Clinical Exploration and Experience Report on Aboriginal Health Services

Introduction

Orange Aboriginal Medical Service (OAMS) is an incorporated aboriginal health service that is an organization that is operated, owned and controlled by the community, and has been providing primary health care and medical services successfully to the local orange community since 2005 February (OAMS, 2014). OAMS is a nonprofit organization governed by seven members of board of directors who local people are skilled and independent. Five positions in the board including four executives posts are held by aboriginal people, while the two remaining are reserved for professionals who have relevant skills. The services provided at OAMS include women’s health, antenatal care, early childhood services, post natal care, immunizations, sexual health, lactating specific consultations, well persons check, Pathology collections, preventive advices and home visiting (OAMS, 2014).

Historical development of the aboriginal health service

In 1971 at Redfern saw the first establishment of Aboriginal medical service (AMS), after high pressure and agitation from the local service (Andrews et al, 2002). This was a part of self deterioration and aspirations of the aboriginal people in the melting-pot and intense environment of the intellectual life of Redfern. Moreover, this was a also a response to the urgent need of provision of accessible and decent health care services to the largely and swelling medically uninsured Redfern aboriginal populations.

The aboriginal medical services are separate from the state government controlled services, and are controlled by the aboriginal communities through their elected board of directors (Blais & Hayes, 2011). Rigby et al (2011) pointed out that the approach of primary health care that Redfern adopted as well as the early ACCHS’s mirrored international aspirations and was innovative for appropriate, effective, accessible need-based health care with social justice and prevention focus

The National Aboriginal and Islander Health Organization (NAIHO), a national umbrella organization was foreshadowed in 1974 in Albury during a national meeting on health of the aboriginal people, and in 1976 was established to promote the aboriginal community control principle in the health of the aboriginal people, to lobby for new service establishment and for holistic approach (Australia, 2009).

From 1970 to 1978 saw new establishment of ACCH in various parts of Australia to 12.however, this was halted for the next 15 years due to the minimal government financial support (Atwal & Jones, 2009). In 1992, NAIHO was replaced by the new national umbrella organization, national aboriginal community controlled health organization (NACCHO). The name change showed that the Torres Strait Islanders decided to campaign for themselves to establish their own organization (Australia, 1999).

There were 140 aboriginal health services funded by Australian government by 2003/2004 of which 127 ACCH were operating in remote, rural and urban areas (Blais & Hayes, 2011).

OAMS is a controlled health service by the aboriginal community providing primary and medical healthcare to the community. OAMS was established on 18th February 2005 and operates under one roof. In 2012, OAMS expanded its services to include outreach dental services to Cowra, Bathurst and Parkes aboriginal communities, and in 2013 to outreach to Forbes (OAMS, 2014).

Inter professional practice

The staff involved in OAMS center include general practitioners, midwifes, family and child health nurses, health workers, dentists and doctors. Inter-professional practice according to (Harding, B., & VEA, 2003) is when more professionals learn from, about and with each other to improve quality and collaboration in care. It is about creation of environments where health professionals can learn about and from each other, and the focus should be on the patient not the health professionals.

The inter-professional practice to indigenous health is very important because it is about preparing and modernizing the aboriginal health workforce in Australia for the challenges they will face in this 21st century. These include ageing population, chronic diseases and workforce trained on the acute care. Another importance to the inter-professional practice to the indigenous health is because it will keep the workforce be updated with changes in technology that they currently experience. This is all about the  organizational change of the entire aboriginal health systems, as well as the way the health professional think, manage, see and do (Andrews et al, 2002).

Cultural competent nursing care includes skills, attitudes and knowledge that support caring of people from different cultures and languages (Blais & Hayes, 2011). Culture influences the health practices and also how the patient and the health care practitioner perceive illness. According to Rigby et al (2011), it is important for the healthcare professionals to be cognizant to the aboriginal culture such as the shared values and traditions, common genetic elements of the aboriginal people. For instance, manifestation of disease, epidemiology and medication effects on the aboriginal people. Similarly, the health professionals should address attitudes, should be aware how individual thinking and behavior is influenced by culture, and be aware of how to interact with the aboriginal people.

Health promotion

The services offered at OAMS included general health checkups, primary health care, adult health checks, family and child health checks, antenatal care, dental services, mental, alcohol and drug health, home visits, transports services such as the ambulances, visiting specialists, and consultations (OAMS, 2014).

Community knowledge

The aboriginal cultures in Australia are diverse and complex. The aboriginal communities keep alive their cultural heritage  by passing rituals, arts, knowledge and performances  to new generations through teaching and speaking, protecting their  cultural materials, significant and sacred sites, and objects. There history spans between 40,000 to 45,000 years ago (Blainey, 2006). At the time of the European settlements, the population of the indigenous populations in Australia was estimated to be approximately 310,000 and 750,000 people (Australia, 2014). The aborigine society was organized into language groups of over hundred, with some containing sub groups and of varying sizes. According to Australia (2010), each language group was characterized by common culture, territory and language. Most of the groups also were semi-nomadic and traversed defined territorial areas of varying sizes from 500km2 to100, 000km2

Name

The aboriginal people call each other by their state (boundary name). Moreover, if an aboriginal person who is residing in a particular state may not be originally from that state, and will still retain his or her original state they came from (Blainey, 2006). The table below lists states and names

STATE NAME
New South Wales Koor/Goorie/Koorie/Coorie/Murrri
Victoria Koorie
South Wales Nunga/Nyungar/Nyoongah
Western Australia Nyungar/Nyoongar
Northern Territory Yolngu (Top End), Anangu (Central)
Queensland Murri
Tasmania Palawa/Koori

The aboriginal people also call themselves by their nation name. The table below lists the names by nation

NATION NAME AREAS
Bundjalung Grafton,Yamba,Gold Coast
Dunghutti/Thungutti Kempsey
Eora Sydney, La Perouse
Kamilaroi/Gamilaraay/Gomeroi Goondiwindi, Lightning Ridge, Tamworth
Tharawal/Dharawal Wollongong,Kiama
Wiradjuri Gilgandra, Dubbo, Wagga Wagga, Bathurts

Elders

Australia. (2014) indicated that certain male members who are senior of a traditional language group may be initiated to be elders. They are selected based on their personal abilities such as compassion and bravery to be ritual leaders and also on their knowledge on law. The elders’ roles are to provide leadership such as on education for the young, dispute resolution, and advising the marriage partners. Australia (2010) stated that in the traditional aboriginal communities, elders’ advice is usually unquestioned and heeded

Similarly, the elders have responsibility for spiritual matters, sacred objects and in ritual performance and spiritual performance. They are the custodians of the law and to pass it to the generations down the line.

 Customs

In the culture of the aboriginals, certain customs are performed by men and women separately. The aborigines have many different customs such ceremonies, dances, songs and music that were seen as central to the culture. For instance, performances of the dances, songs and the decorations of the body, painting and culture were seen as a way of preserving their culture and customs.

The aborigines also have rituals and ceremonies as part of their customs. some rituals according to Blainey (2006) are performed  to ensure continued existence of a species, and other for marking the life passage through important life stages such as puberty, marriage and even death. Moreover, almost all dreaming stories are associated to particular locations and also to sacred objects. For instance, Australia (2014) observed that each adult must perform every year the “increase ceremonies” for his or her totem at the sacred sites to enable release of the life force. This will make sure that the ongoing particular natural species supply which the individual is part.

Traditions and Beliefs

Land is the core of the aboriginal beliefs and their wellbeing. The land itself is not just minerals, rocks and soil, but the whole environment that is sustained and sustains culture and people (Australia, 2010). Blainey (2006) pointed out that for the aboriginals in Australia, the land is fundamental of all spirituality and this association and the “country’s” spirit is key to the issues that are essential to the aboriginals

According to Australia (2014), the aboriginals of Australia were gathers and semi nomadic, with each clan having designated territorial lands defined by geographic boundaries like lakes, rivers and mountains. Therefore, they cared and understood for their environments and are adapted to it. The national parks also contain important sites to the aboriginal communities like artworks and rock engravings.

Conclusion and personal reflection

The development of aboriginal health center has developed and has come a long way. From my essay, I have learnt that the aboriginal people are groups of people that embrace their culture, customs and beliefs.  As a person in the field of health, some of the strategies I can embrace and incorporate in my nursing practice are first, embracing inter professional practices where other health professionals can share ideas on heath matters for better service delivery to the patients. Secondly, another strategy is being competent on the aboriginal cultures and incorporates it in my nursing practice. This way, I will be able to understand my aboriginal patients, know how to handle them, understand their epidemiological trends and also care for them appropriately.

The essay discussed Orange Aboriginal Medical Service (OAMS) and their services they provide to the aboriginal community. Aboriginal health service has a long history as discussed and its development up to the current level has been through many challenges and dedication of the aboriginal community for better healthcare. Embracing of culture and inter-professional practice is beneficial for the health care providers for better nursing practice. Lastly, the essay explored the history of the aboriginal community.

References

Andrews, B., Simmons, P., Long, I., & Wilson, R. (August 01, 2002). Identifying and overcoming the barriers to Aboriginal access to General practitioner services in Rural New South Wales. Australian Journal of Rural Health, 10, 4, 196-201.

Atwal, A., & Jones, M. (2009). Preparing for professional practice in health and social care. Chichester, U.K: Wiley-Blackwell.

Australia. (1999). Inquiry into Indigenous Health: Discussion paper. Canberra: House of Representatives, Standing Committee on Family and Community Affairs.

Australia. (2009). A national Aboriginal health strategy. Canberra: Working Party.

Australia. (2010). Aboriginal people of New South Wales: Aboriginal Australia. Canberra: Published for the Aboriginal and Torres Strait Islander Commission by the Australian Govt. Pub. Service.

Australia. (2014). Indigenous Australia. Canberra: ATSIC.

Blainey, G. (2006). Triumph of the nomads: A history of aboriginal Australia. Woodstock, N.Y: Overlook Press.

Blais, K., & Hayes, J. S. (2011). Professional nursing practice: Concepts and perspectives. Boston: Pearson.

Harding, B., & Video Education Australasia. (2003). Indigenous health in Australia. Bendigo, Vic.: Video Education Australasia.

Orange Aboriginal Medical Service. (2014). Retrieved from http://www.oams.net.au/

Rigby, C. W., Rosen, A., Berry, H. L., & Hart, C. R. (October 01, 2011). If the land’s sick, we’re sick:* The impact of prolonged drought on the social and emotional well-being of Aboriginal communities in rural New South Wales. Australian Journal of Rural Health, 19, 5, 249-254.

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