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Next steps for embedding cultural safety

The new Closing the Gap agreement between Australian governments and the Coalition of Peaks identifies the need to address institutional racism, discrimination and unconscious bias and to embed cultural safety within government mainstream institutions and agencies.

In the article below, Professor Juanita Sherwood, Pro Vice-Chancellor of Indigenous Engagement at Charles Sturt University in NSW, suggests that cultural safety training for politicians, journalists and media organisations may help ensure appropriate implementation and funding for the agreement.


Juanita Sherwood writes:

I am an Aboriginal woman and nurse who has many decades of experience in caring for the health of our people. I have worked in our communities, in hospitals and other health services. I have worked in universities and other organisations, always with a determination to improve our people’s access to healthcare that is respectful and culturally safe.

Prof Sherwood

I have so many stories – from my own life, from my families and communities, and from colleagues and networks – about our people being harmed, instead of being cared for by the health system. For every story of neglect or harm that receives media coverage, I know of so many more such stories that don’t get heard.

So much of my work over many years has been about informing healthcare providers that it is their systems that problematise Indigenous peoples and how that plays out to be problematic for our health and wellbeing. Culturally unsafe health service providers ensure that our People do not receive equitable care.

Where health professionals and researchers can believe they are treating everyone the same, we all know we are not the same, and the impact of colonisation yesterday and today continues to influence our health because of the mainstream services that are provided to us in unsafe ways.

Dominant culture fails to recognise our strengths and our ability to survive. Colonisation is and continues to be a determinant of health that supports the deficit discourse about our Peoples. The way in which they view and relate to our People is often the problem. Their unconscious bias often means they treat our People in a discriminatory way that results in injury and at times loss of life.

Like everyone, I worry for what the pandemic will mean, in the short and longer term, and not only through its direct impacts, especially for those at increased risk because of other health conditions, but also its wider impacts, for example, on employment and education.

Pandemic disruption

But times of crisis and disruption like this are also times of opportunity for creating meaningful change, including for overturning some of the enduring colonial narratives about Aboriginal and Torres Strait Islander people.

These titles from recent academic publications, Aboriginal Community Controlled Health Organisations are taking a leading role in COVID‐19 health communication, First Nations people leading the way in COVID-19 pandemic planning, response and management and Australia’s First Nations’ response to the COVID-19 pandemic, are a reminder of the immense capacity and deep knowledge of Aboriginal and Torres Strait Islander people. No one knows better than us about how to look after our people.

Those articles were written before the most recent emergence of COVID-19 hotspots in NSW and Victoria. We are not complacent about the challenges ahead or the need for us to stay focused.

But the response of our Aboriginal and Torres Strait Islander health sector during the initial phase of the pandemic has made us proud. We have seen our researchers, doctors, Aboriginal Health Workers, nurses and midwives, allied health professionals, our peak bodies, our Aboriginal community controlled health organisations – all working so hard, sharing knowledge, contributing to national policy, and keeping communities safe.

Colonial patterns

I was not so happy, though, to hear recent comments from Ministers suggesting that we Aboriginal and Torres Strait Islander people need to do a better job of looking after ourselves.

These Ministerial comments are reinforcing colonial narratives of us as the problem, while obscuring all the ways that colonial systems are harming us, through removing and locking up our children, punitive and discriminatory policing and justice systems, and through unsafe healthcare. Even the mainstream health system now acknowledges that it needs to do a much better job at providing safe working environments for Aboriginal and Torres Strait Islander people, and for us as patients.

Last Thursday Minister for Indigenous Australians Ken Wyatt and Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO), announced a new way forward for Closing the Gap. This has been a result of peak body pressure to deliver real outcomes in areas of urgent need.

The Government have during the last couple of days stated that the previous program had not been successful as it failed to include Indigenous voices and strategies. They failed to mention that its lack of success had anything to do with the Coalition’s ongoing cutting of funds to community controlled health services and other successful run community projects.

We have as Indigenous people often stated if we set up a program that is effective the government will make sure that it is not funded into the future.

I dearly hope that this is not the way this new way of Closing the Gap will go. There has been no mention of additional funds and that is a tell-tale sign of a serious lack of commitment on the governments’ behalf. A plan that has been in the pipeline for the last two years should have enabled the Federal and State and Territory governments to come up with a financial commitment.

This is indicative of a wider problem. The fact is that the Federal Parliament is, by and large, a culturally unsafe space for Aboriginal and Torres Strait Islander people.

Despite the enormous effort and work of many Indigenous MPs, and of groups such as the Coalition of Peaks to influence policy, so much of the wider policy work and commentary by Parliamentarians has harmful consequences for Aboriginal and Torres Strait Islander people.

The Coalition Government has removed millions from our health budgets, challenges our community controlled health organisations and promotes colonial ideologies such as deficit views. These are culturally unsafe practices and they influence all Australians including mainstream health providers.

Ways forward

I have two proposals, developed with colleagues, that we believe could help Australia to maximise the opportunities arising from this time of disruption in which we find ourselves.

  1. Introduce cultural safety training for all MPs as a mandatory job requirement. Not as a one-off exercise, but as a regular part of their Parliamentary responsibilities. Cultural safety training is not only a tool for addressing the institutional racism embedded in our national governance, it is a tool for opening the eyes of MPs to the enduring strengths and wisdom of the First Nations people.
  2. Introduce mandatory cultural safety training for journalists and media organisations. Media coverage and the questions asked by journalists (or not asked) have such a critical role in framing public and policy debate and have real-world consequences for the health and wellbeing of our people. There are no shortage of examples of interpersonal and institutional racism in the media – such as an all-white-panel discussing Black Lives Matter, on ABC TV’s flagship program, Insiders, and we’ve heard recently from many Indigenous journalists about how unsafe mainstream newsrooms are, as well as the importance of sustaining our deadly Indigenous media.

I commend the work being done by many across the health sector to embed cultural safety into practice, policy and programs. Our politicians and the media could learn from your work.

Professor Juanita Sherwood, who has Wiradjuri, Murri, Maori and Anglo-Celtic lineages, is Pro Vice-Chancellor of Indigenous Engagement at Charles Sturt University in NSW.