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Cultural stepping stones to improved care

24 May 2019

Heather Lee became a cultural mentor for James Cook University (JCU) because she wants to invest in the future health of her family and her people.

“I have four children and 13 grandchildren. I want to make sure that my babies have the best opportunity in the health system that they can possibly get,” said the midwife, who works as the Integrated Services Manager, Maternal and Child Health, in the Townsville Aboriginal and Islander Health Service (TAIHS).

Several years ago, Ms Lee, a member of the Wuthathi tribe, from Shelbourne Bay, was invited by her predecessor, Aunty Dianne Ross – (“a very well respected Elder who has been with TAIHS since its inception”) – to assume the role of cultural mentor for Townsville doctors enrolled in the JCU General Practice (GP) training program.

Equipped with extensive prior experience as a cultural awareness facilitator with Queensland Health, Ms Lee welcomed the opportunity to break down the barriers between trainee GPs and patients within the Aboriginal controlled community health service where she now works.

That begins with identity; helping doctors to appreciate cultural differences between Aboriginal and Torres Strait Islander patients.

“We are often put in the same basket, which frustrates patients, who then feel the doctor doesn’t understand them,” Ms Lee observed.

Doctors must also learn to respect cultural protocols.

“When you are working in an Aboriginal Medical Service (AMS) it is really important for registrars to understand cultural protocols, including appropriate dress, women’s business and men’s business,” Ms Lee said.

“Doctors may come and go, but this service is our home. They need to respect our ways.”

Aboriginal and Torres Strait Islander history is a crucial health influencer for GPs to consider.

“We are still seeing people who are from the Stolen Generation,” the cultural mentor said.

“People who have been displaced and don’t really know their family. They are very vulnerable. History is very important to know where we are today and how some of those people really feel.”

Language can also be a barrier to effective communication between doctors and patients with limited education. Ms Lee sometimes sits in on medical consultations to advocate on behalf of patients.

“Some people don’t understand the language that is being used, the medical terminology,” she said. “When you are very vulnerable and sick, that can be particularly frustrating. Basically, I explain in a way that they understand, what is happening to them.”

“When we work with Aboriginal and Torres Strait Islander peoples within an AMS, we have that passion, we have that drive, because we too, as Aboriginal and Torres Strait Islander workers, have the same conditions as the patients walking through the door,” she said. “So who better to take that information from than us?”

She is keen to introduce doctors to Aboriginal and Torres Strait Islander culture beyond clinical settings – “to wrap culture around them”. Take them for a walk on country and involve them in

community events.

“It’s difficult, because they have timetables and set work goals to achieve,” Ms Lee sighed.

Nevertheless, the majority of registrars who have worked at the Townsville Aboriginal and Islander Health Service have formed genuine bonds with many patients.

“These registrars have been very open to learning our ways,” Ms Lee said. “We like to bring them into our fold, so to speak. Our people have really loved them and been very sad to see them go.”

The cultural mentor takes great pride in these fledging GPs, having “watched them grow”.

“They have learnt our culture and they are ready,” she said. “They’re ready to go out there and be able to give culturally safe and culturally appropriate care to Aboriginal and Torres Strait Islander peoples, wherever they may go.”

Ms Lee hopes her own contribution towards helping to close the gap will benefit future generations, after she is gone.

“I am 56, so I’m one of those people in the statistics (lower life expectancy for Aboriginal and Torres Strait Islander peoples). I want to know that I have put a mark on people that I can be very proud of.

And that culture will be at the forefront of whatever they do in the future,” she said.

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