What does the “third space” mean to you as a health professional?

1. What does the “third space” mean to you as a health professional? Eileen Tan Lisa Molony Kate Brazzale

2. Introduction

3. Definition of third space

4. Aboriginal Terms of Reference – Third Space • Link with Identity • Their Perceptual View/Way of Life • How they deal with things – eg Community involvement.

5. Aboriginal Identity in relation to the third space • Family • Community • Land • Importance

7. Aboriginal Health Statistics Life expectancies of Indigenous versus Non-Indigenous Males and Females. • On average • Indigenous Men die 11 years earlier then Non- Indigenous Males • Indigenous Females die 9 years earlier then Non-Indigenous Females. Data from the Australian Bureau of Statistics 2005-2007 data surveys.

8. Aboriginal Health Statistics

9. Aboriginal Health Statistics

10. Aboriginal Health Statistics Selected Chronic Conditions: Ratio of Indigenous Australian’s to Non-Indigenous Australians — 2004–05

11. Aboriginal Health Statistics • Diabetes Comparison between Indigenous and Non Indigenous 2005 • Cardiovascular Comparison between Indigenous and Non Indigenous 2005

12. Aboriginal Health Statistics

13. Implications for Health Professionals • Third Space • “A place where Indigenous and Non-Indigenous people can come and work together without fear of prejudice from ‘baggage’.” • An area of mutual respect between Indigenous and Non-Indigenous people where they can work collaboratively. • Health Professionals need • Knowledge. • Of where the other comes from; their “space” • Understanding • Of roles and responsibilities • Empathy • Towards both sides • Willingness to be open • Accepting of differences • Avoid stereotyping

14. Implications for Health Professionals • Aboriginal and Torres Strait Islanders are not the same. • Discontinue use of out-dated, derogatory terminology. • Half-caste, full-blood, quadroon, etc. • Always use the terms Aboriginal Man/Woman/People or Torres Strait Islander Man/Woman/People. • Aboriginal people mistrust people who offer services related to “protection” and “intervention. • European colonisation. • Government Policies post colonisation. • The “Stolen Generation”. Government policy til 1969. • “Keep your word.” • Changes made. • e.g. Kevin Rudd’s “Apology”. NSW Department of Community Services 2009 & National Disability Services WA 2009

15. Implications for Health Professionals • Sensitive issues due to past Government policies have contributed to: • Dispossession of land • Family fragmentation • Mental health issues • Social and emotional wellbeing issues • Grief and loss issues • Self-harm and intentional injury • Over-representation of Suicide rates • Family and domestic violence issues • Loss of country • Loss of identity • Poverty • Racism • Unemployment • Poor health outcomes • Poor education outcomes • Below standard literacy and numeracy rates • Alcohol and substance abuse/misuse • Over-representation in the juvenile and criminal justice system NSW Department of Community Services 2009 & National Disability Services WA 2009

16. Implications for Health Professionals • Respect • Elders, • The Land, • Animals, • Ancestors. • “Sorry Business” • Kinship • Defines roles and responsibilities within the family. • Ensure that extended family is included in important meetings or when making decisions. • Gender responsibilities. • Men’s Business – issues which have a male perspective within aboriginal culture. • Women’s Business – issues which have a female perspective within aboriginal culture. NSW Department of Community Services 2009 & National Disability Services WA 2009

17. Implications for Health Professionals • Language • Originally 300 nations speaking 250 languages with up to 600 dialects. • Nonverbal cues • Eye contact. • Hand and facial gestures. • Silence • Progression of Conversation. • Semantic Ambiguity • Swearing • Communication Techniques • Use uncomplicated language, Not “jargon”. • Be wary of comprehension NSW Department of Community Services 2009 & National Disability Services WA 2009

18. Close the Gap Campaign • Australia’s largest Campaign to improve Indigenous Health. • Aimed at reduced the Life Expectancy Gap between Indigenous and Non Indigenous Australians to 0 years by 2031. • OXFAM is campaigning to: • Increase Aboriginal and Torres Strait Islanders’ access to health services • Address critical social issues such as poor housing, nutrition, employment and education • Build Indigenous control and participation in the delivery of health and other services • Get governments at state and national level to work in partnership with Indigenous communities, health organisations and experts to develop and monitor a plan to tackle the Indigenous health crisis • Promote real and meaningful partnerships between Indigenous COAG, 2011 and OXFAM 2006

19. Need for Education • To understand the needs of our Aboriginal or Torres Strait Islander Patients • The majority of Aboriginal people access health care from Non-Aboriginal services. • Downing and Kowal 2011 • Majority of Nurses interviewed felt that didn’t receive enough cultural training to look after Aboriginal and Torres Strait Islander patients • They felt that they weren't giving them the level of care the needed and deserved. • Canada’s Approach • Kilpatrick, 2004 • Looked at the need for Aboriginal Education.

20. Focus Question.

21. References