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How can we advance Reconciliation?

01 June 2020

By Dr Emily Yu Sum Huning FRANZCOG and Dr Ruth Grace FRANZCOG


                                   
 Dr Emily Yu Sum Huning                                                              Dr Ruth Grace

All Australian women should be able to hope for a long and healthy life for themselves and their children. This hope begins with “baby steps” - being able to give birth safely to a strong and vigorous child, at a healthy gestation, with an appropriate birth weight.  The bigger steps follow - ensuring that child has ready and equal access to the other determinants of lifetime good health, such as safe housing, adequate nutrition, healthcare, education and employment.

 

This hope is not reality for many Aboriginal and Torres Strait Islander women in Australia.  A Non-Indigenous girl born in Australia today has an average life expectancy of 83.4 years but an Aboriginal or Torres Strait Islander girl born in rural and remote Australia can expect to live only 69.6 years - barely one year more than a girl born in Ethiopia at the same time.

 

This difference in life expectancy - the most rudimentary and visible gauge of inequality - makes advancing the cause of indigenous reconciliation essential for the betterment of women’s healthcare in Australia.

 

Reconciliation seeks to build a just, equitable and respectful society for all people.  To paraphrase, “in a reconciled Australia, Aboriginal and Torres Strait Islander women have the same life chances and choices as non-Indigenous women, and the length and quality of a person’s life will not be determined by their racial background”.

 

Australian healthcare workers of all races and ethnicities have a unique opportunity to promote Indigenous reconciliation in their work. Not only is the length and quality of a person’s life our primary concern, but health care workers are also generally held in a unique position of high trust by the Indigenous community.  87% of Indigenous respondents to the 2018 Australian Reconciliation Barometer felt they had a “fairly good” or “very good” relationship with doctors, nurses and medical staff - higher than other most sectors, including local shop owners and the police. It is imperative that we look for any opportunity in our work, large or small, to engage with Aboriginal and Torres Strait Islander women in ways that enhance their health and well-being. 

 

At present, one of us is a staff specialist working intensively with Aboriginal and Torres Strait Islander women in Broome and the Kimberley, where 45% of patients are Indigenous.  The other works as a visiting specialist in a Victorian regional outreach clinic, supporting the local Koorie Maternity Service in an area where only 1% of the population are Indigenous.  Our workloads and exposure are very different but what we have in common is the stories - of women and children living with the tangible experience of inequality, and of a “gap” that desperately needs closing. 

 

The history of Aboriginal and Torres Strait Islander women in Australia includes the systematic, forced removal of children from their families on the basis of their race.  To find a way forward - to reconcile - we must first tell the truth of this fact and acknowledge the generational trauma that has resulted.  Then we must ask those to whom we wish to be reconciled how we can best move forward, and be both practical and prompt in our response.   

 

In September 2018, at the time of the launch of the College’s updated reconciliation action plan, RANZCOG comprised approximately 7310 Fellows, Trainees, Diplomates and Certificants.  Of these, only 13 identified as being Aboriginal or Torres Strait Islander.  Increasing Indigenous participation in the women’s health workforce will progressively make the voices of Indigenous people more easily heard and the needs of Indigenous people more visible.  But this priority effort takes time.  In the interim, the demands of many cannot be the work of a few.  By its very nature, reconciliation must be the work of all. 

 

Reconciliation week is a reminder of the opportunities we have to be informed, to raise our own awareness and to participate in ways both large and small.  What can we do?  Consider reading the RANZCOG Innovate Reconciliation Plan 2018-2020 for ideas to adopt in your own workplace.  Offer support to an Indigenous medical or nursing student. Read the 2020 Closing the Gap report. Perhaps seek out your local Indigenous health service, or your hospital’s Indigenous liaison team. Nothing is “the answer”, but everything counts. Baby steps.




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