A New South Wales coroner has made several recommendations to address Indigenous health outcomes after the inquest findings into the death of a Wiradjuri woman and her unborn child concluded on Monday morning.
Twenty-seven-year-old Wiradjuri woman Naomi Williams was six months pregnant when she arrived at the Tumut District Hospital in the early hours of January 1, 2016, with severe pain.
Hospital staff gave her two paracetamol tablets and an ice block before sending her home. 15 hours later, she died as a result of meningococcal and septicaemia, according to the autopsy report.
During the inquest, it was found that Ms Williams had presented to Tumut Hospital 18 times in the months before her death.
At a packed Tumut Local Court on Monday, Deputy State Coroner, Harriet Grahame recommended auditing statistics for discharging Indigenous and non-Indigenous patients against medical advice, in an attempt to weed out systemic bias.
Coroner Grahame also recommended auditing, triage times and referrals for drug and alcohol reviews for patients presenting to the Emergency Department at Tumut Hospital.
Following Ms Williams death, her mother, Sharon, complained that she did not receive the proper care because she was "stereotyped as a drug user", implying that there was racial stereotyping involved.
Outside of court, Professor Anita Heiss, who is Ms Williams’s cousin, said the family hoped that “in Nai’s [Naomi’s] death, that other lives will be regarded with more respect.”
“The whole goal of this process is to make sure that there is structural change, that the racism that is obvious within the health system, particularly here in the region, is addressed,” said Dr Heiss.
She said “unfortunately, racism” was not only prevalent in country health centres, but in the urban centres as well.
“I think the reality is, if Naomi had presented to Tumut Hospital as a non-Indigenous person in the months leading up, her treatment would’ve been completely different.
“Can I ask you a question? If you were an Aboriginal woman and you heard ... that a local Aboriginal woman went to Tumut Hospital, was turned away, and died a few hours later, would you go to Tumut Hospital?” Dr Heiss said outside court.
Lawyer, George Newhouse said because Ms Williams did not receive the appropriate medical treatment, she had “lowered her expectations from the care she would get from the hospital because of the way she was treated those times.”
“The coroner also found that Naomi should have received further examination on the night that she passed away,” said Mr Newhouse.
Ms Williams best friend, Talea Bulger said in the days and months after Ms Williams' death, Aboriginal people in the region were too scared to go to Tumut Hospital because they didn’t feel they were “heard”, “looked after” or “believed.”
“It’s a risk for our family to be driving elsewhere, to be heading out of town, it’s a risk for our family, it’s a risk for our elders, our youth when they should just be able to drive to our own local hospital,” Ms Bulger said.
Other recommendations from the coroner included ensuring Aboriginal Health Liaison Workers are available 24-hours a day, and that there was a quota for Indigenous staff at the hospital.