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Engaging Aboriginal communities in healthcare

In conversation with Aunty Kerrie Doyle

“Life is always good!” It’s hard not to warm to Aunty Kerrie Doyle. She is candid in conversation, gracious in humour and has an upbeat approach to life.

Aunty Kerrie is the Co-Chair and Research Lead of the Aboriginal Health and Wellbeing Clinical Academic Group (CAG) at Maridulu Budyari Gumal. When asked how she came into the role, she replies: “I think my biggest skill is that I have the ability to bring people together.”

The Aboriginal Health and Wellbeing CAG was set up to engage with the Aboriginal community, to co-design research and co-create models of care. Talking about the program, Aunty Kerrie shares that “there’s equality of voices across whatever it is we’re doing”.

Having an equal voice is what’s needed to overcome the barriers to inclusion.

Barriers to inclusion

As a prominent Aboriginal voice in the healthcare community, Auntie Kerrie explains what she sees as the barriers to inclusion. She also shares insights on how to engage with the Aboriginal community to overcome these barriers.
 

The gap in Aboriginal health
The main measure of the gap is life expectancy. Before Australia was colonised, the Aboriginal community lived to be well over 100. That number has significantly declined over the years with average life expectancy now sitting at 72 years of age. This is 10 years lower than non-indigenous communities.

Research has revealed that Aboriginal communities do not get the same healthcare access, services or research as non-indigenous communities. There is an obvious gap in health equality that needs to be closed.

It’s Aunty Kerrie’s mission to focus on social and cultural inclusion within the Aboriginal community.
 

Hesitation to participate
As with any community that’s different from one’s own, there can be a lack of familiarity with the other’s culture and ways.

The Aboriginal community has a rich heritage and sacred culture. Because of this, there is a hesitation from the non-indigenous community to participate in Aboriginal health matters. This is out of respect for the Aboriginal ways and a desire to get Aboriginal healthcare models, approaches and ways of working right.

As Aunty Kerrie says, “there is a lack of familiarity with the mob”.  She knows people don’t want to offend.
 

Communication barriers
Communication varies greatly from person to person, discipline to discipline, and industry to industry. That variation is more pronounced when dealing with people from different cultures. This is as true for non-indigenous people as it is for the Aboriginal community.

Then there is the issue of the general public’s understanding of health versus the health community’s expression of it. Information naturally gets lost in translation, and this has created an ongoing barrier between non-indigenous and Aboriginal Australians.

Overcoming barriers to inclusion

Despite these issues, there are ways around them. It takes trust, collaboration and cultural humility to ensure Aboriginal communities have a voice in healthcare.
 

A caring Indigenous voice
Aunty Kerrie emphasises the need for a caring Indigenous voice in the community. Having someone who understands the Aboriginal community’s needs, culture and way of life is what’s going to make a big difference.

“If you can garner trust with an Indigenous community, you're doing really well.” This is something that takes time and consistent effort. Not false hope and empty promises.
 

Collaboration
“I’ll just ask the community” is something you’ll often hear people say when they don’t know how to approach a health or cultural issue. It’s not right to put the responsibility of finding the solutions onto the Aboriginal community, because they don’t always know.

As Aunty Kerrie points out, “we don’t know the questions, much less the answers”. It’s got to be through collaboration with the healthcare community. To create genuine health equality, problems need to be looked at through both lenses – especially in Australia.
 

Strengthening relationships
In the healthcare space, it’s important to strengthen relationships between academia and the practical Aboriginal communities. Between academia, clinical and community.

Aunty Kerrie hopes to give non-indigenous people the skills to work effectively in Indigenous communities – not just in Australia, but around the world. Educating and training clinicians about working in different communities, will ensure everyone feels confident in multicultural care settings.
 

Cultural Humility
Cultural humility is what’s needed for communities to come together and understand each other better. This will lead to a health system that benefits every person from every community in the country.  

Aunty Kerrie says that there is a real sense of cultural humility across Maridulu Budyari Gumal. Cultural humility, she explains, is when both sides walk in and don’t expect their culture or their way to be the only way.

As she puts it, “It’s more than respect, it’s applied respect. It’s clinical humility.”
 

A strong Aboriginal voice
Having a strong Aboriginal voice is important, and Aunty Kerrie believes that there are a lot more Aboriginal people with strong voices in the sector. It helps to inform government practices and policies, and even clinicians about what they do and how they do it.

Talking about how Maridulu Budyari Gumal supports that voice, she says, “There are so many good people that are willing with good hearts. You look at the rest of the mob from this clan, they put themselves out there and work hard and take risks.”
 

A vehicle for inclusion
Maridulu Budyari Gumal is the name gifted to the Sydney Partnership for Health, Education, Research and Enterprise. It was gifted to the partnership by the Dharug people and means ‘working together for good health and wellbeing’.

More than a name, Maridulu Budyari Gumal is a promise to protect the health of Australia’s first people. It respects the past as healthcare moves into the future.

What does this name mean for the Aboriginal community and their involvement in moving healthcare into the future?

“I think that it speaks to the core values of our whole program” says Aunty Kerrie.

She also talks about how the name plays a role in closing the gap. “It demonstrates respect and it's a vehicle for community inclusion, so that people can feel as though they own this. And having ownership of something means that you have say, and buy-in to what occurs, and that's really important.”