Putting Indigenous Cultures and Indigenous Knowledges Front and Centre to Clinical Practice: Katherine Hospital Case Example

Abstract

The inclusion of Indigenous cultures, known as the cultural determinants of health, in healthcare policy and health professional education accreditation and registration requirements, is increasingly being recognised as imperative for improving the appalling health and well-being of Indigenous Australians. These inclusions are a strengths-based response to tackling the inequities in Indigenous Australians' health relative to the general population. However, conceptualising the cultural determinants of health in healthcare practice has its contextual challenges, and gaps in implementation evidence are apparent. In this paper, we provide a case example, namely the Katherine Hospital, of how healthcare services can implement the cultural determinants of health into clinical practice. However, to be effective, health professionals must concede that Australia's Indigenous peoples' knowledges involving cultural ways of being, knowing and doing must co-exist with western and biomedical knowledges of health practice. We use the Katherine Hospital ABC Radio National Background Briefing interview, which was mentioned by two research participants in a 2020 study, as an example of good practice that we can learn from. Additionally, the six Aboriginal and Torres Strait Islander Health actions contained in the 2nd Edition of the Australian National Safety and Quality Health Service Standards provide governance and accountability examples of how to enable Indigenous people's cultures and their knowledges in the provision of services. The role of non-Indigenous clinical allies and accomplices is imperative when embedding and enacting Indigenous Australians' cultures in service systems of health. When Indigenous Peoples access mainstream hospitals, deep self-reflection by allies and accomplices is necessary to enable safe, quality care, and treatment that is culturally safe and free from racism. Doing so can increase cultural responsiveness free of racism, thereby reducing the inherent power imbalances embedded within mainstream health services.

Keywords: Indigenous cultures; Indigenous knowledges; accomplices; allies; case example; cultural competency; cultural safety; public healthcare policy.

Figure 1

Map of Australia showing the location of Katherine (see the red arrow) and Darwin. Source: Creative Commons: Maps of Australia, Travelmaps.com http://travelsmaps.com/map-of-australia.html. Accessed on 29 October 2023.

Figure 2

Description of the Aboriginal population within the Katherine Hospital catchment area. Source: Royal Australasian College of Physicians. Building an outreach program in remote Indigenous communities Sydney: Royal Australasian College of Physicians; 2022. Available from: https://www.racp.edu.au/advocacy/policy-and-advocacy-priorities/medical-specialist-access-framework/medical-specialist-access-framework-case-studies/building-an-outreach-program-in-remote-indigenous-communities. Accessed on 29 October 2023.