Promoting Indigenous Family Health - Literature review Example

Introduction Aboriginal women have always desired to give birth at home or on country. According to Baer, (2003, pp. 23-30) they prefer to give birth in an environment where they are with their loved ones, friends or relatives and the community at large. Various health care givers have been controversial on the topic. While some support birthing on country, Couzos and Murray (2008, pp. 46-63) assert that there are many risks associated with giving birth at home. This paper will therefore identify key issues or challenges associated with providing family centred healthcare to indigenous families in remote parts of Australia. This paper will further illustrate recommendations about strategies to improve health outcomes for indigenous families. Challenges in providing family centred healthcare There are various challenges or risks that are associated with providing healthcare at home. As earlier on illustrated, Aboriginal women prefer birthing on country rather than going to hospitals. They have their own reasons for making such a choice. According to Brandt, 2000, pp. 78-98 this includes their distaste of how a new born child is welcomed into the world. To them, this leads to contracting other communicable diseases. Many older Aboriginal women say that women who give birth in hospital return home when they are ‘weak’ and have to undergo rituals to strengthen them. They also complain of being mishandled by care givers in the hospitals. The question that one would ask in this case is; is birthing on country safe? What are the challenges associated with providing family centred healthcare? Brandt, (2000, pp. 59-87) Lack of professionalism and skills In his book, Brandt, (2000, pp. 59-87) says that there is a very big challenge in providing family centred healthcare. Most of the healthcare givers in the remote areas do not have any professional training relating to their work. This is a very big challenge as they only get orientation from the traditional medicine men. Due to improper skills, most of the time the traditional healthcare givers use a trial and error method to administer their healthcare. Brandt, (2000, pp. 59-87) This is quite challenging as there are very many diseases in the modern world that have the same symptoms. The lack of professionalism according to Bear, (2003, pp. 90-100) can result in loss of lives especially in complicated cases. For instance, if a woman has excessive bleeding during birth, they may give herbs and nutritious foods which cannot restore lost blood immediately. This can result in death if not well taken care of. Bear, (2003, pp. 90-100) In cases where patients have complicated illness that require surgery, the local healthcare givers cannot go to that extent since they do not have the skills. In case the herbs fail, they could resort to spiritual rituals which waste time as the health of the patient deteriorates. Many of traditional healthcare givers treat virtually ‘everything’. There are no specialists like physiotherapists, radiologists, gynaecologists, surgeons etc. Bear, (2003, pp. 90-100) Lack of modern technology instruments Providing family centred healthcare to indigenous families in remote areas in Australia is challenging because there is lack of modern technology. Traditional healers or healthcare givers do not have laboratories to test various diseases and ailments. They also don’t have instruments such as thermometers, weight measuring instruments etc. Brown, (2002, pp. 110-112) Brown, (2002, pp. 110-115) says that examples of modern technologies found in hospitals include scanning machines, X-rays machines, microscopes etc. These instruments make it easier for doctors to know what exactly a patient is suffering from. With the lack of such instruments in remote areas, it becomes very challenging for traditional healthcare givers to know what exactly a patient is suffering from without such modern technology instruments. Brown, (2002, pp. 110-115) Couzos and Murray (2008, pp. 77- 89) insist that traditional healthcare givers can never tell whether a patient is suffering from typhoid, malaria fever without these instruments. It is also imperative to note that some of the instruments that are used by traditional healthcare givers are not standardised and therefore not reliable. Couzos and Murray (2008, pp. 77- 89) Inability to offer 24hour treatment/services It is always good to give credit where it is due. Traditional health care givers in remote areas of Australia have really tried to treat many diseases. This has helped save many lives of patients who were in dire danger. Burris, (2006, pp. 44-82) says that it is however important to note that this care has been very limited in relation to offering twenty four hour treatment and monitoring of patients. Unlike healthcare given in remote areas or at home, hospitals offer twenty four hour services to patients. Burris, (2006, pp. 44-82) Nurses constantly check patients’ pulse, temperature and their reaction to administered medicine. In case the patient is allergic to the drugs, then they are changed. Nurses also give patients required medicines at specific times as prescribed by the doctor. On the other hand, traditional healthcare givers simply give herbs to sick people and allow them to go back to their homes says Couzos and Murray (2008, pp. 100-127). Relatives are supposed to give the medicine or herbs to patients. Sometimes these people get so busy and forget to administer the medicine at the right time. This affects the overall recovery of the patients, Says Downey, (2003, pp. 40) Since the traditional health care givers have other sick people to check on, they are usually not in a position to check on the patients on a twenty four hour basis. This is a big challenge in providing family centred healthcare to indigenous families in remote Australia. Downey, (2003, pp. 40) Emergency cases Analysis of providing family centred healthcare to indigenous families in remote Australia in Brandt, (2000, pp. 55-87) shows that it is quite challenging to handle emergency cases. It is known that many traditional healthcare givers have other occupations apart from giving healthcare. Many of them also stay far away and this means that patients have to take a long distance to reach them. This becomes a very big challenge when it comes to handling emergency cases. Brandt, (2000, pp. 55-87) Most of these cases are quite critical and in a matter of a few hours or even minutes, the patient can lose his or her life. Before the patients reach the traditional healthcare givers, it is usually very late and the situation is at a stage where it cannot be solved or treated. Due to their inaccessibility all the time, patients can reach the home of traditional healthcare givers when they are not there. Probably he or she had left for a long journey and maybe they cannot be accessed on phone. This becomes a very big challenge. Recommendations on strategies to improve health outcomes for indigenous families The factors illustrated above clearly show that proper strategies need to be put in place in order to improve health outcomes for indigenous families. Collaboration between hospitals and local health care givers According to Dranove, (2003, pp. 66-70) this is one of the strategies that will help improve health outcomes for indigenous families. This is whereby nurses and doctors collaborate with the local health care givers. In this case, doctors and nurses need to the train the local healthcare givers in matters relating to sanitation, first aid, essential information that they need to know when handling pregnant women. Dranove, (2003, pp. 66-70) It is also quite essential says De Ville, (2005, 23-31) for local health care givers to be trained on the importance of educating the community in matters relating to prevention of diseases. There needs to be a cordial relationship between doctors and indigenous health care givers such that doctors and nurses can be consulted in cases that are too hard to be handled at home. Through this relationship, De Ville, (2005, 25) says, local health care givers will also be in a position to get basic instruments like thermometers that can play a big role in their work. Feldstein, (2003, pp. 135-176) asserts that doctors can also educate the traditional healers the importance of incorporating modern medicine in their work. Through this, their work will be much easier. There can be an exchange program between the two parties where local health care givers work in hospitals for some time and vice versa. This will play a very big role in improving local healthcare givers knowledge. This is one of the major strategies that will improve health outcomes for indigenous families. Feldstein, (2003, pp. 135-176) Have hospitals in interior areas that respect the Aboriginal people’s culture Analysis in Couzos and Murray (2008, pp. 90-115) shows that the reason as to why the Aboriginal women do not prefer to give birth in hospitals shows that they really treasure their culture. They also don’t like any care that does not respect their culture. So to help improve health outcomes for indigenous families, hospitals need to decentralise and have branches in the interior places. Couzos and Murray (2008, pp. 90-115) In this case, hospitals can be started and respect the culture of the Aboriginal people. First of all, a research has to be carried out on the culture of the indigenous people. Ginzberg, (2002, pp. 61-70) recommends that local health care givers should be incorporated in the hospitals so that the Aboriginal people gain confidence in the hospitals. Ginzberg, (2002, pp. 61-70) For instance, pregnant women can be allowed to give birth with their loved ones around. These could be aunties and even their mothers. This will make them to have confidence in the hospitals and therefore be in a position to be treated by specialists. Ginzberg, (2002, pp. 63-67) The other reason as to why the Aboriginal people never want to go to hospitals is because of the language barrier. This to Feldstein, (2003, pp. 20) can be solved by incorporating the Aboriginal healthcare givers. This will enable patients to feel free and express how they feel. This will definitely solve the issue of language barrier. Feldstein, (2003, pp. 20) Hardon, (2004, pp. 60) says that hospitals will have modern technology and instruments and this will help a great deal in giving quality healthcare to the indigenous people. This is considering the fact that they will be able to get healthcare in a very clean environment. They will be in a position to be tested using good and standardised equipment. Hadorn, (2004, pp. 65) says that the Aboriginal people need to be re-assured that they can receive specialised care then later on perform their cultural rituals which will psychologically help them feel whole. Education This can be a long term plan to help solve the problem relating to improving Aboriginal people’s healthcare. This can be initiated by building schools in the interior areas. This includes elementary schools, colleges and universities etc. Couzos and Murray (2008, pp. 85-98) recommend that the entire community has to be encouraged to educate their children. As they get basic education, they will learn to embrace modern medicine. Couzos and Murray (2008, pp. 85-98) Through these institutions, Couzos and Murray say, children will learn to interact with other cultures. This will help them in the long run accept to be treated by the whites. Education they say is an eye opener. Through education, the Aboriginal people will be in a position to know the challenges associated with birthing on country and in general getting healthcare at home. This is more so, care given by traditional healthcare givers. Couzos and Murray (2008, pp.42-54) say that they will be able to learn that standardised instruments need to be used to test various ailments. According to Couzos and Murray (2008, pp. 61-69) through education there will be Aboriginal doctors and nurses who will administer healthcare bearing in mind professional standards. This includes the principle of informed choice, confidentiality among others. They will be in a position to know the dangers that are associated with using the same instruments on different people. This includes putting patients at risk of contracting HIV Aids, Tuberculosis among others. Couzos and Murray (2008, pp. 61-69) Conclusion In conclusion, healthcare is a very important aspect to each and every human being. It has been noted that healthcare given at home by traditional healers has its own challenges. They include; lack of professionalism, inability to give twenty four hour services and limitations associated with handling complicated emergency cases. It is highly recommended that there be collaboration between doctors and traditional healers to solve this problem. Aboriginal people need to be educated so that they can know the dangers associated with birthing at home and generally getting treatment from traditional healers. It is also quite essential that hospitals be built in the interior places where the Aboriginal people live. These hospitals should respect the culture on the ground and incorporate traditional healthcare givers. All these aspects will help solve the challenges that the Aboriginal people are facing in line with healthcare. Reference: Couzos, S and Murray, R. (2008): Aboriginal Primary Health Care; Evidence Based Approach; 3rd Ed; Melbourne; Oxford University Press; pp. 9-204 Baer, H. (2003): Essentials of indigenous health; Australian perspective; London; Oxford University Press; 28(11):1103- 1112 Brandt, A. (2000): Family health care for rural people in the modern world; London; Oxford University Press; 8(6):321-329 Brown, R. (2002): Traditional Medicine Men: Medicine; Overall perspective; UC Press, Berkeley; pp. 11-190 Burris, S. (2006): Thoughts on the law and the public's health. Journal of Law, Medicine and Ethics, 22(2):141-7 De Ville, K. (2005): Healthcare in rural areas, Trends in Health Care, Law and Ethics; New York; Macmillan Press, pp. 21-231 Downey, B. (2003): Aboriginal Health Human Resources; A Pillar for the Future; New York; Prentice Press; pp. 20-172 Dranove, D. (2003): The changing nature of health care competition. Journal of Medical Practice Management, 8(4):233-236 Feldstein, J. (2003): Health policy issues an economic perspective, 3rd edition, Health Washington Press; pp. 10-140 Ginzberg, E. (2002): Health care and the market economy; A conflict of interest? New England Journal of Medicine, 323(1):172-174 Hadorn, D. (2004): Setting health care priorities in Australia; London; Free Press; pp. 33-201 Read More