Family, Unity and Success – Australian Indigenous Doctors’ Association (AIDA) 2017

Conference Report

The Australian Indigenous Doctors’ Association (AIDA) celebrated 20 years strong by holding their annual conference for 2017 in the Hunter Valley, traditionally owned by the Wonnarua people. This four-day long intensive collaboration of keynote speakers, engaging workshops as well as invaluable cultural and networking events created a leading platform to connect and be inspired. The AIDA 2017 conference focussed on “family, unity and success” with the overarching theme of supporting and connecting Aboriginal and Torres Strait Islander medical students and doctors to ultimately improve the health of Indigenous people in Australia.[1] This conference has grown to not only bring Indigenous students and doctors together but also to provide networking opportunities for associate members, medical college representatives, other health professionals and key invited guests, making it an important medical and political event.

Hunter Valley

Family

This was the second AIDA conference I have attended as a medical student. I believe many people would underestimate the value of bringing together fellow Indigenous medical students and doctors from across Australia. However, this sense of belonging and knowing you are not alone in medicine, whether it be through sharing stories in the yarning circle or networking in the lunch break, is why I believe the AIDA conference and AIDA itself is so successful. Recently, AMSA Blue Week highlighted conversations regarding the need to do more about the mental health crisis amongst medical students and doctors.[2] Research also shows that mental health disorders are more prevalent amongst Indigenous Australians than their non-Indigenous counterparts [3] and it is well documented that good social support is protective for mental illness.[4] This highlights the importance for Aboriginal and Torres Strait Islander medical students and doctors, in particular, to have a strong support network throughout their medical journey. AIDA provides a support network as a family-like organisation, its members backing each other as they embark on their medical careers and embrace the enormous task of improving Indigenous health.

Unity

So what do we know about Indigenous health? There is still a lot to do, but as an attendee of the AIDA conference, I was surrounded by people who are already are, or are soon to be, making a real impact on many people’s lives. However, the media continues to portray a narrative that there are only a few well-educated Aboriginal or Torres Strait Islander people. Australia’s history of Aboriginal and Torres Strait Islander people is still poorly taught in schools. Not only this but key Aboriginal and Torres Strait Islander people in the past who have formed a better path for our people are either unheard of or undervalued in our society.[5] This is reflected in the medical curriculum, where education about Aboriginal and Torres Strait Islander culture and cultural safety is often poor, undervalued or realistically done too late to change some attitudes and beliefs.[6]

The question then arises: is the problem really about the lack of teaching about Aboriginal and Torres Strait Islander culture, when racism (both institutional and interpersonal) is known to be associated with poorer health and poorer health outcomes?[7] Should the curriculum entail teachings on racism, both identifying it and stopping it? This conference asked whether it is the job of Indigenous people to educate non-Indigenous people on racism itself. The term “hidden curriculum” – the values and attitudes that medical students see around them – highlights the importance of lecturers, tutors, administrators and academics in showing strong leadership and changing the culture of our universities to stop racism and strongly value Aboriginal and Torres Strait Islander culture and health.[8]

It is not just universities that need to step up. The United Nations (UN) recently described Australia’s progress in Closing the Gap as “woefully inadequate”.[9] Hearing this in a room full of people who are driving positive change and having real impacts on lives can be very disheartening, especially when Aboriginal and Torres Strait Islander people make up only 2.8% of Australia’s population.[10] However, this highlights the importance for all Australians to unite to make Indigenous health an absolute priority amongst many key stakeholders. There needs to be a cultural change in broader society, particularly in how we value Aboriginal and Torres Strait Islander lives, challenge racism and become more culturally aware.  At this year’s AIDA conference, it was encouraging to see many of the medical college representatives understand the need for more Indigenous doctors, and the need for cultural change to challenge racism and improve cultural awareness within their own colleges.

Medicare exclusions for prisoners is a key issue that highlights systemic racism and contributes to health disparities. Currently, prisoners in Australia are excluded from Medicare and the Pharmaceutical Benefits Scheme subsidies. This limited access to good healthcare is shortening life expectancy and decreasing the quality of life of many people who are incarcerated.[11] Aboriginal and Torres Strait Islander people are over-represented in prisons and are 13 times more likely to be incarcerated.[12] This is not closing the gap but in fact, widening the existing chasm in health disparities.[13]

The beautiful but complex aspect to Aboriginal and Torres Strait Islander people and culture is that there are many communities, languages and cultural protocols; in improving Indigenous health there is no “one size fits all” approach. The best outcomes at a grass-roots level are when a community is meaningfully involved, a lengthy but essential strategy to drive improvements to Indigenous health.[14] Targeting the social determinants of health are also key, however tackling systemic racism, the lack in cultural awareness and creating a cultural change in society to value Aboriginal and Torres Strait Islander lives should be our focus for enduring change.

All medical students and medical schools in Australia should start talking about the idea that you are not clinically competent until you are culturally competent. This is imperative to reduce existing health disparities and eradicate diseases still present in remote Indigenous communities. AIDA and their supporters are ready to save and improve Aboriginal and Torres Strait Islander peoples lives, but everyone should also feel a sense of responsibility to unite to change the narrative from “woeful” to making real and lasting change.

Painted Stethoscope

Success

One of the most anticipated events of the conference every year is the stethoscope ceremony. This ceremony is where newly graduated Indigenous medical students and newly qualified Indigenous fellows are recognised for their hard work, sleepless nights, sacrifice and often added weight of responsibility by being presented with a hand-painted stethoscope. This creates mentorship at AIDA and inspiration that success is possible and very achievable as an Indigenous medical student and graduate.

The other most anticipated event (for me anyway) is the cultural excursion on the last day. I had very high expectations after last year, living dangerously and tasting a particular species of ant that tasted like citrus. However, I survived that last year, and can tell you that I thoroughly enjoyed the trip this year when people of the Wonnarua nation took us to Biame cave, the site of a significant piece of rock art in the Hunter Valley. These opportunities to have culture and knowledge shared are invaluable. What I also learnt was about how the traditional owners had worked with the non-Indigenous property owners on which this significant site sits in order to protect it, and make it accessible for those who wish to visit and appreciate its significance – thousands of years of culture and knowledge. The Wonnarua people also believe there are many other significant sites around that area. They hope that by setting this as precedent, not only can they work with other property owners in the region, but this can be applied to other significant sites across Australia. So, if you, your family or your friends own a property with an Indigenous site on it, or if you are unsure, please be in contact with your local Indigenous community because there may be thousands of important sites nationwide that need to be protected for generations to come.

When talking about medicine today, we often think of just the mind and body, but for many Indigenous people, there is an element of the spirit. It is also important to recognise that before colonisation, traditional healers or Ngangkari looked after our people, probably with the same care and dedication we hope to have as good doctors one day. These Ngangkari included the spirit in healing; some are still around today treating Indigenous people. So from an Indigenous medical student’s perspective, in a society faced with racism and disparity, perhaps we should put the humanity back into medical school and not just hope, but work hard to create a better world and health outcomes for this nation’s first peoples.

Narawi Foley Boscott

Narawi completed a Bachelor of Science (Biomed) at the University of Queensland and is currently completing a Doctor of Medicine as well as a Graduate Certificate in Business Leadership. Narawi is pssionate about Badtjala culture and aspiring to improve Indigenous and mental health. 

Conflict of Interest
None declared

Correspondance

narawi.kefb@gmail.com

References

  1. Australian Indigenous Doctors’ Association. AIDA Conference 2017 [Internet].[cited 2017 Oct 1]
    Available from: https://www.aida.org.au/conference/
  2. AMSA mental health. About the Campaign. [Internet]. [cited 2017 Oct 1].
    Available from: http://mentalhealth.amsa.org.au/about-the-campaign/
  3. Jorm A, Bourchier S, Cvetkovski S, Stewart G. Mental health of Indigenous Australians: a review of findings from community surveys. Med J Aust. 2012 196 (2):118-121.
  4. Ozbay F, Johnson D, Dimoulas E, Morgan C, Charney D, Southwick S. Social Support and Resilience to Stress. Psychiatry (Edgmont). 2007 May 4(5):35-40.
  5. Do our teachers care enough about Indigenous Australia to bring it into the classroom? [Internet]. 2017 May 9 [updated 2017 May 9; cited 2017 Oct 1].
    Available from: http://www.sbs.com.au/nitv/article/2017/05/09/do-our-teachers-care-enough-about-indigenous-australia-bring-it-classroom
  6. Durey A. Reducing racism in Aboriginal health care in Australia: where does cultural education fit? Australian and New Zealand Journal of Public Health. 2010 July 34(1):87-92.
  7. Larson A, Gillies M, Howard P, Coffin J. It’s enough to make you sick: the impact of racism on the health of Aboriginal Australians. Australian and New Zealand Journal of Public Health. 2007 August 31(4):322-229.
  8. Mahood S. Medical education-Beware the hidden curriculum. Can Fam Physician. 2011 September 57(9):983-985.
  9. Brennan, B. Australia’s progress on Closing the Gap ‘woefully inadequate’, UN says. [Internet]. ABC News. 2017 September 11 [cited 2017 Oct 2].
    Available from: http://www.abc.net.au/news/2017-09-11/closing-the-gap-progress-woeful-un-says/8892980
  10. Australian Bureau of Statistics. Census: Aboriginal and Torres Strait Islander population. [Internet]. 2017 June 27 [updated 2017 June 26; cited 2017 Oct 2] Available from: http://www.abs.gov.au/ausstats/abs@.nsf/MediaRealesesByCatalogue/02D50FAA9987D6B7CA25814800087E03?OpenDocument
  11. Plueckhahn T, Kinner S, Sutherland G, Butler T. Are some more equal than others? Challenging the basis for prisoners’ exclusion from Medicare. Med J Aust. 2015 203(9):359-361.
  12. Australian Bureau of Statistics. 4517.0 Prisoners in Australia, 2016. [Internet]. 2016 Dec 8. [updated 2016 Dec 7; cited 2017 Oct 2] Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4517.0~2016~Main%20Features~Imprisonment%20rates~12
  13. Durey A, Thompson S. Reducing the health disparities of Indigenous Australians: time to change focus. BMC Health Serv Res. 2012 June 12:151.
  14. Rowley K, Daniel M, Skinner K, Skinner M, Whyte G, O’Dea K. Effectiveness of a community-directed ‘healthy lifestyle’ program in a remote Australian Aboriginal community. Australian and New Zealand Journal of Public Health. 2000 April 24(2):136-144.

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