by MAREE MEREDITH

As Aboriginal and Torres Islander people, we value the contribution that medical science can make, but we know our lives are so much more. Our health isn’t solved by a tablet, or a prescription.

Our physical health, our mental health and our life expectancy are poorer on average than our non-Indigenous friends, but if we are going to Close the Gap, our team at Poche SA+NT believe we need to re-develop how we think about health and also what actions we take to improve health.

Poche SA+NT is an Aboriginal-led centre focused on researching and improving health for Aboriginal and Torres Strait Islander people. We are part of Flinders University and based in Darwin and Alice Springs, but we also work with staff across the rest of Australia.

We know that if you don’t have a bed to sleep in tonight, or if you don’t have food in the house for the next two days because you have no money, then that is going to affect your health. We are having conversations with people across our communities, and they are also telling us about the importance of a whole range of factors that influence health, including cultural connection, community resources, spirituality and recognition of traditional healing.

To Close the Gap in health, we are training 500 Indigenous health leaders by 2025 and while some of them will be doctors and nurses, there will also be students, who can help promote healthy lifestyle choices to other kids; there will be work on justice issues, recognising the impact of justice and rights on health and we will work with Aboriginal and Torres Strait Islander organisations, Elders and communities to trial new approaches to improving health.

We all can see past approaches to Closing the Gap in health have not worked, despite good intentions and billions of dollars of investment – and we recognise that empowering communities and individuals to have a voice in health initiatives is vital. But we also face a great risk that community-led programs can’t be ghettoised and involve only community. Just because communities finally get a voice in prioritising initiatives that improve their lives doesn’t mean responsibility and action is simply left up to communities alone.

That is why we are working with communities through research, webinars and publications to identify the key determinants of health, the priorities for different communities on what must change to improve health outcomes and the development of leaders in a broad range of areas who can – and are committed to – changing health for the better.

We have looked very hard at the work we do over the past year and want to focus on partnerships – working on what we do well – conducting research, training leaders and evaluating outcomes. These are good things, but they will not do much on their own. By working with partners with strengths in delivering programs and changing lives, we will achieve far more than if we try to do these things on our own.

The Poche SA+NT team are therefore focused on three key areas of activity:

* growing understanding about the value and impact of holistic approaches to health;

* training Aboriginal and Torres Strait Islander health leaders from all walks of life; and

* partnering with Aboriginal and Torres Strait Islander organisations to help deliver, evaluate and attract new resources for community-focused programs.

As we do this work, we are committed to Aboriginal and Torres Strait Islander ways of working. We want to proudly incorporate our culture into mainstream Australian organisational operations – which we believe is another important element of health. Recognition of the value of Aboriginal and Torres Strait Islander customary and contemporary knowledge is vital in addressing the way that we talk about, think about and act on improving health outcomes.

Our team focus on consensus decision models, culturally-safe and culturally-appropriate work environments and is aimed at looking after the wellbeing of our staff, ensuring we have an environment where we can make our best contribution, and also providing an environment with other Aboriginal and Torres Strait Islander people will want to work.

We think it is important to proudly use Aboriginal and Torres Strait Islander ways of working and ways of being – and to say they are equally relevant to other mainstream Australian approaches. For example, we are building up understanding of what Indigenous health is through holding informal webinars with Aboriginal and Torres Strait Islander people from health, tourism, politics, community organisations, law and many other backgrounds. Rather than start off by claiming to be able to define Indigenous health, we are providing a platform to listen to a broad range of views and perspectives and in doing so, are gaining a much richer, diverse and relevant insight into the nature of Indigenous health.

These conversations are helping to inform our approach to training and empowering as health leaders, and who we need to focus on partnering with to improve health outcomes. They have also reinforced the importance of shaping how we approach research – through genuine consultation and co-design, prioritisation of community work and importantly, finding effective ways to bring research results back to community.

As Australia pulls together in a commitment to Close the Gap, we believe this new understanding, training, research and collaborative action will provide examples of measurable ways that other institutions can contribute.

Maree Meredith is director, Poche SA+NT at Flinders U

 


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