CEO Welcome - CATSINaMcatsinam.org.au/static/uploads/files/catsinam-newsletter-december... · CEO...

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If you cannot read this email please view online. CEO Welcome Just recently I have found myself talking about the skills we have in ‘juggling’ the many aspects and responsibilities of our lives as Aboriginal and Torres Strait Islander nurses and midwives. Recent months at CATSINaM are a case in point. Even though our priority focus leading into and during this quarter was on preparing for, running and documenting the outcomes of our wonderful conference on the Gold Coast, we did not let the foot off the accelerator with the other activities that occupy our time throughout the year at CATSINaM. You will hear about many of them in this newsletter – the launch and establishment of LINMEN, initiating an initiative to develop a national resource on good practice in cadetship and graduate placement programs, writing national submissions and partnership

Transcript of CEO Welcome - CATSINaMcatsinam.org.au/static/uploads/files/catsinam-newsletter-december... · CEO...

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If you cannot read this email please view online.

CEO Welcome 

Just recently I have found myself talking about the skills we have in ‘juggling’ themany aspects and responsibilities of our lives as Aboriginal and Torres StraitIslander nurses and midwives. Recent months at CATSINaM are a case in point.

Even though our priority focus leading into and during this quarter was onpreparing for, running and documenting the outcomes of our wonderful conferenceon the Gold Coast, we did not let the foot off the accelerator with the otheractivities that occupy our time throughout the year at CATSINaM. You will hearabout many of them in this newsletter – the launch and establishment of LINMEN,initiating an initiative to develop a national resource on good practice in cadetshipand graduate placement programs, writing national submissions and partnership

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work with nursing and midwifery organisations to strengthen our profession’scommitment to practicing cultural safety.

On this last point, we want to acknowledge the work we have undertaken with theNMBA over the past year, which has resulted in elevating the importance of culturalsafety within the updated Code of Conduct and updated Code of Ethics for bothnurses and midwives. You will also read about our joint statement on addressingracism and promoting cultural safety in this edition.

On a sad note, following the conference we said farewell to Shane Mohor as Chairof the CATSINaM Board. Shane has dedicated many years to the CATSINaM Boardand we thank him for his hard work and leadership over the years. Our DeputyChair, Ben Gorrie has temporarily stepped into this role. Thank you to the Memberswho submitted expressions of interest to come onto the Board in 2018 – it isfantastic to have this level of enthusiasm and support. The Board will meet earlynext year to finalise its composition – see our website for updates, but we will alsoannounce this in the March 2018 Newsletter.

Just recently, I had the honour of sitting on a panel about Indigenous women ingovernance with June Oscar, who commenced as the Aboriginal and Torres StraitIslander Social Justice Commissioner with the Australian Human RightsCommission in April this year. CATSINaM would like to acknowledge June’s workto establish a national conversation with and about the needs, challenges,aspirations and contributions Aboriginal and Torres Strait Islander women in 2018 -Wiyi Yani U Thangani (Women’s Voices): ‘Securing Our Rights, Securing our Future’– that was launched on December 1st. CATSINaM looks forward to participatingand encouraging as many Members as possible to become involved.

Thank you again to everyone who attended and made our 2017 Conference such aspecial event, the photos are now available on our Facebook page and are a warmreminder of what a great year we’ve had at CATSINaM. We are already planning for2018, which will mark the 20th anniversary of the formal establishment ofCATSINaM/CATSIN.

Janine 

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Were you at the CATSINaMConference?

...227 people were!

Some of the themes woven into the conference are illustrated here. Participantsheard inspiring and candid presentations from speakers including ProfessorRoianne West, Professor Chris Sarra, Dr Lynore Geia, Associate Professor GregoryPhillips, Keri Nuku and Janine Mohamed.

Croakey is a social journalism blog that focuses on health issues and policy. Theycovered our conference and produced multiple articles on it. Read the shortCATSINaM Conference Overview Report here. It shares the key messages,

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highlights several presentations and the experiences of participants.

You can also go straight to Croakey articles on specific plenary presentations,including:

Professor Roianne West: Sharing the learnings of a formidable agent forchangeAssociate Professor Gregory Phillips: Presenting a vision for a better, moreequitable Australia

 

One of the pre-conference workshops was on Mentoring, led by Marg Cranneywho worked with CATSINaM to develop and trial the CATSINaM Mentor TrainingProgram. Hear participants speaking about their positive experience of theworkshop at this Youtube link. 

We had great social media activity:

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It seems like our Members and supporters are becoming increasingly social mediasavvy judging by the number of tweets and the participants that were involved insharing and promoting key messages. Thank you to everyone who helped spreadthe word.

CATSINaM Hall of Fame: Dulcie Flower

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The 2017 CATSINaM Hall of Fame inductee was Dulcie Flower. Dulcie is a TorresStrait Islander woman who grew up in Cairns; her mother belongs to the Meriampeople from Erub in the eastern island group. Early in life she became aware of thedisparity between Aboriginal and Torres Strait Islander and non-Indigenous peoplein living conditions, health, education and employment. This inspired an intentionto create a change to address this inequity.

In the 1950s she began her nursing career at the Cairns Based Hospital, beforemoving to Sydney to study midwifery in 1960. She then spent many years workingas a theatre nurse at the Royal Prince Alfred Hospital in Sydney.

During the 1960s she became involved in Aboriginal organisations, including theFederal Council for the Advancement of Aboriginal and Torres Strait Islanders(FCAATSI). In fact, by 1968 she became the General Secretary for FCAATSI, whichplayed a lead role in advocating for the 1967 Referendum, and then promoting the‘Yes’ vote for Aboriginal and Torres Strait Islander people to be counted within theformal population of Australia, and be included as a group for whom theCommonwealth Government could also make laws.

Dulcie was one of the founding members of the Redfern Aboriginal Medical Servicein 1971, along with Mum Shirl, Gordon Briscoe and Fred Hollows. She went on tovolunteer and work in the Redfern AMS over many years – this included writing andconducting an Aboriginal Health Worker education program – as well as continuingto take on roles in mainstream health services. After retiring from the Redfern AMSin 2003, she became a Board Director within Aboriginal Community ControlledHealth Services, and served on state and national committees, advocating forAboriginal and Torres Strait Islander Australians and their health needs.

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It is a privilege to honour Aunty Dulcie Flower – her accomplishments areextraordinary, within nursing, Aboriginal and Torres Strait Islander health, andhuman rights for Aboriginal and Torres Strait Islander Australians. We hope that ourwork at CATSINaM continues everything that she has worked to achievethroughout her life.

LINMEN swinging into action

Official launch of LINMEN

CATSINaM was very proud to officially launch the Leaders in Indigenous Nursingand Midwifery Education Network (LINMEN) at the CATSINaM Conference onOctober 10, 2017.

LINMEN is the result of over three years of advocacy by CATSINaM to create aninteractive peer support network for nursing and midwifery educators. Although thefunding is modest over the initial three year commitment, it will enable us toestablish LINMEN, develop hybrid funding strategies and make progress towardsthe overall goal: to improve the quality of cultural safety education and training innursing and midwifery. As the network develops, LINMEN will support universitySchools of Nursing and/or Midwifery to:

create a more culturally safe teaching and learning environment for Aboriginaland Torres Strait Islander students and educatorsretain and successfully graduate more Aboriginal and Torres Strait Islanderstudents.

Ultimately, this will help build the Aboriginal and Torres Strait Islander nursing andmidwifery workforce – a key focus of CATSINaM’s work. We also believe thatLINMEN will contribute to graduating non-Indigenous nurses and midwives whoare better prepared to provide culturally safe health services to Aboriginal and

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Torres Strait Islander Australians. 

If you would like to know more about LINMEN or get involved, please contactPhoebe Dent at [email protected]

 

2017 LINMEN Professional Development Forum

The inaugural annual LINMEN Professional Development Forum also occurred atour Conference on October 10. The day focused on the CATSINaM Nursing andMidwifery Aboriginal and Torres Strait Islander Health Curriculum Framework, withpresentations and discussions led by Dr Lynore Geia, Janine Mohamed, AliDrummond, Dr Leonie Cox and Sam Petric. The forum was very well-received withalmost all attendees extremely satisfied with the day. 

Next steps for LINMEN

We recently sent a survey to all Schools of Nursing and/or Midwifery regardingstaffing and professional development needs to establish a baseline that LINMENcan use to plan its activities, finalise the membership process and determineprogress over time. Over the next 12 months we will focus on developing theLINMEN website to share good practice resources on Aboriginal history, health,culture and cultural safety, as well as source and promote, and/or provideprofessional development and networking opportunities for nursing and midwiferyhigher educators.

By early 2018, we will issue formal invitations to become a LINMEN Member – welook forward to welcoming Schools of Nursing and/or Midwifery and otherinterested parties to the network.

Introducing Phoebe Dent – LINMEN Coordinator

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Phoebe started with CATSINaM as the Senior Project Officer in November 2017,which includes being the Coordinator for LINMEN. She began her career as aRegistered Nurse at the Royal Prince Alfred Hospital in Sydney and worked as aNurse Educator in Dhaka, Bangladesh before studying public health and workingfor three years in the Australian Government Department of Families, Housing,Community Services and Indigenous Affairs. Prior to joining CATSINaM, Phoebeworked at Reconciliation Australia managing policy and the IndigenousGovernance Program for five years.

Phoebe grew up in the Blue Mountains and Central Coast of NSW and now callsCanberra home. She is the proud Mum to her one and half year old daughter, andis very excited to be back working with nurses and midwives and in Aboriginal andTorres Strait Islander health – two areas that are very close to her heart.  

How is CATSINaM working for you at anational level?

Engaging with the nursing and midwiferyprofession: Joint statement with the NMBA on

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racism and cultural safety

Over the last few months, CATSINaM and the NMBA have developed a partnershipstatement on addressing racism and creating cultural safety. You can find the fullstatement on our website: Joint statement NMBA and CATSINaM.

National reviews and submissions

During 2017 we have worked with the Australian Health Practitioner Agency(AHPRA) as a member of their official Working Group on embedding cultural safetyinto the Health Practitioner Regulation National Law that oversees the NationalRegulation and Accreditation Scheme for health professionals.  This included twosubmissions: one to the consultation on the Accreditation Review Final Report, andanother to the Independent Reviewer as a follow-up to his consultation with theAHPRA Working Group. The following is our position made directly to theIndependent Reviewer: 

CATSINaM supports an outcome based approach to accreditation where it isappropriate to do so. However, given the lack of consistency and capability ofacademic staff regarding the issue of cultural safety, the need continues for an inputor process-based element within the curriculum. It is of great concern that theAccreditation Review Report failed to make a recommendation regarding culturalsafety, particularly when the Report states that “Guidance and clear direction isrequired to facilitate a pathway to implementation within programs of study, clinicalplacements and in the workplace” and this requires more than just an outcomesfocus.

The first section of the ‘Implementation Plan for the National Aboriginal and TorresStrait Islander Health Plan 2013-2023’ (NATSIHP) is on health system effectiveness.Specifically, Strategy 1B states that: “Mainstream health services are supported toprovide clinically competent, culturally safe, accessible, accountable andresponsive services to Aboriginal and Torres Strait Islander peoples in a healthsystem that is free of racism and inequality”.

We propose that one of the required accountability mechanisms is linked toaccreditation and registration. This approach is aligned with the action “systemicracism and discrimination is better understood, addressed and prevented” and will

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support realisation of the associated 2018 deliverable, i.e. “system levers andaccountability mechanisms established for addressing racism and discriminationhave been developed and their implementation promoted”.

The blueprint for our accreditation and registration scheme is the ‘HealthPractitioner Regulation National Law Act 2009’. It is silent on cultural safety, eventhough concern about racism and the lack of cultural safety in health care has beenformally expressed at a national level ever since the 1989 National Aboriginal HealthStrategy, and legislative models from like countries were available for considerationprior to the development of the 2009 Act. 

Critical to the embedding of cultural safety, is the assessment or review thatnecessitates the centrality of Aboriginal and Torres Strait Islander experience andknowledge. We say that Aboriginal and Torres Strait Islander people must be theones who determine cultural safety.

Amending the ‘Health Practitioner Regulation National Law Act 2009’ to clearlyidentify cultural safety as a priority would be a critical and practical contribution thatHealth Ministers could make to progress the Implementation Plan for the NATSIHP.It would:

ensure that setting and monitoring standards for cultural safety are namedwithin the functions of the Australian Health Practitioner Agency, inimplementing the National Registration and Accreditation Scheme, and theNational Board for each regulated health professionrequire all National Boards to seek out and value Aboriginal and Torres StraitIslander knowledge, skills and attributes, and ensure this is reflected in theirgovernancerequire all National Boards to develop their understanding of cultural safetyand how to determine it is evident within educational preparation forprofessional practice, and ongoing professional practice.

 

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CATSINaM at conferences, forums andsymposiums

The end of the year can be a busy time for conferences. CATSINaM has attendedand spoken at several over the last three months, including two Aboriginal andTorres Strait Islander health profession organisation conferences. Janine Mohamedrepresented CATSINaM at the Australian Indigenous Doctor’s Association (AIDA) inlate September and facilitated a workshop at the Indigenous Allied HealthConference (IAHA) in December, held in Perth.

While CATSINaM shares consistent messages wherever we travel, the topics wespeak into can be broad, as these three examples demonstrate.

Indigenous Women in Governance Masterclass, Sydney

Janine Mohamed joined the panel discussion for this masterclass, entitled‘Challenges and successes of Indigenous female CEOs. She focused on strengthin cultural values and practices, the importance of role models, cultural safety and

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self-determination as underpinnings of good governance. She acknowledgedthat…

Australian Nursing and Midwifery Federation Biennial NationalConference, Hobart

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Speaking to a broad representation of ANMF Members from across Australia inearly October, Janine Mohamed’s plenary presentation focused on the steps thenursing and midwifery profession can take to acknowledge the role that nurses andmidwives played in Australian history: “Health professionals and health serviceshave a long history as agents of colonisation, and they have added to the traumaswhich our people have experienced through colonisation.”

A formal apology as a profession would contribute to healing the damage causedthrough these practices, and work toward understanding and practicing culturalsafety within the profession, and greater recognition of the unique knowledge andskills of Aboriginal and Torres Strait Islander nurses and midwives.

These themes were revisited during Janine’s presentation at the CATSINaMConference. You can read more in this Croakey article: Australia’s nurses/midwivesconsider call to apologise for harms to Indigenous people. The ANMF are currentlydiscussing the idea of making such an apology, which could follow the lead of theAustralian Psychological Society who did this in 2016.

 

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Belonging to country, culture andcommunity was the theme of thisplenary presentation, delivered byJanine to the annual ACM Conference.The presentation honoured the long-standing contribution of Aboriginal andTorres Strait Islander midwives to theircommunities for thousands of years,and acknowledged the impact ofcolonisation on birthing practices andexperiences of belonging.

Australian College of Midwives Annual Conference, Adelaide

Janine then explored the steps that the midwifery profession can take to restoreand support ‘birthing on country’ as a practice that re-centres culture by reclaimingbirthing rituals, naming practices and cultural space, and delivers antenataleducation programs informed by cultural knowledges. This can be furtherenhanced by the midwifery profession if it centres the stories of Aboriginalmidwives in the pre-registration and post-graduate curriculum, and in descriptionsabout the profession and its history. Among others, this includes the stories ofAboriginal midwives such as Muriel Stanley, Alison Bush and Faith Thomas, whosework epitomised belonging to country, culture and community.

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We had a great response to theCATSINaM Policy Survey, conductedacross August and September 2017,with over 160 Members sharingvaluable insights that will shape ourpolicy agenda across 2017-2018 andinform the updating of several existingCATSINaM Position Statements. Thesurvey explored a range of issuesrelating to cultural safety, clinicalplacements, and recruitment andretention. Key findings from the surveywere:

What did we learn from the recentCATSINaM survey?

Opportunities to increase nursing and midwifery pathways for school leavers:Most respondents reported entering higher education as mature agestudents. Few cited high school programs or advice as an influence on theircareer pathway. Better information and encouragement, access to mentorsand role models, and simplified pathways and entry requirements wereproposed as ways that transitions from school to education could beimproved.Cadetships: Respondents called for greater availability of cadetships, whichwere highly valued and appreciated by those who accessed them.

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Culturally safe environments: Employers and educators still had a way to goin building culturally safe environments. While most respondents reportedthat their workplaces or education providers had adopted some culturalsafety measures, many felt these were still largely tokenistic efforts that hadnot resulted in meaningful change.Clinical placements: The survey identified several important ways in whichclinical placements could be improved for Aboriginal and Torres StraitIslander students. These included greater support and mentoring,opportunities in Indigenous healthcare settings, and cultural safety trainingfor all staff involved in the placement. Leadership development: While the importance of Indigenous leaders androle models was emphasised, only one in five respondents had experiencewith programs to support Aboriginal and Torres Strait Islander leaders andchampions in nursing and midwifery.

Respondents were given the option to enter a draw for a Visa Gift Voucher andwe’d like to congratulate our prize winners Kate O’Callaghan, Vernon Armstrongand Skye Painter. More broadly we would like to thank all of you who have takenthe time to respond and share your learnings with us.

Have you thought about highereducation teaching?

In early 2018, we will promote another survey to CATSINaM Full Members. This willbe focused on identifying Aboriginal and Torres Strait Islander nurses and midwiveswho are keen to become involved in higher education teaching, whether at VET oruniversity, or becoming ANMAC Assessors. We encourage everyone to respond sowe can gain a picture of how many Full Members have previously taught, currentlyteach or are keen to teach (or teach again).

This survey will help us with two current initiatives – the LINMEN (see earlier article)and our Enrolled Nursing Qualifications project. We intend to develop a mechanismfor connecting CATSINaM Members who are interested in teaching in VET oruniversity, or being ANMAC assessors, with available opportunities. We lookforward to sharing the outcomes of this work with you in 2018.

 

Consultations on the NHMRC Draft

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Road Map 3

The National Health and Medical Research Council (NHMRC) Draft Road Map 3 isthe Strategic Framework for Improving Aboriginal and Torres Strait Islander Healththrough Research. Information on the public consultation is found here -submissions close December 10th. CATSINaM is currently preparing a response.

Reflecting on my clinical placement:The CATSINaM/RFDS clinicalplacement scholarshipAmy Thompson was the successful candidate for the CATSINaM/ RFDS clinicalplacement scholarship for 2017 – here is Amy’s reflection on her experience.

My name is Amy Thompson, I am a Dunghutti woman from Kempsey NSW. I am a3rd year nursing student studying at University of Newcastle – Port Macquariecampus. As well as being a full-time student, I am a single mum of two young boyswith special needs. I was the successful applicant for a CATSINaM/Royal Flying

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Doctors Service scholarship, which gave me a chance to complete my final twoplacements in Katherine NT. The placement lasted 9 weeks and during this time Iworked at the Aboriginal Community Controlled Health Service (ACCHS), Wurli-Wurlinjang.

Wurli Health Service was started in their own community at Kalano Aboriginalsettlement under the Anti-Health Act 1980. The service went bigger and better in1993 and then in 1995 they got funding to set up the town clinic with 40 staffmembers. Wurli Wurlinjang means mosquito. Dr Andrew Beattie was the firstfulltime doctor who worked at the Aboriginal settlement of Kalano. 

My experience was a once in a life time adventure. I am very privileged to be giventhe opportunity to attend my final placement within a remote location and workalongside my people.  Having the knowledge and cultural aspect being handeddown to me as a young girl from my parents and elders in the Dunghutticommunity, provided me with the cultural safety aspects that enabled me toconnect comfortably with the Indigenous community of Katherine (Guyaman andWatoman people).

I was given the opportunity by Wurli to be welcomed to country by their Elder,Aunty May, who is a Guyaman woman and English is her 4th language. Mywelcome to country was in conjunction with a water blessing in their Yalong(meeting place and where they make decisions as a family gathering moment),spoken in their traditional language. I was quite moved by this blessing, as I fell totears when I was being blessed and Aunty May was calling the spirits/ancestors towelcome me to the land. This blessing meant a lot to me coming from anothercountry and walking on another country that is unknown to me. To be blessed inthe correct way was very humbling and nurturing, and I knew I was safe to walktheir land once I was blessed and welcomed.

During my clinical placement, I was involved in setting up and attending Diabetesdays, outreach visits, nursing assessments, after hours clinic, wound caredressings, RHD (Rheumatic Heart Disease) consults and follow up assessments,NAIDOC celebrations, and STI screenings among other activities. There was a vastvariety of clinical areas that were suitable for me to participate in within a learningenvironment, which enabled me to competently complete my clinical placementrequirements.

My recommendations for future students who attend clinical placements inKatherine is for them to have an empathic understanding prior to going, and havean open mind on health determinants within the Indigenous communities. 

Creating successful cadetship

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programs: Yarning circle

One of our Conference sessions involved a panel followed by a yarning circle on‘Creating successful cadetship programs’. Thank you to our panel members whoset the scene by exploring what helps cadetships work well for both cadets andorganisations: Skye Parsons, Judy Clayton, Danica Greentree and Sarah Uba. Theaudience of 25 people went on to discuss the reasons why cadetship programs area good idea, and what to include in a national good practice cadetships resource.This included people who were in or had undertaken a cadetship.

Why are cadetships a good idea?

The responses to this question consistently fell into the seven benefits ofcadetships illustrated in this diagram:

What information is required in a national good practice resource?

The idea of having a national good practice resource on preparing for and

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The Report of the Royal Commissioninto the Protection and Detention ofChildren in the Northern Territory wasreleased on November 17th. Thefindings emphasis the shocking andsystemic failures over many years thatwere known and ignored at the highestlevels.

supporting successful cadetships for Aboriginal and Torres Strait Islander nursesand midwives was strongly supported, particularly as the cadetships programsacross the three justifications represented in the yarning circle (WA, Vic and NSW)are not the same. Participants believed such a resource may help communicationbetween the program coordinators and the employing service, and increaseunderstanding of the cadetship program within the service. Emphasis was placedon including a ‘manual’ for employers, because cadets found that the ward orsupervisor they were assigned to were not always aware of their or the cadet’s role,responsibilities and expectations. 

Recommended content included:

induction – a one-day workshop prior to starting a cadetship, one each forcadets and employersa standardised scope of practicedescription of the role, responsibilities and/or expectations of the cadet andsupervising staffelements of the Award or rights of cadetsa culturally safe approach to recruitment and placement of cadetscultural safety training and cultural awareness trainingthe importance of identification and/or uniforms for cadets in the workplace.

All of this material will contribute to CATSINaM’s ongoing work on developing anational good practice resource on cadetships over the next few months.

 

The Royal Commission Inquiry intoYouth Detention in the NT

Children and young people were subjected to regular, repeated and distressing

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mistreatment in detention, and there was a failure to follow the procedures andrequirements of the law in many instances. Of the 43 chapters of detailed findings,Chapter 15 focused on health, mental health and children at risk, of particularrelevance to our profession. Among other matters it found that:

Children and young people entering detention did not have an adequate healthassessment upon admission to youth detention, whether at initial or subsequentassessments, as required by regulation 57 of the Youth Justice Regulation. (p. 356)

Ongoing health assessments and treatment were not always available for childrenand young people in detention in a timely or comprehensive manner.  Youth justiceofficers, who did not have medical training, made judgments about whetherchildren or young people required medical treatment. (p. 359)

The Northern Territory Government did not adequately provide for culturallycompetent or age appropriate provision of health services to children and youngpeople in detention. (p. 375)

There are between one and 43 recommendations for each chapter, calling for acomprehensive overhaul of the youth detention system, including the pathwaysinto and out of detention and inclusive of child protection. Commissioner MargaretWhite AO and Commissioner Mick Gooda stated that:

“The time for tinkering around the edges and ignoring the conclusions of the myriadof inquiries that have already been conducted must come to an end. Onlyfundamental change and decisive action will break the seemingly inevitable cyclewe have found of many children in care continuing to progress into the youthjustice system and detention. Perpetuating a failed system that hardens youngpeople, does not reduce reoffending and fails to rehabilitate young lives and setthem on a new course, is a step backwards. The failures we have identified havecost children and families greatly, they have not made communities safer and theyare shocking.”

The ‘Bringing Them Home’ report – 20years on

This year marks the 20th anniversary of the Bringing Them Home report. It is animportant time to reflect and consider what we can do, individually and collectively,to support the ongoing healing process.

The Australian Human Rights Commission has just launched a new interactivewebsite as an educational tool for all Australians. It features information about thereport and the inquiry, as well as personal stories from members of the Stolen

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The Bringing Them Home reportopened the nation’s eyes and ears tothe traumatic and destructive impact ofgenerations of government-approvedAboriginal and Torres Strait Islanderchild removal from their families. In this,the 20th year since the release of thereport, we find that the nation continuesto fail our children.  

Generations and their families.  

Family Matters Campaign

The rate at which Aboriginal and Torres Strait Islander children are removed fromtheir families continues to be an escalating national crisis. Without immediateaction from all levels of government, further generations of children will be lost totheir families, cultures and communities.

The Family Matters Report shows that only 17% of the child protection budget isspent on services aimed at preventing issues for families before they develop,while the bulk of spending is invested in reacting to problems when they arise. Onlyone in every five dollars spent on child protection is invested in family supports.Supportive and preventative services – designed to build the capacity of families to

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care for children and allow children to thrive – are crucial to addressing the over-representation of Aboriginal and Torres Strait Islander children in out-of-home care.

The disproportionate representation of our children, and the failure to adequatelyprovide for their wellbeing and ensure fulfilment of their rights, are characteristicscommon to all jurisdictions. Aboriginal and Torres Strait Islander people have beenforthcoming with solutions to these issues for many, many years. We needgovernment to work with community to prevent another generation of childrengrowing up separated from their family, culture and connection to country.

Key statistics from the Family Matters Report 2017 include:

Aboriginal and Torres Strait Islander children are 9.8 times more likely to beliving in out-of-home care than non-Indigenous children.Projected out-of-home care population growth suggests the number ofAboriginal and Torres Strait Islander children in care will more than triple by2036.From 2010 to 2018, the over-representation of Aboriginal and Torres StraitIslanders in child death statistics has grown from a rate ratio of 1.84 to 2.23.Only 67% of Aboriginal and Torres Strait Islander children in Australia areplaced with family, kin, or other Aboriginal and Torres Strait Islander carers.Only 2% of Aboriginal and Torres Strait Islander children commenced anintensive family support service in 2015-16, a rate well below their rate ofcontact with child protection services.

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Our aim is to demonstrate the benefitsof primary health care as a careeroption, make sure nurses have theopportunity to explore potential careerpathways and, through the self-assessment, demonstrate their value toemployers.

Only 17% of overall child protection funding is invested in support servicesfor children and their families.Aboriginal and Torres Strait Islander women are significantly less likely toaccess antenatal care during the first trimester of pregnancy.

To find out more go to the Family Matters Campaign website.

Spreading the word for APNA –MyNursingFutureMyNursingFuture.com.au is up and running and APNA would like your help tospread the word so that more current and future nurses can take advantage of thetools available to them. 

On the site, you can take the 10 minute career quiz, see some great videos givingan insight into primary health care nursing, and do a self-assessment that can helpcurrent primary health care nurses discover their strengths, demonstrate their valueto employers and plan their CPD.

Wiyi Yani U Thangani Women’s Voices‘Securing Our Rights, Securing OurFuture’

This project was launched by June Oscar, Aboriginal and Torres Strait IslanderSocial Justice Commissioner, on December 1st. It will run from late 2017 throughto the end of 2018, speaking with Aboriginal and Torres Strait Islander women andgirls across the country through community meetings and online opportunities. The

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Wiyi Yani U Thangani website outlines the purpose of the project and explains howto get involved. 

Through the project, these areas will be explored:

the needs, challenges and aspirations of Aboriginal and Torres Strait Islanderwomen and girls todaythe key achievements in relation to the rights of Aboriginal and Torres StraitIslander women and girls over the past 30 yearsways to enhance the lives of Aboriginal and Torres Strait Islander women andgirls so that they can lead happy, healthy and fulfilling livesways to promote and protect culture.

CATSINaM encourages all Members to participate in the process, bringing ourexperience and knowledge to the conversation.

National Strategic Framework forAboriginal and Torres Strait IslanderPeoples’ Mental Health and Social andEmotional Wellbeing 2017-2023

The renewed National Strategic Framework for Aboriginal and Torres Strait IslanderPeoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 was

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released by the Australian Government in October 2017. This has been a long timein coming, as the original National Strategic Framework for Aboriginal and TorresStrait Islander Peoples’ Mental Health and Social and Emotional Wellbeing was forthe 2004-2009 period. The development process for this renewed Frameworkoccurred over 2014-2017, involving many highly experienced and knowledgeableAboriginal and Torres Strait Islander health professionals.

The Minister’s forward explains that:

This Framework provides a dedicated focus on Aboriginal and Torres Strait Islandersocial and emotional wellbeing and mental health. It sets out a comprehensive andculturally appropriate stepped care model that is equally applicable to bothIndigenous specific and mainstream health services. It will help guide and supportIndigenous mental health policy and practice over the next five years and be animportant resource for policy makers, advocates, service providers, clients,consumers and researchers. (p. 1)

The principles on which the Framework is based reflect those in the seminal 1989Ways Forward Report and 2004 Social Emotional Wellbeing Framework. TheFramework promotes and maps out the model of social emotional wellbeing in thediagram below, and describes the ‘new approach’ that must be adopted by mentalhealth programs and services, which includes addressing racism and activelyfostering culturally safe service environments and practices.

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Reflecting the ‘stepped model of primary mental health care service delivery’adopted by the Australian Government (see page 11 of the Framework), there isdetailed information on the following five action areas, with specific outcomes andkey strategies outlined for each, along with examples of relevant actions:

Strengthen the foundationsPromote wellnessBuild capacity and resilience in people and groups at riskProvide care for people who are mildly or moderately illCare for people living with a severe mental illness

Review of the harmful use of alcoholamong Aboriginal and Torres StraitIslander people – just released

The Australian Indigenous Alcohol and Other Drugs Knowledge Centre (Knowledge

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Centre) has published a new Review of the harmful use of alcohol amongAboriginal and Torres Strait Islander people.

The review explores the harmful effects of alcohol use in the Aboriginal and TorresStrait Islander context, examining: patterns of use, health impacts, underlyingcausal factors, policies and interventions to address these impacts, and ways tofurther reduce harm. It highlights that alcohol use among Aboriginal and TorresStrait Islander people needs to be understood within the social and historicalcontext of colonisation, dispossession of land and culture, and economicexclusion. 

While Aboriginal and Torres Strait Islander people are around 1.3 times more likelyto abstain from alcohol than non-Indigenous people, those who do drink alcoholare more likely to experience health-related harms than their non-Indigenouscounterparts. The evidence suggests that effective strategies to address theproblem of harmful alcohol use include:

alternative activities, brief interventions, treatment and ongoing caretaxation and price controls, and other restrictions on availabilitycommunity patrols and sobering up shelters. 

Chief Nursing & Midwifery Officermonthly newsletter 

CATSINaM receives this newsletter each month. It includes a range of articles ofgeneral interest to the nursing and midwifery profession. You can access these

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directly by going to the CNMO website or subscribe personally. Here are the directlinks to the:

the October newsletterthe November newsletter.

Exploring five Rs across the world –reclamation, rejuvenation, recovery,resilience and repatriation: Aninterview with Dr Doseena Fergie

In 2016, Dr Doseena Fergie was inducted into the CATSINaM Hall of Fame as oneof the inaugural Fellows of CATSINaM. That year she also successfully applied fora Churchill Fellowship. This supported almost three months of overseas travelstarting in June 2017 to meet with First Nations Elders and communities, herself asan Indigenous Elder of Wuthathi, Mabuiag and Ambonese descent. Doseena’spurpose was to discuss the impact of colonisation on their communities and howthey were rejuvenating their sense of identity, place and belonging. As this picturefrom Doseena’s report shows, this took her around the world via Rome to Finland,Norway, The Netherlands, Britain, Canada, Hawaii and New Zealand.

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If you attended the 2017 CATSINaM Conference, you heard Doseena talk about heramazing experience. If you could not be there, then this recent interview withDoseena shares some of the highlights. You can read more in the NovemberCroakey article ‘Around the world in 79 days: re-writing colonial narratives’, whichincludes an 11 minute YouTube video where Doseena is interviewed, and a copy ofDoseena’s full 43 page report can be found here on the Churchill Fellowshipwebsite.

Why did you want to do this Fellowship?  

“When I lecture in Indigenous health at the Australian Catholic University, onealways used deficit statistics about the state of health for Aboriginal and TorresStrait Islander Australians. The negativity of that gets you depressed anddiscouraged – I know that community members say that too. In 2016 I realised Ifound this extremely emotionally draining when you are doing this semester aftersemester with so many students. I know from my practice that strengthen-basedprograms always empowered people, so I wanted to see what other First Nationspeoples were doing.

Most of my connections came through the international visitors who attendedCATSINaM’s 2016 International Conference – thank you CATSINaM!  I also gainedlinks from my earlier visit to Rome when I taught my subject at our campus there. Itwas through that experience that I came across the young Aboriginal boy calledConaci who is buried under St Paul’s Outside the Wall Basilica in the Vatican. Thisprecipitated another investigation which ran as a horizontal pathway to the primaryfocus of my Fellowship on community recovery from intergenerational trauma. Thiswas important, as I believe that repatriation is part of the healing that is needed inAustralia for all Australians.”

 

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What did you do during the Fellowship?

Doseena took on so much over these 79 days, so this is a brief summary ofhighlights, interspersed with her personal reflections on the experience. Muchgreater detail is in her Fellowship report.

Some of you may know about the story of two young Aboriginal boys taken fromPerth to Rome by Benedictine monks in 1849 to train as Benedictines – AnoukRide wrote an account of this in the book The Grand Experiment. They wereConaci and Dirimera, aged seven and ten, of the Yuat nation. Conaci died in 1853in Rome and Dirimera died two years later soon after returning to his country.

“In Rome I wanted to see about this brilliant young boy, Conaci, who tragically died170 years ago in Rome. I wanted to find out about his repatriation. When I wasthere to teach, a nun took me where they thought he was buried at St Paul’soutside the wall. I felt that his spirit was very sad to see me go. I thought to myself“this boy wants to go home…to be on country…his spirit would be restless untilthat happens”. I left that with the Ambassadors of the Holy Sea to follow up. I didthe best I could in finding out where he is, and visited some people in the hierarchythere.”

Doseena then travelled to Lake Inari in the north of Finland to visit the Sami people:

“I went to the cultural centre and stayed for most of my time there, as aresearcher….I did craft in the main area of the cultural centre, Sajos, which is alsothe Sami Finnish Parliament, the representative body for Sami people in Finland.People came to see me, they could see I was different, so came and spoke to me.In my week there, I had a radio interview, found out about the Sami people andtheir history, and interviewed an Elder. She explained how she was bullied byFinnish people, had to squash her language, dress and customs. The Older Samiare still traumatised and won’t speak their language for fear of persecution.

I crossed over to Norway to Karasjok in Finnmark country, to see the NorwegianSami people and their Parliament. I visited a mental health addiction service,SANKS, which deals with intergenerational trauma and its symptoms - mentalhealth difficulties and addictions in Norway and parts of Finland. It is an incrediblemental health service that reaches out to the Sami people. I had a tour of thefacilities, had meetings with professionals, ate Sami food, recorded some of theirlanguage greetings and bought some music. I wanted to understand the history ofhow they rose to self-determination. I found that there were key people in the pastwho wanted to revive their poetry and artwork, so they would be proud of theirculture and stand up against the Norwegian, Finnish and Swedish dominance.There is not a lot of research and data collection on Sami people – healthprofessionals still want to pursue that area even though the Sami don’t alwayswant to identify.”

These types of experiences characterised Doseena’s ongoing travels – learning

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about colonisation and its impact, and talking to First Nations people about howthey have and are continuing to reclaim and rejuvenate their cultures, and recoverand grow their resilience from a position that culture is strength. She met withFrisian people of Friesland in the Netherlands, who were dominated by the Dutch,who stopped them from speaking language and practising culture. They arereclaiming and practicing culture, but not without ongoing restrictions anddismissal of their contributions to the country by the Dutch.

Doseena’s decision to visit Cambridge University in Britain was to visit theanthropology and archaeology Oceania section. 

 

Her next stop was Downside Abbey in Radstock, near Bath on Spa. This was thelargest Benedictine cathedral and archival repository in Britain. “I wanted to findout if there were any more Aboriginal children that had travelled to Europe, as I hadpreviously read in Bishop Rosendo Salvador’s memoires, which indicated to methat there may have been more children.” This search continued in London with thenuns from the Faithful Companion of Jesus Generalate in Middlesex. The nunsconfirmed that another young Aboriginal child had come to England in 1848, butdied in 1851 and was buried there. Doseena was able to visit her grave, anddiscuss the intent to repatriate her back to country.

Next Doseena crossed the Atlantic Sea, going to the World Indigenous People’sConference on Education in Toronto, a proud, strength focused and culturallycentred event. Near Vancouver she visited the Tsawwassen Nation, a large FirstNation community who had negotiated a treaty with the Canadian Government.They have their own legislative assembly with a strong governance structure, andbusinesses such as a multi-million dollar shopping mall and a real estate company.

Common themes of engagement continued to emerge: “One thing is food, it wasthe centre of every nation I visited. You sit with Elders with food around you andcan talk your business….In New Zealand, the dining room is the key location in themarae for Maori people. Reciprocity was also a key factor – I saw it in everycontext.”

Experiences and discussions with First Nations communities continued thatemphasised how they shared and celebrated culture, created healing processes,

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and engaged their young people in learning and practicing culture, speakinglanguage and developing leadership.  This included with the Te Kem’lupsSchwempic community in Kamloops, the Squamish and Li’lwat First Nationscommunities at their combined cultural centre in Whistler, and the First NationsHealth Authority (FNHA) in Vancouver. FNHA is similar to a NACCHO Affiliate inBritish Columbia, however it is in charge of all the clinical services for First Nationspeoples across British Columbia and a strong promoter of cultural safety. Thestories behind these centres and services emphasised self-determination,sovereignty and building collaboration across different nations for recovering andcentering culture to achieve shared outcomes.

Doseena’s trip then took a Pacific turn, involving interactions with the IndigenousNursing Program at University of Hawaii and visits across Aotearoa/New Zealand,including teaching and staying at Te Whare Wananga o Arawangianui, anIndigenous specific tertiary institution that has a nursing degree course atWhakatane in the Bay of Plenty. 

What were some of the important learnings and how are theyrelevant for us in Australia?

“I have written about this in the report. Indigenous people are so resilient. Self-determination and sovereignty is so important to us, and culture is the centrepiece.Government is now acknowledging it, but this has always been the case.

language, rituals and ceremonies are critical. Strengths-based programs are thething. We need to hear about the deficits, so we know what we need to tackle, butwe must highlight the magnificent things that Aboriginal and Torres Strait Islanderpeople are getting stronger in – we must do that more.

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I want to share what I have learned – these Fellowships allow creative projects thatincrease knowledge and make us aware of things outside of our normal borders.For the Aboriginal and Torres Strait Islander community, it is spurring us on. Givingideas in how to practice better businesses and checking that there is a goodgovernance structure in place in our organisations…. We have to learn westernways but incorporate our cultural ways into our governance and do that in adelicate way, together.

The experience has brought me conviction, self-empowerment and resilience. Mypassion for Aboriginal and Torres Strait Islander social justice is ever so strong. Ijust wish other Indigenous peoples can experience what I did.”

If you would like to find out more about the Churchill Fellowship or her study tour,Doseena’s email is: [email protected].

‘Addressing Aboriginal healthinequities’ – reflecting 17 years on: Aninterview with Cheryl Sanderson

In 1999, Cheryl Sanderson started a Bachelor of Nursing degree as a mature agedstudent at Flinders University in South Australia. This choice was made to address

Aboriginal health problems and being inspired by her mother, a Central Arrerntewoman from the Alice Springs area. Cheryl explained: “I didn’t know what I wasgetting into really. I knew I wanted to get into a health profession, something thatcould make a difference. They say nursing is a caring profession…so I thought

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about how nursing can improve the situation.”  

What led to you writing this article and what did you focus on?

“I had a 1st year assignment with multiple choices - the last one was: ‘The nurse’srole in addressing inequities in the health system’. This was my opportunity to digdeep into nursing and Aboriginal health, and I just knew ‘this is why I am here’.  Iwent to the library and immersed myself, reading extensively on the topic.

There were two major things I highlighted to improve the situation. The first wasincreasing the number of Aboriginal and Torres Strait Islander nurses because oftheir life experience, cultural understanding, language, family and communitynetworking, which enables them to be a cultural broker and have greater empathyand deeper understanding.

I also highlighted Cultural Safety, as an essential tool required for nurses toexamine what they bring into an interaction with Aboriginal people. Nurses bringtheir own understandings of health, beliefs, life experience and knowledge, whichcan be different to what an Aboriginal person’s world view is. I talked about nursingeducation and institutions including cultural safety and Australia’s history ofcolonisation, and its link to current health problems. Nurses need to know why anAboriginal person is sick, why it has happened from generation to generation andthe links to the social determinants of health. I also talked about nursing taking aleading role in improving health promotion, education and prevention.”

 

What areas have you worked in since you graduated?

“I graduated in 2001 and completed a graduate nurse program in a cardio-vascularspeciality. I then returned to Alice Springs to work in a hub of Aboriginal culture,and the place of my mother’s birth in Arrernte country - ‘Mbarntwe’. I worked at thehospital in the wards and then the Emergency Department for a year.  My referencereport said I was a great nurse and would do well in a primary health care setting. Iwondered why she said that at first, but realised that even if people came in with asore throat, I used all opportunities to incorporate health promotion and healthprevention.

“Seventeen years after writing my original paper, I am exactly where I need to be. Iam in an Aboriginal medical service, in my homeland and in a primary health carerole as a Diabetes Nurse Educator. Diabetes is a significant area to be nursing in, tofocus on primary health care and prevention, provide health promotion, educationand empowerment for self-management, and holistic patient centred care.

In 2003 I started working at Central Australian Aboriginal Congress, an Aboriginalcommunity controlled heath service (ACCHS) in Alice Springs. Working atCongress has nurtured and developed my primary health care nursing career. Myexperience has been varied, including chronic condition nursing, cardiac nursingand diabetes nursing, as well as being a continuous quality improvement (CQI)

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facilitator.”  

Have you noticed any change in the issues you highlighted in your2000 article, particularly given the campaign to ‘Close the Gap’ inAboriginal and Torres Strait Islander health?

“I have seen more Aboriginal Registered Nurses at Congress, which is always aproud moment for increasing Aboriginal employment.  I believe the increase ofAboriginal nurses has the potential to make a real difference to Aboriginal peopleaccessing health services that are culturally safe. The nurse is in the powerfulposition and if he/she is culturally safe, then the patient will feel safe to return.'

I strongly promote and encourage Aboriginal Health Practitioners (AHPs) andAboriginal Health Workers (AHWs). When I started at Congress I was asked tomentor an AHW. I said “absolutely”. I actually learnt so much from her. She wasoutstanding – this was Elaine Campbell and we still work together at Congress now(it has been over 13 years). We have a fantastic group of AHPs at Congress, as wellas an AHP student cohort who are close to graduating. Congress is committed toproviding employment to those AHPs who are graduating, and I am keen to nurtureand help them grow and promote nursing as a career development option. Icurrently work with two registered nurses who have taken their career further afterhaving started as AHPs.

We have some really good nurses here at Congress, both Aboriginal and non-Aboriginal. In contrast, some of the Aboriginal nurses I have talked to who haveworked in hospital settings feel unsupported, often treated as tokens rather thanbeing acknowledged for the strengths they bring to nursing as Aboriginal nursesworking with mainly Aboriginal patients.”

 

What do you want to see happen now with the ongoing Close theGap (CTG) campaign and the government response?

“Unfortunately, from most accounts the Government’s Closing the Gap response tothe CTG campaign has been reported as a failure, with limited progress in keyareas as only one out of the seven key measures being on track. This quote standsout to me from the Closing the Gap Prime Minister’s Report 2017:

 

"As a nation we will walk side by side with Aboriginal and TorresStrait Islander people on the journey of recognition and

reconciliation, to build future for all" 

My experience in primary health care has relevance to the work required to closethe gap – these three points are particularly relevant:

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HEALTHY LIVES: Health and wellbeing are important from pre-conception throughto old age – physical, social, emotional, cultural and spiritual wellbeing andconnection to country and family.

APPRECIATING OUR NATIONAL CULTURE: Aboriginal and Torres Strait Islanderculture is a key part of Australia’s national identity and we must be vigilant inpreserving its knowledge and wisdom.

EMPLOYMENT: Being employed improves the health, living standards and thesocial and emotional well-being of individuals, families and communities.

I proudly acknowledge my Aboriginal identity and Arrernte heritage, and amdedicated to nursing and the improvement in Aboriginal health outcomes. I am veryfortunate to be working at Congress. As an Aboriginal Community ControlledHealth Service it is at the forefront of doing the ground work to close the gap. There is a commitment to employment and support for Aboriginal people. Aboriginal health in Aboriginal hands is what Congress is about and I championthis.

I am excited about the Cultural Safety work done by CATSINaM and being led by astrong proud Aboriginal woman, Janine Mohamed. Incorporating cultural safetyinto educational institutions and codes of practice most certainly will have thepotential to improve health interactions for Aboriginal people. By Cultural Safety, Iam referring to the nursing theory from New Zealand developed in 1989 originallyby Irihapeti Ramsden to address recruitment and retention issues of Maori nurses.Cultural safety was incorporated into the NZ nursing curriculum assessmentprocesses in 1990. The cultural safety guidelines were initially written by IrihapetiRamsden in 1991 and last reviewed in 2009.

At Congress Aboriginal people have a culturally safe service to work in and attendwhere their identity is valued and respected in the health clinics. I am alwaysmesmerised to hear traditional language spoken, and bush food, medicines andcultural practices incorporated into a health care environment. Mainstream healthshould look at how they can do it better for Aboriginal people accessing healthcare, including employing more Aboriginal staff and ensuring they are empoweredin their roles to work to their full capacity using all of their cultural knowledge andskills.”

If you are interested in gaining a copy of Cheryl’s article, it was published in theAustralian Nursing Journal, Volume 7, Number 11, June 2000. Cheryl can send it toyou, email her at: [email protected]

Thank You 

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As 2017 draws to an end the CATSINaM Board, CEO and Staff send our bestwishes for a safe and relaxing holiday over the Christmas and New Year break - welook forward to sharing 2018 with you. 

Level 1, 15 Lancaster Place, Majura Park  ACT  2609 Phone:  02 6262 5761

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