Pre-Invasion Health Status of Indigenous Australian Elders
The health status of the elders was better during the pre-invasion stage that at the post-invasion error. During the pre-contact period, the healthcare system relied on three aspects of social inter-relationships to provide quality medical attention. The relationship between the indigenous elders and their land, creator beings, and other ages offered culturally-sensitive care (Braun et al., 2013). The Aboriginals researched diseases and provided answers to family, community, and personal health concerns. However, the introduction of the healthcare policies interfered with the Elders’ quest for quality medical attention. Therefore, the Aboriginal’s health deteriorated post-invasion.
The Elders believed and witnessed a decline in their status of health after the invasion by the western settlers. The settling of the Europeans increased the health problems among the Aboriginal population. Therefore, the mortality and the morbidity rates have been rising since the beginning of the invasion. The elderly indigenous people believed that the western people brought diseases to their land (Marrone, 2007). They also have a notion that the invasion has caused a decline in their socio-economic prowess. Therefore, the growing levels of poverty have hindered the elderly individuals from accessing quality healthcare.
The policy intended to incorporate the indigenous people into the white majority Australian tribes. The government proposed to achieve its mission by taking fair-skinned Indigenous young ones from their parents (Findandconnect.gov.au, 1961). The authorities took the children to specialized institutions for training on the ways of the white tribes. The primary objective of the policy was to destroy the indigenous societies. The elders that underwent assimilation at a tender age have admitted that the excise hassled to culturally-insensitive healthcare. The majority of white tribes do not consider the cultural beliefs of the Aboriginals before the provision of care.
The Assimilation Policy of 1961 escalated the racism and health deterioration among the elderly indigenous population. The treaty came into force to correct the injustices that the policy created on the Aboriginals. The deal affirms that the aboriginals have equal rights like the majority groups (Tully, 2000). Therefore, the government should acknowledge and respect the differences between the indigenous people and the white majority groups. The agreement also states that offering different treatment to people due to the disparity in religion, race, origin, and others is a racist move. An individual that does not respect the diversity should face the law.
The incorporation of the indigenous children with the others increased discrimination towards the aboriginals. The bias made the elders and other age groups o shy away from visiting health facilities for medical attention. Therefore, the policy increased the mortality rates among the elderly indigenous individuals. The treaty has a duty of correcting discrimination by stating that the Aboriginals should freely exercise their rights without prejudice (Short, 2003). The assimilation also intended to destroy the Aboriginal people; therefore treaty demands that the authorities should respect the culture of the indigenous people. Incorporation of beliefs in health care improves the life expectancy of the population.
The assimilation policy took away the children of the indigenous people for specialized training on the ways of the majority tribes. Therefore, the treaty intended to restore the rights of the old aboriginals to train their children. The agreement affirms that the indigenous people have the right to educate and train their children along with their cultural beliefs (Short, 2003). The declaration also requires the Australian government not to interfere with the elders’ freedom of self-determination. The United Nations have vowed to protect the elderly individuals against racial discrimination. The aboriginals should, therefore, receive quality medical attention like the others.
Current Health Status of Indigenous Australian Elders
The 1961 policy also hindered the free assess of medical attention for the individuals who resisted the changes. The provisions led to a decline in the health status of the elderly Aboriginal population. The treaty gives the elders the freedom of getting quality treatment regardless of their beliefs (Couzos et al., 2005). The declarations require the government to recognize the varied historical backgrounds of the Aboriginals. Therefore, the health stakeholders should seek the opinions of the old aboriginals before drafting the various treatment methods. The provision of treatment in partnership with the Aboriginals improves their quality of living; therefore, the treaty is effective.
The assimilation policy worsened the spread of the two complications thereby increasing the mortality rates. A plan that does not respect the cultural diversity of the elderly aboriginals increases the severity of the symptoms of the diseases. The implementation of the 1961 policies increased the prevalence and the risk factors of the chronic heart diseases. Research conducted between the years 1994 to 1995 indicates that one in every eight aboriginal had a heart complication (Carapetis, Wolff, and Currie, 1996). Additionally, the spread of the disease is rampant in the elderly and the women population of the Aboriginals.
Recent research has shown that cardiovascular diseases cause the death of many elderly patients than any other disease in Australia. The policy frustrated the indigenous population making them revert to activities that increase the risk of heart complications. Some of the risk factors of the complexity include physical inactivity due to old age and cigarette smoking (Carapetis, Wolff, and Currie, 1996). Other factors include diabetes, obesity, hypertension, and elevated consumption of alcohol. The discrimination due to the assimilation policy has made the disease to be more rampant in the indigenous than the white majority groups. Furthermore, the elderly indigenous population records more risk factors than the non-indigenous groups.
The elderly indigenous population has also witnessed an elevation in the spread of chronic kidney disease due to the impact of the assimilation policy. The culturally-insensitive regulations have reduced the quality of an elder’s life. Additionally, the health outcomes from treatment are poor due to the lack of person-centered care. The 1961 legislations concentrated health facilities in the urban centers away from the aboriginals. Therefore, the elders having the kidney complications cannot travel to the metropolitan regions for treatment due to high transport costs (Zhang, and Rothenbacher, 2008). Recent research has indicated that caregivers report a majority of kidney diseases in the indigenous patients than the non-indigenous individuals.
Apart from the epidemiology, the hospitalization rates due to the complication are higher in the elderly aboriginals than the rest of Australians. Additionally, the elderly indigenous population recorded higher death rates than the other age groups (Hoy et al., 1998). The elevated mortality rates are making the government spend a lot of funds in treating the patients with the disease. Just like cardiovascular complications, the remote location of the old aboriginals hinders their access to quality medical attention. The assimilation policy is responsible for the increased death rates due to cardiovascular and chronic kidney diseases in Australia.
Assimilation Policy of 1961
The assimilation policy has impacted the end-of-life and sorry business among the elderly aboriginals negatively. The regulations led to the isolation of the aboriginals and the development of quality health facilities for the white majority groups. The caregivers identified chronic complications among the aboriginals in the late stages of development. Healthcare facilities are inadequate among the indigenous population; thus resulting in poor palliative care (PALLIATIVE, 2003). The policy depreciated the health conditions of the aboriginals and resulted in social inequality. Additionally, the services provided by aboriginal caregivers are not related to the mainstream services. Therefore, the elderly patients do not know the exact services that make up the end-of-life care.
The mainstream providers of palliative care have little or no idea of the cultural needs of the aboriginal patients. The isolation due to the assimilation policy has created minimal tome for the indigenous people to access the end-of-life care services (PALLIATIVE, 2003). Furthermore, a majority of the elderly aboriginal patients have no idea about the existence of palliative care. The lack of infrastructure development in the rural indigenous communities prevents their access to palliative care units. Therefore, the 1961 policy limited palliative care to the white majority tribes.
The assimilation policy intended to destroy the cultural orientations of the aboriginals such as the performance of the sorry business. According to the elderly aboriginals, sorry business is a collective term for cultural protocols and practices after the death of an individual (Carlson, and Frazer, 2015). The elders are responsible for delegating obligations to the rest during the funeral functions. The cultural beliefs of the aboriginals indicate that funeral arrangements should include the participation from the entire society. However, the assimilation policy limits the attendance at the burial of an individual to the family and few friends. Therefore, the regulations are against the cultural beliefs of the aboriginals.
The protocols of the sorry business also differ between the aboriginals and the non-indigenous Australians due to the assimilation policy. The old aboriginals believe that the organizers of a funeral should not mention the name of the deceased individual (Musharbash, 2017). However, the regulations require all Australians to recognize the identity of the departed soul. The aboriginals stop their activities to honor the dead whereas the policy requires individuals to halt operations on the date of the burial. The indigenous population restricts their members from conducting operations that contradict the funeral, a restriction that lacks in the new policy.
The negative impacts of the assimilation policy have led to the provision of culturally-insensitive care. As a registered nurse, I have the duty of ensuring culturally-sensitive medical attention to the elderly aboriginal patients. Additionally, I have to prevent racism during treatment to improve the health status of the clients. Clinical care that adheres to the cultural beliefs of the aboriginals increases their life expectancy (Brascoupé, and Catherine Waters, 2009). I also have an obligation of ensuring that my fellow caregivers follow the standards of practice during their line of duty. The diligent adherence to the international treaty ensures social safety in care.
International Treaty on Indigenous People
The inequitable distribution of health facilities and medical resources is also culturally unsafe for the elderly aboriginal patients. I have an obligation of mobilizing the Australian government to construct health facilities in the rural indigenous areas. I also have to ensure that my medical attention is in line with the emotional, mental, and physical needs of the patients. Additionally, I should ask the hospital administrator to facilitate the recruitment of Aboriginal doctors who understand the culture of the clients. Furthermore, I intend to train the indigenous patients to learn the English language; since the language barrier impedes conclusive medical attention.
The Australian government should incorporate the cultural beliefs of the patients before forming the treatment methods. As an RN, I have the responsibility of explaining the treatment methods to the old indigenous patents and allowing them to make their choices. The indigenous community has financial constraints which should not prevent them from receiving quality medical attention (Mbuzi, Fulbrook, and Jessup, 2017). I have the duty of mobilizing the health stakeholders to introduce universal healthcare to every Australian citizen despite the difference in race and origin. Additionally, the aboriginals should have equal chances of receiving specialized treatment like angiography like the other Australian tribes.
The primary cause of mortality among the aboriginals is the chronic heart disease. Cancer follows cardiovascular diseases in the killer list for the indigenous population. Recent research has also shown that death rates due to cardiovascular diseases are high in the aboriginals than the majority tribes (Sahle et al., 2016). The grim statistics are due to lack of culturally-safe medical attention for the aboriginals. I have the duty of ensuring cultural safety during medical care to reduce the mortality rates. Furthermore, I have to ask the aboriginals about their opinion on the methods of reducing the death rates due to the chronic complications like cancer.
The main barriers to culturally-sensitive medical attention are the communication difficulties and discrimination. I have the duty of persuading the hospital administrator to hire a language translator for patients who do not understand English. The Australian government should educate the aboriginals on the language of the majority tribes to break the barrier of communication during treatment. The health practitioners should ensure that the indigenous patients visit the same hospitals as the other Australians. The caregivers should also respect the medical decisions of the elderly indigenous patients having chronic complications (Couzos, and Thiele, 2016). Therefore, solving the communication and racism barriers ensures cultural safety.
References
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Carapetis, J.R., Wolff, D.R. and Currie, B.J., 1996. Acute rheumatic fever and rheumatic heart disease in the top end of Australia’s Northern Territory. The Medical journal of Australia, 164(3), pp.146-149.
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Couzos, S., Lea, T., Murray, R. and Culbong, M., 2005. ‘We are not just participants—we are in charge’: the NACCHO ear trial and the process for Aboriginal community-controlled health research. Ethnicity & Health, 10(2), pp.91-111.
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Musharbash, Y., 2017. ‘Sorry Business is Yapa Way’: Warlpiri Mortuary Rituals as Embodied Practice. In Mortality, mourning and mortuary practices in Indigenous Australia (pp. 43-58). Routledge.
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Sahle, B.W., Owen, A.J., Mutowo, M.P., Krum, H. and Reid, C.M., 2016. Prevalence of heart failure in Australia: a systematic review. BMC cardiovascular disorders, 16(1), p.32.
Short, D., 2003. Reconciliation, assimilation, and the indigenous peoples of Australia. International Political Science Review, 24(4), pp.491-513.
Tully, J., 2000. The struggles of indigenous peoples for and of freedom. Political theory and the rights of Indigenous peoples, pp.36-59.
Zhang, Q.L. and Rothenbacher, D., 2008. Prevalence of chronic kidney disease in population-based studies: a systematic review. BMC public health, 8(1), p.117.
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