NSB202: Cultural Safety, Racism, and Aboriginal Wellbeing Essay

This essay examines the critical issues surrounding Aboriginal and Torres Strait Islander peoples' wellbeing within the Australian healthcare system, focusing on the impact of racism and the importance of cultural safety. The essay begins by defining racism, differentiating between personal and institutional forms, and highlighting its detrimental effects on healthcare experiences, including instances of discrimination reported by Indigenous individuals. The essay then explores cultural competency versus cultural safety, emphasizing the latter's potential to foster equality and respect. The essay delves into the historical context of Indigenous health, tracing the impacts of colonization, discriminatory policies, and the resulting health disparities, including the 'health gap.' The essay further discusses the concept of cultural safety in healthcare, emphasizing the need for healthcare providers to create unbiased and respectful environments. The student reflects on their learning, recognizing the impact of white privilege and the need for personal and professional changes to promote a culturally safe healthcare environment. The essay concludes by emphasizing the importance of awareness, respect, and a commitment to providing holistic, equitable care for all patients.

Running head:NURSING
Aboriginal and Torres Strait Islander Wellbeing
Name of the Student
Name of the University
Author Note

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STEP 1 (500 words)
a) Aboriginals and Torres Strait Islanders long-since faced discrimination in the country,
and the racial disparity has been said to account for the differences in healthcare
between the Aboriginals and Torres Strait Islanders. Personal racism accounts for the
discrimination by an individual, guided by personal thoughts of racism, conscious and
unconscious. This impacts interpersonal relationships, and often disguised as a
personal opinion. This is usually directed at individuals (Slaughter-Acey et al., 2019).
The definition of Institutional Racism according to Macpherson can be described as
the unequal or inappropriate service provided to a group of people or population
based on their culture, ethnicity or colour of their skin. This unequal treatment can be
apparent via their behaviour, ignorance, stereotyping and other factors that ultimately
lead to discrimination. This put that group of people in serious disadvantage
(Holdaway & O'Neill, 2006). A study untaken in Victoria shows significant racism
experienced by Aboriginal and Torres Strait Islander adults, both systemic and
interpersonal (Markwick et al., 2019).
b) The concept of being a 'white Australian' has always had its unjust implications in all
sectors, and healthcare is no different. Many Aboriginals and Torres Strait Islanders
have reported being receiving worse healthcare than that of their white counterparts.
Many pregnant Aboriginals and Torres Strait Islander women spoke of their
experience with racism and reported to have received less attention. A pregnant
aboriginal woman reported that midwives would often treat them different from the
white pregnant women in the same room, for example checking on her for no
particular reason, while many black women were ignored. They also faced demeaning
comments, distrust, talking down and downright mistreatment from the midwives, as
recollected by many new fathers from the maternity ward (Jennings, Bond & Hill,

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2018). In a study conducted with Aboriginal women, it was observed that
institutional racism is one of the leading causes of poor mental health in Aboriginal
Australians (Macedo et al., 2019).
c) Cultural competency can be described as the ability of healthcare providers such as
nurses to administer high-quality care to all individuals, irrespective of their race. It
also includes administering healthcare while being aware and respectful of their
culture. On the other hand, cultural safety can be described as establishing a
physically, culturally, socially accepting environment for people from any ethnicity
and race. While both is very important, an intensive review of the literature tends to
lean in favour of cultural safety rather than cultural competence. Cultural competence
involves knowing about culture and the basic aspects of it, and approaching
individuals while being aware of their culture. However, cultural safety involves not
just knowing about the patient's culture, but rather establishing a healthcare setting
that is inclusive and respectful towards patients from all ethnicities and race and aims
to provide the best quality healthcare to all patients. It has been preferred by many
because it has better potential to achieve equality in terms of healthcare (Curtis et al.,
2019). Hence the healthcare professionals must work towards making the healthcare
settings culturally safe for everyone so that patients are not deterred from seeking the
best quality healthcare.
STEP 2 (100 words)
From reading Chapter 1 (Sherwood & Geia, 2014) I learned about the poor health of
the Aboriginal and Torres Strait Islanders and the current issues they tend to face. Since the
event of colonisation, they have been dismissed as irrelevant, and their issues are not taken
seriously. This chapter, as conveyed by the Aboriginal Registered nurses, describes how the
colonial policies lead to the ill-health of the Aboriginals and Torres Strait Islanders and the

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emergence of the healthcare gap. Currently, the leading cause of morbidity in Aboriginals is
cardiovascular disease, followed by cancer, injury, and self-harm. Reading this chapter
enlightened me with the specifics of the health issues faced by the Indigenous Australians and
what changes need to be implemented to 'close the gap.'
STEP 3 (400 words)
Institutional or systemic racism has long since tarnished the history of Australia, ever
since the British colonisation. This racism is majorly directed against the Indigenous
Australians. The Aboriginals and Torres Strait Islanders have long been discriminated against
in all sectors, including public health sectors, judicial sectors, and others. In terms of
Australia's history, 1967 was the first year when the Aboriginals and the Torres Strait
Islanders were counted as citizens. The white Australia mind-set was still pretty much
prevalent. Before that, they were downright ignored as citizens.
The Aboriginals and Torres Strait Islanders were riddled with diseases since the time
colonisation itself. They lost their land and livelihood, and several introduced diseases
spread. However, little was provided in terms of medical assistance. In 1837, under the policy
for protection for Aboriginal populations, 'protectors' were appointed who had the right to
move the Aboriginals from here to there between government settlements. Till the 1930s, the
prevailing attitude was that Aboriginals were inferior to the white race (naccho.org.au.,
2020).. The Aboriginal Protection Act of 1869 in the colony of Victoria, gave the government
rights to move the Aboriginal population where ever they liked, and also enabled them to take
away any Aboriginal children below the age of sixteen. This put a significant barrier in the
lives and education of the Aboriginal children and gave rise to the 'stolen generation.' These
policies and practices played a significant part in creating what is now known as the 'health
gap' (Sherwood & Geia, 2014). The health gap contributes to the death of Indigenous

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Australians every year (Aida.org.au., 2020). Such policies were dismantled not before the
1960s. It was not till 1972 that grants were permitted for Aboriginal health initiatives. At this
point, funding for the health services controlled by Aboriginals was granted (naccho.org.au.,
2020). The Aboriginals suffered not only physically, but as well as socially, emotionally, and
psychologically after the colonisation. As of 2012, the gap in live expectancy between the
non-Indigenous and Indigenous Australians is around ten years. The first primary health care
center for the Aboriginals rose not before 1971 due to the inability of general healthcare
services unable to meet the requirements (Harfield et al., 2018).
This sort of systemic racism has been faced by Aboriginals and Torres Strait Islanders
not only in healthcare but also in the case of education as well as in employment till the
present times. Even now, the Indigenous students face inequality in higher education
institutes as there is a lack of education about inequality and Racism (Hollinsworth, 2016).
They also tend to face psychological issues such as depression. Overall, racism has proven to
be an important factor in the poor health of Aboriginals (Priest et al., 2011).
STEP 4 (300 words)
Cultural safety in the context of healthcare can be described as the implementation of
a safe, unbiased, and respectful healthcare environment for people of any race, ethnicity, or
colour. In a country like Australia, where a significant health gap exists between the non-
Indigenous Australians and Aboriginals and Torres Strait Islanders, this is of utmost
importance. Culturally safe nursing care entails that the nurses and midwives be aware of
themselves as well as the patients, and the disparities in languages and culture must be
intertwined. The belief systems of the Aboriginals and Torres Strait Islanders are much
different than that of non-Indigenous Australians, and the nurses must remember to remain
respectful towards the beliefs and culture of the Aboriginals and Torres Strait Islanders. It has

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been seen that lack of culturally safe healthcare environments lead to the Aboriginals and
Torres Strait Islanders not seeking the healthcare that they need (Daly, Speedy & Jackson,
2017). This form of cultural safety is essential in healthcare systems. It has been said that the
hospitals are 'Institutionally racist' and there is inadequate funding to take care of the issues
like the language and culture barrier (Henry, Houston & Mooney, 2004). Cultural safety and
critical consciousness must be taught in the health practitioners of Australia as it has been
seen that being culturally aware has proven to improve the equal treatment and consideration
in healthcare settings. Cultural safety ensures that no discrimination occurs in terms of
healthcare (Curtis et al., 2019). Being aware of other cultures and learning to respect them
will ensure that the nurses overcome their personal misgivings and discriminatory thoughts
while caring for the patients, thus abolishing personal racism. If the healthcare staff ensures
cultural safety in the workplace, eventually systemic racism will be abolished. Steps have
been taken to ensure a discrimination-free healthcare setting.
STEP 5 (500 words)
Reporting
From the above writings and information, I was enlightened about the struggles faced
by the Aboriginals and Torres Strait Islanders in all public sectors, mainly the healthcare
sector. I learned about the discrimination faced by them while seeking treatment,
employment, or education. I also gathered information about the history of the Aboriginals
and Torres Strait Islanders and the health gap that exists between them and the non-
Indigenous Australians. Finally, I became aware of how cultural safety practices can be used
to create a healthcare setting that provides the best patient care to everyone irrespective of
their culture and ethnicity.

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Responding
As a non-Indigenous Australian nurse, I always knew the statistics of the issue, for
example, the differences in life expectancy and poor health of the Aboriginals and Torres
Strait Islanders; however, I was never aware of such a deep-rooted issue. Now that I realise
how the concept of white privilege is toxic and still surrounds us till date. Most of us are
ignorant of the struggles faced by the Aboriginals and Torres Strait Islanders, simply because
we do not delve deep enough into the ideas, or try to relate them to our surroundings. I
learned about personal and institutional racism and realised how these impacted the
Indigenous population. It was enlightening and upsetting at the same time.
Relating
Now that I learned the concepts and became more observant of my surroundings, I
realised how the non-Indigenous population like me have do not have to face certain hurdles
like the Aboriginals and Torres Strait Islanders. I realised how they are still apprehensive of
seeking healthcare due to the inequality and underlying racism that exists among the
healthcare workers. I only really knew about how they do not seek healthcare or do
immunisation follow-ups (Philips et al., 2019), but never before I understood the reasons so
clearly.
Reasoning
While the policies discriminating against the Aboriginals and Torres Strait Islanders
have been abolished, I understand why they might still be apprehensive of the government
institutions. The older Aboriginal adults, who experienced discrimination, are right to be
defensive or feel like they are still being discriminated against (Markwick et al., 2019).
Another issue that might be responsible for this is the underlying discrimination and
ignorance among non-Indigenous people for the Aboriginals. For example, many white

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nurses and midwives tend to discriminate against the patients based on their skin colour as
well as their background (Wren Serbin & Donnelly, 2016). From this, I have realised that I
can help my patients by being aware of their issues, as well as respecting their culture. It is
necessary that I learn and understand how this works, and be aware to equally care for all my
patients, irrespective of their ethnicity and race.
Reconstructing
From what I learned, I can conclude that this issue can be helped if we all become a
little bit more aware and change our approaches in our personal and professional life. I will
be sure to implement this knowledge in my practice and also teach others about the ways we
can build a culturally safe environment. I will learn more about the Aboriginal culture,
practices, and beliefs in order to care for my patients in a holistic way.

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