Our Vision for Reconciliation
As a profession, our vision for reconciliation in Australia is a society that values and recognises Aboriginal and Torres Strait Islander cultures, knowledge, connection to land, and ways of healing. We envision a society that is free of institutional racism and where justice and healing has occurred through acknowledgment and acceptance of the wrongs of the past and their intergenerational effects.
As a voice in the health community and as a profession of integrity, we acknowledge our responsibility to ensure all Australians participate equally and equitably in all areas of life. The opportunity remains for our profession to become culturally safe in our various roles as physiotherapy professionals, medical experts, researchers, educators, advocates, and collaborators. In turn, we aim to make our collective contribution towards reconciliation in Australia.
Reconciliation Action Plan - Innovate 2017-2019
Building on the foundations laid in the APA’s first Reconciliation Action Plan, the second iteration, Innovate RAP 2017-19, has at its core the practical steps the profession can take to move towards reconciliation with Aboriginal and Torres Strait Islander communities.
The APA’s Innovate RAP 2017-2019 provides us with the opportunity to create a culturally safe and sensitive profession. The current focus of our efforts to ‘Close the Gap’ in life expectancy is on education of current and future physiotherapists who are culturally safe and sensitive, with the goal of ending any trace of institutional racism present in our profession.
Through the implementation of this RAP, it is our hope to provide physiotherapists with opportunities to help close the gap in their communities, educational institutions and hospital settings.
Aboriginal and Torres Strait Islander Health Committee (ATSIHC)
The Aboriginal and Torres Strait Islander Health Committee (ATSIHC) will play a significant role in guiding the implementation of the Innovate RAP, alongside the APA leadership team which will have stewardship of its key responsibilities. Our ATSIHC comprises Aboriginal and non-Aboriginal clinicians and researchers, and reports directly to the APA Board of Directors. The ATSIHC has ex-officio membership of APA National President Phil Calvert, a champion of the RAP, broad support from APA CEO Cris Massis, also a champion of our RAP, and additional members with experience or a passion in Aboriginal and Torres Strait Islander health and wellbeing.
Cultural safety for Australia’s first peoples
What is cultural safety? ⊖⊕
In general, cultural safety as a healthcare concept is poorly understood and even more poorly evaluated. Cultural safety is a significant element of culturally responsive care. Considered ‘a matter of priority for any organisation involved in service delivery for Aboriginal and Torres Strait Islander clients’ (Johnstone & Kanitsaki 2007), cultural safety is a framework within which health practitioners and the health service organisation evaluates its work practices and determines methods by which to empower its Aboriginal and Torres Strait Islander stakeholders to obtain culturally responsive care.
How is cultural safety developed? ⊖⊕
The cultural safety of Aboriginal and Torres Strait Islander peoples is promoted and developed first and foremost through the development of cultural awareness and sensitivity. Cultural awareness training (CAT) provides information on pre-colonial Aboriginal peoples’ spirituality, language groups, culture, stories (the Dreaming) and governance (the Lore) and the very healthy lifestyle of pre-Colonial Aboriginal and Torres Strait Islander peoples (often walking 50 km per day to find food, high protein diet, no sugar, no wheat, no dairy and no alcohol). CAT progresses through history providing education in relation to the impact of government policy on Aboriginal and Torres Strait Islander peoples over the last 200 years that has resulted in the Stolen Generations and the inter-generational trauma that we see today demonstrated in poor education and employment outcomes, alcohol abuse, addiction and self-harm, as well as solutions. Cultural sensitivity training educates the practitioner in methods of communication and engagement with Aboriginal and Torres Strait Islander community members so that a quality trusting relationship is developed between the patient and the practitioner.
As an example, if a patient—in this case a young mother—does not keep her physiotherapy appointment on time, a culturally sensitive practitioner will know, or be able to work out, why the no-show. If the patient has children, does she have anyone to look after the children in a safe environment while she attends treatment? Does she feel comfortable to bring the children to the clinic? The practitioner will also know how far the patient lives from the clinic, and whether she has a car or funds for travel. The practitioner will understand or be sensitive to cultural obligation, whereby the young mum may have to give her car to an Elder and not have any credit on her phone to call and cancel. The culturally sensitive practitioner will understand the Aboriginal and Torres Strait Islander concepts of ‘shame’ and be sensitive to those concepts when the patient returns for treatment. The practitioner may be able to work with the patient to sort out cultural issues that are preventing attendance and compliance.
What are the benefits of cultural safety? ⊖⊕
The benefits of implementing a framework of cultural safety within a physiotherapy service are manifold.
Aboriginal and Torres Strait Islander peoples (indeed people of all culturally and linguistically diverse backgrounds) will more likely feel safe within the healthcare service environment that is culturally sensitive. That is, when their opinion and culture is valued and understood, and their decisions regarding healthcare choices are respected, people will be more likely to engage positively and beneficially with the physiotherapist resulting in improved health outcomes. The flow-on effects to the physiotherapist and the physiotherapy service or business are obvious to the educated reader. As an oral culture, information about your culturally safe physiotherapy service will be recognised by your patients, and your business can thrive as a result.
Cultural awareness, sensitivity and safety training also ensures that the practitioner feels safe when engaging and treating Aboriginal and Torres Strait Islander patients. Part of cultural safety training is to also educate the practitioner on how not to be caught up with political correctness or fear of offending the Aboriginal and Torres Strait Islander patient, or their family, and be able to get on with the business of getting better.
How APA members can develop a culturally safe environment in their practice? ⊖⊕
- undertake cultural awareness training
- be familiar with the APA Reconciliation Action Plan 2017–19
- develop their own Reconciliation Action Plan
- provide an inviting environment for Aboriginal and Torres Strait Islander clients (eg, the clinic has culturally relevant art or a plaque acknowledging the Traditional Owners).
Reconciliation: our journey continues
Find out more by visiting the October issue of InMotion. Read about the APA reconciliation journey, hear from those who helped shape the plan,those who incorporated its tenets into education and professional realms and those to which its objectives have a deeply personal connection.