CSGPN’s July newsletter has an Aboriginal theme in recognition of NAIDOC week, which this year is from 3-10 July 2011.

During NAIDOC week the history, culture and achievements of Aboriginal and Torres Strait Islander Australians are celebrated nationally. Originally NAIDOC stood for National Aborigines and Islanders Day Observance Committee, the group responsible for organising national activities.  However the acronym itself has now become the name of the event.

NAIDOC emerged in the 1920’s from Australia Day protests by Aboriginal rights groups against the treatment and status of Aboriginal people. Between 1920 and 1991 there were several evolutions with the group broadening its support base and shifting its focus from one of protest to that of celebration. Support for NAIDOC gained momentum following the overwhelming results of the 1967 referendum and it was eventually lengthened to include a week of celebrations. In 1991 the name was changed from NADOC to NAIDOC in recognition of the distinct culture and heritage of Torres Strait Islander peoples.

Each year a theme is selected for NAIDOC week which reflects important issues and events. The theme for 2011 is “change: the next step is ours”. This year’s theme is about encouraging Aboriginal and Torres Strait Islander people to take responsibility for their future. Non-Indigenous Australians can show their support for NAIDOC by finding out more about their local Aboriginal communities and attending local celebrations. Councils generally advertise events on their websites and in local newspapers.

Within general practice support for Aboriginal patients can begin through staff discussion around issues and strategies to address inequities. There are several Aboriginal specific measures available through Medicare and the PBS which are directed particularly at reducing the burden of chronic disease and early mortality. If you are not familiar with these measures information is available at:
http://www.health.gov.au/tackling-chronic-disease

Alternatively I would be happy to visit your practice and go through it with you.

Even before these services can be provided however, the patient must identify as being Aboriginal and/or Torres Strait Islander. Identification is the key and yet also one of the major barriers to effective health service delivery. There are a number of reasons why correct identification of Aboriginal people doesn’t take place in a busy practice, including the following staff issues:

• discomfort at asking the question (views that the question is discriminatory or racist)
• fear of causing offence
• thinking that identification should be determined by appearance
• feeling it is a waste of time and effort
• believing that Indigenous status is irrelevant to the care provided and that everyone should be treated the same.

In the report Improving the identification of Aboriginal and Torres Strait Islander people in mainstream general practice (2010) Kelaher et al record GP and practice staff education as being the most effective strategy for improving identification rates within mainstream general practice. Cultural awareness training provides essential context and justification for routine identification. It also provides insights into the Aboriginal experience of visiting mainstream general practice and strategies for becoming a more culturally safe environment. CSGPN is holding another two cultural awareness training sessions this year on 21 July and 13 October 2011. GPs and all practice staff are welcome to attend.

In summarising, key principles wanted by Aboriginal people around identification Kelaher et al write:
“Aboriginal and Torres Strait Islander people indicated that it is important to ensure that the processes used for identification embody respect for Indigenous people and they suggest that this could be achieved by promoting cultural safety, explaining why the information is required, and ensuring the Indigenous person’s privacy and autonomy are respected” (Kelaher et al, 2010)