The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) is well positioned to contribute to improved health, employment and education outcomes for Aboriginal and Torres Strait Islander communities at a pivotal time, according to senior leaders of the profession.
This article is published by Croakey Professional Services as sponsored content as part of a series celebrating CATSINAM’s 25-year history of collective and individual activism. See the campaign portal.
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Wiradjuri academic Juanita Sherwood was working at The Block in Redfern in inner Sydney in the late 1980s when she first saw the need to decolonise research to improve health outcomes for Aboriginal and Torres Strait Islander peoples.
Professor Sherwood is a founding member of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), a member of its Elders Circle and a Board director. She said CATSINaM’s model of Indigenous governance today was “a beacon of light in how to do business in Indigenous health” compared to a generation ago when she started work as a nurse.
“Our governance model reflects on what is important in our culture, our lore, how we pay respect to Elders, and how we promote primary healthcare as critical care for our community,” she said.
CATSINaM’s membership is comprised of Aboriginal and Torres Strait Islander nurses, midwives and students, its board is 100 percent Indigenous and governance is supported by the Elders Circle and the research consortium, Muliyan.
Board President Marni Tuala, a Bundjalung registered midwife, said CATSINaM’s model of Indigenous governance could be seen in multiple layers of the organisation where the distribution of power often seen in Western systems was replaced by the reciprocal distribution of knowledge that reinforces “our Aboriginal ways of knowing, being and doing”.
“What we’re doing at CATSINaM is demonstrating the model of excellence in Indigenous governance,” she said.
“Everybody holds knowledge but how do you make that a reciprocal process that promotes collective leadership? You remove the Western power distribution structures and it becomes a true knowledge distribution structure, which is how our communities have managed to survive for more than 60,000 years.
“In my community – and in many Aboriginal communities – we’re raised from a very young age on the principles of garrima (respect) and ngimbalien (contribution). Everybody in a community has a role to play and understanding these principles and the application of those within our organisational processes is why our collective leadership model works so well.”
A strong position
Marni Tuala said CATSINaM’s governance model put it in a strong position to drive its vision to improve health, employment and education outcomes for Aboriginal and Torres Strait Islander communities.
The commitment of the new Federal Government to implement the Uluru Statement from the Heart has been widely welcomed throughout the Indigenous health sector, as have the appointments of Wiradjuri woman the Honourable Linda Burney as Minister for Indigenous Australians and Yanyuwa woman the Honourable Malarndirri McCarthy as Assistant Minister for Indigenous Health and Assistant Minister for Indigenous Australians.
“The next three or four years are going to be pivotal in Aboriginal health investment and we’re ready,” Ms Tuala said.
“We will use our collective leadership to say to government this is what we need: Aboriginal and Torres Strait Islander nurses and midwives are 60 percent of the Indigenous health workforce but we are not funded to reflect that figure. Funding needs to match the distribution of the Aboriginal Health workforce.”
CATSINaM will soon release an updated getting em n keepin em report, first published in 2002 by the Indigenous Nursing Education Working Group, with recommendations for governments on the recruitment and retention of Indigenous nurses. The new getting em n keepin em report will be launched at CATSINaM’s national conference on August 19 on Gadigal land in Sydney where the Congress of Aboriginal and Torres Strait Islander Nurses (CATSIN) was formed 25 years ago.
CATSINaM Chief Executive Officer Professor Roianne West, a descendant of the Kalkadoon and Djunke peoples, said the success of the Indigenous governance model could be seen in CATSINaM’s gains in improving best practice in nursing and midwifery across Australia and its ongoing advocacy and activism.
“The strength of CATSINaM is in its collective leadership because our Indigenous voices together give us our strength,” she said.
“We would like to see more collective Indigenous leadership and representation on boards of all other organisations representing nurses and midwives.”
Wisdom of Elders
The CATSINaM Elders Advisory Circle was established two years ago to advise and assist the Board and the Chief Executive Officer on cultural governance, cultural leadership and membership matters.
Auntie Dr Doseena Fergie OAM is one of 10 members of the Elders Circle who bring decades of knowledge and experience in nursing, midwifery, research and education.
“We are all respected in our own right as clinicians and educators but also the fact that we’ve had that long length of experience,” she said.
“We bring that wisdom through our yarning and our cultural knowledge of language, art, song and so on. It adds a depth to our organisation that non-Indigenous organisations perhaps don’t recognise.”
For younger Indigenous nurses, midwives and university students, the Elders Circle brings a continuity of cultural education and strengthens respect for Elders.
“We do know historical facts that young people may not know that enables us to have that added wisdom in pursuing CATSINaM’s goals. We have all lived through extreme racism and discrimination,” Auntie Dr Doseena said.
“It helps our young people to be comforted in whatever challenges – and joys – they face in their workplaces or institutions and helps them to navigate that space because we in the Elders Circle have been there before and are able to give them advice.”
Like many members of the Elders Circle and the Muliyan researchers, Auntie Dr Doseena has for many years worked in and with universities to embed Indigenous history and culture into nursing curricula and cultural safety across workplaces and institutions.
“In the Elders Circle we have seen so much development in this area but we know how much further we need to go,” she said.
The latest addition to CATSINaM’s Indigenous governance structure is Muliyan, a national consortium of practitioners, researchers, educators, policy-makers, funding bodies and community organisations committed to providing better care for Aboriginal and Torres Strait Islander communities.
Muliyan means eagle in the Ngunnawal language and was gifted to CATSINaM following discussions with Ngunnawal Elders.
Consortium members collectively have track records in undertaking research that has led to health workforce and systems reform. Professor Juanita Sherwood, for example, is widely credited for further recognition of colonisation as the primary determinant of Indigenous health and increasing the uptake of decolonising research methods.
Knowledge translation is a guiding principle of Muliyan so that research learnings are communicated to communities as well as throughout the health research sector.
“What Muliyan has tried to do is to work with our communities. There’s some amazing people in Muliyan who have rich research histories, and collectively great wisdom and expertise,” Professor Sherwood said.
In May 2020, Bwgcolman woman and academic Dr Lynore Geia, a Muliyan researcher and a member of CATSINaM, led a call to action with more than 100 Australian nursing and midwifery leaders to address racism and oppressive practices in nursing and midwifery.
The call to action was published in response to the Black Lives Matter protests in the United States following the murder of African American man George Floyd by a white police officer. The publication aimed to raise the voice of First Nations people in the Australian context and highlight the ongoing racism experienced by Aboriginal and Torres Strait Islander peoples in Australian healthcare systems.
“Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress,” Dr Geia wrote together with colleagues in A unified call to action from Australian Nursing and Midwifery leaders: ensuring that Black Lives Matter.
“The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care,” they said.
The call to action was signed by a number of CATSINaM founding members and CEO Professor Roianne West. It called for Indigenous and non-Indigenous practitioners to work together to reform university curricula so that all graduates entered the health workforce knowledgeable and skilled in culturally safe care.
“It aims for non-Indigenous nursing and midwifery academics to be confident in themselves to teach Aboriginal and Torres Strait Islander content. Reform processes also include creating collaborative collegial engagement and care for each other as academics and students and to engage in reflective practice, critiquing and challenging structures of bias, while working towards reforms that contribute to dismantling oppressive practices in the health system,” Dr Geia said.
A unified call to action set out four principles for reform:
- Recognition that Indigenous health is everybody’s business.
- Indigenous nurses and midwives should be actively and authentically included in the dismantling and reform of healthcare and education institutions that perpetuate racism.
- Further cultivate nursing and midwifery curriculum that promotes the social and cultural determinants of Australia’s First Peoples. “The mandatory use of the CATSINaM Nursing and Midwifery Health Curriculum Framework in nursing and midwifery degrees must be enforced and embedded in a meaningful way”.
- Celebrate ‘belonging’ to the caring culture of nursing and midwifery. “The caring paradigm enables us to share and reciprocate in collegiality, in friendships and comradeship.”
“As nurses and midwives, we are the largest workforce in the health care system and we do have the capacity to collectively work to bring reform in our health care so that Aboriginal and Torres Strait Islander peoples experience and receive culturally safe health care,” Dr Geia said.
This article was funded by CATSINaM and edited by Professor Roianne West. It was written on behalf of Croakey Professional Services by Linda Doherty, and also edited by Dr Tess Ryan and Dr Melissa Sweet.