanations may confuse the issue Yes, does not always mean yes as a direct answer to a question A pause in the conversation does not reflect avoidance just thinking time Family business means all the family including children and elders Communicating with people from another culture is often difficult. While it is not necessary to be an expert on a culture or linguistics to communicate effectively with others, it is essential to be aware that these differences may exist. A number of communication difficulties are commonly encountered when dealing with Aboriginal patients. Several are outlined below. Keep in mind, however, that there is a huge diversity in the Aboriginal community. Are we speaking the same language? Aboriginal people seek information by hinting at an issue rather than discussing it directly. A common example is Aboriginal people make a statement then wait for you to either confirm or refute it. Time to think is essential for Aboriginal people, especially when important decisions are to be made. Don t always expect immediate answers, you may have to wait until another time. Nodding does not always mean yes. Nodding is a cultural norm which encourages smooth social relationships. So an Aboriginal patient may nod but may not agree with you or understand what you have said. I don t know may have more to do with your inappropriate communication than the Aboriginal patient s lack of knowledge. It may also be due to a lack of appropriately developed patient relationship. The lack of eye contact should not be seen as evasive or dishonest. 42

47 It may be past but it is not forgotten! The past affects the present and a number of Aboriginal people are still suffering from past Government policy. Some were taken from their families as children. Others suffered mistreatment and isolation, on racial grounds, in hospitals and other health care facilities (Binan Goonj, 1995). With little reason to trust the mainstream health care system, many Aboriginal people find it difficult to access adequate heath care. They may also need help to find their way around our health system. It s always been done this way The best health advice may be ignored because change takes time. Aboriginal patients may need a lot of encouragement and support to change their behaviour. Often health advice conflicts with long-standing behaviours. For example, advice to lose weight may be ignored because a diet high in fat and sugar has been standard for generations. Sharing is also very important in the Aboriginal community. Sharing of resources was important to the survival of traditional groups. Sharing of resources today may also include sharing prescribed medications, especially when funds are limited (Binan Goonj, 1995). Men s and women s business is kept separate in traditional Aboriginal society. Some of these traditions exist today. It is important to offer the patient choice if possible when it comes to the sex of the doctors. It s a matter of priorities Be aware that no show at appointments does not necessarily mean a lack of commitment to health care. Aboriginal patients may have unavoidable family commitments or harsh economic circumstances. These may include: Transport not readily available or difficulty using public transport Telephone no access to a telephone to cancel and change appointments Family responsibilities these can take priority Housing homeless or highly mobile Death funerals take precedence over everything else in an Aboriginal community. Relatives will travel a great distance to be with grieving family. Births families and relatives gather together for births and care of the baby. Finances if finances are low, money will go towards food for the family rather than transport to an appointment. What is my role? The Health Professional has an important role to play in improving health services to Aboriginal people. How he/she communicates with Aboriginal patients will largely determine whether or not the patient will be receptive to dental health advice. Strategies that may help you communicate with Aboriginal patients: Gain as much general information as possible but remember Aboriginal people are not all the same. Communication styles differ. Alter your style to accommodate your patient. Provide a user-friendly waiting room. Posters of Aboriginal people and Aboriginal literature may make it more welcoming. Take as much time as possible at the first contact. Shake the person s hand and sit at the same side of the desk to make them feel more comfortable. Spend time in conversation and establish common links if possible (e.g. Places you have worked, other Aboriginal people you know) 43

48 ABORIGINAL HEALTH TRADITIONAL ABORIGINAL HEALTH CONCEPTS Everyone working in the field of Aboriginal health should have some appreciation of Aboriginal concepts of health. In western society, the feeling of well-being identified as good health is usually related to the absence of disease or disability. Aboriginal people on the other hand, relate this sense of well-being to their socio-cultural world rather than their own physical condition. This world as has been pointed out above is dominated by relationships, particularly family and the living land. It is disturbances in these relationships that are often seen as the cause of illness rather than the agents of disease so familiar to non-aboriginal health professionals. This difference of view about cause, however, does not necessarily exclude acceptance of western medicine, even if it is sometimes without conviction. Aboriginal people have an intimate knowledge of the living world around them and prepare a range of herbal medicines for the treatment of such ailments as wounds, sores, coughs, diarrhoea and constipation. The remedies are for the relief of symptoms and do not seem to be related to the more fundamental question of illness and its sources. (Bush Book, A Guide to Field Staff, NT Department of Health, 1979) TRADITIONAL HEALERS There are traditional healers in most tribal Aboriginal communities. Their role seems to be related to dealing with what they see as the cause of the illness rather than its manifestations. Health care staff should try to identify local traditional healers to foster co-operative relationships with them. Aboriginal people frequently consult traditional healers and conventional health services for the same illness, and mutual respect between the respective practitioners will promote the acceptance of health centre activities within the community. (Bush Book, A Guide to Field Staff, NT Department of Health, 1979) 44

49 CAUSES OF ABORIGINAL ILLNESS Adapted from J. Reid A number of health problems have arisen from the change in living conditions which followed the transition from semi-nomadic to settled life on cattle stations, government settlements and missions, and in or on fringes of townships. Bush foods are not so readily available. Poor hygiene and sanitation prevail and in such circumstances trachoma, leprosy, worm infestations, infections and various other diseases emerge. Primary Secondary Outcome Invasion Poverty Anomie Dispossession Dependence Substance Abuse Disease: -small pox -measles -influenza Rejection from Colonial settlements & access to material resources Powerlessness Massacre & Genocide Colonial Racial Discrimination No political representation Value Systems: Power base Destruction Capitalist v s Socialist Alcoholism: -inappropriate housing -education -lack of access to information & resources Malnutrition: -diabetes -malabsorption -feto - alcohol syndrome. Incarceration: -reserves -missions -stations (sheep & cattle) -gaols Destruction of Reserves: Aboriginal culture & society -Loss of traditional roles. Loss of knowledge of traditional medicines & healthy practices Lifestyle diseases: -circulatory/heart -renal failure -diabetes Distress & breakdown in: -mental health -drug abuse /suicide 45

50 KAMSC (Kimberley Aboriginal Medical Services Council) is a regional Aboriginal Community Controlled Health Service (ACCHS), providing a collective voice for a network of member ACCHS from towns and remote communities across the Kimberley region of Western Australia. The Broome Regional Aboriginal Medical Service (BRAMS) was the first Aboriginal Community Controlled Health Service (ACCHS) established in the Kimberley in 1978, and was followed by the East Kimberley Aboriginal Medical Service (EKAMS, in Kununurra) in The vision for a unified voice, to provide centralised resources and collective advocacy for the sector, achieved reality in 1986 with the establishment of KAMSC. Today, the KAMSC collective represents five independently incorporated ACCHS the Ord Valley Aboriginal Health Service (OVAHS, previously EKAMS), the Derby Aboriginal Health Service (DAHS), Yura Yungi Medical Service (YYMS in Halls Creek), Jurrugk Aboriginal Health Service (JAHS, representing communities along the Gibb River Rd) and Palyalatju Maparnpa Health Committee (PMHC in the Kutjungka region). KAMSC Governing Council is made of one representatives from each of its independent member services and one representative from the community councils of Beagle Bay and Bidyadanga, where independent ACCHS are not yet established. KAMSC general meetings are held quarterly in different locations across the region. KAMSC provides a wide range of regional services to support member ACCHS, with business units including: Population health Health Promotion Pharmacy support and training Accredited health training and education Research Social and Emotional Well Being Business Support Information technology Corporate Services including payroll support, HR, accounting and administrative services Regional renal services including dialysis Culture While its major role is in regional advocacy and support for member services, KAMSC also provides comprehensive primary health care services in the remote communities of Beagle Bay, Bidyadanga and Kutjungka (Balgo, Mulan and Billiluna communities). The KAMSC regional collective of ACCHS is a major employer for in the Kimberley, with Aboriginal people representing more than 70% of its 300+ strong workforce. KAMSC is a member of the Aboriginal Health Council of WA (AHCWA and of the National Aboriginal Community Controlled Health Organisation (NACCO KAMSC website 46

51 WAYS OF WORKING NURSES IN THE FIELD WHAT A STAFF MEMBER NEEDS TO KNOW Working permit - Organised by the employing body Different - Be aware that everybody is different - cultural values, beliefs and practices Ethnocentric views - you will be going out there with your views - just remember that the Aboriginal people out there do not necessarily have your views. Their views are different. Don t expect them to share your views. Accept this difference Get an Aboriginal Clinical Assistant and or an Aboriginal Health Worker who has good standing to go with you to meet the Chairperson on your first day - you will be introduced. Language groups and protocols Ways of knowing No go places - business - men and women By-laws No grog - dry community Speed limits Research - who s who Aboriginal Health Workers - male and females who are skilled to deal with a number of scenarios throughout the community Be aware of who may be restricted from the community Be aware of who is of good standing in the community Who is respected in the community Men s Business - initiation use a male health worker/assistant to work with men, not you. This business is taboo for you and other women in the community. You need to prepare months ahead to ensure that your head office gets a male dental health staff available to work in the community during this period. This period can go on for at least 3 months. Sorry Business - this is when someone has passed away - it is the period leading up to the funeral where locals leave their homes and all live together at a certain place. You still need to provide health service delivery to them. Be fully aware of the situation - the relationship dynamics etc. Express your sorrow but just don t go overboard. Ask Elders Law Business - male for male - female for female 47

52 Avoid simple blunders" - no short skirts, no shorts above the knee, no tight pants, no cleavage etc Photos - don t take photos unless you do get permission. Do not use for personal use Be aware of community politics - just do not get involved. Don t take sides in the community Clinic has to be seen as a place of healing not a place where people die - unless it is an emergency and a death does happen - BUT just remember there may be payback. PAYBACK: You could be blamed for not saving the person s life. It is important to evacuate the patient ASAP via RFDS to the nearest hospital. Food Customs - at certain times of life certain foods are avoided. Also totem symbols avoided e.g. if Emu is a totem then the person is forbidden to eat emu Marbun Man - traditional healer Lifestyles preferences - people like sleeping outside under the stars sometimes even in winter. House - if someone died in the house then the family/relatives move out for certain period and will go back only when the time is up, probably after smoking the house and a twelve months timeframe. Time differences not guided by the clock Ears to the ground - Listen and participate only if invited - Don t talk Don t talk a 100 miles a minute, you are not the leader Don t get involved in community politics Don t get involved with the opposite sex under any circumstances Always on show - when you go into town you can t get drunk and drugged and run amok - you have to set an example. People are always watching - the Bush Telegraph Male and female in separate group discussions Ask the people what the issues are for them - you don t use your agenda Focus on the project and don t name drop Take Dental worker or Aboriginal Health Worker with you at meetings Translators to be paid Talking softly not loudly to elders Be prepared to sit on the ground or qualify if you can t Avoid being alone with male the opposite gender. Get their partner to be with them 48

53 STAFF IN THE HOSPITAL Listening skills - be patient Translator to be used and paid Marbarrn Man Spirituality important Lights may need to be left on - people spirituality - people frightened of spirits present in the dark Don t make any promises that you cannot keep Name of deceased - refer as Naburu and Kumanjai Cover your body and limbs it is offensive to wear short skirts and shorts Observe tribal skin group s avoidance protocol Food traditional food - introduce in menus e.g. kangaroo, bungarra, emu. Sharing same rooms - just because they are Aboriginal people don t put them in the same room unless they specifically ask Dress attire appropriate. Slacks are good Culture and History - learn about it Diseases e.g. kidney transplants - be aware of cultural avoidance of talking about giving donor organs or removal of organs Death and Dying Position them in a room away from others so that they have privacy with their families - as family will be coming from long distances and all hours of visiting. It is very important that the respects are paid prior to death. All those related must attend. 49

54 TEACHING & LEARNING Hands On Learning at a Pace Curiosity Real life Lessons Natural skill Song & Dance Person Orientated Teaching Understanding Code- Switching Children Two Rules Verbal and visual learning is very effective, as opposed to written form Pace of learning is set by oneself without pressure and /or competition Curiosity and a strong interest motivates a desire to learn from within oneself Real life lessons are learned through situations rather than abstract theory Skills are learnt through trial and error Song and dances teaches history, spirituality, and environmental connections It is important to build up personal teacher/ learner relationship Take into account the value systems and communication practices with which Aboriginal people identify Code-switching is of great importance when living with another culture Children are important and have a right to their own identity as individuals Two rules apply when dealing with adults. Women s business and Men s business. To be dealt with as gender specific 50

55 51

56 The WA Aboriginal Communities Maps are is used with the kind permission of DIA 2007, and can be found at 52

57 EAST KIMBERLEY CONTACTS Kununurra - Wyndham - Halls Creek Contact details for businesses, community groups and residents Aboriginal Legal Service Konkerberry Dv Freecall PO Box 2 Fax Aboriginal Legal Service Halls Creek Comm. Resource Centre Thomas St Fax PO Box 162 Bethel Community Inc Weaber Plain Rd PO Box 38 Department of Indigenous Affairs Lot 2250 Coolibah Dr Fax PO Box 672 East Kimberley CDEP Pty Ltd Upper Level 116 Coolibah Dve Fax Po Box 1344 [email protected] Gawooleng Yawoodeng Aboriginal Corp Crisis Centre Mistletoe St Fax PO Box 997 [email protected] 53

58 Gelganyem Trust Unit 2/12 Cottontree Ave Fax PO Box 5 Indigenous Coordination Centre (ICC) Coolibah Dve Freecall PO Box 260 Fax Jardamu Safe House Astridge Wy Fax PO Box 377 Wyndham 6740 [email protected] Joorook Ngarni Aboriginal Corporation Kangaroo Drive PO Box 209, Fax Wyndham 6740 [email protected] KAAS (Kimberley Aboriginal Advisory Services) PO Box 213 Fax [email protected] Kalumburu Aboriginal Corporation Kalumburu Rd, Fax PMB 10 54

59 Wyndham 6740 Kilkayi Trust Unit 2/12 Cottontree Ave Fax PO Box 5 Kimberley Aboriginal Advisory Services PO Box 213 Fax [email protected] Kimberley Land Council Halls Creek PMB 245 Fax Halls Creek 6770 Kimberley Land Council Kununurra Lot 2229 Speargrass Fax PO Box 821 [email protected] Kimberley Language Resource Centre Lot 158 Terone St Fax PMB 11 Halls Creek 6770 [email protected] Kundat Djaru Aboriginal Corporation PMB 301 Fax Halls Creek 6770 [email protected] MG Corp Coolibah Dr Fax

60 Po Box 2110 Mindibungu Aboriginal Corporation PMB 13 Fax Halls Creek 6770 Mirima Council Aboriginal Corporation Button Dve Fax PO Box 48 Mirima Dawang Woorlab-Gerring - Language & Culture Centre Button Dv Fax PO Box 48 [email protected] Miriwong Community Support Patrol / St Martins Way Fax PO Box 162 Wyndham 6740 Ngaliwurra Wuli Association Timber Creek PO Box 154 Katherine 0852 Ngnowar Aerwah Aboriginal Corp Great Northern Hwy PO Box 250 Fax Wyndham 6740 [email protected] 56

61 Oombulgurri Assoc. Inc PO Box 208 Public Wyndham 6740 Public Fax Ord Valley Aboriginal Health Services (OVHAS) Ironwood Dve Fax PO Box 216 Puranyangu - Rangka Kerrem (Aboriginal Radio) PO Box 178 Fax halls Creek 6770 [email protected] Waringarri Aboriginal Corporation Speargrass Rd Fax PO Box 162 [email protected] Warmun Community Inc PMB Warmun Fax Turkey Creek [email protected] Wirrimanu Aboriginal Corporation PMB7 Balgo Hills Via Fax

62 Halls Creek 6770 Wunan Cnr Messmate & Coolibah Fax PO Box Yawoorroong Miriuwung Gajerrong Yirrgeb Noong Dawang Aboriginal Corporation Coolibah Dr Fax PO Box 2110 The East Kimberley Directory website is a look-up facility for business, community groups and residences in the East Kimberley Region covering the towns of Kununurra, Wyndham, Halls Creek. A hard copy of the Directory is produced each year and is delivered to the businesses and residents. It is also available through the Kununurra Post Office. Copyright East Kimberley Directory Disclaimer Site Created by Simon Woodard 58

63 INTERNET ADDRESSES FOR AUSTRALIAN ABORIGINAL ISSUES ABS Indigenous themes ATSI WWW Resource Directory Aboriginal and Torres Strait Islander Links Aboriginal Studies AIATSIS Australian Indigenous Soldiers Homepage Aboriginal Sites Directory Australian Indigenous Health Australian Heritage Council Office of Native Title Bringing Them Home Oral History Project Reconciliation Australia Department of Indigenous Affairs Heritage Council of WA Human Rights & Equal Opp. Commission National Sorry Day Committee Native Title (Mabo, Wik, Native Title Act) Native Title Tribunal WA Indigenous Tourism Operator s Committee 59