Edwina Osborne Student No.

22205340 1 Wednesday 5 June 2024

Assignment 1 Health and

Indigeous peoples

Task: Key differences between indigenous and Western concepts of health and well-being.
Provide care that is holistic free of bias and racism, challenges belief based upon assumptions
and is culturally safe and respectful for Aboriginal and Torres Strait Island peoples.
Health through an indigenous lens is one of holistic approach to celebrating the natural world

approach to being and doing. John’s story Mareese Terare, Margot Rawsthorne (2020) is an

example of the deep spirituality and connection to the land. It is a touching and poignant story

with esoteric significance and restorative connection to John’s Grandmother and her land. John

went to a ceremonial place and took off his shoes. He describes the energy he felt which

travelled through his feet and through his body. It brought him to tears...the feeling was

overwhelming and left him in a state of epiphany. John has cardiovascular health issues and

diabetes and says, ‘but country made him well, more so than all the doctor’s pills.’ John’s story

of connectedness with the land and ancestors made him feel he was called home. He knew now

the land was calling him to his own counry.

Being home is an important part of belonging. Many indigenous people have suffered from the

Stolen generation. Government policy supported by Social workers and others saw the removal

of thousands of indigenous children from their families. There is a legacy of the lost generation

who contribute to the rich diversity and tapestry of Aboriginal and Torres Strait peoples and

elder wisdom of country and ceremony, knowledge that should not be lost.

Poor and ill-considered removals of children by the Government is still a hangover of the past

which requires challenge. There are ‘stark health inequities’ (AIH and welfare, 2017).

Indigenous people having ‘a substantially shortened life span for indigenous peoples.’ ‘A first
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nation child born between 2010-2012 is likely to live 10.6 years less for boys and 9.5 less for

girls, than non –indigenous people. (AIH and welfare, 2017).

Carmichael and Hamilton (1967) described ‘institutional racism as the covert means ran by

established and respected societal force for the purpose of subordinating and keeping control

over a racial group, they regarded institutional racism as a form of colonisation and when socio-

economic status is considered, have been attributed to institutional racism in many studies.

Social workers must acknowledge the learnings, capabilities and contributions to the Aboriginal

and Torres Strait Islander people, which is an integral part of social work knowledge and

practice. National Coalition of Aboriginal and Torres Strait Islander Social Workers Association

(NCATSISWA) and the Australian Association of Social Workers (AASW) emphasizes the

advocacy work related to Indigenous rights and social work practice.

Institutional racism at an Australian Hospital. An assessment of the management of institutional

racism in Australian Hospital Services identified five key areas of institutional racism which

revealed in ‘governance; policy implementation; service delivery; employment and financial

accountability.’ (Bindi Bennet, Sue Green (2019). They found a need for trans formative change

as ‘racial groups can be damaged by institutional racism.’ (Bennet & Green 2019), Western

concepts of health are more segregated, both with indigenous people but also within the ranks of

health.

Social Work Practitioners should be savvy about Clinical Yarning with Aboriginal and Torres

Strait Islander peoples and ‘applying clinical yarning to improve clinician- patient

communication in Aboriginal health care.’ Lin Ivan, Green Charmaine Basarab Dawn. (2016).
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‘The overarching framework for practitioners to help them reorientate their communications with

Aboriginal participants using ‘Clinical yarning,’ a patient centred approach that improves the

conceptions of illness and disease using metaphors about the natural environment. A patient

needing help with scabies was suspicious of the remedy - a special wash. The doctor broke

down barriers to this health treatment by talking generally to the patient and included his

knowledge of the clutches of eggs from turtles. This promoted great understanding from the

indigenous patient who went on to tell his stories about the turtle and his encounters. The doctor

used the turtle eggs as a metaphor for scaby eggs and how he could remedy that. The indigenous

person could relate to that metaphor, and all was well.

There are three types of yarning, the social yarn, where the practitioner can find common ground.

The diagnostic yarn, where the practitioner facilitates the patients' health story while interpreting

it through a biomedical lens. There is cultural research which supports this approach which

improves patient outcomes.

Bailey et al. (2018) describes ‘a myriad of ways in which racial discrimination manifests in

society by mutually reinforcing systems of fiscal values.’ Bailey finds: - ‘housing; education;

employment; earnings; benefits; credit; media; health care and criminal justice as systems of

subjugation which reinforces discriminatory beliefs and values.’ Indigenous people have

different values and use the wellness wheel attributes for their well-being: - community health

and safety, sense of community, Education and learning, community well-being, health structure

and services, Economic strength and development, access to country, leadership and

influence.The slow wheels of change have meant Racism Theory has taken 50 years to change.
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Today’s theoretical offerings only provide a ‘one-dimensional and reductionist explanation of

race relations. Carmichael and Hamilton ,(1967), with little consideration for the multi factorial

nature of healthcare.

Communication issues are further heightened when aboriginal people feel alienated by

unfamiliar health care settings and when their family are not involved in the communication

processes and when there are prejudicial attitudes of health care staff. If there is a prejudicial

attitude of healthcare staff the person can hold a view of mistrust and suspicion by Aboriginal

patients to the health care practitioner.

Reference list
Aboriginal Well-Being wheel
https://www.researchgate.net/figure/The-Strengthening-Aboriginal-Community-Wellbeing-
Framework_fig1_287428530
Burke, A. W., Welch, S., Power, T., Lucas, C., & Moles, R. J. (2022). Clinical yarning with
Aboriginal and/or Torres Strait Islander peoples—A systematic scoping review of its use and
impacts. Systematic Reviews, 11. https://doi.org/10.1186/s13643-022-02008-0
Lin I, Green C, Basarab D. 'Yarn with me': applying clinical yarning to improve clinician-patient
communication in Aboriginal health care. Aust J Prim Health. 2016 Nov;22(5):377-382. Doi:
10.1071/PY16051. PMID: 28442021.
Marreese Terare, Margot Rawsthorne, Country Is Yarning to Me: Worldview, Health and Well-
Being Amongst Australian First Nations People, The British Journal of Social Work, Volume 50,
Issue 3, April 2020, Pages 944–960, https://doi.org/10.1093/bjsw/bcz072
National Coalition of Aboriginal and Torres Strait Islander Social Workers Association
(NCATSISWA) and the Australian Association of Social Workers (AASW)
Our Voices: Aboriginal Social Work, edited by Bindi Bennett, and Sue Green, Bloomsbury
Publishing Plc, 2019. ProQuest Ebook Central, https://ebookcentral-proquest-
com.ezproxy.scu.edu.au/lib/scu/detail.action?docID=6235059.
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