This National Close the Gap Day, we have something different to consider.
The campaign co-chairs, Mr Rod Little and Ms June Oscar AO, along with all the Close the Gap members, have decided that it's a time to celebrate our victories.
Instead of publishing a shadow report to the Prime Minister's Close the Gap report, this year Our Choices Our Voices features stories that the campaign co-chairs say, "clearly demonstrate that when Aboriginal and Torres Strait Islander people are involved in the design and delivery of the services they need, we are far more likely to achieve success."
Prepared by the Lowitja Institute, the report was released this morning at Tharawal Aboriginal Corporation – Aboriginal Medical Service South Western Sydney, as part of National Close the Gap day events around the country.
The people and programs featured in Our Choices, Our Voices honours all those who work at Closing the Gap, seven days a week, 52 weeks of the year. Throughout the report, the ten stories all share "a common strength in leadership, initiation and design by Aboriginal and Torres Strait Islander peoples".
Below is a selection from the report, which proudly promotes black excellence across the board from leadership to governance, and participation.
Birthing on Country Project
The Birthing on Country Project provides Aboriginal and Torres Strait Islander women access to culturally and clinically safe, inclusive care, incorporating cultural birthing traditions within mainstream maternity services.
"The Aboriginal and Torres Strait Islander midwives and health workers understood my family background and became my friends during the process."
Karina Hogan, who participated program in Queensland, said prepared her for what to expect for her first pregnancy. She added that having her second child whilst participating in the program was much easier, feeling confident knowing she had full support from the Aboriginal and Torres Strait Islander midwives and health workers.
"The Birthing Program is built on a background of understanding," she said.
"The Aboriginal and Torres Strait Islander midwives and health workers understood my family background and became my friends during the process.”
Established by the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), the Australian College for Midwives (ACM), and members of the University of Sydney and University of Queensland, Birthing on Country programs support Aboriginal and Torres Strait Islander women who may be cautious, uncomfortable, or refuse to present at mainstream services, by offering culturally safe antenatal care. The program nurtures individual needs from the beginning of pregnancy to the end.
Hayley Longbottom used the Mums and Bubs Birthing Program run by Waminda in NSW said, "knowing that when I was to become a mum again, my experiences from my previous children was going to be different. I was comfortable, I was treated like a woman expecting a baby, and not a person with an illness."
The experience and hopes of participants and workers, voiced by Karina and Hayley, is that the Birthing on Country project ‘is the bridge to giving babies the best start in life’.
Family Wellbeing Empowerment Program for Young Aboriginal Men
Aboriginal Family Wellbeing coordinator, Nigel Millgate has been running the men's development program since its inception in 2012.
He has seen more than 200 Aboriginal young men aged between 13 and 18 participate across eighteen programs.
"I love this project," he explains. "I’ve watered it and nurtured it from the beginning."
Nigel explains that empowerment, teachings and development weave through the program, and how these learnings support young men who have often experienced "a lack of positive male role models in their lives."
Funded by the Primary Health Network, this program is an avenue of support for young men in the NSW Central Coast area who may not have expressed their vulnerability to a doctor, an Aboriginal Medical Service or a counsellor.
It is beneficial that the people running the program understand the different situations young men present, and the vulnerable, and occasionally reluctant, nature in which some young men may attend the program.
"I’m vulnerable, and the same as they are, I share my full story from the highs to the lows – they don’t teach that in schools"
Nigel expressed how he genuinely relates to the young men by sharing his own personal experiences.
"I’m vulnerable, and the same as they are, I share my full story from the highs to the lows — they don’t teach that in schools," he said.
"It is fundamental that the program is community driven and supported."
Nigel believes community engagement with the program is imperative to the program’s success, though expresses deep concern around the way in which uncertain government funding affects the program’s security. Highly skilled staff members have ceased working for the program due to insecure funding.
One of the program’s first participants, Anthony Freeman, shared the impact the program has had on his life, saying he was sceptical about the program initially, saying that "talking about feelings" wasn’t really for him.
Aside from the experience Nigel brings to the program, there are Elders and community members to call for support, offering knowledge and guidance for the young men.
Institute for Urban Indigenous Health - Inner City Referral Service
The Institute for Urban Indigenous Health’s (IUIH) Inner City Referral Service (ICRS) is an outreach service that supports Aboriginal and Torres Strait Islander people who have alcohol, tobacco and other drug and/or mental health and/or chronic health issues, living within a five-kilometre radius of the Brisbane GPO.
The program utilises a number of approaches including intensive case management, assertive outreach and strengths-based, community and family-focused practice.
Randall Frazer, a Bidjara man and team leader with the ICRS, believes the program's success is due to the embedded respect, compassion and empathy within it.
"[I] love being able to work with mob who may require extra support initially but who grow to be able to advocate for themselves and seek appropriate supports and services as need arises," Randall says.
"Seeing someone who has never had a place of their own, obtain and maintain their own housing and linking someone who hasn’t received any support for their health issues with the appropriate continuing care is very rewarding".
Randall noted that ICRS is often the only service to break through to people who do not, or cannot, access other services.
ICRS have successfully housed Elders back on their own Country at times of terminal illness, supported young women to access domestic violence services and obtain their own housing in a safe environment, and linked people experiencing severe mental illness to appropriate specialised care.
Randall said respect of mob's human rights and the self-determination and value of autonomy to make their own decisions is paramount in giving Aboriginal and Torres Strait Islander people the ability to live the lives they want to live.
"We intentionally challenge structures, systems and organisations by encouraging compassion, empathy and respect for our mob and the ways they should be supported by these structures, systems and organisations," he said.
"And by supporting our Mob on their pathways to transforming their lives — whether that be from the street or park, to places where they feel strong, safe and empowered to live their lives."
Anaemia Prevention Program,
Anaemia, a condition in when there aren't enough healthy red blood cells to carry adequate oxygen to the body's tissues, is a critical public health issue in Australia for Aboriginal and Torres Strait Islander people.
Research has found that a prevention program needs to be started early in life, before the age of three months, with education and an iron dose that is provided consistently by a dedicated Aboriginal Health Practitioner who has an intimate knowledge of the community and the local social determinant issues that hinder parents and primary health care services from providing the care required to prevent an anaemic episode.
An integral component of the success of this prevention program in Katherine East (Northern Territory) has been the engagement of an Aboriginal Health Practitioner, Ms Katrina Mitchell, practising at Sunrise Health Service.
Katrina is a local young mother and has close connections with other parents in the community. As a local, she is able to explain the program and encourage mothers to attend the clinic.
Katrina says, "as an Aboriginal health practitioner, my first job was monitoring for the yearly full child health check; immunisation and the anaemia iron program for the under-five kids.
"I get lots of good positive feedback from the child health coordinator, teachers and mums, aunts and other extended family members."
"Health and education go hand-in-hand, you cannot have one without the other in order to create change."
Ms Raelene Brunette, an Aboriginal researcher working on the evaluation says that one of the key findings in the program's success was due to the commitment from the Community Health Centre's local staff who held strong connections within the community and who were well respected by their people.
"Health and education go hand-in-hand," she said. "You cannot have one without the other in order to create change. This is very much so with Aboriginal Health Practitioners who have a challenging and rewarding job at the frontline of primary health care.
We cannot achieve success in improving good health outcomes for our people without Aboriginal Health practitioners' involvement”.
IndigiLez Leadership and Support Group
IndigiLez Leadership and Support Group was founded by Rebecca Johnson and Tanya Quakawoot in 2008.
Since then — and currently without any funding — these two dedicated women volunteer their own time and resources to support Aboriginal and Torres Strait Islander lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) women whenever it is within their power to do so.
Working at local, state and national levels as an advocate, Rebecca explains why this work is so important to our community.
"It’s important to provide a space for women to develop pride as Aboriginal and Torres Strait Islander women as well as a deadly and proud LGBTIQ+ woman," she said.
Building self-esteem provides opportunities for women to feel empowered and educated in areas of sexual health, general health, and social and emotional well being which may otherwise not be addressed if the space is unsafe.
Rebecca believes, simply including Aboriginal and Torres Strait Islander LGBTIQ people in health strategies is "not good enough" and she would rather see Aboriginal and Torres Strait Islander LGBTIQ women included in governmental targets and not seen as a sub-category in the overall strategies.
"Mob saw themselves in the programs, recognising that when we work together that it increases social inclusion and service access."
Success so far has been demonstrated by witnessing women expressing pride in their sexuality, gender, cultural identity and overall sense of feeling valued.
IndigiLez co-designs programs with Aboriginal and Torres Strait Islander LGBTIQ women, which means that mob could see themselves in the programs and recognise that, as Rebecca says, "when we work together, it increases social inclusion and service access."
Mununjali Housing and Development Company Ltd
Mununjali Housing and Development Company Ltd is a community-owned and operated organisation built over the past 43 years to improve the standard of living for Aboriginal and Torres Strait Islander people who live in the Beaudesert and Logan City areas of Queensland.
They provide long-term housing, aged care as well as wellbeing and early intervention programs.
Known as Mununjali Jymbi or the Mununjali family, the mob behind the service put their success down to delivering community-controlled programs, operating on traditional land.
"Mununjali provides holistic support," says Brad Currie, General Manager of Mununjali Housing. "It’s important to be acceptable to change and think outside the box and be very flexible".
Many lessons learned through this initiative, however, as Brad notes that barriers to further success include regular changes in government funding streams, the closure of the Aboriginal and Torres Strait Island Commission (ATSIC), and an increasing compliance burden, which impacts on service delivery.
Torres Strait Island Regional Council
The Torres Strait Island Regional Council recently saw the successful transfer in home ownership of five rental properties to families in the Poruma area who had expressed interest in becoming private homeowners.
The process of home ownership had been a goal for the Council in Poruma, who had been advocating for this outcome for a long time.
The success of these transfers looks positive for other people around the Torres Strait Islands who may not have considered home ownership to be a viable option.
In a recent media release from the Council, Mayor Fred Gela said, "I’m ecstatic and proud of this achievement and will support many more home ownership outcomes to come."
Acting Housing Manager, Marie-Claire Cull concluded, "the process has shown promising results with people feeling a sense of pride in home ownership that was once not considered a possibility."
The Yawuru Home Ownership Program
The Yawuru Home Ownership Program was established in 2015 to address the disparity in home ownership experienced by the Yawuru people in Broome.
The program is a first for Australia and was developed out of a partnership between Nyamba Buru Yawuru Ltd (NBY), a not-for-profit company owned by the Yawuru Native Title Owners with the Kimberley Development Commission and State Government mortgage lender Keystart. Its aim was to support Yawuru first home owners entering the housing market, through a shared-equity purchase arrangement.
Naomi Appleby is one of the proud home owners to benefit from the YHOP program. Yawuru made 50 per cent of the funds available, and Naomi repays the shared mortgage with Yawuru. Now three years into the arrangement, she plans to, eventually, own her home outright.
Naomi believes the program provides a very affordable option for home ownership and excellent options for anyone seeking a home; single parents, young families, and older people.
For some people, YHOP has meant achieving accessible housing finance, when previous attempts have failed.
Achieving home ownership has provided Naomi with security and provides a foundation for a secure future.
“Home ownership has a flow-on effect because it provides a healthy start for kids," Naomi says. "Aboriginal people can face many other issues, so to build a good foundation and plan for the future with that security is really positive. It has a real effect on people’s lives."
Health System Reform – Winnunga Prison Health Service
Winnunga Nimmityjah Aboriginal Health and Community Services (Winnunga) provides a range of medical and social health services in the Canberra region and has provided outreach corrections health services to surrounding districts in Goulburn and Cooma for many years.
Ms Julie Tongs has been the CEO at Winnunga for the past 21 years.
"While Canberra is considered to be a wealthy city, behind the affluence there are people who struggle with poverty; who don’t have stable housing, perhaps don’t even have mobile phones, and can find themselves in a destructive cycle," she said.
After the death of an Aboriginal man in custody in 2015, a formal inquiry found that the broader treatment of the detainee was deficient, marred by a series of failings involving corrections, police and health authorities.
In 2018, the ACT Government announced a 24/7 holistic model of care would be led by Winnunga for all detainees in the Alexander Maconochie Centre (AMC) prison and remand centre.
"This model will mean that Winnunga will have an ongoing presence at the AMC," Julie explains. Aboriginal and Torres Strait Islander staff will be there as support staff.
"There will be a psychologist to provide one-on-one counselling; there will continue to be Aboriginal support staff in there, and they will know when people are going to court and be in court with them... Doctors are now available as needed, and the program will be supported by four nurses including mental health, who can commence their day at 6.30am, to be available for detainees going to court."
Winnunga is hopeful that this service will support the AMC to be a human rights compliant detention centre. That compliance will go some way to helping detainees overcome a cycle of illness and hence be rehabilitated rather than come out of prison worse than when they entered.
Northern Territory Aboriginal Health Academy Project
Indigenous Allied Health Australia (IAHA), working in partnership with Aboriginal Medical Services Alliance Northern Territory (AMSANT), has developed an innovative project to increase the number of young Aboriginal and Torres Strait Islander people completing Year 12 and entering the health workforce.
The Northern Territory Aboriginal Health Academy project (the Academy) was designed over four years with Northern Territory (NT) students, families, community and key stakeholders.
The Academy is taking a new approach to education and training. This is a community-led learning model focused on re-shaping and re-designing the way training is delivered to Aboriginal and Torres Strait Islander high school students.
Rikki Fisher has been involved with the Academy since its commencement and thinks that its success is due to the people involved, the support the program has been getting from families and the community and people seeing the value and believing in what the program is about.
"I think it’s been a really well-designed process, with commitment from families and communities," Rikki said. "But it also needs funding commitment that aligns with the values and integrity of the program. We wouldn’t want it to be vulnerable to a lack of support or governments funding cycles."
The Academy promotes educational achievement and leadership with students actively setting the direction for their learning, the way in which they learn, and the environment in which they feel both safe and included.
Moving forward to Close The Gap
Australian Human Rights Commissioner, Ms June Oscar AO said the report highlights the need to have genuine and meaningful engagement with Aboriginal and Torres Strait Islander peoples in the decision-making process.
"An investment in our community-controlled organisations is an investment in success"
“We have a right to self-determination and full participation in decision-making about matters that affect us," she stated. "We need to invest in and support on the ground voices and solutions. An investment in our community-controlled organisations is an investment in success."
National Congress of Australia's First Peoples co-chair, Mr Rod Little said he hopes that National Close the Gap Day will encourage further commitment to address the challenge of health inequality.
“Health outcomes and life expectancy in Aboriginal communities are affected by many different factors, such as housing, educational opportunity, access to community-controlled primary health services, a culturally safe workforce, racism, and trauma and healing," he said.
“I want Aboriginal and Torres Strait Islander peoples to have the same opportunity to live full and healthy lives, like all other Australians."
The campaign Co-Chairs said the over-riding principle throughout the stories is that the success of these initiatives is based on community governance and leadership, which is imperative to the success and longevity of the programs.
“These stories illustrate that ‘our choice and our voice’ is vital if we are to make gains and start to close the gap.
“We are optimistic that by supporting Aboriginal and Torres Strait Islander-led initiatives and a commitment to working in genuine partnership, that we can close the gap."
Close The Gap Day gives an opportunity to send a clear message that Australians value health equality as a fundamental right for all.
Close The Gap's aim is to bring people together to share information and to take meaningful action in support of achieving Indigenous health equality by 2030.
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