Aboriginal and Torres Strait Islander Health

Core Generalist#

Knowledge#

CG.K.1#

Describe your community and evaluate its resources, strengths and vulnerabilities

CG.K.2#

Discuss the diversity of Aboriginal and Torres Strait Islander peoples, values, beliefs, self-identification, impacts of colonisation and intergenerational traumas

CG.K.3#

Identify the local Aboriginal and Torres Strait Islander Health Organisations/ Services, Health Workers and Cultural Mentors

CG.K.4#

Identify local health knowledge and practices

CG.K.5#

Understand that cultural safety requires lifelong development, understanding culture, history, self-awareness with beliefs and values, then integrating this with practice and being accountable for actions

CG.K.6#

Discuss the importance of, and connection between, cultural safety, recognition of cultural diversity among Aboriginal and Torres Strait Islander peoples and self determination

CG.K.7#

Discuss the factors involved in communicating cross-culturally, including:

the different communication styles of Aboriginal and Torres Strait Islander peoples
the impact of different grammar with communication with a person for whom English is not their first language
challenges of interpreting biomedical terminology into Indigenous languages
communication cues from Aboriginal and Torres Strait Islander peoples particularly in relation to gender issues in the patient/doctor relationship, body space and touching, questions about initiation marks, limitations on questions about sexual organs, Lore and about other peoples
the barriers to effective communication between doctors, other staff and community members including socio-economic background, cultural issues, language, health beliefs, Lore, authority figures, anticipation of approval from authority figures and gender, and
the concept of culture shock

CG.K.8#

Describe the barriers to access and understanding of traditional and western health services

CG.K.9#

Discuss racism and the impact of racism on the health and the delivery of health care to Aboriginal and Torres Strait Islander peoples

CG.K.10#

Describe the living picture of the population and distribution characteristics of Aboriginal and Torres Strait Islander peoples at a local and national level, including:

the population of Aboriginal and Torres Strait Islander peoples relative to the whole population, pre- and post-colonisation
major features of the distribution of Aboriginal and Torres Strait Islander peoples, nationally, in each state, rural–urban distribution, in his/her own region, town, community
demography of the Aboriginal and Torres Strait Islander people’s population in terms of age and gender, and
the broad diversity of backgrounds and ways of knowing and being for Aboriginal and Torres Strait Islander peoples

CG.K.11#

Describe an overview of colonisation in Australia including:

the background underlying colonisation in Australia
the term ‘terra nullius’ and its significance
the process of colonisation, and
the resistance of Aboriginal and Torres Strait Islander peoples to colonisation

CG.K.12#

Describe an overview of the history of Australian government regulation in relation to Aboriginal and Torres Strait Islander peoples including:

genocide/massacres, segregation and protection policies, ‘smoothing the dying pillow’ to ‘training for citizenship’
assimilation, removal of children, the ‘stolen’ generation
contemporary policies, community empowerment, self-determination, the growth of Aboriginal and Torres Strait Islander people’s organisations
land rights
reconciliation
incarceration
Northern Territory Emergency Response

CG.K.13#

Explain current social and economic inequities experienced by Aboriginal and Torres Strait Islander peoples and the link between socio-economic factors and health status, including:

employment status, education status, economic status, housing status, access and standard of environmental infrastructure
current children living in out of home care
impacts of intergenerational trauma
barriers to accessing primary, secondary and tertiary health services, and
the social and economic determinants of health

CG.K.14#

Discuss the health status of Aboriginal and Torres Strait Islander peoples, including:

the pre-colonial health status of Aboriginal and Torres Strait Islander peoples
the current views and understandings of the meaning of health in a personal and community sense
Traditional health practices in the community
the major current mortality and morbidity patterns of Aboriginal and Torres Strait Islander peoples particularly in relation to fertility rate, life expectancy, maternal mortality, infant mortality, age-specific mortality and morbidity
major regional differences in mortality and morbidity patterns, common age and sex specific causes of morbidity, mortality, clinic presentation and hospital admission for local Aboriginal and Torres Strait Islander peoples, linking them with the associated socio- economic, cultural and environmental factors

Skills#

CG.S.1#

Display an openness and willingness to identify and explore own cultural values, beliefs and attitudes and to explore the same things from the perspective of people from cultural backgrounds other than their own

CG.S.2#

Work effectively alongside Aboriginal and Torres Strait Islander peoples, communities and organisations to ensure culturally safe health care that responds to Aboriginal and Torres Strait Islander people’s health care needs and priorities

CG.S.3#

Support and collaborate with Aboriginal Health Workers and local cultural mentors

CG.S.4#

Demonstrate culturally appropriate strategies for working with people from diverse cultural backgrounds

CG.S.5#

Deal effectively with maintaining confidentiality in rural/remote and Aboriginal and Torres Strait Islander communities

CG.S.6#

Create an enabling environment through enough seating, space, light, imagery, colour and time

CG.S.7#

Enquire sensitively about a patient’s Indigenous and/or cultural identity

CG.S.8#

Recognise an Aboriginal and/or Torres Strait Islander person as someone who identifies themselves as such and is accepted as Aboriginal and/or Torres Strait Islander by their community

CG.S.9#

Use the Aboriginal Interpreting Service where available

CG.S.10#

Undertake a systematic and culturally sensitive approach to health assessment for Aboriginal and Torres Strait Islander patients

CG.S.11#

Identify and address situations where one-on-one consultations may be inappropriate with some Aboriginal or Torres Strait Islander patients including:

gynaecological and obstetric examinations
other intimate examinations, and
when customary Lore and traditional law issues are involved

CG.S.12#

Effectively negotiate and develop an agreed management plan working with the patient, their values, beliefs and goals

CG.S.13#

Select from Medicare Benefit Item numbers and other services available for Aboriginal and Torres Strait Islander peoples

CG.S.14#

Contribute to research consulted with and lead by Aboriginal and Torres Strait Islander peoples

Attributes#

At.11#

Integrity

At.6#

Compassion

At.17#

Resourcefulness

At.1#

Accountability

Advanced Specialised#

Knowledge#

AS.K.1#

Identify the Traditional Custodians of the Land, Elders, kinship systems and major family groups within your local community

AS.K.2#

Describe the evolution, philosophy and characteristics of health service delivery for Aboriginal and Torres Strait Islander peoples, including:

historical health services and providers in pre-colonial communities and their legacies in current communities, in detail
the types, quality and effectiveness of western-style health services provided prior to the Aboriginal Community Controlled Health Services movement
social and health conditions that underpin the evolution of community-controlled health services
the philosophy of community-controlled health services and the services they provide
the roles of Aboriginal and Torres Strait Islander employees and health workers
‘self-determination’ as it is exercised in the context, operation and activity of community-controlled health services
the relationship between government health agencies and community-controlled health services, nationally, regionally and locally  concepts of social justice, equity of health outcomes, and health rights in relation to Aboriginal and Torres Strait Islander peoples’ health care provision, and  the integral role of intersectoral and interprofessional collaboration and the function of Aboriginal and Torres Strait Islander health workers in facilitating effective care of the individual and the community  mainstream service provision, services and role in providing care to Aboriginal and Torres Strait Islander people

AS.K.3#

Identify the contemporary socio-cultural characteristics of Aboriginal and Torres Strait Islander people’s communities including:

the diversity of family organisation, extended family and responsibilities
patterns of reciprocity and decision making, and
Lore, and identity

AS.K.4#

Discuss the importance of working with patients’ families, appreciating variations in roles and responsibilities in relation to health

AS.K.5#

Discuss own strengths, values and vulnerabilities in maintaining a personal and professional balance in a cross cultural, rural and remote context

Skills#

AS.S.1#

Develop a reflective, respectful and balanced relationship with the local community, Aboriginal Community Controlled Health Organisation boards of governance and management including:

recognising the importance of spending time developing trust
understanding and respecting cultural difference and ways of knowing
identifying areas where there is potential for abuse of professional power and developing strategies to prevent such abuse
understand the role of key members in the community
understanding the role of the board, the CEO and others within the organisation
understanding own role
identifying and acting on opportunities for learning, engagement and negotiation, and
developing effective relationships with the community and senior management.

AS.S.2#

Advocate to improve the health outcomes of Aboriginal and Torres Strait Islander peoples

AS.S.3#

Create health resources with communities in response to identified need

AS.S.4#

Assist with culturally sensitive research lead by Aboriginal and Torres Strait Islander peoples, including:

knowing where and how to find information
working as part of a cross cultural team
assisting with identifying processes, such as intervention studies rather than merely descriptive studies, that will assist in improving health outcomes, and
being aware of, and using, the NHMRC ethical guidelines in Aboriginal and Torres Strait Islander research.

AS.S.5#

Teach, mentor and clinically supervise doctors in training

AS.S.6#

Address racism in the health care setting