aboriginal families
TRANSCRIPT
We would like to acknowledge the traditional custodians of this land and
pay our respects to the Elders both past, present and future, for they hold the memories, the traditions, the culture and hopes of Indigenous Australians.
Acknowledgement
“What do you need to keep in mind
when working with Aboriginal families?”
A family is a group of two or more people that are related by blood, marriage, adoption, step or fostering, and who usually live together in the same household.
(Australian Bureau of Statistics , 2011)
It is important for Workers to have an understanding of the concepts of ‘family’ and ‘kinship’ as they exist for Aboriginal and Torres Strait Islander people and their family structure is significantly different to the Western view of a family unit.
(Australian Institute of Family Studies, 2011)
Know more about the Aboriginal families and tradition
The Elders
Story-telling
Stolen Generation(Shaoli, Finn and Thomson. 2009)
“What do you need to keep in mind when working with Aboriginal families?”
CULTUREHealth professionals’ lack of understandingImportance of extended family and of country
Considerations
- Putting Aboriginal men and women together
- Mixing family groups inappropriately
- Male doctors attending female patients and vice versa
- Younger providers advising older Aboriginal patients
(Shaouli, Finn and Thompson, 2009)
SOCIAL GRADIENT
WHO description: “The poorest of the poor, around the world, have the worst health.”
Factors
High level of stress in daily life
Loss of cultural continuity
Geographic dispersion Racism
(Sheperd, et. al., 2012)
Not always the language of choice
No readily available interpreter services in Perth
Ability to feel lack of compassion in interpersonal interactions from healthcare providers
Silence: part of culture
Dissimilarities between Aboriginal beliefs and cultural consideration and the approach of the Western medical system
(Shaoli, Finn and Thomson. 2009)
COMMUNICATION
English
Non- verbal communication
Importance of effective communication
Invasion of privacy leads to shame and embarrassment
(Shaoli, Finn and Thomson. 2009)
PRIVACY
PREVIOUS EXPERIENCES
Resulted to loss of trust
(Shaoli, Finn and Thomson. 2009)
EnvironmentWhen working with Aboriginal families, it is important to consider the
family’s environment they find themselves in.
Home, School, Community, Friends and Family.
Can vary between families and also the locations they reside in.
In 2011 the average family in Australia consisted of 2.6 persons, compared to Indigenous Australian families, consisting of 3.3 persons (DPMC, 2011).
Modern houses in Australia built to accommodate “Typical” nuclear family of two parents and 2 children, 3 bedroom, 2 bathrooms.
Does not accommodate the majority of Indigenous family sizes, 3-4 persons per household, with often visiting persons also residing for periods of time (ABS,
2008).
Indigenous families tend to be larger, with 39% being one parent families compared to 9% of Non-Indigenous families (Bailie and Runcie, 2001).
Overcrowding is an important factor to consider, has been addressed by EnviroHealth Workers across Australia during in field promotion,
inspections and assessments (ABS and AIHW, 2003).
In 2008, 25% of Indigenous Australian population over 15 years of age, were living in overcrowded living conditions (ABS, 2011).
13% in major cities, 20% in regional areas and 48% in remote areas.
Statistics had not changed in 6 years between 2002 and 2008 (ABS, 2011).
Resulting in fewer resources, higher levels of stress, higher rate of infectious and parasitic disease (Thomson, 2003).
Inadequate water quality and supply, electricity and gas.
“Poverty poor housing conditions” despite first world country (Pholeros, Rainow and Torzillo, 1993).
Indigenous households 2.5 times more likely to be in the lowest income bracket in Australia (ABS, 2004).
Nearly half of all Indigenous children living in jobless families in 2006 (ABS and AIHW, 2008).
45% of dependent children in Australia from Indigenous communities (ABS and AIHW, 2008).
Influences from the environment can have detrimental impacts on family health.
40% of community housing efforts of accommodation
still resulting in overcrowding.
Properties managed by Indigenous Housing
Organisations (IHOs), 23% required major repairs, 7%
required replacement in 2006 (ABS, 2007).
Consider influences of possible drug, alcohol,
violence, neglect, support, networks, safety house, police, which could be
close to the family home which could indirectly
impact.
Education in the home, in 2008, Indigenous
Australians aged 25-38 years 78% had completed
year 10 or above, compared to 27% of those
aged 55 years or older (ABS, 2011).
Slowly as generations are gaining and retaining their education, their households are attaining
educated persons in their home. With better education, comes better health knowledge and employment opportunities.
However, Government funding needs to be improved to
accommodate larger than average families amongst our Indigenous
communities.
Considerations in the practical setting:
• Naturally shy- encourage other family members for support.• In some circumstances, may be lack of transport, income, medicare
card.• Different concepts of time- when informing medication. Instead of
“take medicine with food every 4 hours”, “have with lunch or dinner”.• Social approach rather than biomedical questioning.• Allow extra time, give time to talk, build rapport.• Learn about person’s background prior to addressing clinical issues.• Family or community events may take priority over personal
appointments.• Tend to identify with one health worker and may expect to associate
with only this person for health related issues.• Self referrals- serious. Accessing Non-Indigenous organisations for help
indicates the person is likely to be in desperate need of help. If asked to come back later, they usually won’t return.
Considerations in the practical setting:
• Never assume, find out as much information as you can.• Alternative communication methods, pictures, interpreter.• Acknowledge embarrassing questions from the beginning, make them feel more
comfortable• Avoid intrusive questions, use more open ended questions.• Avoiding eye contact is polite in particular indigenous communities. Particularly cross
gender.• Be mindful of own body language.• Avoid finishing sentences for them, they may be searching for the right English word,
don’t rush them.• Exchange and share cultural basis, build rapport.• Artworks and posters create more friendly environment• Avoid discussing scars and wounds if possible, can symbolise initiation, conflict or
grief.• Consult whole family, not just the individual, often all or most will influence decision
making for the individual.• Aboriginal Health Workers (AHWs) active assistance and support when necessary.
(UDRH, 2012).
http://www.youtube.com/watch?v=MYuCvesBszQ
Conclusion
References:Australian Bureau of Statistics (2004) National Aboriginal and Torres Strait Islander Social Survey, 2002. Canberra: Australian Bureau of
Statistics Australian Bureau of Statistics. (2011) Characteristics of Families (No. 6224.0.55.001). Retrieved from: http://www.abs.gov.au
Australian Bureau of Statistics (2007) Housing and infrastructure in Aboriginal and Torres Strait Islander communities, Australia, 2006. Canberra: Australian Bureau of Statistics
Australian Bureau of Statistics, Australian Institute of Health and Welfare (2003). The health and welfare of Australia's Aboriginal and Torres
Strait Islander peoples 2003. Canberra: Australian Institute of Health and Welfare and the Australian Bureau of Statistics Australian Bureau of Statistics, Australian Institute of Health and Welfare (2008) The health and welfare of Australia's Aboriginal and Torres
Strait Islander Peoples (2008). Canberra: Australian Bureau of Statistics and Australian Institute of Health and WelfareAustralian Institute of Family Studies (2001) Working with Indigenous children, families, and communities. People. Retrieved from:
http://www.aifs.gov.au/cafca/pubs/sheets/ps/ps6.html
Australian Institute of Health and Welfare (2011). The Health and welfare of Australia’s Aboriginal and Torres Strait Islander People. Retrieved from: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737418955
Bailie RS, Runcie MJ (2001) Household infrastructure in Aboriginal communities and the implications for health improvement. Medical Journal
of Australia; 175: 363-366 Department of the Prime Minister and Cabinet (2008). 2. Profile of Australian Families; Families in Australia. P9. Retrieved from:
http://www.pmc.gov.au/publications/families
Pholeros P, Rainow S, Torzillo P (1993) Housing for health: towards a healthy living environment for Aboriginal Australia. Newport Beach, NSW: HealthHabitat
ReconciliationAus.( 2013, January 31).Family and Kinship [Video file]. Retrieved from http://www.youtube.com/watch?v=mNtPcW4t1PY
Shahid, S., Finn, L. & Thompson, S. (2009) Barriers to participation of Aboriginal people in cancer care: communication in the hospital setting. Med J Aust 2009; 190 (10): 574-579.
University Department of Rural Health. (2012). Practical Considerations for Health Professionals Working with Aboriginal Clients. Greater Green. Retrieved from: http://www.greaterhealth.org/education-training/indigenoushealth/practicaladvice/
Thomson N, ed. (2003) The health of Indigenous Australians. South Melbourne: Oxford University Press