Discuss about the Critical Reflection for BMC Health Services Research.
Understanding first people health care is an important part in delivering a person centered health care in professional practice. The Australian history from colonization and policy has had adverse health effect to the indigenous Australians. Indigenous people/ first people in Australia refer to Aboriginals and Torres Islander Slate who occupied Australia before colonization (Kirmayer, 2012). The indigenous people had their culture, way of knowing and doing things and a history for their community. Colonization and subsequent government policies undermined indigenous people way of life whose effects are also felt in today’s indigenous communities. The unit on first people health and practice has exposed me so several policies that affected the indigenous communities that give me understand in and appreciation of diversity and need for respect in professional practice in or to deliver quality and person centered health care. The following essay is a critical reflection on how own culture, life experiences, worldview and dominant cultural paradigm that do influence perceptions of and interactions with indigenous people in health care. This will involve defining and discussing protection and segregation policies of 1850 to 1950 and a critically reflection how the policy relates to health care and my professional practice.
Protection through segregation was a policy era in 1890s to 1950s. The protection and segregation policy era aimed to move indigenous people onto reserves and control their relation with other Australians. This policy era was after colonization and White Australia policy eras that did not consider indigenous people needs as part of the Australian citizens. The protection through segregation policy era was characterized by several themes that had profound effect to first people of Australia. One of the issues is that they were perceived inferiority of the first people of Australia. The indigenous people were viewed as inferior to other Australian. For example, the New South Wales had established Protection Boards that controlled the Aboriginal populations. This theme entails that the indigenous Australians has no freedom of self determination and their practices where viewed as threat to the Australian society. The second theme in the protection through segregation was social Darwism where the indigenous people were expected to die out (Scott et al., 2012). It was estimated that the indigenous population had fallen to 60000 in 1920s from more than 300000 in 1788 (Long, 2012). For example, in 1909 the Boards had power that allowed them to remove Aboriginal people from urban areas and put them in control reserves. This theme show the perception that the policy makers had that the aboriginals would die out and were not envisioned to be part of the Australian society. The third theme in the protection by segregation policy era is custom alienation. Different cultural groups of indigenous people were forced to stay together. Indigenous people had different cultures and being forced to live together caused disharmony. The indigenous communities were also relocated from their ancestral land. This alienated their culture that enhanced their well being. For example, the Aboriginals had spiritual connection to land while Torres Islander has spiritual connectivity to the sea. Alienating the indigenous customs had a profound wellbeing of indigenous people. The fourth theme evident in the protection through segregation era is separation of children from their parent. Separation of children had social and health negative effects to both parents and children. Parents of indigenous children were separated from their children that were a painful and stressful event that changed indigenous people perception to other Australia. The indigenous people became less trusting of white Australians. For instance, boys were forcefully removed and taken to Kinchela Boys home while girls were taken to Coontamundra girl. The other theme in this policy era was poor living conditions. The indigenous people were provided with poor conditions that included meager rations of products such as sugar, flour, tea and other substance (Muller, 2014). This affected the indigenous people accessibility of adequate food and living conditions that adversely affected their health. Therefore, the protection through segregation policy era had adverse social and health effects to the indigenous people of Australia.
The protection through segregation topic was an outstanding case of traumatizing events in relation to my life experiences, my culture, and professional practice. Before this course, I had limited understanding of this policy era that I feel had profound health impact that can be observed even today in indigenous communities. Fro0m my culture and professional value, I think and feel several issues were not right in the protection through segregation policy era. First, the issue of forceful separation of parent and their children is a stressful event. From a worldview, parent to kid separation is a painful and stressful event to both the parent and the kid. Forceful separation destroys special connectivity that indigenous people had to family and kinship that made up their society (Muller, 2014). Secondly, the protection through segregation undermined the indigenous people human rights. From my life experience, human rights are basic for human survival and dignity. Undermining human rights is oppression that causes mental illness. The indigenous people were denied right to self determinations. Their lives were controlled by Board who determined what they do and how they do it. As a human being, I can relate to an instance where my right for self determination and privacy are undermined. This means living under oppression when one cannot work towards personal goals and attain fulfillment out of their achievement. From professional practice, self determination is an important part to delivering holistic health care. Denying self determination therefore means that holistic approach to health care delivery cannot be attained. Thirdly, the issues of equity are critical in the society today. The notion that indigenous people were inferior compared other Australians encouraged stigmatization, racism and social disadvantage in the society (Durey & Thompson, 2012). From my life experience, people feel bad when they are neglected or looked down as inferior. I believe there is no race that is superior to the other and the difference in societies is not a weakness by diversity to be respected (Maddison, 2013). In the professional practice, equity provision of health care is paramount to meeting high quality health care. Lastly, provision of poor living condition exposed indigenous people to risk of contracting infections. Living in poor conditions make an individual more susceptible to infections compare to an individual living on good conditions. In professional practice, an individual social, economic, environment factors contribute to their health. Poor living conditions make an individual susceptible to infections hence contracting diseases (Muller, 2014). Following this understanding of protection through segregation, I have acknowledged the impact of history to indigenous people health. First, I understand some of the problems that exist among indigenous people are as a result of trauma and loss experiences in the past that affect their health up to date (Whyte, 2016). Secondly, I have understood and appreciated the role of family and kinship among Aboriginals and recognition of diversity that should be protected. Lastly, I have appreciated and accepted the concept of holistic health care among indigenous communities. Therefore, the study on protection through segregation was unfavorable experience and could have caused health implication to any population.
Dominant cultural paradigm has influence and shape perceptions. The dominant culture assumption and view point on protection through segmentation issues are driven by the objective of providing quality health care and respect to human dignity (Artuso, Cargo, Brown & Daniel, 2013). The first viewpoint of dominant culture is respect for culture and diversity. This refers to appreciation and acceptable of difference in cultures and need to preserve diversity. Cultures are not looked down but they are used to providing person centered health care. This viewpoint enhances by perception to appreciate culture and diversity and it role in providing health care. The second dominant viewpoint is respect to human life. Human life is viewed as sacred and should be sustained. No human being should take away another person’s life. This view enhances the dignity of human life. This view point enhances my interaction with first and objective to treating their life with utmost dignity when providing health care. The third dominant view point is equity in provision of services. Equality is an important part to the dominant cultures and all human beings are supposed to be treated the same (Runciman et al., 2012). This enhances my interaction with indigenous people when providing health services. The fourth dominant culture viewpoint is self determinant of a person. People have a say on their health and professional practitioners should incorporate patients wish in the administration of health care (Aspin et al., 20112). This viewpoint influences my perception toward incorporating patient views when administering health care to indigenous people. The last predominant culture relating to issues of protection through segregation policy era is holistic health care approach. A holistic approach goes behold physical and mental treatment and includes cultures and spiritual wellness. This viewpoint influences my perception and future interaction with indigenous people with an objective of providing a holistic health care that lead to holistic wellbeing.
The reflection process has enabled me to learn by focusing what I knew, what happened, and what other people say about the issues as a result of protection through segregation. This enabled me to get a deeper understanding of the underlying issues in indigenous people health. First, I have learnt that human rights of indigenous people need to be recognized to enhance human dignity among the community in order to deliver health care. Secondly, I have learnt the central role of self determination in providing health services to indigenous people. In my practice, I will allow patients to comment on their treatment so that I can incorporate their views in the treatment. Thirdly, I have learnt that the trauma caused in the past continue to contribute to impairment in the indigenous health and culture. The forceful separation of children from their parents and land was a traumatic event that affected the mental wellness of the indigenous people. Family and kinship is an important part of the indigenous people and part of wellbeing (Jeffreys, 2015). In my professional practice, I will involve indigenous people’s family. I have also learned that racism, adversity, stigma, and social disadvantage led to health problem experienced by the population. To address this issue in my professional practice, I will advocate for equality to indigenous people in Australia. Lastly, I have learnt about the holistic approach to health care. This approach incorporates more aspect of wellness beyond physical health and mental wellness. I will adopt holistic approach of health care.
From the critical reflection process, I have gained significant knowledge and skills that will transform my practice in health care. First I have gained knowledge on cultural awareness. I have been able to assess my knowledge on indigenous people, their customs, and history. I am now aware and I can take responsibility of my stereotype, assumptions, values and biases in relation to indigenous health. Secondly, I have attained cultural respect for indigenous people. I can recognize, protect, and advance inherent rights, traditions and cultures of indigenous people. This will enable in achieving equitable health outcome. Lastly, I have acquired cultural competence skills that I will continuous advance effective intercultural interactions with indigenous people. I have aligned my knowledge, attitude, and skills to work effectively with indigenous people and meet high quality health care.
From the essay, protection through segregation had profound effects to indigenous people health. It led to traumatic experiences as result of forceful separation, provision of poor living condition, culture disharmony, alienation of the indigenous people culture, and perceived inferiority. These issues are extreme cases that undermined indigenous Australian health care. According to my experience, dominant culture, protection through segregation issues undermined human rights, human dignity, discriminated and self determination. From the essay, I have learnt several lessons that will improve my profession practice through cultural competency.
References
Artuso, S., Cargo, M., Brown, A., & Daniel, M. (2013). Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study. BMC Health Services Research, 13(1), 83.
Aspin, C., Brown, N., Jowsey, T., Yen, L., & Leeder, S. (2012). Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study. BMC health services research, 12(1), 143.
Durey, A., & Thompson, S. C. (2012). Reducing the health disparities of Indigenous Australians: time to change focus. BMC health services research, 12(1), 151.
Jeffreys, M. R. (2015). Teaching cultural competence in nursing and health care: Inquiry, action, and innovation. Springer Publishing Company.
Kirmayer, L. J. (2012). Rethinking cultural competence.
Long, T. B. (2012). Overview of teaching strategies for cultural competence in nursing students. Journal of Cultural Diversity, 19(3), 102.
Maddison, S. (2013). Indigenous identity,‘authenticity’and the structural violence of settler colonialism. Identities, 20(3), 288-303.
Muller, L. (2014). A theory for Indigenous Australian health and human service work. Allen & Unwin.
Runciman, W. B., Hunt, T. D., Hannaford, N. A., Hibbert, P. D., Westbrook, J. I., Coiera, E. W., … & Braithwaite, J. (2012). CareTrack: assessing the appropriateness of health care delivery in Australia. Medical Journal of Australia, 197(2), 100.
Scott, E. M., Hermens, D. F., Glozier, N., Naismith, S. L., Guastella, A. J., & Hickie, I. B. (2012). Targeted primary care-based mental health services for young Australians. Med J Aust, 196(2), 136-40.
Whyte, K. (2016). Indigenous food systems, environmental justice, and settler-industrial states.
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