Racism holding back closing the gap health target on the Border: UNSW academic

UNSW Medicine and Health associate dean Indigenous Brett Biles, a Murrawarri man working on Wiradjuri Country for the past 20 years, said his research showed cultural education training for doctors and health workers was vital to addressing systemic health inequity.

"We know racism kills and we have plenty of experiences with it," Dr Biles said

"The idea around culturally safe practices is to understand historically and contemporarily what Aboriginal people are going through.

"If a non-Aboriginal practitioner asks the question 'Do you identify as Aboriginal or Torres Strait Islander', what do you then do with that information?"

Dr Biles' comments came at an event for medical students on national Closing the Gap day, which since 2008 has measured equality in health for Aboriginal and Torres Strait Islander peoples.

The national target to close the life expectancy gap within a generation reported last year that it was "not on track" to reach its goal by 2031.

Though two early childhood priorities showed improvement - those relating to healthy birthweight and preschool enrollment - others relating to social determinants of health had fallen further behind.

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With the support of Albury Wodonga Aboriginal Health Service, the UNSW Rural Clinical Campus has announced it is expanding its teaching program to include a two-day cultural education placement as well as looking to increase other medical student placements with the health service.

Dr Biles said Aboriginal people in Albury-Wodonga gravitated to health services they trusted or had positive experiences with, such as AWAHS.

He said this raised issues for urgent or emergency health care services, and that at times poor communication between Albury Wodonga Health and AWAHS had interfered with continuity of care.

"AWAHS can only do so much," Dr Biles said. "If there is an acute crisis, they have to go to the emergency department.

Dr Biles said building the capability of health services to be culturally safe required evidence-based reforms that addressed the impacts of racism, with a client-centred approach going a long way towards building trust in the health system.

"When an Aboriginal client goes into the emergency department to access a service, it could be a six or seven hour wait. If they haven't been seen or triaged in that time and they leave, they get recorded as discharged against medical advice," Dr Biles said.

"We as Aboriginal people are not the problem, your services are not responding to our needs. What we're trying to do with our research is shifting the blame from the person back onto the health service to provide a culturally safe environment."

At an event planned to further the relationship between UNSW Rural Clinical Campus and Albury Wodonga Aboriginal Health Service on March 16, Dr Biles and a passionate audience gathered to witness the unveiling of an artwork donated to the school by AWAHS cultural advisor Uncle Sam Wickman.

The Reconciliation and Relationship day was attended by UNSW medical students, AWAHS staff, Albury Wodonga Health staff, UNSW Rural Clinical Campus director of medical education Dr Mark Norden and professor Tara Mackenzie.

A plaque under the Uncle Sam's artwork titled Tjuttiwonbah Warlloo Pooku states the piece represents "a reconciliation and ongoing relationship between Albury Wodonga Aboriginal Health Service and UNSW Rural Clinical Campus".

Wiradjuri man Darren Wighton performed a smoking ceremony and Welcome to Country, taking the opportunity to speak to future doctors about the intersectional difference and holistic nature of social and emotional well-being.

"For us, to be in peak fitness is not just a physical thing. It is an emotional, mental and spiritual thing, and you are all part of that," he said.

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