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With the Voice, we’re on the road to better health and wellbeing

The Voice is important for health at many levels, including through addressing the disenfranchisement felt by many Aboriginal and Torres Strait Islander people, according to Beck Thompson, a Warrimay woman from NSW and Remote Area Nurse.

“…a true Voice encompasses a permission to speak, which challenges us to break the uncomfortable silence insisted of us in the past, a Yes vote implies that our fellow Australians WANT us to speak,” she writes below.


Beck Thompson writes:

On 14 October Australia will answer the question:

To alter the constitution to recognise the First Peoples of Australia by establishing an Aboriginal and Torres Strait Islander Voice.

Do you approve this proposed alteration?

The decision that Australians make on 14 October will send our country down one of two paths. Regardless of the path we are sent on, the outcome of the referendum should be a catalyst for change.

It is an opportunity for those of us working in Indigenous health to critically examine how we recognise our Indigenous clients and colleagues, how effectively we listen to those voices, and how we respond in practice.

As a Remote Area Nurse (RAN) for the past four years, I have had the privilege to live and work in nine different communities stretched over three separate States and Territories. The work is challenging clinically, physically, and emotionally.

I am one of only a handful of RANs who is also Indigenous; on the front line of ‘Closing the Gap’ in health outcomes and life expectancy. The point of difference we bring to the discourse is our lived experience of the Gap outside of our professional lives.

As an Indigenous clinician, I have an advantage. Even though the people I am nursing are not my mob, there is a level of trust that I am afforded solely on the assumption that I am less likely to judge or that I understand. This trust can be lost in a heartbeat but when fostered, leads to better outcomes.

I was asked by my last team leader on several occasions how I uncovered vital information in my first consultation with a patient who had attended the clinic for years – information that staff had not known this whole time and information that could then inform their care and achieve better results.

Too often the relationship between the health industry and Indigenous people is still seen as an ‘us and them’ relationship. One of paternalism and judgement.

I still regularly hear clinicians refer to local people in community as ‘they’ and ‘them’, and judgement about people’s lifestyle, beliefs, or priorities. This basic lack of understanding is all too common.

As an Indigenous person, I feel the judgement in those words and I can guarantee that the community does too. Judgement discourages Indigenous Peoples from speaking.

Shame and mistrust prevent people from seeking the care they need and receiving appropriate care when they do. Shame, for example, is an ever-present part of culture and it exists on several levels. Traditionally when we talk about shame, it is in the context of breaking lore or through self-aggrandisement. However, since colonisation when Indigenous people were corralled onto missions, shame takes on further meaning and is directly related to western domination of culture.

Australia has a long history of blaming Aboriginal and Torres Strait Islander peoples for their own socioeconomic situation and health. This is still an issue today, it is very common for an Indigenous person to not tell a healthcare provider the ‘whole story’ leaving out things that are perceived to be shameful, which impacts substantially on treatment adherence.

It’s not that this patient doesn’t want to adhere to the treatment suggested, it’s just that there are barriers. It may be that the medicine requires refrigeration and the patient is too ashamed to tell you that their power is cut off or that they don’t have a working fridge. It might be when you educate people to wash sheets and clothes to decrease reinfection following scabies treatment but your patient feels too ashamed to tell you that they have no sheets and sleep directly on mattresses with a blanket – the norm for people in remote communities – so the fact that you even mentioned sheets implies a lack of understanding and a projection of western expectations.

Empowerment

Our country’s history of dispossession and disempowerment of our First Peoples, decades of broken promises, lack of meaningful consultation, the description of remote communities and, by extension, their occupants as a problem to be solved has resulted in deeply embedded disenfranchisement.

The NT Electoral Commissioner Iain Loganathan was quoted in 2020 as stating that the voter turnout in remote communities was, on average 50 percent across the NT. He also gave the example of Maningrida in Arnhem Land, one of the largest communities in the NT, where voter turnout was just 24 percent despite attempts to make voting more accessible. I see this disenfranchisement daily, there is a lack of hope that hangs in the air over remote communities, a general resignation to the status quo.

I am a strong supporter of enshrining an Aboriginal and Torres Strait Islander Voice in our constitution as both a symbolic and substantive recognition of Australia’s First Peoples.

More than recognition, it provides a non-partisan, independent conduit for Indigenous people and Government to work co-operatively in the formation of policies and laws which affect Australia’s First Peoples. It will be better than the current system of partisan appointees to advisory roles, which results merely in the illusion of consultation rather than legitimate representation.

I approach discussion of the Voice to Parliament with some trepidation, both as a registered nurse and an Aboriginal woman.

This trepidation reflects my world view, shaped by both history and experience; it takes a certain temerity to contravene convention and present my observations, experiences and opinions publicly. That is what the Voice is about at its core, beyond the simplicity of listening; a true Voice encompasses a permission to speak, which challenges us to break the uncomfortable silence insisted of us in the past, a Yes vote implies that our fellow Australians WANT us to speak.

The Aboriginal and Torres Strait Islander Voice is an opportunity to address the disenfranchisement felt by many Indigenous Australians, empowering people to participate in decision making and regenerate a currently lacking sense of hope that it is possible to create change.

More than 210 health organisations in Australia have stated their public support for the Voice to Parliament. I am proud that our industry has recognised the unique opportunity that the Voice provides to improve health outcomes through better policy decisions that are influenced by representatives of the Aboriginal and Torres Strait Islander community.

This support is a really necessary first step to ensuring that Australia’s First People know that we WANT to hear their voices. My hope is that we are moving toward a future when these barriers are no longer. Where we have built the trust and respect and eliminated the judgements.

So, Voice to Parliament or no, I ask everyone in health to walk with, sit with, and listen to Aboriginal and Torres Strait Islander people. Ask questions, learn culture, understand better.

Reflect on the assumptions, expectations and judgements, conscious or unconscious, that you bring to the conversation.

Critically assess how well we do this and utilise the experience and knowledge of your Indigenous colleagues to break down the barriers to both our First People speaking and to us listening.

Beck Thompson. Photo supplied

• Beck Thompson is a Warrimay woman from NSW. An Aboriginal artist, Indigenous health communicator and Remote Area Nurse, providing primary health and emergency care in remote Aboriginal communities across Australia. Follow on Twitter @BlaktruthBeck


See Croakey’s portal on the Voice, compiling articles, resources and statements

 

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