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Opinion Piece
'It's only a mistake if you make it twice'
Kim O'Donnell
Research Associate, Flinders Aboriginal Health Research Unit, Flinders University, SA
Article Text
My name is Kim O'Donnell and I'm a Barkindji woman from far Western New South Wales. I have worked in many different settings, including Dubbo, Sydney, Bathurst, Peppimenarti (an Aboriginal-controlled cattle station in Northern Territory), Darwin, Japan and currently, Adelaide.
I have a Diploma of Teaching (Primary) and recently graduated from Flinders University with a Master of Primary Health Care. I am mother to the light of my life, Jake Mirrimpillyi, who was my first computer teacher at the age of five. My computer skills have improved since then, and I now work at Flinders University as a Research Associate in the Flinders Aboriginal Health Research Unit.
This Unit works closely with the Cooperative Research Centre for Aboriginal Health (CRCAH), which is a public good research centre based in Darwin at the Menzies School of Health Research. It is funded through the Commonwealth Government's Research Centre's Programme, its 12 core partners and other external agencies. The CRCAH brings together eight universities (including Flinders), four industry partners and six associated partners. Guiding this process is the vision statement: Sustained improvements in Aboriginal health through strategic research and development. Advocating for strong and effective Aboriginal input, control of high quality strategic health research and engagement in effective development activities with Aboriginal communities, service providers, policy formulators and decision makers is the way forward to making the vision become a reality.
When I was asked to write my opinion in this journal in relation to Aboriginal health, I accepted the challenge. I saw it as an opportunity to be heard with the hope that people (who have the power to bring about equitable systemic changes) will be inspired to step outside their comfort zones and 'have a go' at making a difference in the lives of Aboriginal people because what they will discover is that Aboriginal people will make a difference in their lives too.
The poor health of Aboriginal people is due to poverty, social disadvantage, alienation and health care systems that have not sufficiently addressed Aboriginal people's needs. My mother says, 'If they get it right for Aboriginal people, they'll get it right for all people.'
My role as a Research Associate is to coordinate Aboriginal health research at Flinders that will lead to improved health outcomes for Aboriginal people. To achieve this involves bringing together stakeholders (representatives from Aboriginal organisations & communities, Government & other agencies) to develop partnerships in research that lead to practical sustainable solutions. Strengthening the capacity of Aboriginal people to achieve full participation in services and appropriate means of control of these services is critical to tackling Aboriginal health deficits. Partners need to take a holistic view of health which includes addressing social and emotional well being as well as the absence of disease. Partners need also to understand the research process and how research will benefit Aboriginal people.
'Research' is a dirty word for many Aboriginal people because of the disrespectful and intrusive ways it was conducted. For example, my Aunty told me that in the early 70s, two researchers from a prominent university in NSW appeared at my Uncle's home. They said they wanted to record and map cultural sites so Aboriginal customs would not be lost. Uncle didn't trust them because he didn't know them. They were strangers asking for information which was none of their business and he asked them to leave. The following day, the researchers came back with two muni-munis (policeman) who demanded Uncle go with the researchers. He had to take them to cultural sites and tell them all the information they wanted to know. If he refused to go, the muni-munis would lock him up. Uncle had no choice but to go with the researchers. He gammoned (pretended) to take them to cultural sites and told them the biggest amount of bullshit. He was not paid a wage for the two weeks away from family, nor was any consideration given to how his family would cope without him. Having the privilege to work with researchers from a prominent Australian university was his payment. Uncle said that all them whitefellas were interested in was that bit of paper to prove they were experts in Aboriginal culture... they didn't care about the people.
As an Aboriginal health researcher, the challenge for me is convincing Aboriginal people that research is beneficial to their health and wellbeing and that, there are good whitefella researchers out there and, on the other hand, convincing whitefella researchers to do respectful research. Respect is earned by taking the time to build trusting relationships through listening, yarning (talking) with the people and giving back...giving back the knowledge generated through research in appropriate ways, mentoring, sharing one's own family stories and teaching meaningful skills. It's a two-way process where you also learn about yourself. You will find that when you make a commitment to work respectfully with Aboriginal people, you begin a journey of self reflection. Just ask any whitefella who is respected by Aboriginal people...and learn from them. Don't be afraid to make mistakes along the way - admit the mistake, apologise and work towards fixing it. This is an example of honesty, a characteristic that builds relationships. As another Aunty once said to me, 'Kim, it's only a mistake when you make it twice'. I asked, 'What do you mean Aunty?' And she said, 'Because when you make it twice, you haven't learned.'
Victoria Simon raises the following principles in her study, Characterising Maori Nursing Practice. I've adapted the explanations to reflect these principles and their significance in the context of people who work in Aboriginal health:
- Cultural affirmation and identity (know who you are and where you come from) - Feel secure and proud of your identity without denigrating others.
- Cultural Awareness - Understand Aboriginal culture and value the knowledge and skills Aboriginal people bring. Always treat Aboriginal people how you would like to be treated.
- Networks - Take the time to find out about Aboriginal networks, including knowledge of Aboriginal health organisations and how to contact one when working with Aboriginal people. Find out about resources (developed by Aboriginal people that also appeal to other Indigenous cultures) and promote them in your workplace. The knowledge of Aboriginal organisations and their practices could better assist mainstream organisations to develop appropriate ways to care for Aboriginal people.
- Holistic Models of Health - Indigenous models of health that are inclusive of understanding the social and emotional causes of ill health on a person's wellbeing as well as treating the physical presence of illness and disease. To understand wholeheartedly is to understand the impact of colonisation on the first nation peoples of this country and to treat clients as people first, and illness and disease second.
- Role models - The promotion of Aboriginal role models is fundamental because it inspires the next generation to work hard to succeed, which in itself is a sustainable outcome. Promoting Aboriginal doctors, nurses, researchers, teachers, pilots, engineers, architectures, veterinarians, business entrepreneurs (with a social conscience) and other professions through positive media coverage is a start. Encouraging them to be involved in mentoring programmes adds value to the professions.
- Work Setting - The influence of work setting significantly influences practice. A work setting that is based on humanitarian and environmental principles as the underlying foundation is more likely to encourage team building skills and use multi-disciplinary approaches to problem solving, which in the long run, will have better health outcomes for Aboriginal people. Funding for research that builds best practice evidence should be supported so we learn from what does work, rather than focusing on what doesn't work. It's a shift in mindset from cycles of destruction to cycles of life.
- Political issues - Aboriginal controlled services and programmes are often seen as a threat to mainstream services because many provide far better health outcomes (on a shoestring budget) than mainstream services. Qualified Aboriginal people are often seen as a threat by other people in the field of Aboriginal health, (particularly those who hold higher positions) because they fear losing their jobs. My advice is: Don't take on a job in Aboriginal health if you are not prepared to share your skills and, some time down the track, to step aside to allow an Aboriginal person to take control. By resisting, you become a barrier to sustainable outcomes in Aboriginal health because you are afraid to share the power that can create a level playing field.
- Practical learning environments - those that provide a strong foundation for practice based on different ways of learning and teaching. Be prepared to explore two-way models of teaching and learning.
- Personal skills - This relates to confidence, assertiveness and advocacy; having supportive mentors and supervisors who teach self reflection, questioning systems of practice and finding better ways of doing things (rather than conforming to a practice because that's how things have always been done).
- Knowing who I am, where I come from and being proud of my identity as an Aboriginal woman in a system that 'negatizes' the first nation peoples of this country is a challenge and one that is fraught with much heartache, anger and pain. I cope by not giving up hope and learning from my mistakes. It's a personal choice I make every day. I urge those who have the power to create actions for change to walk beside Aboriginal people and, as Sherwood and Edwards state in their article, Decolonisation: A critical step for improving Aboriginal health, it is Aboriginal people who are the experts in Aboriginal health so let their voices be heard.
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