CNA156 Reflective Essay: Cultural Safety in Aboriginal Healthcare

This reflective essay examines the critical aspects of providing quality healthcare to Aboriginal and Torres Strait Islander peoples. It emphasizes the importance of cultural safety, self-determination, and collaboration in interactions with patients, their families, and healthcare workers. The essay discusses how to address cultural challenges and language barriers by collaborating with indigenous health workers. It also advocates for health service delivery tailored to the specific needs of Aboriginal communities, such as substance abuse treatment, while respecting their unique beliefs and values. Furthermore, the essay explores advocacy activities to close the healthcare gap, including social justice campaigns and lobbying for improved healthcare facilities in indigenous communities, guided by the principles of self-determination and equality. The author references multiple scholarly sources to support their arguments.

Interactions with Aboriginal patients, their families and Aboriginal health workers
In delivering quality healthcare to indigenous people, I know that I will be interacting
with both the patients, their families and as well the healthcare workers from those communities.
I agree that the patient and the caregiver relationship must be good for the effective delivery of
quality care to be achieved. That is why I will be employing the concept of the patient’s right to
self-determination when interacting with patients from Aboriginals. The patient’s right to self-
determination dictates that a patient reserves the right to make a decision based on his cultural
beliefs and values about the medical procedure he is to be subjected to (Burnette, et al. 2014
p.364). Therefore, in the process of interacting with the patients, I will be offering them advice
about the benefits and disbenefits of the medical procedure they will be subjected to and let them
decide about the same. If they decide either to go ahead or not to continue with the procedure, I
will respect their decision. However, I understand that indigenous communities in Australia have
been subjected to social justice for a very long time since they have experienced inequalities
regarding education and quality healthcare (Browne, Hayes & Gleeson, 2014 p. 362). As a result
of this, most people from indigenous families do not trust healthcare professionals to deliver
quality care to them. That is why I will be employing the concept of cultural safety to gain the
confidence of the Aboriginal families. Cultural safety refers to the provision of an environment
that is safe for people regarding their social, emotional, spiritual and physical lives (Cameron, et
al. 2014 p. 16). In delivering a cultural safety environment, I will ensure that Aboriginal patients
are not discriminated against or assaulted in the process of delivering quality care. However, as a
person from the non-indigenous community, I will be experiencing some cultural challenges as
well as the language barrier in the process of delivering care to these patients from Aboriginal
communities. That is why I will be collaborating with the health workers from the indigenous

communities who understand the cultural concepts of Aboriginal communities. These health
workers from indigenous communities will help translate what I am saying to the patients and
vice versa in the process of care delivery. These health workers will also help educate me on
cultural norms that I should adhere to in the process of delivering quality care. Adhering to the
cultural norms of these communities I will be providing a culturally safe environment for
aboriginal patients.
Advocacy for health service delivery that ensures health for Aboriginal and Torres
Strait Islander peoples
Healthcare is not evenly distributed among the Aboriginal and Torres Strait Islander
peoples (Drawson, Toombs & Mushquash, 2017 p. 8). This makes it difficult for these people to
access health services which negatively affects their health. Therefore, the best way I will
promote the health of these people is by taking health services they need most to them
periodically. The most ideal health service that the indigenous people need is substance abuse
treatment. This is so because the rates of substance abuse among the indigenous are high
compared to non-indigenous people (Gracey et al. 2014 p. 1114). For example, more than 27%
of indigenous people were involved in substance abuse majorly tobacco in 2016 alone (Ibiebele,
et al. 2015 p. 1476). This was 1.8 times higher than for non-indigenous which was 15.3%
(Richmond, & Cook, 2016 p. 56). Most indigenous people smoke because they do not
understand the health consequences of smoking (Browne, Hayes & Gleeson, 2014 p. 362).
Therefore, I will carry out health education to sensitize these people the health effects of
smoking. However, since health education involves community participation, I will need to
collaborate with the indigenous community members through their leaders who will help me
facilitate this activity. However, I understand that some people from indigenous communities

will not want to participate since they are addicted to smoking. That is why in carrying out health
education among the indigenous people, I will be employing the concept of self-determination
which gives people the right to accept or refuse medical procedures that they are being subjected
to. Based on this concept, I will have to respect the decisions of those people who refuse to
participate. Having said that I understand that indigenous people hold unique beliefs and values
which must be respected. For example, as a result of British colonization which negatively
affected land use, laws and spiritual beliefs of indigenous people, the indigenous people live a
traumatized life (Taylor & Guerin, 2019 p. 67). Therefore, to provide a culturally safe
environment when offering these health services, I will be educating them more compassionately
to make them understand that I do not agree with the injustices that they have been subjected to.
This will create a culturally safe environment for these people since it will convince them that I
am respecting their rights to access quality care, quality education and other aspects that matter
to them.
Your advocacy activities that will contribute to ‘closing the gap’
I agree that indigenous people have experienced various inequalities especially in access
to quality healthcare. This has negatively affected the health of these people because the
mortality rates among the indigenous people are high compared to non-indigenous people
(Walker, Schultz & Sonn, 2014 p. 220). For example, the infant mortality rate among the
indigenous people as of 2012 stands at 5 deaths per 1000 live births while in non-indigenous
people it's 3 deaths per 1000 live births representing a 27% gap (Walker, et al. 2014 p. 2026).
Also, the literacy levels among the indigenous people are low compared to non-indigenous
people based on the documented statistics. For example, in 2015, 78.7% of the Aboriginal
student’s achieved literacy benchmark for year 3 compared to 95.6% of non-indigenous people.

These statistics show some of the gaps that exist between the indigenous people and non-
indigenous people in Australia. To ensure justice for all people living in Australia, there is a need
to close these gaps. One of the activities I will engage in to close the gap is a social justice
campaign that will advocate for indigenous people to be treated equally in resource allocation
just like non-indigenous people. For these campaigns to be successful, I will collaborate with
like-minded agencies especially the civil rights activists who also advocate for equality in
society. But the social justice campaigns are expensive and I cannot manage to finance these
campaigns fully as a person. Therefore, I will seek the support of donna agencies, for example,
the United Nations which its special Office of the United Nations High Commissioner
for Human Rights (OHCHR) supports the human rights activities globally (Browne, Hayes &
Gleeson, 2014 p. 362). However, I understand that some non-indigenous people in the country
feel that they are more superior to the indigenous people and because of that, they will not want
to participate in social justice campaigns since this campaign will bring equality in the country.
That is why in carrying out social justice campaigns, I will be guided by the concept of self-
determination which dictates that I should respect other people’s decisions. Another activity that
I will undertake to close the gap is lobbying the government to establish healthcare facilities in
the indigenous communities to help the indigenous people to access quality care. To make this
happen, I will have to collaborate with legislators by advising them on the need for the
indigenous people to access quality care like non-indigenous. The legislators will then create
effective policies that will close the healthcare gaps which the government will implement by
establishing more healthcare facilities in the indigenous communities.

Reference
Burnette, C.E., Sanders, S., Butcher, H.K. and Rand, J.T., 2014. A toolkit for ethical and
culturally sensitive research: An application with indigenous communities. Ethics and Social
Welfare, 8(4), pp.364-382.
Browne, J., Hayes, R. and Gleeson, D., 2014. Aboriginal health policy: is nutrition the ‘gap’in
‘Closing the Gap’?. Australian and New Zealand Journal of Public Health, 38(4), pp.362-369.
Cameron, B. L., Plazas, M. D. P. C., Salas, A. S., Bearskin, R. L. B., & Hungler, K. (2014).
Understanding inequalities in access to health care services for aboriginal people: A call for
nursing action. Advances in Nursing Science, 37(3), E1-E16.
Drawson, A.S., Toombs, E. and Mushquash, C.J., 2017. Indigenous research methods: A
systematic review. International Indigenous Policy Journal, 8(2).
Gracey, M., 2014. Why closing the Aboriginal health gap is so elusive. Internal medicine
journal, 44(11), pp.1141-1143.
Ibiebele, I., Coory, M., Boyle, F.M., Humphrey, M., Vlack, S. and Flenady, V., 2015. Stillbirth
rates among Indigenous and non‐Indigenous women in Queensland, Australia: is the gap
closing?. BJOG: An International Journal of Obstetrics & Gynaecology, 122(11), pp.1476-1483.
Richmond, C. A., & Cook, C. (2016). Creating conditions for Canadian aboriginal health equity:
the promise of healthy public policy. Public Health Reviews, 37(1), 2.
Taylor, K. and Guerin, P., 2019. Health care and Indigenous Australians: cultural safety in
practice. Macmillan International Higher Education.

Walker, R., Schultz, C. and Sonn, C., 2014. Cultural competence–Transforming policy, services,
programs and practice. Working together: Aboriginal and Torres Strait Islander mental health
and wellbeing principles and practice, pp.195-220.
Walker, M., Fredericks, B., Mills, K. and Anderson, D., 2014. “Yarning” as a method for
community-based health research with indigenous women: the indigenous women's wellness
research program. Health care for women international, 35(10), pp.1216-1226.