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INDIGENOUS HEALTH POSITION PAPERIndigenous New Zealanders in 1840 4 , there have nevertheless been cultural and social barriers toadvancements in Māori health.The College acknowledges that historical inequalities in social and economic status currentlyexperienced by these groups contribute significantly to poorer health outcomes, particularly to decreasedlife expectancy 2,4,5 .2.3 Cultural issuesThe College appreciates the diversity in the Aboriginal, Torres Strait Islander and Maori cultures,languages, spiritual beliefs and recommends that Indigenous healthcare policies, projects and researchfrom all institutions and organisations are developed in collaboration with the Indigenous people toensure they are culturally relevant and delivered in an understandable and useful way. There are severalreasons for this.Firstly, there will be localised issues affecting healthcare where the local communities have knowledgethat may be medical or social in nature (related to the physical environment, locality, or circumstances).Furthermore, the College lacks the mores of these cultures to develop effective initiatives that would beattractive and meaningful to the Indigenous populations.The differences between Indigenous populations necessitate taking account of local culture, spiritualityand beliefs when developing Indigenous healthcare policies. Despite these differences, there is anunderstanding that strong kinship ties, connection to land, and the important role of and belief intraditional healers, are common to Indigenous cultures and must be respected, and indeed should be avalued inclusion in the solutions to Indigenous health problems.2.4 Indigenous population statistics in Australia and New ZealandThe Australian Bureau of Statistics (ABS) reported in the population Census of 2006 that around 456,000(2.3%) of the 19,855,287 population of Australia identified themselves as an Aboriginal or Torres StraitIslander. A report from Statistics New Zealand’s 2006 Census Count 6 indicated that the Maori populationmade up around 565,000 (14.7%) of the total New Zealand population..Although Aboriginal, Torres Strait Islander and Maori people are a minority in the Australian and NewZealand populations, the College believes that higher proportions of health resources need to beinvested in achieving goals for Indigenous health to reverse the unacceptable consequences of historicalinadequacies.2.5 Indigenous medical practitioners in Australia and New ZealandThe College submits that Indigenous people would be more likely to present for medical treatment andcomply with treatment guidelines if increased numbers of Indigenous people were represented in themedical workforce at all levels of the provision of care 7 .It is important to note that in Australia there are approximately 125 Aboriginal and Torres Strait Islanderdoctors within a medical workforce of approximately 50,000 doctors. This represents a mere 0.25% ofthat workforce despite an Indigenous population of 2.5% overall. Indigenous New Zealanders aresimilarly under-represented among medical practitioners 8 . The Medical Council of New Zealand’s(MCNZ) 2007 Annual Report confirms that Māori doctors made up 2.6% of the 9518 doctors thatcontributed to the MCNZ 2005 workforce survey 9 .Furthermore the College acknowledges that Australia and New Zealand have a severe shortage ofIndigenous surgeons, and that there is currently no evidence of change to this disproportionate underrepresentationof Indigenous healthcare workers in the field of surgery. This may be a result of prior lackof access to research and publication opportunities, and a general lack of broadly based educational andcareer opportunities, which has had a profound impact on the choice of surgery as a career. The Collegerepresents over 6000 surgeons in Australia and New Zealand. While the College is considering providingRoyal Australasian College of SurgeonsManual:Division:Subject:Guidelines and Position PapersFellowship and StandardsINDIGENOUS HEALTH POSITION PAPERRef. No.:Approval Date:Review Date:FES_FEL_001June 2009June 2012Page 2 of 9