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An uncomfortable conversation 
Marcus Dripps

There has been a lot of recent commentary about racism in Australia, and its effect on sections of our community, in particular our Aboriginal and Torres Strait Islander community. I won’t repeat any of the discussion that has taken place in the broader community, apart from saying that racism has no place in the APA.

Over the last several years, the APA has increased its focus on playing a role in closing the gap in indigenous disadvantage in Australia. We have been members of the Closing the Gap steering committee for the last several years. Our inaugural reconciliation action plan was launched in 2012, and a subsequent plan is currently under development. Our Aboriginal and Torres Straight Islander Health Committee has continued to play a role in leading policy discussion regarding health issues affecting aboriginal people.

Recently I was fortunate enough to visit a number of regional and remote aboriginal communities with Australia’s oldest Aboriginal Physiotherapist, Marilyn Morgan. In addition to being able to see firsthand the challenges affecting individuals and these communities, we were able to spend a little time seeking to understand local views on how to address some of these issues. The health challenges are confronting, and very different to those affecting “mainstream” Australia. The profile of the burden of disease is different, with strong issues around infectious diseases and their impact being quite different from what would be seen in Sydney or Melbourne.

The interface between what is a “societal” issue, what is a “cultural” issue and what is a “health” issue is also complex, and this also varies greatly between communities. In this complex environment, it is not totally surprising that policy responses from state and commonwealth governments over a period of time have arguably not been successful in finding solutions.

So, what role can physiotherapists play in closing the gap on aboriginal health outcomes? More broadly, what is the role of the profession? There are no simple answers, and the responses required will vary in different communities.

One traditional owner said to me when discussing this issue: “How can we hope to close this gap if we can’t reconcile our own history together? Until we understand each other, how can we move forward?”.

So it would seem to be a reasonable starting point to get to know more about the indigenous community close to your home and work setting. What is their tribal name? What is the history of their connection to this land? What effect has colonisation and the last 200 years of history had on their culture and traditions? Is there a local cultural centre or other resource that can be accessed to get more information?

A physiotherapist recently commented to me “I know that my ancestors did shameful things to the indigenous population, but that was a long time ago, and I shouldn’t be made to feel bad about it.” It is my view that the key to reconciliation is not guilt or shame about past actions, but similarly it is not about denial. It is about a genuine desire to understand a traditional culture, how it has been changed since colonisation, and the challenges that face communities today.

In the same way that one of the cornerstones of any physiotherapy treatment is to understand the context of your patient, their experiences and beliefs as well as their condition, as a community and as a nation we should also seek greater understanding.

Before my recent experiences in remote communities I thought I had a reasonable understanding of the issues facing aboriginal communities. Now know that I don’t. But I do have a drive to know more, and a drive to play my part in closing the gap on indigenous disadvantage in Australia.

APA National President

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