Essay On Narratives Of Health And Illness

Introduction 


“Rheumatic Heart Disease (RHD)” is one of the most concerning ailments in the Aboriginal community of Australia (aihw.gov.au, 2022). RHD is attributed to furthering of the existential gap of racism and the subsequent healthcare access of the “Aboriginal and Torres Strait Islander community (ATSI)” which is shown in the documentary of Four Corners, “Heart Failure: An Investigation into the Hidden Killer in Remote Australian Communities” in Australia (ABC News In-depth, 2022). The paper aims to provide with a discussion on the Four Corner’s documentary Heart Failure: An Investigation into the Hidden Killer in Remote Australian Communities” and highlight the issues in health and RHD of the ATSI community with special emphasis to the existential colonial, racial, and social construct and factors impacting the health outcomes of the community.
 

Impacts Of Colonisation And The Subsequent Dispossession Of Aboriginal Lands And Discussion On Intergenerational Trauma And Racism Which Negatively Impacts Atsi Health


Four Corners in their documentary Heart Failure: An Investigation into the Hidden Killer in Remote Australian Communities” provided a very direct yet touchy depiction on how the silent killer, RHD is disserving the heart and overall health outcome of the ATSI community (ABC News In-depth, 2022). Major focus of the documentary that shook the nation and major stakeholders of healthcare is based on the ATSI people with RHD from north-west Queensland, Australia. ABC News highlighted the case of Betty Booth who was an 18-year-old young fellow from the ATSI community of Queensland. She lost her life due to preventable RHD due to reluctancy and leniency of the healthcare professionals of the state and lack of rapid response for a patient having an Aboriginal cultural and socioeconomic background (racgp.org.au, 2022). The message of the documentary was based on the idea that when lives could be saved, leniency and the casual and unempathetic approach and behaviour of the healthcare system of the nation led to the loss of three lives like Betty Booth. Had the lives of three non-Indigenous people were under consideration in such a situation, there would not have been such situations as implicitly hinted in the documentary (ABC News In-depth, 2022). Despite having all the adequate care facilities and infrastructure, preventable lives are being lost in many forms, not just heart diseases or RHD which is the main message of the documentary (racgp.org.au, 2022). RHD is prevalent in 81% of the Indigenous Australians of which every 56 people in 100,000 people live in Queensland alone (aihw.gov.au, 2022). Colonization is the main determinant of health of the ATSI community of Australia which is profoundly illustrated and commented upon by Junit Sherwood (Sherwood, 2013). The roots of colonization and kts long-term implications are still prevalent in the social construct of Australia which has been proved over time again and again. Even after passing of 100 years of independence, still racism that is institutionally adapted invisibly in the social system of nation is known to all and evident in many forms (racgp.org.au, 2022). If the health of the ATSI community is considered, it is majorly governed by the factors associated with colonization (Sherwood, 2013). Moreover, Sherwood suggested that history taking while treatment and medication is a must that all clinician of the nation should do before doing anything else (Sherwood, 2013). History is not just the colonial tragic past of the Indigenous or the First Australians but taking detailed note of their social, occupational, economic, and political history which will enhance the chances of better medical treatment and interventions (Doran et al., 2019). This suggestion is also proven and emphases by other researchers and experts that there lies a very strong link between the health condition of individual or communities with their social, cultural, historical, and economic factors like the other social determinants of health (SDHs) (racgp.org.au, 2022). The past 200 years of colonial brutal and dark history of the nation is something that every healthcare professional must understand and cherish in their minds or else, they will not be able to do justice to the people of Australia or the First Australians at large (Sherwood, 2013). Land dispossession of the British colonists which is the way of usurping land form the First People that is the Aboriginal Australians and forcing them to sent exile and live lives and forest dwellers is a dark history of how colonialism impacted the lives of the Indigenous Australians (Sherwood, 2013). This act of dispossession of powers, land usurpation, and tyranny on the natives is not compensated even today. Moreover, institutional hopelessness and despair that is common among the people of the ATSI community can be traced back to the trauma that was a result of overwhelming pain, tyranny, misrule, dispossession, racism, and brutal behaviours with the Aboriginal people during colonial times (Verbunt et al., 2021). These sustained and repeated merciless processes over time have impinged permanent despair and trauma among the Indigenous Australian that is responsible for the alarming cases of depression, mental health ailments, addictions and substance abuse, and hopelessness of the community at large (Sherwood, 2013). Lack of knowledge of the colonial history of the nation and how racism has been institutionally embedded in its healthcare construct is responsible for what is being exhibited in form of preventable deaths and adverse health outcomes such as RHD in the ATSI community and other diseases as well in the non-Indigenous community of Australia at large (Doran et al., 2019). Additionally, the author suggested that only cultural and historical understanding of the Indigenous culture can help clinicians and nurses to serve purposefully in elevating the health outcomes of the ATSI community and collaborative work with healthcare staff with understanding of the Aboriginal culture, languages, and of the same background is the need of the hour (Sherwood, 2013). 
 

Discussion On How Cultural Factors Impact On Atsi Health And Wellbeing 

 
Culture is one of the most vital determinants of health of the ATSI community. Distinct culture of the community (Taylor & Guerin, 2019). Cultural determinants also play a major role in governing the wellbeing and health outcomes not just in the recent context but these determinants have been intricately attached with the community’s health over the years formatively. The ATSI community over the years follow a very comprehensive and wider concept of family and they value family members more than others (Sherwood, 2013). This family-centred life definitely has something very positive to physical and mental health which is very rare to find in the Westernized or Anglicised societies where most of the older people are separated from their families when the grow old (Doran et al., 2019). This cultural or family orientation increases family-binding, cohesion among family members, older people guide and advise the younger ones regarding natural remedies and maintaining a healthy and vibrant life from their experience which they have inherited from their grandparents centuries back (Best, 2021). Moreover, cultural elements that are centred on preservation of nature and natural resources also generate a strong sense of wellbeing among the younger members which makes them understand concepts like why to conserve nature and what are the natural nectars to get out of diseases, and how to preserve biodiversity even without going to schools and spending hours in finding inconclusive studies from thousands of futile publications (Doran et al., 2022). 
 

Discussion On Cultural Safety, Its Definition And Necessity

 
As per the “National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025” cultural safety is a very crucial element in the plan which includes provisions for cultural respect, inclusion of the ATSI community in the healthcare system of the nation, and providing a safe healthcare workforce at par with the national codes, standards, and guidelines (nacchocommunique.files.wordpress.com, 2020). Culturally safe practices in the context of the ATSI health is the sum of reflection of healthcare professionals’ knowledge, practicing behaviours, attitudes, skills, power differentials so that safe, accessible, responsive, and comprehensive healthcare system can be gifted to the ATSI people which is free form racism and social injustices (Doran et al., 2019).  Facilitating improved health services with safe and quality care for the ATSI community is also a major goal of cultural safety as per the plan (Finlay et al., 2021). Moreover, ongoing commitment to continuous learning, training, and education are also major deliverables of cultural safety regarding the ATSI community (Parter et al., 2021). In order to maintain culturally safe, secure, and respectful practice, health professionals should cater towards having proper knowledge and understanding of racism, colonial past of the nation, economic and social factors impacting the health of the ATSI people, and cultural and behavioural attributes (Laverty et al., 2017). Overcoming all racial and cultural biases, dismantling the barriers in the head of healthcare professionals regarding ‘White Supremacy” and undermining the First Australia due to their racial and cultural construct is a crucial objective in the direction of cultural safety and respect (McGough et al., 2022). Additionally, cultural safety is necessary for empowerment of the ATSI people, helping them making decision-making, informed choices, helping them getting out of the trauma and hopelessness that they face intergenerationally (nacchocommunique.files.wordpress.com, 2022). Moreover, working towards development of safe, inclusive, respectful, and humane healthcare environment which is free from all kinds of social injustices and racism can boost the health outcomes of the ATSI people which makes cultural safety as a very important attribute in the Australian healthcare system (Taylor & Guerin, 2019). 
 

Conclusion 

 
The paper discussed the Four Corner’s documentary Heart Failure: An Investigation into the Hidden Killer in Remote Australian Communities” and highlight the issues in health and RHD of the ATSI community with special emphasis to the existential colonial, racial, and social construct and factors impacting the health outcomes of the community. It was observed that Four Corners in their documentary Heart Failure: An Investigation into the Hidden Killer in Remote Australian Communities” provided a very direct yet touchy depiction on how the silent killer, RHD is disserving the heart and overall health outcome of the ATSI community. The need of the hour is cultural and historical understanding of the Indigenous culture can help clinicians and nurses to serve purposefully in elevating the health outcomes of the ATSI community and collaborative work with healthcare staff with understanding of the Aboriginal culture, languages, and of the same background.
 

References 


ABC News In-depth | An investigation into the hidden killer in Australia’s remote Aboriginal communities | Four Corners (2022). Retrieved 25 July 2022, from https://www.youtube.com/watch?v=LJHFUw0NXzw&ab_channel=ABCNewsIn-depth 
 
 
Acute rheumatic fever and rheumatic heart disease in Australia, 2015–2019, Rheumatic heart disease - Australian Institute of Health and Welfare. (2022). Retrieved 25 July 2022, from https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/acute-rheumatic-fever-and-rheumatic-heart-disease/contents/rheumatic-heart-disease 
 
 
AHPRA & National Boards. (2020) | National Scheme’s Aboriginal and Torres Strait Islanders Health and Cultural Safety Stratgey 2020-2025 (2020). Retrieved 25 July 2022, from https://nacchocommunique.files.wordpress.com/2020/02/aboriginal-and-torres-strait-islander-cultural-health-and-safety-strategy-2020-2025-1.pdf 
 
 
Best, O. (2021). The Cultural Safety journey: an Aboriginal Australian nursing and midwifery context. In O. Best & B. Fredericks (Eds.), Yatdjuligin: Aboriginal and Torres Strait Islander nursing and midwifery care (3rd ed., pp. 61-80). https://acquire.cqu.edu.au/articles/book/Yatdjuligin_Aboriginal_and_Torres_Strait_Islander_nursing_and_midwifery_care/13428503 
 
 
Cultural Respect Framework 2016-2026 (2022). Retrieved 25 July 2022, from https://nacchocommunique.files.wordpress.com/2016/12/cultural_respect_framework_1december2016_1.pdf 
 
 
Doran, F., Wrigley, B., & Lewis, S. (2019). Exploring cultural safety with Nurse Academics. Research findings suggest time to “step up”. Contemporary Nurse, 55(2-3), 156-170. https://doi.org/10.1080/10376178.2019.1640619 
 
 
Doran, F., Wrigley, B., & Lewis, S. (2019). Exploring cultural safety with Nurse Academics. Research findings suggest time to “step up”. Contemporary Nurse, 55:2-3, 156- 170, https://doi.org/10.1080/10376178.2019.1640619 
 
 
Doran, F., Wrigley, B., & Rix, E. (2022). 'Teaching in Circle' with student nurses contributes to experiential understanding of cultural safety. Contemporary Nurse, Online ahead of print(Latest Articles), 1-26. https://doi.org/10.1080/10376178.2022.2054840 
 
 
Finlay, S., Canuto, K., Canuto, K., & et al. (2021). Aboriginal and Torres Strait Islander connection to culture: building stronger individual and collective wellbeing. Medical Journal of Australia, 8, S12– S16. https://researchnow.flinders.edu.au/en/publications/aboriginal-and-torres-strait-islander-connection-to-culture-build 
 
 
Laverty, M., McDermott, D., & Calma, T. (2017). Embedding cultural safety in Australia’s main health care standards. Medical Journal of Australia, 207(1), 15-16. https://www.mja.com.au/system/files/2017-06/10.5694mja17.00328.pdf 
 
 
McGough, S., Wynaden, D., Gower, S., Duggan, R., & Wilson, R. (2022). There is no health without cultural safety: why cultural safety matters. Contemporary Nurse, 1-10. https://doi.org/10.1080/10376178.2022.2027254 
 
 
newsGP - Why are Aboriginal Australians still dying from an entirely preventable disease?. (2022). Retrieved 25 July 2022, from https://www1.racgp.org.au/newsgp/clinical/why-are-aboriginal-australians-still-dying-from-an 
 
 
Parter, C., Murray, D., Mohamed, J., Rambaldini, B., Calma, T., Wilson, S., ... & Skinner, J. (2021). Talking about the'r'word: a right to a health system that is free of racism.
 
 
Public health research & practice, 31(1). https://researchportal.scu.edu.au/esploro/outputs/journalArticle/Talking-about-the-r-word-a-right-to-a-health-system-that-is-free-of-racism/991012925544302368 
 
 
Sherwood, J. (2013). Colonisation–It’s bad for your health: The context of Aboriginal health. Contemporary nurse, 46(1), 28-40. https://doi.org/10.5172/conu.2013.46.1.28 
 
 
Taylor, K., & Guerin, P. T. (2019). Health care and Indigenous Australians: cultural safety in practice. Bloomsbury Publishing. https://books.google.com/books?hl=en&lr=&id=Fh5HEAAAQBAJ&oi=fnd&pg=PR1&dq=Taylor,+K.,+%26+Thompson+Guerin,+P.+(2019).+Health+Care+and+Indigenous+Australians:+Cultural+Safety+in+Practice+(3rd+ed.).+London:+Red+Globe+Press&ots=iC3Mya87c5&sig=1I7TuuTvQf7PjuzMjxGdehwOFDc 
 
 
Verbunt, E., Luke, J., Paradies, Y., Bamblett, M., Salamone, C., Jones, A., & Kelaher, M. (2021). Cultural determinants of health for Aboriginal and Torres Strait Islander people–a narrative overview of reviews. International Journal for Equity in Health, 20(1), 1-9. https://doi.org/10.1186/s12939-021-01514-2
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