Engaging with Aboriginal and Torres Strait Islander communities

Each of the community focus groups devoted considerable discussion to the issue of community consultation, with all agreeing that this is a clear priority for health professionals. 

People need to know what's around in this local area, like sites, who are the key people; you need to touch base with Aboriginal organisations and key people in the community

However, each group spoke about the diverse nature of Aboriginal community composition, particularly in more urbanised areas heavily effected by by multiple influxes of Aboriginal and Torres Strait Islander peoples from other regions. They also identified the important role played by all Aboriginal organisations in improving health. Consistent with community views Wand and Eades (2008, 585) have commented:        

Identifying who represents a particular community may be complex. In some areas this role may not belong to an Aboriginal community-controlled health service, but to a council or other community authority.

Activity: Land Councils  Aboriginal Land Councils play a significant role in their communities. Watch: NSW Aboriginal Land Council Justice Will Be Done pt1 NSW Aboriginal Land Council Justice Will Be Done pt2 NSW Aboriginal Land Council Justice Will Be Done pt3 Northern Territory Central Land Council  Choose one of the Land Council  websites: NSW Aboriginal Land Council  Cape York Land Council  Central Land Council  The Metropolitan Aboriginal Land Council  South West Aboriginal Land and Sea Council  What is the purpose of the Aboriginal Land Council? How do their goals impact on Aboriginal Torres Strait Islander health? Do you know any Aboriginal and Torres Strait Islander organisations in your area? What are their functions? Activity: Using Aboriginal Symbols Making Two Worlds Work: Building the capacity of the health and community sector to work effectively and respectfully with our Aboriginal Community is an award winning collaboration that has produced resources to inform good practice when engaging with Aboriginal people and communities. Among their strategies is the use of art to reflect program goals in a culturally appropriate manner Watch:Making Two Worlds Work: Karin McMillan "The Importance of Art in the Indigenous Community"  What does McMillan see as the value of using Aboriginal art in promotion and communication? Do you agree with the importance of using Aboriginal images? Why/ Why not?

 

Building Trusting Relationships with Aboriginal and Torres Strait Islander Communities

Creating trusting professional relationships with any community is challenging. With Aboriginal and Torres Strait Islander communities, these relationships can be affected by:

• Legacies of historical poor treatment and disempowerment;
• Cross-cultural issues in communication and appropriate treatment;
• Ongoing funding instability;
• Policies that don't reflect local priorities, and
• ;Internal community conflicts.

While these difficulties can make health service providers cautious when engaging with Aboriginal and Torres Strait Islander communities, it is important that clear changes in policy and practice are occurring in the Australian Health system. Extensive consultation with communities and service providers have contributed to Guides and Checklists for new initiatives help to provide a structure for developing programs and relationships.

Activity For an example of relationship building and consultation in strategic development with Aboriginal communities see the NSW Health Aboriginal Health Impact Statement and Guidelines Do the guidelines and checklist address the potential difficulties mentioned above eg: reflecting local priorities? Can you think of other items, which would be useful to include in the checklist?

 

There is a perception in mainstream Australia that Aboriginal and Torres Strait Islander communities do not want non-Indigenous people involved in health service provision or policy making. In contrast, many of our community members recognised the need for non-Aboriginal professionals to be part of addressing Aboriginal and Torres Strait Islander health needs. A practicing Aboriginal GP spoke highly of his non-Indigenous colleagues who provided services to Aboriginal people.

Focus group members cautioned that in building relationships, community opinions need to be listened to and respected. One elder commented:

We have to use people who have those skills… but please respect and understand that the grass roots level people - we still know the issues. And please hear us out. Don't think that we're speaking in the wrong way, but trying to ensure that you understand we need you, you need us and we all work together for the whole circle.

Members of the national Aboriginal and Torres Strait Islander Health community have also highlighted the importance of partnerships with Australian peak health bodies (For more information see Mackean et..al. (2008 554-5). Our community members and their organisations are enacting these linkages at a localised level with one saying:

We build partnerships with NSW Health, Area Health and a number of different health organisations, even some of the local clinics…

Activity Think of a personal or professional relationship where you felt you could trust another person. What were the steps in developing trust? If trust is betrayed, can it be rebuilt/ how? What professional and personal qualities would you need to demonstrate to build trusting relationships with Aboriginal and Torres Strait Islander communities? Examine at least one of the following best practice guides, and make your own list of good practices for developing trusting relationships with Aboriginal and Torres Strait Islander people A Best Practice Model for Health Promotion Programs in Aboriginal Communities The Making of a Great Relationship: A review of a healthy partnership between mainstream and Indigenous organisations Respect, acknowledge, listen: practical protocols for working with the Indigenous community of Western Sydney