“Yani-nonyin” “Come walk with us through the experience of postnatal depression”

One in five Australian women experience postnatal depression (PoND). However, there are no historical studies that investigate postnatal depression in Victorian Aboriginal communities. Although we know a great deal about postnatal depression – it is predominantly about non-Aboriginal women. We have not heard the voices of Aboriginal women from within the context of Australian colonisation particularly in relation to the history of the Stolen Generation. The early identification and design of care that is based on Aboriginal community values could improve early access and relevance of care during pregnancy and parenting for Aboriginals. The aim of this PhD study was to explore the experiences of Aboriginal women who had experienced postnatal depression. The focus of the study was on their unique PoND ‘journey’; the contextual influences that impacted on their lives at the time; the family and community reactions, and the enablers and barriers regarding health service provision and support. Fifteen recommendations were given to the researcher from the participants. They included recommendations in relation to advice given to women generally in overcoming the perceived stigma of having a mental illness; preventative measures such as the provision of relevant health education so as to enable community members to intervene early with support to affected families; health services attainment of a high standard of quality that is inclusive of culturally appropriate resources and programs, so that Aboriginal people feel ‘culturally safe’ to access and participate. Finally, the participants recommended that it was imperative that Victorian Government provide sufficient funding for Aboriginal communities in their endeavour toward self-determination and early intervention for women and families affected by that ‘Black Dog’ known as postnatal depression

Cultural context in practice in Australia

[Extract] The First Nations people of Australia consist of two distinct ethnic groups: mainland Aboriginals and the Torres Strait Islanders. This chapter discusses the cultural context and historical background of Australian Aboriginal and Torres Strait Islander peoples in order to gain an understanding of the mental health issues that affect them in contemporary society. Compared with other Western countries, Australia is one of the wealthier nations, rich in resources and with a highly skilled health workforce. Yet the health disparity between non-Indigenous Australians and Aboriginal and Torres Strait Islanders remains significantly wide. The traumatic impact that colonisation had and continues to have on each generation is immense. In this chapter, the effects of historical, cultural and social determinants of health on Indigenous Australians will be discussed, as well as the risk factors and protective factors involved. British invasion is discussed, as well as the period of colonialism leading to the effect that government policies had on Aboriginal communities. Colonisation had a devastating effect on the social and emotional well-being of Indigenous Australians. Indigenous Australians have a holistic view of mental health. Holistic health incorporates the physical, social, emotional, spiritual and cultural well-being of a person. Indigenous Australians demonstrate strength, perseverance and resilience in society and the environment

Caring for our elders

[Extract] This chapter explores the heath and wellbeing of older Aboriginal and Torres Strait Islander peoples and the factors that need to be considered in relation to their care, including chronic disease, a shorter lifespan and culturally safe and appropriate ages care. We argue that older Aboriginal and Torres Strait Islander people and their families make conscious decisions around care and that the role of nursed is to assist individuals and their families in making informed decisions. We discuss the reasons why some Aboriginal and Torres Strait Islander people may be viewed by some health professionals as being non-compliant or disengaging in the health system and their on-going care, including palliative care, when in fact they are making conscious choices, which can be culturally defined

Transition to governance: building capacity in an Indigenous community

This paper from the 2007 Australian Social Policy Conference outlines the issues and challenges faced by the Transition to Governance project, its partners and the Indigenous community members who are committed to establishing a new Aboriginal community controlled health organisation.Historically the Indigenous community in outer eastern Melbourne was serviced by an Aboriginal Community Controlled Health Organisation (ACCHO). However, in 1998 following a review by the Office of Aboriginal and Torres Strait Islander Health (OATSIH) the health service was de-funded and OATSIH approached Yarra Valley Community Health Service (YVCHS) to accept the auspice for the delivery of Indigenous heath services in the Shire of Yarra Ranges. The Indigenous community’s response to the transmission of services to YVCHS was varied as the Indigenous community is in principle committed to aboriginal control of health services. The transmission of service delivery to an Indigenous specific team within a mainstream health organisation was a bold move and a new model of management for OATSIH. The auspice arrangement is an interim arrangement, subject to the development of an accountable aboriginal community controlled organisation.In 2004 a report was commissioned to investigate and propose models for the governance of the Indigenous health service. The preferred proposal was the transfer of Indigenous health services back to community control and subsequently the transition to governance project was established.This paper provides a case study of the journey by partners and Indigenous community members as they undertake the ‘transmission of business’ from Yarra Valley Community Health Service to a newly constituted Aboriginal Community Controlled Health Organisation

Traditional midwifery or ‘wise women’ models of leadership: Learning from Indigenous cultures

This article originated in a leadership program for Indigenous1 Australian researchers, where a participant who had worked with traditional midwives in South Sudan reflected on her experiences. While there is increasing interest in how leadership studies can learn from Indigenous leadership experiences, much of this work has focused on men’s experiences or has not paid particular attention to women’s leadership. In this article, we suggest that women’s experience as traditional midwives or ‘wise women’ has been a crucial domain of leadership over millennia. We begin by describing the features of traditional women’s leadership through midwifery before reviewing Indigenous and non-Indigenous leadership theories. Drawing on published and unpublished sources, four principles of midwifery leadership are identified: being a leader who empowers and frees others with ‘no one person wiser than the other’; embodying wisdom and ethical practice which nurtures social, cultural and spiritual needs of women and mentors the next generation by ‘walking together’; being competent and skilled as well as emotionally attuned (‘feeling the job’) to engender trust and calm which is crucial to birth, ‘depending on each other but looking to her to be in charge’ and paying attention and being responsive to emergent change and unfolding present reality rather than being prescriptive, ‘using her knowledge to adjust the situation’. While these emphases are recognisable as part of several ancient wisdom traditions, we suggest that they connect to, and have relevance for, emerging leadership thinking and practice beyond the midwifery or medical context, for men as well as women and for non-Indigenous and Indigenous leadership alike