CNA156: Reflective Essay - NAIHO - Health Strategy - Assessment Answer

Reflective Essay Assignment

Assignment Task

The Na?onal Aboriginal and Islander Organisa?on (NAIHO, 1982, p. 2) has stated that health is: ‘not just the physical well-being of the individual but the social, emo:onal and cultural well-being of the whole community. This is a whole-of-life view... Health care services should strive to achieve the state where every individual is able to achieve their full poten:al as human beings, and thus bring about the total well-being of the community...’

The four required components:

1. Describe a potential health strategy that could be used to achieve the health services envisioned in the NAIHO statement above.
2. Discuss the implications of participating in the potential health strategy for your own health care practice, including an explanation about how you would interact with AboriginalTorres Strait Islander payments, their families and Aboriginal and Torres Strait Islander health staff.
3. Describe how the potential health strategy would contribute towards ‘closing the gap’.
4. Demonstrate your understanding of the conceptsof cultural safety, self-determination and collaboration in components 1, 2, and 3.

Introduction

The health disparities among the indigenous communities raise a public concern, more so because it is a direct violation to the human right to health which states that everyone is entitled to quality health services. It is the responsibility of the government to ensure that its citizens receive all human rights. The current situation in Australia is that the government has failed to provide health workers to the Aboriginals and the Torres Strait Islanders ( (Tsey, et al, 2009). The main reason is that the turnover for staff is high. This essay discusses the gap that has created an inequality on the provision of health services between the indigenous and non-indigenous communities as well as a strategy that when implemented will help balance the health system in the country.

The Aboriginals and the Torres Strait Islanders are struck with the most shocking health problems (Hughes & Somerset, 2004). Just to mention a few that are on top of the list are: a high rate of infant mortality. This is in comparison with the non-indigenous community. The reason to this is because expectant mothers are subjected to harsh conditions where they can only access minimal clinical care. They also are prone to low life expectancy. This is due to a number of reasons. Right from birth, indigenous communities suffer from malnutrition due to adverse poverty. Poverty contributes to poor housing and sanitation. Given such circumstances, communicable diseases like tuberculosis spread fast, killing many. The leading killer in the communities is cardiovascular diseases. They also record the highest number of mental disease patients (Nagel, et al, 2009). Despite this grave situation, the health structure of the Aboriginals and Torres Strait Islanders remain underdeveloped, both in terms of structure and staff. Non-indigenous Australians find working with the indigenous communities strenuous. The environment, to begin with, is different. This is not all that the health givers have to cope with. There is also a diverse culture which is worsened by language barriers. On the other hand, the Aboriginals and the Torres Strait Islanders struggle with accepting the new norms that is brought by the health employees. They perceive their intentions as disrespectful as it intrudes with their customs. In response, they become hostile to the very people who are working for the betterment of their health. The nurse-patient relationship is constrained from the beginning. Eventually, it is the health giver who quits. The government is finding it difficult to post workers in these remote and very remote areas yet quitting nurses bring with them a bad report. We need to address the cause root that is making it difficult for non-indigenous nurses to work for the indigenous communities (Rigney, 2010). Only then can we know how to increase the health staff in these regions thus improving the health of the people and equally important, bringing into equilibrium their health system with the rest of the country.

As a health provider, I need to learn the language of the people. This will only facilitate communication (Fasoli & Johns, 2007). In order for me to be effective in my work, I need to learn the culture of the people. However, understanding the heritage and traditions of the people is not enough. I need to be culturally intelligent to have the trust of my patients. I need to understand why the communities hold great importance to their culture that they have passed it down, for many generations, to their offspring, to preserve it. My mindset has to shift from an individualistic society that I am accustomed to, to a collectivistic mentality, as most of the indigenous people practice (Nelson & Hay, 2010). This means I have to take into account what they treasure; their land, their natural plants and their governance. I have to understand the spirituality they attach to their surroundings, even though I would normally perceive this as superstitious. Once I comprehend this, I can offer health services while practicing cultural safety. At this point, I can relate to my patients in a productive manner.

There has been various research conducted on cross-cultural experiences, mainly on international students and multinational companies. The result has been positive once the necessary steps were taken. There is more cultural tolerance among the mentioned subjects at this point when compared to the initial situations (Coffin, Larson, & Cross, 2010). However, little research has been conducted among the non-indigenous health givers and the indigenous communities. Therefore, we cannot define the extent of cultural shock experienced by the two; neither can we draw the necessary solutions for the existing drift. Therefore, the government needs to research on the best practices of cultural safety among the Aboriginals and Torres Strait Islanders (Paradies, 2006). This will place us in a better position to know what to expect and how to overcome it. The non-indigenous health givers endure difficulties while trying to adapt to a new culture. They need training that will help them during this period. The training should create a resilience that will help them fight through until they have attained cultural safety. The health carers should collaborate with the communities to establish a system that will boost the traditions of the people, such as supporting the use of traditional medicines. If we take into account what the communities treasure, then we can address their issues without resistance (Tsey & Every, 2010). The communities will not draw enmity with us. They would rather co-operate because they will feel safe associating with us. This will narrow the gap of inadequate staff because the hostility that make nurses quit will have dwindled.

Culture is defined as the collective behavior of a people that is deemed acceptable among them. It is a way of life that unites a community. It differs from community to community. Culture adaptation is the adjustments that one experiences to fit in a culture of another. Kalvero Oberg, an anthropologist, designed a model to illustrate the four stages one goes through to attain cultural adaptation (Rigney, 2010). The model has been modified with time. Currently, the four stages are known as the honeymoon stage, the rejection stage, the adjustment stage and the bicultural stage. The first stage is where one encounters a new culture and is fascinated by its customs. Its differences are viewed as enjoyment because of the excitement that accompanies a new experience (Gerlach, 2012). A little later, there comes a frustration due to change from what one is accustomed. People experience stress when what is familiar fades. The third stage is when one begins to re-adjust to the new culture until they are finally able to function in it. In the final stage, one is able to understand and practice cultural safety. These are the four shifts that health givers in indigenous communities are bound to experience. The culture for these communities is very different from the mainstream culture. With proper training, health givers will be able to develop self-determination because they will work with the perception that they can deliver quality services to these people once they form an enduring rapport. However, all these can be accomplished with collaboration. Health givers need persons from the inside who can guide them through the way of life of the indigenous communities (Pearson, 2009).

Conclusion

Cultural safety is an important component when working with indigenous communities (Gerlach, 2012). It is important to overcome the barriers of cultural indifference in order to become productive as a health giver. The process of articulating a new culture into someone’s values is challenging. It takes self-determination to press on until one has become assimilated to a culture that one is able to collaborate with leaders of a people to instill a positive change. These processes are the whole purpose of producing an effective health strategy that can close the gap between the indigenous and non-indigenous communities.