Leading the way in Indigenous Health

Most Australians enjoy one of the highest life expectancies of any country in the world, but this is not true for Aboriginal and Torres Strait Islander people. Indigenous men and women can expect to live 10 to 17 years less than other Australians. They experience higher rates of preventable illness such as heart disease, cancer and diabetes. And babies born to Indigenous mothers die at more than twice the rate of other Australian babies.

Professor Shaun Ewen and Shawana Andrews (BSW 1999)

There are many, complex reasons for this disparity. But for Professor Shaun Ewen (DEd 2011), the University of Melbourne’s Pro Vice-Chancellor (Indigenous), one important factor is a shortage of Indigenous health practitioners and leaders with the skills and cultural knowledge to bring about change in their communities.

“It wasn’t until 1983 that Australia saw its first Indigenous graduate in medicine – Professor Helen Milroy,” says Professor Ewen, who is also the Director of the Melbourne Poche Centre for Indigenous Health.

“By 2006, there were 100 Indigenous medical practitioners. But while this was a tremendous and encouraging increase, it still only represented 0.2 per cent of Australia’s medical workforce. If parity is our goal – 2.6 per cent of the medical workforce – we have a long way to go.”

The discrepancy is the driver behind a suite of initiatives at the University of Melbourne, designed ultimately to improve health outcomes for Indigenous people.

“Every Indigenous person who gains expertise in a health-related discipline is a tremendous asset in improving the health and wellbeing of Indigenous Australians,” adds Professor Ewen. “They mentor future health practitioners and researchers, take leadership roles in addressing health problems and connect communities of people with programs that work to improve health outcomes.

“We must foster and build a community of Indigenous thought leaders within the University and beyond. It is the only way that we will be able to make an impact on Indigenous health and wellbeing for generations to come.”

MAKING PROGRESS

Professor Sandra Eades

Professor Sandra Eades

Affecting tangible improvements in the health of Aboriginal and Torres Strait Islander communities has long been a focus of the University of Melbourne. Since 2010, the University has formalised its contribution to reconciliation through a Reconciliation Action Plan (RAP), which creates pathways and programs that support Indigenous Australians to succeed in higher education.

The Faculty of Medicine, Dentistry and Health Sciences is expanding opportunities for Indigenous participation in study and in the training of the next generation of Indigenous health professionals and academics. The Faculty’s Indigenous students, teachers and researchers are recognised as a valuable and respected asset – they broaden expertise and knowledge, bring skills and insights that enrich the Faculty’s perspectives, and enhance the impact of the University’s work on the health of Indigenous communities.

The Faculty is increasing Indigenous representation in leadership and establishing respected partnerships with Indigenous communities, which is seen as vital for improving Indigenous health.

Professor Sandra Eades was this year appointed to the Faculty as Associate Dean (Indigenous). In 2003, she was Australia’s first Aboriginal medical doctor to be awarded a Doctorate of Philosophy, at the Telethon Institute for Child Health Research in Perth. That year, she was also recognised as NSW Woman of the Year for her work in paediatric and perinatal epidemiology, identifying links between social factors, such as housing, and infant health.

“Achieving health equity in Aboriginal and Torres Strait Islander communities is a complex undertaking that requires a deep understanding and respect for long-held cultural practices,” she explains. “Without the involvement and leadership of Indigenous peoples and organisations, we will not succeed.

“Australia has had a history of excluding Indigenous students from higher education, so many of our students are the first in their families to attend university. As a result, they have additional challenges and require additional support.”

A network of pathways and programs is being introduced to recruit, mentor and train students who will become the next generation of Aboriginal and Torres Strait Islander health professionals. The University currently guarantees all Indigenous PhD candidates a standard doctoral stipend to ease financial pressures.

It also provides flexible educational pathways and leadership opportunities to help students graduate and begin a research career or move into their chosen professional field. The Faculty is also diligent in maintaining connections with students after graduation, so they can then mentor and support future students.

“For me to be able to complete the Masters in Narrative Therapy  and Community was a really big deal. I never thought I would ever  study at this level and the support that I got from the University of  Melbourne and Dulwich Centre has helped me do that. Both my  parents were not allowed to go beyond Grade 6 primary school,  and this was the case with all my other family members in their  generation. This meant that I didn’t have role models who had  gained university degrees, so the thinking was that we couldn’t do it, or we weren’t expected to be able to achieve at that higher level. But now I have done it! I did it for my parents who had hoped that  my life would be different. I did it for myself, and I also did it for my  children and future generations. I’m now using narrative ideas in my  counselling work and I also use the Tree of Life Narrative Approach  with groups and communities. We’re even using it to assist us in  reclaiming our language.”

Carolynanha Johnson (M Narrative Thpy & Com Work 2015), Inaugural Graduate of the Masters of Narrative Therapy Program. An Adnyamathanha woman from the Northern Flinders Ranges in South Australia and a counsellor and educator at the Cancer Council SA.

MAKING CHANGES


One of the University’s newest programs that highlights its accessibility to Indigenous students begins in July 2018. The Ngurra-Jarraddjak (Healthy) Study and Career Options Program is a ‘gateway’ program for first and second-year Indigenous undergraduates from any discipline interested in exploring careers in health.

The week-long residential program includes tours and practical sessions with Faculty institutes and partners, introductions to leading academics, and ‘speed dating’ sessions with course co-ordinators that give potential recruits a chance to ask questions about courses on offer. Student Ambassadors mentor participants and alumni help students engage with community partners.

Other key Indigenous-focused initiatives are:

  • THE MELBOURNE POCHE CENTRE FOR INDIGENOUS HEALTH

    Since it was founded in 2014, the Centre has provided training and development programs for emerging and established Indigenous leaders. It is one of six centres across Australia. Collectively, each Centre contributes to the national Poche Indigenous Health Network, established by philanthropists and Indigenous health advocates Mr Greg Poche AO and his wife, Mrs Kay Van Norton Poche.

    The aim of the Poche Centres is simple but complex – “to help close the gap in life expectancy and achieve health equality for Aboriginal and Torres Strait Islander peoples.” Melbourne’s Poche Centre provides support and opportunities for graduates, emerging leaders and established leaders in health to grow their influence and network and mobilise an agenda for change in their field of health practice.

  • THE MASTER OF NARRATIVE THERAPY AND COMMUNITY WORK

    The Department of Social Work at the University of Melbourne has worked with The Dulwich Centre to develop this unique degree. Established in 1984, The Dulwich Centre in Adelaide is the international centre for narrative therapy training. The collaboration with the University of Melbourne to develop the Masters program is a world-first.

    Narrative therapy is used by social workers, psychologists, community development workers, nurses, teachers, doctors and other health professionals, and recognises people as the experts in their own lives. It sees problems as separate from people and assumes people have skills, competencies, beliefs, values, commitments and abilities that can help them lessen the influence of problems in their lives. In 2017, four of the graduates were Aboriginal students who achieved first class honours.

  • GRADUATE CERTIFICATE IN INDIGENOUS RESEARCH AND LEADERSHIP

    For more than 10 years, the University has hosted a summer course for Aboriginal and Torres Strait Islander research students wishing to complete a Professional Certificate in Indigenous Research. Due to the success of that program, the University has established a Graduate Certificate in Indigenous Research and Leadership – an inter-disciplinary program offered annually.

  • THE ATLANTIC FELLOWS FOR SOCIAL EQUITY

    The University of Melbourne is one of six global centres training a new generation of leaders, particularly Indigenous Australians, committed to tackling social disadvantage. The University was selected by The Atlantic Philanthropies organisation to focus on examining and challenging social inequalities. During a 20-year timeframe, the Atlantic Fellows for Social Equity program will create a cohort of up to 400 leaders and change makers from diverse backgrounds, sectors and disciplines. Based on Indigenous sensibilities and strengths, the program aims to build a generation who will work together across the Pacific, and globally, to improve communities.

  • ORMOND RESIDENTIAL COLLEGE

    Ormond is home to about 20 Indigenous students who form a strong, supportive network within the wider college community. Ormond houses the Thwaites and Gutch WEHI Centenary and Alexander Scott Medical Research Fellows who provide mentoring to younger medical researchers, and the Fremantle Fellow whose role is to support Indigenous student

TAKING LEARNING FROM CLASSROOM TO COMMUNITY

To ensure that the University’s research and community engagement programs and projects address the health concerns and priorities of Indigenous Australians, the Faculty works in community settings with Indigenous health and medical researchers, practitioners, community leaders and Elders. For many Indigenous Australians living in remote areas, access to culturally appropriate and timely health care is often unavailable – a situation that has a profound effect on health outcomes and quality of life. Building partnerships with Indigenous communities and organisations are key to making tangible changes and health improvements.

Current community-focused projects include:

  • The Melbourne Dental School’s partnership with Miwatj Health in East Arnhem Land is improving local oral health and giving Bachelor of Oral Health students hands-on experience. The partnership is building community-led oral health projects and services, oral health promotion and research centred on local needs. While the University brings expertise, the design and implementation of programs comes from Miwatj, with an imperative of the agreement being two-way learning and the enabling of the Yolngu people to increase their control over their oral health. The program is developing oral health champions in remote communities to help coordinate services and to involve people in those services.

    “My time there proved firsthand how the social determinants of health affect oral health and the way services are able to be provided. Isolation and compromised access to nutritious food, dental hygiene products and fluoride toothpaste, expert care and unreliable access to resources, such as water and electricity, all contribute to poorer oral health.”

    Emma Cubis, Bachelor of Oral Health student (BOralHlth 2013), describing her time on a clinical rotation in the Northern Territory as part of Melbourne Dental School’s Indigenous Oral Health Placement Program, which received the University’s 2015 Award for Excellence in Indigenous Higher Education
  • With the support of private donors, philanthropic trusts and the Department of Health, the University of Melbourne’s Indigenous Eye Health Unit has been proactive in researching and establishing The Roadmap to Close the Gap for Vision. The Unit is providing advocacy and technical support towards the Roadmap’s implementation and the work is having impact. Recent data reveals blindness rates have been reduced from six times higher than standard rates to three times, with the prevalence of trachoma having also been reduced. Diabetic retinopathy screening has risen from 20 per cent of standard rates to 53 per cent.
  • Within weeks of birth, and before immune systems are strong, babies born in remote Indigenous communities are exposed to germs that cause chronic ear disease. The University and the Royal Victorian Eye and Ear Hospital are working together to understand the risk factors and steps for minimising chronic ear disease among young Indigenous children.
  • The First 1000 Days Australia program joins forces with healthcare workers, community organisations and governments to develop intervention programs during pregnancy and in the early months and years of a child’s life. The aim is to support Aboriginal and Torres Strait Islander families and to address core issues such as nutrition, access to early life education and adult personal relationships, so they are ready to provide children with the best opportunities. The learnings from the program are spreading to communities as far afield as Indonesia, Norway and Russia.

    Professor Shaun Ewen acknowledges that while there is still much work to be done to increase Indigenous participation within the Faculty, and to address the real health issues facing Indigenous communities, heartening progress is being made. He is proud of the Faculty’s role in supporting the next generation of Indigenous health professionals, academics and leaders. “By supporting the emerging generation of Indigenous leaders in health, we are able to contribute to the transformation of policy, research, clinical care and health systems in general, such that the playing field between Indigenous and other Australians is level,” he says.

    “We must foster and build a community of Indigenous thought leaders within the University and beyond. It is the only way that we will be able to make an impact on Indigenous health and wellbeing for generations to come.”