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Medical Journal of Australia special edition centres Indigenous knowledges

*** Aboriginal and Torres Strait Islander readers are advised that this article contains images and details of people who have passed *** 

Introduction by Croakey: “Who is speaking for us? Identifying Aboriginal and Torres Strait Islander scholarship in health research.”

That was the headline for a 2021 letter to the editor of the Medical Journal of Australia from leading Aboriginal and Torres Strait Islander health academics Adjunct Professor Janine Mohamed, Associate Professor Veronica Matthews, Professor Roxanne Bainbridge, and Dr Megan Williams.

The letter, calling for MJA leadership in “foregrounding Indigenous sovereignty in health research”, has led to an historic special edition of the MJA, published this week in the lead-up to NAIDOC Week 2024 (7-14 July).

The special issue, titled Centring Indigenous Knowledges, transferred editorial decision-making to a group of external expert Aboriginal and Torres Strait Islander guest editors, serving as a lesson, its opening article says, that “ceding power is a prerequisite if progress is to be made in Indigenous health, and is a process that should feel uncomfortable and unfamiliar”.

Sally Block, News and Online Editor at the MJA, reports below about the issue.


Sally Block writes:

The special issue of the Medical Journal of Australia, Centring Indigenous Knowledges, recognises and celebrates Aboriginal and Torres Strait Islander leadership and excellence in health and medical research.

In the first issue of its kind at the MJA, the journal has partnered with the Lowitja Institute, Australia’s only national Aboriginal and Torres Strait Islander community controlled research institute, to create a unique publication to coincide with NAIDOC Week 2024.

The issue pays homage to the life of the late patron of the Lowitja Institute, Dr Lowitja O’Donoghue AC CBE DSG.

“Dr Lowitja O’Donoghue AC CBE DSG often spoke of being courageous when it came to championing research led by our peoples, for our peoples. We thank MJA for providing this opportunity to showcase Blak excellence in health research,” Paul Stewart, CEO for the Lowitja Institute, told us.

For this issue, the MJA team worked with a group of Aboriginal and Torres Strait Islander academics and health leaders: leading nephrologist Professor Jaquelyne Hughes, University of Newcastle researcher and Lowitja Institute research advisor Associate Professor Michelle Kennedy, ear nose and throat surgeon Professor Kelvin Kong, former Lowitja Institute CEO Adjunct Professor Janine Mohamed, senior research Associate Professor Odette Pearson, Stewart and infectious diseases epidemiologist Professor James Ward.

They were engaged by Lowitja Institute as guest editors, who oversaw the peer review and decisions made on the issue.

The MJA’s Editor-in-Chief Professor Virginia Barbour said the issue, which ceded editorial control to the guest editors, was a recognition that the current model of publishing practices has not served Indigenous research and researchers well, and was, for the MJA, a specific response to the outcome of the Voice referendum in 2023.

“Meaningful change will only come when those in power are prepared to step aside and let Aboriginal and Torres Strait Islander peoples lead their own affairs whilst supporting where required,” Professor Barbour said.

One of the guest editors, Associate Professor Michelle Kennedy, said the issue provided an opportunity to correct publishing practices that have left Indigenous voices out.

The guest editors called for research papers led by Aboriginal and Torres Strait Islander people to reflect their own experiences, culture and knowledge and to address an area of health and wellbeing that is a priority for Aboriginal and Torres Strait Islander communities. There were a large number of high quality submissions in response.

All papers were led by Aboriginal and Torres Strait Islander researchers, who were invited to acknowledge the Indigenous knowledges that informed their work and to include their Language groups in the authorship line — upholding Aboriginal and Torres Strait Islander calls made in the MJA and BMJ’s Tobacco Control journal on ethical publishing practices.

Kidney disease, ageing and help for women prisoners were some of the topics covered, all from an Indigenous perspective, not commonly seen in mainstream medical publishing.

Health in aged care

Accessing high quality and safe aged care services should be a given for everyone. A paper from Odette Pearson (Eastern Kuku‐Yalanji and Torres Strait Islander) and colleagues looks at how aged care services are used by Aboriginal and Torres Strait Islander people, whose overall outcomes in health lag behind those of non-Indigenous people in Australia.

The research showed that only half of Aboriginal and Torres Strait Islander people who are eligible for approved aged care services access them, concluding that the health and aged care needs of older Aboriginal and Torres Strait Islander people are not being adequately met.

The paper calls for a holistic, tailored, integrated and collaborative approach to care to help people with multiple medical conditions. Models of care for Aboriginal and Torres Strait Islander people also need to include family and community, with consideration of cultural needs for best outcomes in health and wellbeing.

Supporting women

Another article looks at the evaluation of a program to help Aboriginal and Torres Strait Islander women prepare for their release from prison by Professor Pat Dudgeon (Bardi) and colleagues.

The Cultural, Social and Emotional Wellbeing Program at the Boronia Pre-release Centre for Women in Perth involves presentations, workshops, activities, group discussions and self‐reflections designed to enhance social and emotional wellbeing.

The women who participated in the program reported personal growth, including acceptance of self and acceptance and pride in culture, reflecting enhanced social and emotional wellbeing through connections to culture and kinship.

Preliminary findings suggest that the program could improve the resilience of Aboriginal and Torres Strait Islander women in contact with the justice system throughout Australia.

Kidney transplantation

Kidney disease continues to affect Aboriginal and Torres Strait Islander people at much higher rates than non-Indigenous people, and kidney failure has been increasing among Aboriginal and Torres Strait Islander children and young adults.

The MJA special issue includes research from Swasti Chaturvedi and colleagues, including Professor Hughes (Wagadagam), on kidney transplantation access and outcomes in Aboriginal and Torres Strait Islander children and young adults, reporting that they have poorer access to transplantation than non-Indigenous children and young adults.

The paper calls for models of care that achieve transplantation in shorter periods of time than is currently experienced and priorities that address inequalities for Aboriginal and Torres Strait Islander children.

There are also health disparities in treating chronic kidney disease in Aboriginal and Torres Strait Islander adults. In the Northern Territory, it’s estimated that 85 percent of adults who are dependent on dialysis identify as Aboriginal and Torres Strait Islander.

A ‘lessons from practice’ paper, on optimisation during transition to dialysis commencement, reveals that a care model based on Indigenous health ethics shows significant positive outcomes over a sustained period.

This paper was co-written by the patient whose story is described, Kaurareg woman Relma Luta, and combines scientific reporting with Storying, focusing on a model of care which prioritised Indigenous health ethics.

By prioritising culturally safe healthcare, Indigenous self‐determination, and acknowledging socio-cultural determinants of health, the model advances health outcomes and positions it as a new standard of healthcare delivery.

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Listen: MJA Podcasts 2024 Episode 21: “By the community, for the community” with Professor Kelvin Kong

Read: Securing surviving futures: Zenadh Health Science Research and Education Council

Read: Seeking a voice: the inadequacy of the “four principles” and the need for care ethics in the provision of health care to vulnerable populations

Read: Optimisation during transition to dialysis commencement

Read: “Simply put: systems failed”: lessons from the Coroner’s inquest into the rheumatic heart disease Doomadgee cluster

Read: Implementing the cultural determinants of health: our knowledges and cultures in a health system that is not free of racism

Read: Indigenous leader says Australia is nearing a tipping point to close the gap in academia


Read Croakey’s archive of articles on First Nations health

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