01 Aug 2011
Communiqué, Alice Springs, July 2011, Health, Conflict and Culture
Health, Land, Conflict and Culture is a project initiated by Global Reconciliation, an international network seeking to promote dialogue across national, religious, ethnic and other cultural-political differences. The project follows in the tracks of the Little Children are Sacred Report to learn about and respond to issues of Aboriginal health and wellbeing in Central Australia and Victoria.
Discussions and visits to country occurred in Melbourne, Lake Condah, Western Victoria, and Central Australia, focusing on Alice Springs, Hermannsburg and Bore No. 5 Settlement. A delegation from the Middle East, together with Australian researchers-practitioners, visited Alice Springs and remote communities in Central Australia from 16–21 July 2011. Their aim was to facilitate cross-cultural discussion of options for local community involvement in health care.
The Middle East has been characterized by gut-wrenching conflict and division, which has greatly affected the long-term health and wellbeing of the communities that live there. While there are clear differences between the health conditions of people in the Middle East and Aboriginal Australia, there are also some striking parallels. In both, health and wellbeing issues are tightly bound up with cultural difference and identity, and the effects of colonization. They are affected by social dislocation, internal stress, power asymmetries, racism, unequal distribution of resources, and complex political relations. Poverty, interpersonal violence, unemployment, substance-abuse, diabetes, cardiovascular disease and infections remain major health issues in both regions.
Like Australia, the Middle East has been the site of innovative responses to health care needs and models of health care development, including those which draw on and seek to develop community resources and capacity. In both countries, these initiatives are fragile and need supporting.
The visiting health professionals are Dr Ada Ben-Sasson (Central Israeli District) and Professor Zvi Bekerman (Hebrew University, Jerusalem), Professor Mohammed Shaheen (Al Quds University, Ramullah), Dr Rand Salman (American Near East Refugees, Ramallah) and Dr Orit Oettinger-Barak. Unfortunately, Dr
Yasser Abujamei (Gaza Community Mental Health Program) who was invited to come was stopped on the Gaza-Egypt border and his travel was restricted.
The other members of the delegation were Paul Komesaroff (Monash University), Paul James and Elizabeth Kath (RMIT University), Sally Gardner (Deakin University), Elizabeth Reid (ANU).
The project was initiated by Global Reconciliation in partnership with the Central Australian Aboriginal Congress, the Lowitja Institute, the Victorian Aboriginal Health Service, the National Australia Bank, Monash University, RMIT University, the Health and Development Alliance, Hadassah Australia, the Palestinian-Australian Educational Exchanges, and other community groups.
Calls for Change
- Out of a profound respect for the Australian democratic system and a global commitment to civic values, we call on the Australian Government to respond creatively and urgently to the asymmetry of power experienced by Aboriginal people in Central Australia.
- We call on the Government to broaden and target funding in a way that expressly encompasses the connections between health and broader areas of social life. In particular, we urge culturally sensitive attention to the connections between health and education, sport, language, and sustainable livelihoods.
- Overcoming the marginalization of Aboriginal communities is fundamental and requires their active engagement in realizing their aspirations. We suggest that this requires a new structure at the national level to make governments, across all levels, legally and ethically accountable for implementation of engagement policies.
- As recommended by The Little Children are Sacred Report (and never taken up systematically) we urge that any intervention be shaped by and mediated through continuing community engagement and delegated community authority.
- Acknowledging that comprehensive health and wellbeing is crucial—including primary clinical services and action to address the underlying structural determinants of health and wellbeing—we urge that Aboriginal organizations and communities be actively engaged and involved in decisions about resource distribution and program development and delivery.
- We encourage active partnerships across local, regional, national and global networks and organizations, with local communities and their organizations taking active responsibility for their own futures.
- Continuing dialogue and negotiation based on communities’ stated needs and evidence are essential. This entails more than just additional rounds of community consultation. It must lead, we suggest, to effective, funded, and community-based action.
1. Principles of Good Practice
- Initiate a global dialogue on empowering and effective practices and pathways. This will involve discussion about how general principles that underpin comprehensive wellbeing and health development can be translated and operationalized in ways that take into account local differences. The dialogue would include 1. an ongoing mediated web-based forum; 2. a series of workshops leading to a national Aboriginal Summit on comprehensive primary health care hosted by a broad coalition of organizations led by Congress with partners such as Global Reconciliation and the Lowitja Institute; 3. continuing exchange visits between global partners.
- Initiate an internal process inside Congress to discuss the basic framing of the main objectives, the
normative goals, and the conflicting and synthesizing issues.
2. Specific Projects
2.1 Linking Education, Health and Wellbeing
- To enhance the understanding of health professionals of the centrality of education in human development.
- To provide a setting that supports Aboriginal people to become professionals in health, including through university training.
- To develop a framework that reorients the approach of health professionals, administrators,managers, and bureaucrats towards an integrative and community-based approach to health and wellbeing that is more sensitive and responsive to Aboriginal people.
- To extend the ambit of current outreach programs and clinical support for children to include early childhood development programs with an emphasis on parental education and support.
- Creating an enabling environment that fosters access to health-relevant, university-level education.
2.2. Youth Violence and Marginalization
- To bring together a coalition of civil society, local municipal and business people under the auspices of the United Nations Global Compact Cities Programme and Global Reconciliation.
- To develop a sustainable and comprehensive response to Aboriginal youth violence and marginalization in Alice Springs that encourages participation and engagement in civil society.
2.3. A Comparative Research Project on Community Controlled Health Development
- To rigorously collect data across different local settings about the effects and outcomes of the community-controlled heath-care model.
2.4. Bush Medicine Project
- To document the complex meanings of bush medicine, including both the uses of both herbal medicines and spiritual practices.
- To ensure that cultural copyright and intellectual property remain with Aboriginal peoples.
2.5. Outstation Viability Project
- To develop a pilot project to test models of community mobilization.
- To collect information from existing successful local communities.
- To identify and support the development of self-sustaining outstation communities.
- To enable policy-makers and administrators in a reorientation of their understanding of the processes of change.
2.6. Towards an Ingkintja Reconciliation Football Team
- To work towards developing a top-level AFL team based in Alice Springs called ‘Ingkintja Reconciliation’, with a brief to link sport, health and reconciliation—this would begin in a modest way by sponsoring and working with the Hermannsburg u/17 team, and then draw in more teams.
- To provide inspiration (and role models) for Aboriginal and non-Aboriginal youths in relation to issues of health and wellbeing.
- To develop a model for the use of local sport for reconciliation, health and wellbeing that can be extended to other sports and across gender lines.
- To win the AFL flag by 2030, with the Grand Final held in Alice Springs, the year that ‘the Gap’ will be closed.