CHCDIV002 Promote Aboriginal

2. What are twelve current cultural realities that need to be addressed to facilitate full participation in service delivery be Aboriginal and/or Torres Strait Islander clients and/or co-workers?

• Language
• Day to day living environments
• Degree of acceptance by different groups and the need for education
• Deaths in custody
• Possible distrust of mainstream services
• Family Violence
• Acknowledgement of land and original custodians and Welcome to Country
• When organising a meeting, event or conference, it is respectful and good practice to acknowledge the land in which you are meeting and its original custodians.

Grief and loss issues can result in:

• mental health issues
• self harm and intentional injury
• suicide — particularly with youth
• drug and alcohol misuse and addiction
• over-representation in the juvenile and criminal justice system
• over representation in welfare systems
• homelessness
• family and domestic violence
• general feeling of hopelessness
• relationship/connection breakdown
• loss of country
• loss of identity

Various government legislation and policies have contributed to:

• dispossession of land
• family fragmentation
• mental health issues
• social and emotional wellbeing issues
• grief and loss issues
• poverty
• racism
• unemployment
• poor health outcomes
• poor housing standards
• below standard literacy and numeracy rates
• alcohol and substance abuse/ misuse
• over-representation in the juvenile and criminal justice system.

Aboriginal people continue to be over-represented in the following areas:

• welfare systems
• child protection systems
• homelessness
• health systems
• juvenile and criminal justice systems
• unemployment
• Rituals associated with death and dying
• Overrepresentation of aboriginals in the juvenile system
• Anglo-European influences

3. List twelve basic strategies that might be implanted to address the cultural factors that impact on service delivery.

• Adaption of hospital or other facility, service admission or entry procedures
• Discharge processes that are understandable and acceptable for clients
• Health/community services that serve the privacy of needs and protect indigenous dignity
• Screening services that are non-threatening
• Health/community promotion programs to which indigenous people can relate and adhere
• Referral protocols and procedures that take into consideration the necessary cultural factors
• Adaptation of reception and enquiry services- to include wherever possible local language use
• Culturally accepted diagnostic services and processes
• Inpatient services that fit client culture
• Non-patient/outpatient services to meet specific needs
• Health/community promotion programs to which indigenous people can relate and adhere
• Acceptable and appropriate advisory services

Activity 2

1. List and explain in 300 words, the critical issues influencing workplace and professional relationships with Aboriginal and/or Torres Strait Islander co-workers

Race is one of the critical issues that impact aboriginal and Torres Strait Islander people, this causes lack of communication and also bias and poor cultural awareness among service staff. Another would be cultural, cultural misunderstanding often occurs In response to language differences, various cultural expectations and interpretations may also cause misunderstandings which can result in workplace tension for example pitch or tone of voice may be misunderstood. Land is also a critical issue for aboriginal people from their perspective cultural issues related to land, tradition and cultural difference can be factors for affecting relationships with non indigenous co workers and clients. For example aboriginal and Torres strait people may have a negative view of these interactions with government and private health, education, welfare and community service agencies because they are a part non indigenous systems. A lack of understanding and acceptance of cultural differences between aboriginal and Torres strait islander people and the non indigenous population may contribute to a one size fits all approach to service delivery.

Religion is another of the critical issues that impact aboriginal and Torres strait islander people, there are so many different religions and belief systems in Australian society that it is very likely an educator will encounter a number of different beliefs in their childcare centres, these can affect the children’s day to day lives it is important to be aware of their beliefs and respect them.

2. How can community or health service workers develop effective relationships with indigenous communities and the individuals in them? List at least eight strategies

Providing a culturally safe environment and implementing strategies that reflect an understanding of Aboriginal and/or Torres Strait Islander history and place are essential. Services providers should:

• foster an understanding of spiritual relationships, the Dreaming and Indigenous Australian history
• be aware of family relationships, kinships and the place of Elders as decision-makers
• be flexible enough to support different cultural values and beliefs
• take a holistic approach to service, recognising all aspects of an Indigenous Australian person’s life
• provide culturally appropriate care and educational programs and acknowledge individual differences
• maintain effective networks to ensure appropriate referrals can be made.

Activity 3

1. To establish the key aspects of cultural safety it will be necessary to consult with indigenous co-workers, community members and elders. In 400-450 words explain cultural safety, its importance to relationships between service providers and indigenous communities and how it can be integrated into your own work and workplace.

Culturally safe service delivery is crucial in enhancing personal empowerment; and therefore should promote more effective and meaningful pathways to self-determination for Indigenous people.

Cultural safety relates to the fact that indigenous people often feel unsafe in the dominate cultures environment. The experience of the dominant society can be stressful and overwhelming for indigenous people, to the point where they feel threatened and unsafe. To make dominate cultural environments culturally safe, schools, hospitals and other service provisions need to be culturally appropriate, so they do not offend the sensibilities of indigenous people.

Cultural safety can be integrated into your own work and workplace by:

• Respect for culture, knowledge, experience, obligations
• No assault on a person's identity
• Clients to be treated with dignity
• Clearly defined pathways to empowerment and self determination
• Culturally appropriate service delivery/environment
• Basic rights to - education, housing, medical services, employment, environmental health services and hardware etc.
• Right to promote, develop and maintain own institutional structures, distinctive customs, traditions, procedures and practices
• Recognition of more than one set of principles, one way of doing things
• Access to prerequisites of effective participation in the system of the 'dominant culture'. These prerequisites can include - organisational and communication skills, financial resources, administration support, appropriately trained and resourced staff, and political resources
• Commitment to the theory and practice of cultural safety by personnel and trained staff
• Debunking of the myth that all Indigenous people are the same
• Working with where people are at and not where you want them to be
• 'Right to make own mistakes', People doing it for themselves, being active and not passive;

2. List at least ten community’s strategies that might be employed to support a culturally safe environment for delivery of health services

Rapport

In many traditional cultures, a high sense of value is placed on building and maintaining relationships. Taking a 'person before business' approach will help form this relationship and build rapport.

• Introduce yourself in a warm and friendly way.
• Ask where people are you from, share stories about
• yourself or find other topics of common interest.

Language

Many Aboriginal and Torres Strait Islander people do not speak English as their first language. Some also speak English in different dialects such as Kriol, Aboriginal English and Torres Strait Creole. Some general tips to overcome language barriers may include:

• Avoid using complex words and jargon.
• Explain why you need to ask any questions.
• Always check you understood the meaning of words the person has used and vice versa.
• Use diagrams, models, dvds and images to explain concepts, instructions and terms.
• Be cautious about using traditional languages or creole words unless you have excellent understanding.
• If required, seek help from local Aboriginal and Torres Strait Islander staff.

Time

In Western culture, emphasis is placed on time to meet deadlines and schedules. Time is perceived differently in Aboriginal and Torres Strait Islander cultures, as more value is placed on family responsibilities and community relationships.

• Consider allocating flexible consultation times.
• Take the time to explain and do not rush the person.

Non-verbal communication

Some non-verbal communication cues (hand gestures, facial expressions etc.) used by Aboriginal and Torres Strait Islander people have different meanings in the Western context. Be mindful that your own non-verbal communication will be observed and interpreted. For example, feelings of annoyance may be reflected by your body language and are likely to be noticed.

Personal space

Be conscious about the distance to which you are standing near a person. Standing too close to a person that you are unfamiliar with, or of the opposite gender, can make a person feel uncomfortable or threatened.

Touch

Always seek permission and explain to the person reasons why you need to touch them. Establish rapport first to make person feel comfortable.

Silence

In Aboriginal and Torres Strait Islander cultures, extended periods of silence during conversations are considered the ‘norm’ and are valued. Silent pauses are used to listen, show respect or consensus. The positive use of silence should not be misinterpreted as lack of understanding, agreement or urgent concerns. Observe both the silence and body language to gauge when it is appropriate to start speaking. Be respectful and provide the person with adequate time. Seek clarification that what was asked or discussed was understood.

Eye contact

For Aboriginal and Torres Strait Islander people, avoidance of eye contact is customarily a gesture of respect. In Western society averting gaze can be viewed as being dishonest, rude or showing lack of interest. Some (but not all) Aboriginal and Torres Strait Islander people may therefore be uncomfortable with direct eye contact, especially if unfamiliar. To make direct eye contact can be viewed as being rude, disrespectful or even aggressive. To convey polite respect, the appropriate approach would be to avert or lower your eyes in conversation.

• Observe the other person's body language.
• Follow the other person's lead and modify eye contact accordingly.
• Avoid cross-gender eye contact unless the person initiates it and is comfortable.

CHCDIV002 Promote Aboriginals

In Aboriginal and Torres Strait Islander cultures, the terms ‘Aunty’ or ‘Uncle’ are used to show respect for someone older than you. This person does not have to be a blood relative or necessarily an Elder.

• Only address people with these titles if approval is given and/or a positive relationship exists.

Shame

‘Shame’ (deeply felt feelings of being ashamed or embarrassed) for Aboriginal and Torres Strait Islander people may result from sharing private or personal information, cultural beliefs and from breaches of confidentiality.

• Take a discrete approach and avoid discussions in open or
• public spaces.
• Build trust and rapport to help people feel safe and
• comfortable with you and in their surroundings.
• Ensure confidentiality and consider Men’s and Women’s Business.

Listening

Explaining may take time because of narrative communication style or due to linguistic differences. The person may be struggling to communicate what they are trying to get across.

• Avoid selective hearing and ensure you are ‘actively’ listening.
• Paraphrase by summarising and repeating what the person said. This will help with clarification and signal you have been listening.
• Show empathy, be attentive and avoid continually interrupting or speaking over the person.

3. Explain, in 300 words, what cultural competence is and what it means in terms of integrating cultural safety into your own work and workplace.

in your workplace, you develop relationships with various groups of people including:

• your co-workers, supervisors and management
• individuals in your care and their family members
• visitors to your service or program
• health professionals, case managers or service coordination staff other services providers or care services.

The way you work with people from each of these groups is important, as the relationships you develop with them are a reflection on you professionally, as well as on your workplace or organisation. Think about how you speak, interact and behave when dealing with others and be considerate of their views, values and backgrounds. There are many ways to actively build good workplace relationships with others. This often depends in part on who the person is, as well as your role in interacting with them. Two fundamental requirements are mutual respect and tolerance of diversity

Activity 4

1. In 500 words explain why it is necessary for health service staff to demonstrate knowledge of and respect for the diversity of culture, skin and language groups, family structures, art and religion in indigenous cultures. How does this assist with ensuring that you work practices are grounded in awareness of yours own cultural bias? Support your answer with, where possible, examples. You might need to undertake some extra research in order to do this

It is necessary that health service staff demonstrate both knowledge and respect for the diversity within Indigenous cultures for many reasons. For example, if there is feuding amongst families a client may be absent or avoid contact with other clients who may be from the same family (kin) group so they cancel appointments or not turn up to the service until a resolution is made within the wider family (kin) group. By understanding and respecting community protocol, i.e. whether there are any ceremonies that may coincide when visiting the community service or if there is a death that coincides with an appointment can help the service staff have empathy and understanding of why that client has missed an appointment.

As there is such a diversity in language between different Aboriginal groups it can be very beneficial to learn 'Aboriginal English' however this should be discussed prior with the client to find out what they are most comfortable with and an interpreter made available if needed.

Often one or two family members have a special role as carer or for ‘looking out for’ the client who has been referred. These carers usually give the most valuable history and will often act as spokesperson for the client so understanding this and directing questions to the person who holds this position with the family structure can be extremely beneficial.

Within the service itself it important that Aboriginal art is displayed to ensure Aboriginal clients feel welcomed and comfortable using the facilities.

Service providers need to understand how Indigenous people see themselves and why they see themselves as they do. By doing this staff will have the respect and understanding needed to service their client in the best possible way. It is also important to sharing information and build relationships with community leaders and Indigenous run organisations who can provide valuable insight and information that will assist in the service delivery and the success of it. All the above are examples of being culturally aware and are extremely important when providing and building relationships with ATSI clients within the service.

2. What cross-cultural training should health/community services staff receive, what issues might such training address and why is such training necessary? How does this help with understanding the culture of others and of self?

Cross cultural training packages are available to help staff to develop their capacity to work with culturally diverse patients/consumers and to work as part of a culturally diverse workforce. The following training packages are currently available:

Customer Service in a Diverse Society (formerly Safe Services Diverse Communities) – Workshop to support frontline staff in their daily interactions and communication with consumers from culturally and linguistically diverse backgrounds. Frontline staff will gain increased understanding of the impact of culture in health services and be able to identify the barriers impacting on access to services as a result of language and cultural barriers.

Managing a Diverse Workplace

This workshop is suited to managers and leaders and provides participants with insights, knowledge and strategies to proactively manage the issues and challenges associated with leading a culturally diverse team.

Working in Diverse Teams

This workshop is for all Queensland Health staff and provides participants with insights, knowledge and strategies to proactively deal with issues and challenges associated with working in a culturally diverse team.

Cultural Issues in Clinical Practice

This workshop equips health professionals to understand the importance of including culture into assessment frameworks and the potential negative consequences if culture and language are not addressed. It will strengthen the clinician’s assessment skills by incorporating cultural aspects into practice frameworks

Activity 5

1. In 200-300 words explain how it is possible to identify communication issues and ensure they are addressed?

Many Aboriginal and Torres Strait Islander people do not speak English as their first language. Some also speak English in different dialects such as Kriol, Aboriginal English and Torres Strait Creole. Some general tips to overcome langauge barriers may include:

• Avoid using complex words and jargon
• Explain why you need to ask any questions
• Always check you understood the meaning of words the person has used and vice versa
• Use diagrams, models, dvds and images to explain concepts, instructions and terms
• Be cautious about using traditional languages or creole words unless you have excellent understanding.
• If required, seek help from local Aboriginal and Torres Strait Islander staff.
• Some non-verbal communication cues (hand gestures, facial expressions etc.) used by Aboriginal and Torres Strait Islander people have different meanings in the Western context. Be mindful that your own non-verbal communication will be observed and interpreted. For example, feelings of annoyance may be reflected by your body language and are likely to be noticed.
• Be conscious about the distance to which you are standing near a person. Standing too close to a person that you are unfamiliar with, or of the opposite gender, can make a person feel uncomfortable or threatened.
• Always seek permission and explain to the person reasons why you need to touch them. Establish rapport first to make person feel comfortable.
• In Aboriginal and Torres Strait Islander cultures, extended periods of silence during conversations are considered the ‘norm’ and are valued. Silent pauses are used to listen, show respect or consensus. The positive use of silence should not be misinterpreted as lack of understanding, agreement or urgent concerns. Observe both the silence and body language to gauge when it is appropriate to start speaking. Be respectful and provide the person with adequate time. Seek clarification that what was asked or discussed was understood.
• For Aboriginal and Torres Strait Islander people, avoidance of eye contact is customarily a gesture of respect

2. What are 12 communication issues that need to be addressed to develop and maintain effective relationships with Aboriginal and/or Torres Strait islander clients and/or co-workers?

• Interpersonal approaches
• Thinking/learning styles
• Expectations
• Responsibilities
• Priorities
• Experience
• Working styles
• Gender and kinship differences
• Languages
• History
• Educational experiences
• Realities

 

Activity 6

Explain in 150 words, the benefits of engaging Aboriginal and Torres Strait Islander interpreters and cultural brokers

As well as using the services of an interpreter, Indigenous Australian liaison officer or a colleague with specialised skills, there are other professionals and specialists who can help you meet your duty-of-care responsibilities to service recipients. People such as healthcare workers, teachers, community workers and your colleagues can act as effective culture brokers, bridging the gap between Aboriginal and/or Torres Strait Islander cultural practices and western culture.A cultural broker is a person who mediates between people of different cultural backgrounds for a particular purpose, such as reducing conflict or producing some kind of change.

The benefits of engaging Aboriginal and Torres Strait Islander interpreters and cultural brokers they can help:

• They have experience in dealing with conflict situations between cultural groups.
• they are often seen as having an affinity with/understanding of the two cultures.
• They can cultivate varied social relationships and mediate between people/ systems or act as a go-between.
• They can translate interests and messages between groups

Activity 7

Put together a list of 10 resources that you believe would assist health/community service organisations to facilitate effective service delivery and partnerships. You might need to conduct your own research in order to do this.

• Cultural awareness services
• Language services
• Government health websites providing data on Aboriginal and Torres Strait Islander health
• The department of Aboriginal and Torres Strait policy website
• The council for Aboriginal Reconciliation
• Commonwealth Department of health and ageing
• The office for Aboriginal and Torres Strait Islander health
• Australian indigenous Health Resources
• Yarning places-electronic networks that enable people with an interest in indigenous health/community to share information, knowledge and experience.
• Australian indigenous Healthlnfonet- a website on indigenous health

Activity 8

Write 250 words to explain cultural safety and how it increase participation

It may increase their participation because they are viewing the centre and noticing how culturally informed we are and that we like to involve all cultures of different families in our daily program and experiences the educators plan with the children

Activity 9

What does it mean to say that indigenous people need to be self-determining and to have some control over community services and programs? What stage might be implemented to support this?

To say indigenous people need to be self-determining means having the same rights as other Australians and being in charge of their own lives in the same way as mainstream Australians.

Previous Australian governments have implemented what they thought to be best for Indigenous people without consulting with them. However, initiatives developed on the ground in consultation with indigenous people are more likely to work and promote collaboration and partnerships, which lead to self-determination.

To be successful in self-determination Aboriginal people need:

Freedom. They can exercise of the same rights as all citizens. They can choose where they want to live and how their time will be occupied. They can be ambitious and creative, and express themselves. They do not have to trade their inalienable human rights for supports or services. Freedom includes the freedom to make mistakes.

Support. They can autonomously determine how to organise their resources. This means that people do not receive “supervision” and prescriptions. Rather, they may seek partners for support and contract for any number of tasks for which they need assistance.

Knowledge. Knowledge of what has and hasn’t worked elsewhere helps avoid mistakes or going the wrong way. This means also allowing Aboriginal people build their own knowledge base rather than prescribing what is ‘best’ for them.

Some of the work that successfully supports self-determination includes

Succession planning. Leaders prepare a younger generation to take over at some time, but also sponsor younger people to attend conferences.

Investment strategies. Groups design investment strategies to look after future generations as well as the current needs of Aboriginal people.

Business agreements. Clans and nations negotiate agreements with the private sector or governments.

Aboriginal programs. Programs that build on the practical capacity of Aboriginal people in communities to run education, policing and health systems themselves will be more successful than if prescribed by external parties.

Activity 10

why outcomes and measurement metrics must be identified and agreed upon. Who should participate in the agreement and the subsequent evaluations of the strategies and outcomes, and why. What is this likely to achieve?

outcomes and measurement metrics must be identified and agreed upon because it offers opportunities to address inequities in health/community care and service provision and makes it possible to:

• Improve health/community care access for all nations
• Acknowledge that we are all bears of culture
• Expose the social, political, and historical context of health/community care
• Interrupt unequal power

The agreement and the subsequent evaluations of the strategies and outcomes must be an agreement between government/ government agencies/ service providers/ indigenous communities and indigenous leaders.

This is likely to achieve:

• Have ownership of the processes
• Can actually see what is being achieved
• Can actively contribute
• Can make suggestions regarding changes or improvements to strategies and processes
• Will have some input into things that directly affect them

Activity 11

Why is it necessary to evaluate programs and services against desired outcomes?

Evaluation of programs and of services provided should be undertaken with the input and engagement of relevant indigenous people who need to be directly involved in the assessment of current strategies and the development of on-going strategies that will affect their live-to be in a position to describe the things they believe will be of benefit to them and have a large measure of control over when and how things happen. Review and evaluation lead to a determination of where the desired or expected outcomes of negotiated strategies are actually being achieved.