The 5th Aboriginal and Torres Strait Islander Health Summit – a biennial event of the National Aboriginal and Torres Strait Islander Health Standing Committee, established by the Australian Health Ministers Advisory Council (AHMAC) – was held in Sydney last Friday.
Co-hosted by the NSW Ministry of Health’s Centre for Aboriginal Health and the Aboriginal Health & Medical Research Council of NSW (AH&MRC), the event brought together Indigenous and non-Indigenous leaders, from government and non-government sectors, and from policy, research and practice areas across health and health care.
Its focus on finding the ways to “reset” Aboriginal and Torres Strait Islander health through self-determination and privileging Indigenous voices had the event hashtag #IndigenousHealthSummit trending nationally throughout the day.
In this comprehensive wrap below, Summer May Finlay – a Yorta Yorta woman, public health researcher and Croakey contributing editor – reports for the Croakey Conference News Service on the main themes that emerged and the ways ahead.
Don’t miss also this post (to come) of her video interviews with presenters and panellists from the Summit, plus some Twitter highlights (and selfies). See more tweets at the bottom of this post too.
Summer May Finlay writes:
What’s required to reset the approach to Aboriginal health?
Truth, power and love are universal themes found in stories throughout history: Shakespearian plays, Robert Browning’s poems, Margaret Attwood’s books and Martin Scorsese’s movies.
These themes don’t just feature in fairy tales and horror stories but in the lives of Aboriginal and Torres Strait Islander people, according to the presenters at the 5th National Aboriginal and Torres Strait Islander Health Summit last Friday.
Co-hosted by the NSW Ministry of Health’s Centre for Aboriginal Health and the Aboriginal Health & Medical Research Council of NSW, the theme of the Summit was “Aboriginal health – it’s time to reset”.
Our Cultures were front and centre either implicitly or explicitly because the majority of speakers were Aboriginal and Torres Strait Islander people. An Aboriginal and Torres Strait Islander agenda was a deliberate strategy to demonstrate that, we, Aboriginal and Torres Strait Islander people, really are the knowledge holders of our communities. That we are the solution.
Power = Self-determination
Power was a persistent and dominant theme. Power of the majority to maintain the status quo. Power where people other than Aboriginal and Torres Strait Islander people made and make decisions affecting us and we are merely consulted. Power in deciding what information is collected about us and how it’s used.
We heard how that power plays out in the health system and in individual people’s lives daily. Throughout the day, Aboriginal and Torres Strait Islander people, many working at senior levels in the health and research sectors, recounted personal experiences of poor treatment and care in the health story or those of people they know. They all agreed that the sub-standard care and treatment was driven by racism: individual and institutionalised.
Federal Indigenous Health Minster Ken Wyatt‘s announcement at the Summit of an expert panel to “investigate and identify barriers faced by First Nations people needing kidney donations” was a powerful illustration of how the system is skewed against us.
This national inquiry is driven by the evidence that Aboriginal and Torres Strait Islander people with chronic kidney disease are more than three times less likely to receive a donor kidney than non-Indigenous patients, and nine times more likely to be reliant on dialysis.
In another keynote address, Janine Mohamed, CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), spoke of how Aboriginal and Torres Strait Islander people are often expected to solve the issues facing their communities, yet it’s the 97 per cent of non-Indigenous Australians who hold power.
The responsibility lies with them to share power so Aboriginal and Torres Strait Islander people can lead, she said.
Mohamed described the current decision-making systems, i.e. Governments and other bodies which are the current “operating system” as “a colonial apparatus”, in which we are constantly described in deficit and therefore viewed as the problem.
It’s a system and perspective that was famously rejected by Rosalie Kunoth-Monks on ABC TV’s Q&A, when she declared: “I am not the problem”, a sentiment echoed through the Summit discussions.
“The system needs to reflect on itself; it needs to problematise itself, not us,” Mohamed said, calling for recognition from those in power that the current system is the problem and that there is s a “fundamental need to redistribute power”.
Queensland University Associate Professor Gregory Phillips, whose PhD is entitled ‘Dancing with Power: Aboriginal Health, Cultural Safety and Medical Education’, also discussed the impact of power on voice and funding.
He said the voices of Aboriginal and Torres Strait Islander people are often ignored or drowned out by the weight of the 97 per cent of non-Indigenous people. This is either intentional or unintentional but both are products of past and ongoing colonisation, he said.
Self-determination is what is needed, and is not something that government “do for us” but rather something they should “give us”, he said. “Government’s role is to get out of the way”, he said.
Phillips highlighted the Victorian Government’s recent support for Aboriginal self-determination as an example of what can be achieved. He said the Victorian Government was also “getting out the way” in April this year when it handed the responsibility and funding for Aboriginal children in out of home care to the Victorian Aboriginal Child Care Agency (VACCA) and, in late 2016, when it handed over responsibility of social housing to Aboriginal Housing Victoria.
Phillips said Aboriginal and Torres Strait Islander people should not be playing the role of consultants in these processes – which only served to maintain the power imbalance – but should be in the decision-making seat, directing how and where the money is spent.
Pro Vice Chancellor Maggie Walter from the University of Tasmania agreed, saying she no longer agrees to be on advisory committees because “that’s not voice” and it also maintains the power of “the 97 per cent”.
She believes that advisory committees are “so 1980s” – stemming from the mentality that things should be done “for” or “to” Aboriginal and Torres Strait Islander people rather them being led by us or at least done “with” us.
Walter is a champion of Indigenous data sovereignty, a growing international movement which calls for Indigenous people to determine what data needs to be collected, how it’s analysed and how it’s used.
She said Aboriginal and Torres Strait Islander people are conflicted by a “data paradox”, where there is both “too much and not enough (data) at the same time”. We are “saturated” with studies looking at the “prevalence of disease”, but have little data on other issues, such as how many people are from each Aboriginal nation or the extent to which racism impacts our health, she said.
What’s needed to address that, she said, is to have Aboriginal and Torres Strait Islander people leading the research so they can determine what data needs to be collected to assist our communities and how it will be used.
Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation, was unable to attend the event due to ill health but has subsequently published her speech. She also called for self-determination.
“Why are the Aboriginal self-determination concepts accepted only by parts of our machinery of federal government rather than as a whole of government planning principle? The Feds pick and choose what they like, what they fund and how they access our Indigenous data!” she said.
From the audience, Romlie Mokak, CEO of the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Strait Islander Research, agreed that Aboriginal and Torres Strait Islander people should be leading the research.
He said he knows this can be done because 87 per cent of projects funded by the Lowitja Institute are led by Aboriginal and Torres Strait Islander researchers, compared to a fraction of that from National Health and Medical Research Institute funded projects on Indigenous health.
“I don’t buy the ‘reset’, we need a new operating system,” he said.
There was universal support from presenters on the call in the Uluru Statement of the Heart for a Makarrata truth telling commission, underscoring growing calls in mainstream health for the Federal Government to reverse its rejection of the Uluru Statement, on health grounds alone.
Panelists agreed that to get to a point that Aboriginal and Torres Strait Islander people are trusted to be self-determining Australia needs to be honest about what has happened in this country to Aboriginal and Torres Strait Islander people. At the moment Australia often denies or minimises past wrongs to Aboriginal and Torres Strait Islander people, a lack of truth that is maintained by those in power. Without honesty, there can be no trust or healing, for our people and as a country.
The Summit heard from multiple speakers that truth-telling is a process where individuals, families and communities can share how the actions of governments and non-state actors have negatively affected them. It is a process many colonised countries, including Canada and South Africa, have opened up to with their Truth and Reconciliation Commissions.
Truth-telling would be an opportunity for this country to recognise and acknowledge past wrongs so all Australian can heal and build trust.
Walter said it’s not just Aboriginal and Torres Strait Islander people who need to heal. She believes that non-Indigenous people have been sold a lie, that the impacts of colonisation don’t affect them but they do. Phillips agreed:
In relation to healing, it’s always talked about as if the mistreatment has happened in the past. It’s also happening now. It’s not only Aboriginal people who need healing. We have a system and a history which affects us all.”
Trust was a critical issue raised over and over again. Without trust, there can be no reset. Without trust, there can be no partnership. Without trust, there can be no significant change in the health and wellbeing of Aboriginal and Torres Strait Islander people. It will be us who continue to die. Continue to be locked up. Continue to lose custody of our children.
Love = culture = protection
Indigenous Health Minister Wyatt talked about the role of family, love and culture and how they must be at the forefront of the early years of learning and acquisition of knowledge .
“Our mothers and fathers, uncles, aunts and grandparents – our families are the first protectors of our children, the warriors for their welfare and their future,” he said.
As children – love, certainty and protection nourish our bodies, brains and cultural souls.”
Wyatt said these imperatives were at the heart of the First 1000 Days project led by Professor Kerry Arabena from the University of Melbourne, who facilitated the Summit. Arabena told the event:
There is no such thing as a vulnerable child or a marginalised family. There are families who experience vulnerability and families who experience marginalisation. To understand this will take a reset.”
From the audience, Rod Little, Co-Chair of National Congress of Australia’s First Peoples, said love is never mentioned or even considered in government policies, and yet love was the critical reason Aboriginal and Torres Strait Islander people seek to work with and advocate for our mob.
Practical ways to reset Aboriginal health
A panel on how to reset the agenda provided a case study on how Aboriginal and Torres Strait Islander people and organisations can and do lead the way, and work well in partnerships with non-Indigenous health agencies and leaders that recognise that need and can act with honesty and integrity.
The discussion included Darryl Wright, CEO of Tharawal Aboriginal Corporation, and Amanda Larkin CEO and Nathan Jones, Director of Aboriginal Health of South Western Sydney Local Health District (LHD).
Through their partnership, there has been a shift in the way staff worked with Aboriginal and Torres Strait Islander people, improvement in health outcomes and employment opportunities for Aboriginal and Torres Strait Islander people at all levels, they said.
Watch this interview with them about what makes their partnership successful.
Where to from here?
Non-Indigenous journalist Dr Jeff McMullen, who helped close the day’s discussions, spoke of how he came to realise that the health system was actually hurting Aboriginal and Torres Strait Islander people. He would see the same story of sub-par treatment and care being repeated, and recognised that it wasn’t our people who were the problem but the health care system.
The day ended with a call for more than a reset. It called for a significant update of the operating system. An operating system which relinquishes power to Aboriginal and Torres Strait Islander people, communities and organisations.
And there was a call for the Uluru Statement from the Heart – which is all about power, truth and love – to be supported by all organisations present.
The way ahead: some pointers and pathways
You can bookmark this link to follow Summer May Finlay’s coverage of the Summit.