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Thirty years later, what has the health sector done to address Aboriginal deaths in custody?

Introduction by Croakey: As Australia marks the 30th anniversary of the Royal Commission into Aboriginal Deaths in Custody (RCIADIC) on 15 April, the health sector has been urged to reflect on whether it is part of the problem or offering solutions.

In the article below, Associate Professor Megan Williams, Wiradjuri justice health researcher and educator, identifies multiple areas where the sector has failed to address the health needs of prisoners.

The article is compiled from tweets this week at @WePublicHealth by Williams (@MegBastard), who is the Research Lead and Assistant Director of the National Centre for Cultural Competence at the University of Sydney.

Meanwhile, the Law Council of Australia has called for a comprehensive national response to address the vastly disproportionate imprisonment of Aboriginal and Torres Strait Islander peoples, highlighting the need for self-determination to drive such approaches (read the full statement here).

The Council cites figures showing that in December 2020, the Aboriginal and Torres Strait Islander imprisonment rate was 2,333 persons per 100,000 adult Aboriginal and Torres Strait Islander population, compared to the imprisonment rate of 208 persons per 100,000 adult population generally.


Megan Williams tweets:

Yiradhu marang g’day all.

I work on mainstream justice health workforce development, programs and evaluation including with the National Centre for Cultural Competence and Sydney Institute of Criminology.

I’ll share 20-plus years of tasks I’ve worked on in justice health: national data, palliative care in prisons, family stories, system planning, incompetence, community solutions.

Justice is essential for health, for all people in Australia. How we disregard the Royal Commission recommendations is as sick as how we treat First Peoples.

$40 million, three years of testimony and evidence about 99 Aboriginal deaths in custody in the 1991 final report. The 339 recommendations here but what about deaths since? More than 474. Is another Royal Commission needed?

Barely a family not affected by #Aboriginaldeathsincustody #PoliceBrutality #poverty #racism.

Do a word search of the RCIADIC recommendations for ‘police’ and that tells us exactly what needs to happen, that has not been happening.

The Uluru Statement is essential for achieving recommendations of #RCIADIC30Years – still not implemented #selfdetermination.

Where is health sector?

It’s time to make a list of all the government frameworks that overlook, minimise, forget, ignore, exclude, tokenistically mention or silence Aboriginal and Torres Strait Islander people in prison, and all people in prison.

Why is the Federal Government so afraid of prisoners and why will they ‘lead’ health care decisions about Aboriginal and Torres Strait Islander people but forget we are over-represented in prisons? Major disconnect and don’t get me started on no access to Medicare for people in prisons.

A search of Australian National Strategic Framework for Chronic Conditions for ‘prisoners’ or ‘prisons’ yields no mention, not even that prisoners are disproportionately over-represented in having chronic conditions? Tell me I am wrong!

As well as prisoners being excluded from the National Strategic Framework for Chronic Conditions (please let me be wrong!), they are also excluded from the #NDIS, yes. Here’s why and how discrimination occurs.

Prison staff, all types of them, need training so that they can show more respect for Aboriginal and Torres Strait Islander peoples, cultures and rights. Basic respect.

A Wiradjuri friend whose family member is in prison says it better:

And not be negligent. They seem to have no idea, in the way they spoke to us, the things they did, about care from an Aboriginal cultural perspective.

The ones writing the policies in the prison health services – do they have experience in writing policies or are they trained as health care workers – nurses? The policies seem poor or don’t seem to exist not at least for family to get hold of.”

Palliative care in prison

I work on new National Palliative Care in Prisons Project. It has two levels of governance by Aboriginal and Torres Strait Islander people underway. I am all for this leadership and influence. But, I am all for no one dying in prison, ever.

I’ve prepared expert reports to inquests including about a palliative care in prison. In my reviews of evidence, I saw gaps, silencing, poor training on supporting people dying, post-death and for families.

The bias about ‘compassionate release’ for people expected to die from life-limiting conditions! I am confused why this is ‘compassionate’ not a right nor obligation for people to die at home, with mob, on Country?

Family stories

Voices of families have a power that cuts through like nothing else.

My gorgeous cousin, SW, died a violent death in a prison I had visited and worked in. I am astounded there is anything OK with people dying in prison, ever, expected or not.

Things you missed out on SW, so sorry. My kids being born, the kids of our other cousins, Nan passing on, Pop’s 80th wow, Pop passing on, the recording he made for his funeral, his funeral – damn, the house Mark built, the big family reunion, your love for us…

“Staunch families refusing to rest” oh yes. Never going to stop until I know the full story of our SW, RIP gorgeous one.

And more from a family member #RCIADIC30Years to Coroners:

Take more care when delivering findings about deaths of Aboriginal people in custody. The process for us is brutal. You are handling the truth and you need to bring the truth out. Don’t hide it.”

Further reading and listening

Thank you @boeknow + @AllanJClarke for all your podcasting efforts.

Aboriginal deaths in custody are often from system and professional conduct failures and should not be expected just because of ‘over-representation’. That ‘fait accomplice’ attitude is fatal and #prevention is possible.

“We thought a royal commission [was] going to be a good thing, we might get answers,” Glen Boney said.

Colonisation “moved [Aboriginal people] away from the resources they used to stay healthy”. Prison does that too. Article by Yorta Yorta Legal Director of the Human Rights Law Centre Meena Singh here.

Read more about The Language Project.

There are more voices of Aboriginal and Torres Strait Islander people in the free ebook #JustJustice – tackling the over-incarceration of Aboriginal and Torres Strait Islander peoples | Croakey – over 90 articles by 70 authors identifying Aboriginal and Torres Strait Islander people’s solutions to over-incarceration and improving health and wellbeing of Aboriginal and Torres Strait Islander people in the criminal justice system and their families and communities.

Big respect to @Mibbinbah health promotion community organisation for ongoing support and constant use of the Mad Bastards film and Be The Best You Can Be group events  https://www.madbastards.com.au/

A Working Paper analysing the extent of implementation of four RCIADIC recommendations themes will be released by @ANU_CAEPR on April 15 – see @WePublicHealth for details.


National Day of Action

Photos by Marie McInerney from rally in Naarm/Melbourne, 10 April.

#EndBlackDeathsInCustody rally in Naarm/Melbourne
#EndBlackDeathsInCustody rally in Naarm/Melbourne
#EndBlackDeathsInCustody rally in Naarm/Melbourne