more_vert
SOARING through long white clouds from Auckland to Melbourne, we mulled over the proceedings of the Royal Australasian College of Physicians (RACP) annual congress and, especially, the striking inclusion of Indigenous voices, knowledge systems and ways.
The RACP annual congress was held earlier this month in Aotearoa (New Zealand) and, as anticipated, the Kiwis put on a great show. The congress had a strong New Zealand identity, which was particularly highlighted through the use of Te Reo (the Māori language) and embrace of Tikanga Māori (generally referred to as the Māori way of doing things). The Australian contingency was impressed and rightly so. New Zealanders are well known for their support and willingness to engage in Māori culture and language.
Australia and New Zealand share many similarities but there are also unique differences. As a result of colonisation, the Indigenous peoples of both Australia and New Zealand were dispossessed from their land, prohibited from practising their language and customs and suffered under discriminatory, racist and often violent colonial laws and policies. The numbers of Indigenous peoples in both countries dramatically decreased as a result of imported illnesses, massacres and loss of land, rights and access to food.
Despite these similar colonial experiences, there are important reasons for the differences in the ways in which non-Indigenous Australians and Pākehā engage with their country’s respective Indigenous languages, political movements and customs. Some of these include:
- the Māori language is more unified than the hundreds (over 250) of different Aboriginal and Torres Strait Islander languages;
- Māori people make up 15.4% of the New Zealand population compared with Aboriginal and Torres Strait Islander peoples at 3.3%, which gives Māori people a larger presence and voice;
- the New Zealand government has reserved Māori places in parliament whereas the Australian government does not;
- New Zealand has a treaty (the Treaty of Waitangi) whereas Australia doesn’t, although the Victorian Government is currently working towards Australia’s first treaty with Aboriginal and Torres Strait Islander Victorians. The absence of a treaty in Australia is a crucial difference. The Treaty of Waitangi in New Zealand promotes partnership, participation and protection, and has given the Māori people a greater influence in the political system.
As a result of these differences, it is likely that Aboriginal and Torres Strait Islanders experience more racism and marginalisation than Māori people., although we do recognise that each individual has their own unique experience. Without a treaty or constitutional recognition however, there has been no mandate to protect and promote the rights of Aboriginal and Torres Strait Islander peoples.
It is important to acknowledge the shared similarities and the differences between Australia and New Zealand; and both nations have a way to go in reducing disparities for Indigenous peoples. While Māori political rights are more advanced and there is greater inclusion of language and culture across Aotearoa, like in Australia, major inequities in health, education and incarceration rates remain (here, here and here). For both countries, these inequities have been shown to be directly attributable to colonisation and institutional racism.
What can non-Indigenous Australians do to show respect and solidarity with Aboriginal and Torres Strait Islander peoples?
There are many small actions that non-Indigenous Australians can do themselves, and in their workplaces and communities to send a message of respect, understanding and reciprocity with Aboriginal and Torres Strait Islander peoples:
- Learn about the traditional owners of the land on which you were born, grew up on and work on.
- Acknowledge country and the traditional owners at the start of every meeting, seminar or talk and, more importantly, personalise it to the topic of your meeting or talk. Here is a good example.
- Encourage flying Aboriginal and Torres Strait Islander flags alongside the Australian Flag. All three flags are considered our national flags. Find out who designed the Aboriginal and Torres Strait Islander flags and what they mean.
- Use the Aboriginal and Torres Strait Islander language names for places; that is, Uluru for Ayers Rock, Gariwerd for the Grampians, Minjerribah for North Stradbroke Island and Waiben for Thursday Island.
- Use strengths-based language rather than a deficit discourse.
- Encourage your workplace to write a Reconciliation Action Plan.
- Celebrate NAIDOC week – the theme this year is “Voice, Treaty, Truth”.
- If you have questions but are not sure who to ask, the Victorian Government has established a great resource where you can find the answers to common questions and ask your own deadly question.
Australia is home to the oldest, living, continuous culture in the world and that is something of which all Australians can be proud. By taking these small steps, we can make the relationships between non-Indigenous Australians and Aboriginal and Torres Strait Islander peoples stronger. Strengthening relationships is fundamentally at the core of reconciliation efforts in Australia and stands to benefit all Australians.
Dr Alyce Wilson is a public health registrar at the Burnet Institute working in global maternal, child health and nutrition. Alyce has practical clinical and public health program experience working reciprocally with Aboriginal and Torres Strait Islander communities in Victoria, Cape York, the Torres Strait and the Northern Territory. She holds an appointment as a lecturer in First Nations’ Health and nutrition within the Department of Medical Education at the University of Melbourne.
Dr Ngaree Blow is a Yorta-Yorta, Noonuccal woman and doctor. She is currently working as the Director in First Nations’ Health at the University of Melbourne, as well as completing research in the intergenerational health team at the Murdoch Children’s Research Institute. She completed both her Masters of Public Health and the Doctor of Medicine degrees concurrently and has a keen interest in public health and paediatric medicine. She has been a member of the Australian Indigenous Doctors Association since 2011 and has been involved in many First Nations health and education roles.
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.
thankyou Ngaree and Alyce
It is wonderful to see you taking up the leadership for a just world in keeping with your ancestors
Thank you for this article. While I am not in favour of identity politics at all, our indigenous people are a special case. Historically they have suffered terrible health outcomes and disadvantage since Europeans arrived which has not been fully remedied. So thanks again and I respectfully disagree with some of the above comments.
Marcus, John and anonymous should be congratulated for contributing to an important debate. They give a more liberal perspective (in the classic sense of the word) to counter the article which is based on identity politics.
What is concerning are the personal attacks against them by other people who wrote comments.
The article by Wilson and Blow gives one socio-political view on the topic. You might believe and agree with that view or you might not.
Marcus and co-responders give a valid, historically-informed and widely held view. Indeed even the Chief Justice of the US Supreme Court saliently expressed concern with the ultimate consequence of identity-based illiberalism when he warned that “if you want to stop racial discrimination you have to stop discriminating on the basis of race”. The authors of the article would do well to inform themselves of the liberal tradition as espoused by Martin Luther King.
A brilliant author who challenges the basis for identity politics is Heather MacDonald from the US. Once again the authors, Wilson and Blow, would do well to challenge themselves by reading her work.
So there are different and legitimate positions. But to suggest that because Marcus and John hold a different position that “I hope they are not medical professionals but fear they are. I fervently hope they are not in positions of authority or teaching roles with respect to the doctors of the future.” is the very definition of intolerance. Or to borrow a phrase from Gilbert and Sullivan’s famous musical, it is the very model of the modern left’s intolerance.
Marcus, John and anonymous offer a perfectly legitimate perspective that has a widespread historical and intellectual heritage. The target article offers a different perspective; an identity politics based perspective. Fair enough. Debate the underlying philosophical issues.
On a wider note, rather than only publishing Indigenous-related articles that are in lock-step with the identity-politics based view, MJA Insight should publish some more liberal views.
For instance, we urgently need to debate the scope and justification of Special Measures that are used to justify elements of indigenous policy. Special Measures (or equivalent) are used to obviate otherwise unlawful racially discriminatory policies.
There’s a saying that in modern liberal democracies such as Australia that racism is in high demand but short supply. It’s a very salient saying!
Dear Drs Wilson and Blow. Thank you for this highly relevant piece. The lessons you’ve highlighted from our Aotearoa neighbours are useful in understanding the role of strong, representative, governance and leadership for achieving “excellent health care for all”. Rather than “perpetuating notions of invasion [sic]” as reader John James suggests, such frameworks acknowledge historic events whilst providing forward-looking solutions to intergenerational barriers that have arisen. I hope readers, especially John James and Marcus Aylward, will use these lessons as they care for people who identify as Aboriginal and Torres Strait Islander into the future.
It is depressing to see Marcus Aylward, John James and Anonymous trotting out this antiquated, patronising, ignorant tosh – I hope they are not medical professionals but fear they are. I fervently hope they are not in positions of authority or teaching roles with respect to the doctors of the future.
I also attended the RACP conference in Auckland. The session on indigenous health was very good. As an Australian doctor, I was very impressed by the respect shown in New Zealand and I was unsure how I could try to replicate that in Australia. I want things to be better and I think this article sets out some responses that some may find useful. I am very disappointed and surprised by some of the negative responses to this article. There are other resources such as those from the Australian National Safety and Quality in Healthcare Commission referring to the special needs of our first nations people (https://nationalstandards.safetyandquality.gov.au/resources) which are relevant to all Australian healthcare providers and services, as well as the ATSI Foundation course on Core cultural Learning (www.AIATSIS.gov.au) that clearly needs broader dissemination.
Dear Drs Wilson and Blow,
As an Australian doctor, thank you. This is a well written and highly relevant piece, with very helpful resources for those of us interested to learn more but unable to attend.
My sincere apologies for some of the comments above. As an Australian, I am well aware of the undercurrent of anger and deeply held racist views within our community, but it is still disappointing to see them so blatantly and confidently trotted out. We still have far to go. However, as a society we are slowly improving, and there many Australians who feel and act differently. This is not all Australia. Please remain strong and continue your wonderful and important work!
Dr Olding
Ngā mihi nunui Alyce kōrua ko Ngaree for your insightful and thoughtful article, which from an indigenous perspective is both accurate and helpful to colleagues willing to make change.
As a participant in the RACP Congress, I would like to affirm that the Māori tikanga was indigenous-led and in no way token. In one important session, research from a PhD Fellow of the College highlighted clinical interactions which improve individual clinical care in chronic respiratory disease, resulting in directly attributable improvement in clinical outcomes.
In further acknowledging some of the commentary above, “ka whawhai tonu matou” – the struggle (for emancipation, equity and justice) goes on, until such time as blind indifference is reduced to ever more obscure irrelevance.
This a very disappointing article, steeped in myth that passes for fact, in relation to Indigenous Australians.
It perpetuates the notion that the first British settlement at Sydney Cove represented an ‘invasion’, that there was a concerted attempt at cultural and physical genocide, by non Indigenous Australians, and that the foundations, laid by early Australians of this wonderful country, Australia, which both Indigenous and non Indigenous Australians call home, is built on racism and an indifference to the well being of the Indigenous community.
The solution to much of what confronts the Indigenous community is to assist these Australians to participate in, and benefit from, the economic wealth building which enables Australia to offer its citizens what is amongst the highest standard of living in the Western world.
Included in that is our health care delivery.
Many Aboriginal communities are racked by drug addiction, alcoholism, unemployment, social isolation and the abuse of women and children.
A highly tendentious piece – even by the standards of MJA Insight – which cannot sadly pass without comment, as through repetition these views are taking on an air of veracity (which is of course as is intended) which they do not deserve.
The article was apparently about the RACP conference, the scientific content of which was not really revealed. Did one hear about Tikanga Māori (generally referred to as the Māori way of doing things) in its application to diagnostic and therapeutic approaches, or was it merely as patronising, virtue-signalling (or in the case on New Zealand, legislated) tokenism?
There is indeed a crying need to close the gap in indigenous health outcomes: there is no need for this to be tied to political posturing such as this:
*Reconciliation Australia is a partisan political organisation with a distinct political agenda
*There is only one national flag of Australia
*There may remain examples of isolated individual bigotry, but there is no INSTITUTIONAL racism is Australia today: claiming it does not make it true (and no, differential incarceration rates don’t prove it if there is a confounding variable of a crime having been committed)
*Dedicated parliamentary seats is racism by any other name
Australia is one country; all its citizens are Australians and should benefit from the rich opportunities that provides. All Australians might be better served to accept Australia as it now is, instead of carping on an historical grievance now over 200 years old which will never be resolved to the satisfaction of the aggrieved.
For goodness sake, join the main game and let’s get on with dealing with the health inequities that we face.
Hi anonymous, thank you for your comments. This piece is not politically motivated. Aboriginal and Torres Strait Islander health is a core component of medical education as outlined by the Australian Medical Council. Yes we do aim to provide excellent health care for all but the next step is doing that equitably and with cultural competence. Best wishes
We should stick to our knitting please!
Most of us are focussed on our provision of excellent health care to all. Our political actions are private and unprofessional!
fantastic article and resources
Thanks