Health Status of Indigenous Australians since Colonisation - Essay Example

Undeniably Australian policies have directly impacted upon the health status of Indigenous Australians since colonisation Name Course Tutor’s Name Date PART A Australian policies have affected the mental, physical, and spiritual wellbeing of Indigenous communities. This paper will demonstrate the exact manner in which the Indigenous communities’ wellbeing has been affected by specific policies. The paper argues that Indigenous communities had a holistic way of life, and this can no longer be achieved because modern policies have fragmented the indigenous experience and made it difficulties for members of the indigenous community to attain wholesomeness in how they live. The paper is divided into two parts with the first part discussing pre-invasion health, the policies that affected Indigenous communities, and the current physical and mental health of Indigenous Australians. The second part identifies and describes an Aboriginal community-controlled health organisation and discusses its role in health improvement among the Indigenous people. 1. It is undeniable that Australian policies have greatly affected the general wellbeing of Indigenous Australians. Before Australia was invaded by migrant populations, the general wellbeing of Australian Indigenous populations fared much better. Scott, Webb and Sorrentino (2011) note that the wellbeing of the Indigenous people was not perfect prior to 1778, but they “had control over every aspect of their life” (p. 70). Their diet was for example healthy since they depended on bush tucker. Additionally, they lived on land they considered their own, and therefore took responsibility over it. Moreover, they did not have issues of waste management because none of the products they used had non-biodegradable qualities as is the case today. Since they were a people at peace, and dependent on land and the environment for health, the Indigenous people were physically and mentally healthy. Scott et al. (2011) note that the spiritual, psychological, communal, biological and sociological aspects of every Indigenous person were highly regarded. Consequently, they had a holistic approach to life. The physical exercise, usually manifest through ceremonial activities, food preparation and hunting and gathering, ensured that the Indigenous people remained physically healthy. Additionally, they did not have a history of infectious and lifestyle diseases such as smallpox, measles, diabetes and high blood pressure among others (Scott et al., 2011) 2. The policy of protection was adopted at around 1837, for purposes of protecting Indigenous communities from abuses. The policy also sought to provide them with medicines, blankets and food rations (Australian Law Reform Commission (ALRC), 2010). The impact of the protection was that in addition to denying Indigenous communities the natural foods and medicines that they were used to, it exposed them to new diets and medicines. For example, the highly processed diets led to lifestyle diseases. The prevalence of such diseases was compounded by the fact that Indigenous populations’ movement was restricted within reserved areas, hence limiting the physical activities they could engage in. The restriction had also been made to make it easier to protect them, while preventing them from inbreeding with the white population. The mental effect of the protection policy meant that Indigenous people lost their sense of identity, freedom, and even pride. The policy of assimilation was adopted in the 1950s to assimilate Indigenous communities in the manner of living practiced by other non-Indigenous Australians. Through this policy, the Indigenous communities were expected to enjoy similar rights and privileges as their non-Indigenous counterparts. However, there was a condition attached to this policy; the Indigenous communities had to accept the customs and beliefs of other non-Indigenous Australians (ALRC, 2010). The requirement for Indigenous Australians to abandon their customs and beliefs affected them physically and mentally, because it exposed them to lifestyle diseases. An example of the foregoing would be lifestyle diseases such as diabetes and high blood pressure. The assimilation policy displaced them from their natural environment, and effectively, this meant that they could not eat the food that they were used to or engage in hunting and gathering. The latter was a potent way of physical exercise for them. Instead, they were exposed to a new form of diet and a new form of life that did not allow them to engage in vibrant physical activity. Consequently, they became sick, especially since they were also exposed to other diseases which their bodies had no immunity for (Watson, 2010). 3. The present physical and mental health status of Indigenous Australians is related to: Social aspect: Indigenous Australians have always been socially disadvantaged (Dohia & O’Rourke, 2011). To start with, the disenfranchisement from their lands and the subsequent mistreatment in the hands of European colonisers left them grief-stricken. In subsequent years, they have faced human rights abuses, stigma and racism. In 1998 for example, the Native Title Amendment Act (NTAA) was passed and as a result, the Aboriginal people’s ability to negotiate government use of pastoral land was limited (Wood, 2002). Combined, the foregoing factors have contributed to the Indigenous peoples’ social disadvantage. Dohia and O’Rourke (2011) also note that family and kinship is very important to the social life of Indigenous communities, but this too they have been denied since their land rights have already been interfered with. Mentally, the social disadvantage has led to the Indigenous communities losing their sense of worth since they are poor, less educated, removed from their land, and disconnected from their families’ spirituality and culture (Poroch, Arabena, Tongs, Larkin, Fisher & Henderson, 2009). The aforesaid factors can lead to serious psychological distress, which if not checked, can compromise their mental health. Additionally, the same factors can compromise their physical wellbeing because poverty leads to poor housing, poor diets, and the adoption of health risk behaviours such as alcohol consumption, cigarette smoking, gambling, violence, and aggression among others (Dobia & O’Rourke, 2011; Kelly, Dudgeon, Graham & Glaskin, 2009). Even when they are at risk, Indigenous people are less likely to get quality healthcare compared to their non-Indigenous counterparts. Emotional aspect: The emotional life of most Indigenous Australians is direr compared to the rest of the population. Due to their disadvantaged position in the society, Kelly et al. (2009) note that they are more prone to adverse life events that scar their emotions for life. For example, the Indigenous people increasingly lose their loved ones, suffer from serious illnesses and/or disability, witness violence more often, and are more likely to feel the effect of discrimination. Most of them are an emotionally scarred people, and this can lead to bad temperament, negativity, lack of coping skills, bad social and emotional skills, and poor performance in school. Consequently, they find themselves in conflict with the authorities and other people either in school or other sectors of the society. Inevitably, their emotional trauma can lead to isolation and further discrimination and can even push them to vices which include violence and crime. Finally, Indigenous Australians suffer increased discrimination and socioeconomic disadvantage, which negatively affect their physical and mental wellbeing. Physically, the effects of emotional distress are seen in overindulgence in substance abuse, alcohol consumption, cigarette smoking or binge eating among other physically risky practices. Consequently, the Indigenous people are at an increased risk of lifestyle diseases, which most of them cannot afford to manage or treat due to their social disadvantage. Mentally, the emotional distress can lead to stress, depression and in extreme cases, insanity (Kelly et al., 2009). Psychological aspects: Indigenous people see health holistically. As such, their psychological (mental) wellbeing is affected by the presence or lack of “healthy relationships between families, communities, land, sea and sprits...” (Kowal, Gunthorpe & Bailie, 2007, p. 18). In other words, their communities, spirituality and cultural identification affect their physical and mental wellbeing. Physical aspects: The physical aspects of mental and physical health are closely related to other aspects of their wellbeing, because as Dudgeon, Wright, Paradies, Garvey and Walker (2010) indicate, when Indigenous people face barriers in the socioeconomic, geographical, historical and cultural factors, their physical wellbeing suffers too. Today, the Indigenous Australians are a physically sick people (Dudgeon et al., 2010). When they were dispossessed of their lands, they were not able to move to other places through nomadic activities as they would have done in an ideal indigenous life. Additionally, they did not have hunting and gathering activities anymore, and neither did they participate in customary activities (Dudgeon et al., 2010). Nelson, Abott and McDonald (2010) indicate that physical activity as is understood in the west is a totally different concept from the indigenous understanding of the same. Nevertheless, the physical aspect of the Indigenous peoples’ wellbeing is fraught with multiple challenges which include: cultural challenges – for example, it is currently difficult for most Indigenous people to include family and/or community members in physical activities; geographical challenges – for example, current locations of Indigenous communities make it hard for them to engage in physical activities, which include cultural ceremonies; and socioeconomic challenges that entail Indigenous people living away from their families and relatives, hence making organising of physical activities a complex and costly undertaking. Marshall, Hunt and Jenkins (2008) found out that 70% of Indigenous Australians live in urban areas, making it even harder for them to participate and/or organise culturally-appropriate physical activities. Consequently therefore, they suffer from chronic diseases, and their inactivity and the resultant diseases also affect their self-image hence affecting their mental wellbeing. Spiritual aspects: Garvey (2008) argues that “the destruction of areas and objects of sacred and spiritual significance...remains a source of unrelenting turmoil and sadness” to Indigenous communities (n. pag.). Unlike non-Indigenous communities, the Indigenous people perceived the spirit ‘world’ as the source of their livelihood, healing and other things that made life more bearable (Garvey, 2008). The fact that such sacred sites have been destroyed has led to a loss of spiritual identity and this has been proven to be mentally distressing. Emotional distress, if not handled in good time, can lead to the manifestation of disease in the physical body. Cultural aspects: Most of the cultural practices were lost when the Indigenous communities were excluded from their lands and natural resources. As recent as 2009, a tree that had much significance to the Indigenous people in New South Wales was cut to create room for a bypass road. Korfs (2014) states that the tree was known as the ‘Guardian Tree’. It is argued that indigenous culture is nowadays more of a state of mind rather than an adherence to specific behaviours, customs and/or beliefs (Hampton & Toombs, 2013). The foregoing is despite the fact that a majority of Indigenous Australians still adhere to the remnants of what was the indigenous culture, consisting of complex spiritual and cultural beliefs (Hampton & Toombs, 2013). The non-Indigenous Australians however, expect Indigenous communities to live in remote areas, and as such, most of the indigenous culture that is practiced in urban areas is rejected. As a result, Indigenous people suffer rejection and discrimination, factors that affect their mental and physical wellbeing. PART B 1. Charleville Western Areas Aboriginal and Torres Strait Islanders Community Health (CWAATSICH) was founded in 1993 by a group of 29 people, and was officially opened on April 29, 1994 (CWAATSICH, 2009; CWAATSICH, 2014). The facility is based in South West Queensland and seeks to offer culturally-appropriate and supportive services to Indigenous communities within the region (CWAATSICH, 2009). In addition to its base location, the facility has over the years extended its outreach services to Quilpie, Mitchell and Roma. The services offered by CWAATSICH fall into three categories, namely: clinical services, chronic disease management, and emotional and social wellbeing (ESWB) (CWAATSICH, 2009). Clinical services include general health checks, women’s, men’s and children’s health, immunisation, and general practice services. Under chronic disease management, the facility offers services pertaining to sexual health, diabetes, nutrition, eye and hearing health, and physical activity. Finally, ESWB offers services relating to mental health, massage and reflexology and counselling. The founders of CWAATSICH were inspired by the need to offer health services that were in line with the cultural, social and spiritual aspects of the Indigenous people (CWAATSICH, 2009). The founders were aware that contemporary doctors did not always understand the emotional wellbeing of Indigenous communities. CWAATSICH would not only provide health services to Indigenous Australians, but would also act as an information resource to disseminate information to the larger Australia regarding Indigenous people’s health (CWAATSICH, 2014). Among the unique traits of CWAATSICH is that it has culturally skilled workers who understand the spiritual, physical, social, cultural, and emotional aspects that affect Indigenous communities. The location of CWAATSICH in South West Queensland was well informed by statistics. Bredt and Ferrier (2008) observe that Queensland has 3.5% of Indigenous people compared to a 2.2% in the larger Australia. This means that the region has a higher concentration of Indigenous people. Additionally, the problems of unemployment and social disadvantage were also rife in the region. Consequently, the Indigenous communities could not afford or even access medical care. Where access was possible, most clinical facilities were modelled to target non-Indigenous Australians and, did not attend to the spiritual, cultural and emotional wellbeing of Indigenous populations. The pioneers of CWAATSICH also had the objective of making Indigenous people aware that they had a responsibility to steer their health and wellbeing in the direction they so desired (CWAATSICH, 2014). This was an apparent attempt by the institution to make Indigenous people own up to the responsibility of adopting and sustaining healthy practices. 2. South West Queensland is home to CWAATSICH. In addition to having the greatest Indigenous population at 32% compared to other parts of Australia, South West Queensland is increasingly facing environmental pressure from mining and coal industries (CWAATSICH, 2014a). The incursion of the industries to indigenous lands is also an issue that is putting more strain on Indigenous communities (Hossaon, German, Chappelle, Mann, & Penton, 2013). To most Indigenous communities, land has sacred meaning and as such, mining is an irreparable ill, which cannot be compensated with money or relocation to another place in Australia. The anxiety which Indigenous communities have regarding land and their ability to defend their cultural heritage sites in Australia further worsens the situation for them (Adermann & Campbell, 2010). The region also needed awareness regarding several issues such as reporting violence. According to Cripps (2010), Indigenous women rarely reported or sought medical help for injuries from domestic violence because they feared reprisals from their kin, the justice systems or the perpetrator. Most perpetrators had come to accept violence as a part of life, having witnessed colonial brutality during land dispossession, or having acquired such violence from preceding generations (Cripps, 2010). Emotional health CWAATSICH indicates that it’s “first generation clients, their families, and their dependents” still suffer from “past removal policies” (CWAATSICH, 2014b). To try and alleviate the pain and the effect of the removal policies, CWAATSICH has a special health programme aptly named ‘Bringing them Home (BTH)’. BTH is a counselling programme that seeks to attain the social and emotional wellbeing of the affected people by counselling and supporting them to overcome issues of trauma, loss and grief. The programme further helps its clients to search and reunite with their kin, whom they had lost contact with, and usually offers support even after the reunion (CWAATSICH, 2014b). Through its efforts, CWAATSICH has made access to care easier for Indigenous Australians residing in South West Queensland, and from an emotional perspective, the Indigenous people perceive such efforts as an expression of care or even love. As Ruth, Brennan and Brown (2010) argue, Indigenous communities are disadvantaged “by reduced access to medicines, delayed access to acute care facilities and lower rates of intervention once they have been admitted to these approaches”. The three authors therefore suggest that a community-based approach would be better positioned to stem systemic barriers and alleviate emotional distress that have in the past prevented Indigenous communities from accessing information and awareness regarding health and health empowerment. Since CWAATSICH targets Indigenous communities, it has provided relevant programmes and trained cultural-sensitive workers to provide specialised health services to the Indigenous people. Physical health Diabetes was and still is a major issue among Indigenous communities in South West Queensland, and is responsible for high mortality and morbidity cases. As a result, CWAATSICH (2014c) set up diabetes specialist clinics, which are staffed with highly skilled personnel. To effectively manage diabetes, the workers at CWAATSICH liaise with external health workers who include optometrists, podiatrists and exercise physiologists among others in order to fully meet the needs presented by the communities. CWAATSICH also runs several nutrition programmes that are meant to educate the Indigenous communities about the advantages of adopting healthy eating habits (CWAATSICH, 2014e). The programmes cover healthy food preparation, cooking and eating. A dedicated dietician is responsible for these programmes. Most of the physical illnesses that Indigenous communities suffer result from lifestyle choices. One of such critical choices is the diet that Indigenous people choose to adopt. Poor diets have led to high incidence of type II diabetes, obesity, coronary heart disease, and high blood pressure in the Indigenous communities (Gray, Macniven & Thomson, 2013). Mental health Mental health is also another health issue that the Indigenous people in South West Queensland had to grapple with. In recognition of the foregoing, CWAATSICH has a mental health programme that is dedicated to helping the local population overcome depression and other mental issues (CWAATSICH, 2014d). CWAATSICH appreciates that mental health interventions must be in line with indigenous worldviews and cultural beliefs as indicated by Ypinazar, Margolis, Haswell-Elkins and Tsey (2007). The programme is held each month in combination with other activities, which include gentle exercises, reflexology and massage. It is important to note that massage therapy and reflexology are also offered as separate programmes. Reflexology is offered twice every week for purposes of reducing stress in patients and helping with other areas of the body, which include headaches, respiratory weaknesses, back, shoulder and hip pains among other physical discomforts. As an indigenous practice, reflexology was used to calm people down, and CWAATSICH uses it for similar reasons especially among the stressed Indigenous clients. Closely related to reflexology are the services offered twice weekly by a massage therapist. Massage therapy was close to the hearts of Indigenous people because they believed that by massaging a person using special herbs and traditional tools, they are returning a spirit which may cause a person pain or discomfort to its rightful place (Hastwell, 2014). When dealing with matters of mental health, the health service providers at CWAATSICH are taught how to use some persuasion and massage therapy to restore a client’s ‘equilibrium’, and wellbeing. This is close to what traditional healers use to “restore the spirit balance within the body” (Hastwell, 2014, p. 2). CWAATSICH’s contribution Arguably, CWAATSICH’s approach improved the Indigenous people’s access to integrated services, and as a result, the community is more empowered and likely to have registered improved health outcomes since CWAATSICH located its offices and clinics in Queensland. Overall, CWAATSICH operates from an understanding that indigenous health is holistic. However, CWAATSICH also appreciates that Indigenous communities may never have access to the huge territories that serve as their source of food, cultural, social, spiritual and physical wellbeing. As such, the institution is providing Indigenous communities with the coping mechanisms as well as health interventions and advice needed to cope with the changing times. Overall, CWAATSICH is an example of what cultural-conscience community-based organisations can do to alleviate the suffering of Indigenous communities. As indicated herein, Indigenous communities not only suffer social discrimination, they are also suffering from being forced from their traditional way of life into modern ways of living. Such forced disempowerment exposes them to increased levels of physical and mental ill-health, as most of them cannot cope with the social and cultural pressure. CWAATSICH is an example of what a little dedication in communities where Indigenous people live can accomplish. Such a community-based institution can act as a place where members of the Indigenous community go not only to seek health services, but also to seek knowledge on matters related to nutrition and other health practices. CWAATSICH is evidence that Indigenous communities can benefit from enhanced access to health, and that for health providers to effectively address the needs and wants of Indigenous communities, they must be willing to understand members of the community and their perceptions about health and wellbeing, and must also be willing to exhibit cultural sensitivity while treating members of the Indigenous communities. Arguably, CWAATSICH has earned the trust of Indigenous communities because people therein perceive the health facility as part of their larger society. The foregoing is significant because Indigenous communities do not perceive health from an individualistic perspective; rather, they perceive it as part of a family or community. References Aderman, J., & Campbell, M.A. (2010). Anxiety and Aboriginal and Torres Strait Islander young people. In N. Purdie, P. Dudgeon & R. Walker (Eds.). 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Stamford, CT: Elsevier. http://books.google.co.ke/books?id=Ghu3LcL4WzkC&pg=PA69&dq=pre-invasion+health+status+of+the+Australian+Indigenous+population&hl=en&sa=X&ei=JobsU6rCEamu0QXQ94HwBA&redir_esc=y#v=onepage&q&f=false Watson, J. (2010). Palm island: Through a long lens. http://books.google.co.ke/books?id=7TXPpmQVlj4C&pg=PA93&dq=pre-invasion+health+status+of+the+Australian+Indigenous+population&hl=en&sa=X&ei=JobsU6rCEamu0QXQ94HwBA&redir_esc=y#v=onepage&q=pre-invasion%20health%20status%20of%20the%20Australian%20Indigenous%20population&f=false Ypinazar, V., Margolis, S., Haswell-Elkins, M., & Tsey, K. (2007). Indigenous Australians’ understandings regarding mental health and disorders. Australian and New Zealand Journal of Psychiatry, 41, 467-478. Read More