The Partnership for Justice in Health (P4JH) is working to address racism in the health and justice sectors at individual, institutional and systemic levels, according to its co-chairs, Dr Janine Mohamed, CEO of the Lowitja Institute, and Karl Briscoe, CEO of the National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP).
Aboriginal and Torres Strait Islander readers are advised that this story includes the names of people who have passed away, and discusses sensitive issues such as deaths in custody and loss of life within the health system.
Janine Mohamed and Karl Briscoe write:
We are both health professionals who have built strong, dedicated careers in Aboriginal and Torres Strait Islander health, healthcare and health research.
But what still comes as a shock to many of our non-Indigenous colleagues is that rather than health services being viewed as places of healing and safety, they are too often neither safe nor welcoming. And for some of our people, they are dangerous and fatal.
The complicity and failures of the health system and professions to care for us goes back to the early days of colonisation.
We saw it in medical experimentation and the lock hospitals, the removal of children from their mothers’ arms by nurses and doctors, and in ongoing, systemic abuse and neglect.
In recent years, two names speak loudly to how that experience of unsafe healthcare continues for our people.
Ms Dhu, a 22-year-old Yamatji woman who died in custody in Western Australia in 2014 because of “deficient” medical care — with the Coroner finding that both police and hospital staff were influenced by their racial bias.
And Naomi Williams, a 27-year-old Wiradjuri woman, who was 22 weeks’ pregnant with a son when she died of septicaemia at Tumut Hospital in New South Wales in January 2016.
The coronial inquiry into Ms Williams’ death found she went to hospital 15 times in the months before she passed away without receiving a referral to an expert, and she should have received further examination on the night she passed away.
Both she and Ms Dhu died from preventable causes within racially biased systems.
A self-determining alliance
And it is their stories, and those of others, that has led to the formation of the Partnership for Justice in Health (P4JH).
The P4JH is an alliance of self-determining Aboriginal and Torres Strait Islander academics, legal experts, and national peak health and justice organisations.
We are committed to working together to improve Aboriginal and Torres Strait Islander health and justice outcomes through addressing racism at individual, institutional and systemic levels, specifically focusing on the health and justice systems.
We hear a lot in Australia — though still not enough — about Aboriginal and Torres Strait Islander deaths in custody, about the failings of the justice system for our people.
But we rarely hear about the harm, just as fatal, caused by racism in the health system.
The stakes are too high to wait any longer!
The Royal Commission into Aboriginal Deaths in Custody contained dozens of recommendations about failures in the health system or from health professionals that played direct roles in deaths in custody.
Yet, 30 years on, most of the Royal Commission’s recommendations have been left on the shelf or poorly implemented, if at all.
The stories of Ms Dhu and Naomi Williams and others since are finally beginning to resonate across the health system and among those who shape its policies.
So too of course did the death of the world acclaimed musician Dr G Yunupingu, who battled through his life with kidney and liver disease following childhood hepatitis, but received poor treatment because his liver damage was interpreted as alcoholism.
As leaders operating at the interface of the health and justice systems, we are committed to ensuring that Aboriginal and Torres Strait Islander people enjoy health and wellbeing that is free of racism in the health and justice systems.
That is also the professed vision of the Australian Government through the National Aboriginal and Torres Strait Islander Health Plan, the first such document to mention racism. In 2013 (finally, we would say!), it declared a vision of the Australian health system being free of racism.
But what’s been missing from government policy since is how to do that.
Since coming together, the Partnership for Justice in Health have worked together to build a shared understanding of race and racism, how these constructs function and the harmful impacts they cause.
We are aiming to initiate a cultural shift and influence the implementation of system-focused efforts to identify and eliminate racism and embed truth telling and cultural safety across health and justice.
Our focus recognises that the burden does not lie with Aboriginal and Torres Strait Islander people to have confidence that both the justice and health systems will protect and defend accordingly.
The burden lies with both systems demonstrating a commitment to eliminating racism, through the reform of practices and policies, in all areas of operation.
So, we are urging leaders and champions from across all levels and domains of both the health and justice systems to reflect on their roles and consider what they can do to inform, influence and empower change, to create systems free of racism.
The P4JH is well positioned to work alongside other organisations and campaigns to create the political will necessary for considered comprehensive long-term action.
Collectively we have:
- lived experience
- a comprehensive understanding of the interaction and impacts of race and racism across the health and justice systems
- professional expertise in redress, cultural safety, shared decision making and determination
- influence, connections, and extensive networks across Aboriginal and Torres Strait Islander Australia and Governments, and
- a demonstrated track record in cross sectoral collaboration and delivering services in partnership.
Going forward we will be working to:
- embed truth telling as a guiding principle in the operation of Australian systems and public discourse
- place Aboriginal and Torres Strait Islander people at the centre of driving solutions
- establish shared understandings so that racism and discrimination are better understood, addressed and prevented
- support Aboriginal and Torres Strait Islander people to understand their rights, the avenues for redress and to encourage them to report and act against racism
- ensure high quality approaches to culturally safe and responsive practice are embedded across the health and justice systems.
At a recent Partnership event, the Lowitja Institute launched a new discussion paper: on ‘Race, Racism and the Australian Health System’, written by Associate Professor Chelsea Watego, Dr David Singh and Dr Alissa Macoun.
The paper offers a lever and some broad initial recommendations in an attempt to bring together a more explicit and cohesive anti-racist agenda that is culturally, intellectually and politically aligned with the organising and activism that has always fallen on under-resourced Indigenous communities.
“These recommendations are not about how to solve racism, but how to make a more concerted investment in strategising in undermining racism,” said Associate Professor Chelsea Watego at the event.
We were also privileged to hear at that event from proud Yorta Yorta, Wemba Wemba and Barapa Barapa woman Apryl Day, who continues to demonstrate incredible strength and courage after losing her mother in the most unjust of circumstances.
Apryl’s dedication and leadership has influenced significant policy change, after Apryl and her family successfully fought for the abolition of public drunkenness laws in Victoria. After the tragic death of her mum, Apryl helped to bring the issue of racism in the health and justice systems to the fore through the establishment of the Dhadjowa Foundation, a grassroots organisation that provides strategic, coordinated and culturally appropriate support for Aboriginal and Torres Strait Islander people and families whose loved ones have died in custody.
P4JH members include:
- ABSTARR Consulting
- Associate Professor Chelsea Watego
- Australian Indigenous Doctors’ Association
- Congress of Aboriginal and Torres Strait Islander Nurses and Midwives
- Indigenous Allied Health Australia
- Institute for Collaborative Race Research
- Lowitja Institute
- National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners
- National Justice Project.
Follow us on Twitter: @P4JH and Instagram: @Partnership4jh
See previous Croakey articles on racism and health.
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