Family Health Care: Health Issues and Australian Indigenous People

Basic principles and the process of colonization of Australia

There are four basic principles that led to the colonization of Australia by the British. These include “intellectual capacity and scientific climate of that time, basic xenophobia and ethnocentrism, violence within the cultural boundaries and the protestant industrialization and Ethic” Eckermann, et al 2006). Ethnocentrism is that aspect of a particular society to view the world or other societies in the world from their own perspective. It is driven by believing that their culture is the best among the others. Ethnocentrism leads to an attitude called xenophobia in which the people develop a fear towards the foreigners. Due to this phobia it was very easy for the colonizers to take control of them. The aboriginal people were lagging behind in terms of scientific discovery and innovation. They were considered to be living through instinct and not intelligence by the colonizers.

Due to this inferiority the colonizers were able to take full control of them. Institutional racism also formed the basis for their colonization. This is a situation where the laws, regulations and rules are biased towards one society. These enabled the colonizers to dominate the indigenous people. Industrialization is another factor that led to colonization. The colonizers were looking for labor for their developing industries. This was acquired through colonization. Australia was colonized by the British starting from the year 1788. Captain Phillip author led the establishment of British Colony Crown of the New South Wales at Sydney cove on January 26 the year 1788. The date later came to be known as Australia’s national day. “The land masses in which they settled included New Zealand’s current islands which were therefore administered together with New South Wales” (Eckermann, et al 2006).

A separate colony was settled on the lands of Van Diemens in 1803 and now it is known by the name Tasmania which became a colony of its own in 1825. Britain however formally took over Australia’s western part in 1929. There were some aspects of cultural violence such as poor housing, discrimination, lack of employment, lack of access to health care due to physical or economic barriers that greatly disadvantaged the indigenous Australians. These made them languish in poverty and poor health. The doctrine of Terra Nullius was used by the British to dispossess the indigenous people of Australia of their land. This meant that the indigenous people could not sell or assign the land to a person of their choice. This was meant to justify the grabbing of the land from the indigenous people. This also implied that they were inexistence since they were not supposed to use any land freely. This affected them negatively both socially and economically since successive governments considered them to be roaming in the land rather than owning the land. This perpetrated discrimination and injustice towards the indigenous Australians. This made it easier for the colonizers to control them and to use them in provision of labor.

Protectionism and segregation


Segregation is the division of different people in a community according to their tribe or race. Racial segregation is specifically the separation of people in a group in terms of their races. This may involve discrimination in offering job opportunities or lending and sale of property to certain groups of people. It may also involve preferring to work or partner in business with members from certain members of the community only. The Aboriginal people were segregated in many ways by the non Aboriginal people. They were not allowed to own land, they were not allowed to visit certain health facilities for treatment and they were not allowed to work anywhere else apart from provision of free manual labor (Eckermann, et al 2006). These were all forms of segregation. In 1837 there was an ordinance passed by the British colonizers that made it an offence to sell or supply any alcoholic drink to the Aboriginal people.


Whereas segregation describes the discrimination of certain groups of people, protectionism involves the assimilation and association of a different race or group of people’s culture into another. This includes integration of economic, political and social life of different groups of people. In the 1650s there was an assimilation of the Aboriginals’ social and spiritual life into the white communities. The white communities were interested in religious ministers and the churches of the Aboriginal people. They were an association between the two groups of people whereby the white people provided educational assistance to the indigenous society. After the invasion of all the social, jurisdictional, political and economic life of the Aboriginal people by the colonizers, they were sympathetic to the Aboriginal people and gave them the rights and freedom over their land (Eckermann, et al 2006). This was a form of protectionism.

Primary health care

Primary health care is the incorporation of health promotion with personal care, community development and prevention of diseases. Philosophy of PHC also includes interrelated principles of access, equity & empowerment, self-determination of the community and intersection of oral collaboration. It is inclusive of the cultural, financial, political, and societal health determinants. Primary health care in Australia seeks to expand the first measure of the health care system from the normal health care systems to health development. Primary health care in Australia has greatly assisted in curbing diseases and infections of the indigenous people of the country

Cultural safety has also been applied as a major tool for delivering effective health care to the Aboriginal people. The Aboriginal people safe guarded their culture mainly through the community controlled health facilities. In the community controlled health facilities, they were able to have their own health officers who understood their culture and therefore adhered to it. They also defended their language and also their territories so that they could be able to have the community controlled health facilities.

Primary care is taken to be the health care provided by clinical medical staff to a client. Primary care is therefore widely practiced in nursing. It is the medical attention that a patient seeks first when infected by diseases. Primary health care there takes care for the general welfare of each member of the population since anybody can get infected or affected by diseases. Through its preventive and the primary care branch the system is able to take care of every individual in the population. An example of a culturally appropriate health plan is a community based nursing program.

This is a program in which people of a particular community or locality were trained as nurses to practice in the same area. It was believed that such consultants would be having background information of the client they are dealing with and in addition they would clearly understand the patient’s needs at any one time. This program was very successful in delivery of services to the people (Eckermann, et al 2006).

Definition of Community controlled health services

Throughout Australia a community medical service is defined as PHC that is initiated by often operated by locals to give comprehensive, holistic and culturally acceptable health care to the people of the community that runs and controls it albeit through a management board elected locally as opposed to mainstream primary health care system managed directly by the government The first community medical service in Australia was established in 1971 in the Redfern’s Sydney suburb. This was formed with the aim of increasing access for the local natives to health services. This was by creation of an environment appropriate culturally to the community. Since that time many changes have been evident in the arrangements of primary HC for native Australians.

The most important concept however beside the formation of the initial service remains the national body that is according to ACCHSs The members of the board are elected from the native Aboriginal community and are given the responsibility of taking care of the health issues of the community. The board is believed to be the most appropriate organ to run the health services since the members are conversant with the local peoples needs, they also understand the local language and they understand the environmental problems in that area. (Eckermann, et al 2006) noted that, “Right now there are almost 140 local health check up services throughout Australia which greatly diverge in terms of magnitude and also in staffing levels”

They are also unique in their funding structure and the management depending on the community. Provision of appropriate primary health care for locals is one of the foundations of improving health. This community based HCS have been initiated by the local’s inability to reach the main stream PHCS services due to barriers inhibiting them and also due to quench for expression of determination (Eckermann, et al 2006).

Cross Cultural stressors that could bring about culture shock within institutions such as health facilities between Torres Islanders and Aboriginal people include issues such as powerlessness on the side of the Aboriginal people, loss of identity and autonomy, isolation, different believes and attitudes as well as mechanical differences. These set the two groups worlds apart and in most cases disadvantaged the Aboriginal people.

The ANMC is the Australian body on midwifery and nursing established in 1992 with the sole purpose of formation of a national approach in regard to midwifery and nursing regulation. ANMC performs its duties together with the government, territorial nurses and authorities governing midwifery to provide national standards an integral part of the regulations and rules assisting the midwives and nurses to give safe and adequate services.

The standards included by the ANCM are nationally recognized standards for nurses registered by the government. Other standards include competency standards for nurses, midwives and other practitioners enrolled by the government, professional codes of conducts and ethics. Two dots that registered nurses should consider to avoid conflicts with ANMC include:

  • The registered nurse should show or demonstrate ability and competence in providing nursing care exactly as specified in the license from the registering authorities to practice, preparation in terms of education, relevant legislation codes and standards as well as care context. If a nurse fulfills all these requirements then there would be no conflicts between them and ANMC. The nurse should be able to practice independently and also interdependently and not assume responsibility and accountability on their part or their actions including delegation of their duties to either enrolled nurses or health care workers. Handing over of duties should take into account instruction and edification of health care workforce as well as that of enrolled nurses and also the care circumstance. The nurse should be able to way delegation cases and find out those that are risky to be left in the hands of others.
  • The registered nurse should be able to give evidence based care tips to individuals of different ages and cultural groups. Their role includes maintenance and promotion of health, prevention of infection in individuals with mental or physical problems and alleviation of suffering and pain at the last stages of life.

Elements of cultural vitality in the case study ‘Our past is our future’

The elements of cultural vitality in this case study include;

  • Language: another vital aspect of culture is language. Every community has its own language that is different and unique from others. The local aboriginal community had their own language which they used to describe themselves with. Though the authorities termed the language as vomit the community was determined to raise their voice and be heard since language was very important as far as their culture was concerned. It was through language that the community participated in their social, economical or religious activities. It is by use of language that the community composed songs, poems, folk tales which were also very important cultural elements.
  • Name: the name of a particular community is also an important aspect of culture. A community without a name will not be recognized and such a community will not be in existence. It is then from the community’s name that their culture originate. This is another reason that forced the local aboriginal community to fight for recognition. The authorities failed to recognize their name and hence denied them recognized existence since it is even very difficult to describe a community that does not have a name.
  • Oral literature: this is another important aspect of culture. Every community has its rich set of oral literature that includes songs, poems, and narratives. These are widely used in various ceremonies which rituals such as marriage and death ceremonies or for entertainment purposes (Eckermann, et al, 2006).
  • Land: land is a very important cultural element since it defines our origin, value and even wealth. Land to the local Aboriginal community was very important element of their culture since it defined them. It was only through the land that they possessed that could form the basis of their identification. Communities consider themselves superior to others depending on the quantity of land they possess. This formed the basis on which the local aboriginal struggled so hard to acquire it.

Forces and barriers that the community faced;

  • Regional land council; this claimed that the local aboriginal community did not exist.
  • Western neighbors; these claimed that all the land belonged to them
  • Construction Company: this was a major barrier since it had been instructed not to listen to them.

Communication as a major cultural-shock stressor

Aboriginal and the non aboriginal people of Australia have been working together for the past decade or so to ensure cross- cultural communication between the two groups of people. Direct interpretations, evaluations and observation of each others communication and behavioral patterns during workshops or meetings have shown that interaction with each especially across cultures involves some very enriching culture. Cultural shock is that feeling of discomfort, anxiety and stress that arises spontaneously as a result of change of language, interpersonal interactions, likes and actions and must be modified to fit the foreign expectation. It is mainly accompanied by both psychological and physical changes which result due to adoption to the changes. Cross cultural communication which is effective involves checking and verifying whether any information that is leaving our mouths is serving the intended purposed.

Cross cultural communication between the aboriginal people and visitors, refugees and the immigrants was the major cultural shock of the Aboriginal people. The Aboriginal people who were considered to be the minority in relations to the dominant culture were alien even to health facilities such as hospitals. The interaction between the Aboriginal people and the foreigners brought both emotional and physical stress. This interaction was mainly through language and therefore communication was considered to be a major cultural shock stressor by the Aboriginal people. It can also be defined as a disturbance, discomfort which is caused by numeral differences of work, customs, habits, value systems and attitudes making it difficult for sociability performance and reasoning in various cultural environments. Cultural shock also applies to refugees that is, people who have moved to other countries for refuge, entry to an alien facility for example a hospital.

A cultural shock stressor may therefore be taken to mean something that is difficult to bear especially where two or more different cultures collide. Contact between Aboriginal and non- Aboriginal people was another stressful moment especially in language since each of them had to adjust their communication so that they could pass information. The adjustment was stressful to the two communities equally. Communication is therefore taken as the main cultural-shock stressor since it mainly through communication that different communities interact (Eckermann, et al, 2006).

The role of the concept of ‘Reciprocity’ in relation to Indigenous Australians culture of community and sharing

Reciprocity means the patterns used in sharing based on very clear procedures rules and regulations defining each individuals rights duties and obligations as per the structure of their kinship relationships. These exist in all the aboriginal communities but how they are applied differs from one community to another and also in different family organizations. Reciprocity patterns are more complex than the simple term sharing which becomes crystal clear when reciprocity is viewed beyond income or goods and services.

Patterns of sharing as clearly defined by affinity and consanguinity should include the following aspects: from children to parents and vice versa, between siblings frequently referred to as reciprocal relationships, from adults to nephews and nieces often not a reciprocal relationship, to the grandchildren from grandparents and finally from age mate to another. Sharing therefore does not involve a very complex network. Within the framework discussed above and further beyond it a lot depends on affection and power elements. Giving does not only show how individuals do things but is also a way of establishing a powerful where the person giving may sometimes want to influence, boss, or pressure the receiver.

If the exchanges are weighed as fairly equal, then the power equation does not change. In case the exchange is viewed as one sided then, individuals might be tempted to manipulate or even control the recipient. The above discussed items form the perception of some of the complexities that surround reciprocity in the aboriginal communities. However any relationship either sharing or giving can be exploited and therefore being able to show examples of exploitation does not imply that all values associated by reciprocity or reciprocated respect are vague in all the communities. Some have very strong principles (Eckermann, et al, 2006).


Eckermann, et al (2006). Binan Goonj: Bridging Cultures in Aboriginal Health. (2nd ed.). Sydney: Churchill Livingstone.

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