Vector Volume 11 Issue 2 - 2017

or networking in the lunch break, is why I believe the AIDA
conference and AIDA itself is so successful. Recently, AMSA
Blue Week highlighted conversations regarding the need to
do more about the mental health crisis amongst medical
students and doctors.[2] Research also shows that mental
health disorders are more prevalent amongst Indigenous
Australians than their non-Indigenous counterparts [3] and it
is well documented that good social support is protective for
mental illness.[4] This highlights the importance for Aboriginal
and Torres Strait Islander medical students and doctors, in
particular, to have a strong support network throughout their
medical journey. AIDA provides a support network as a familylike
organisation, its members backing each other as they
embark on their medical careers and embrace the enormous
task of improving Indigenous health.
Unity
So what do we know about Indigenous health? There is
still a lot to do, but as an attendee of the AIDA conference, I
was surrounded by people who are already are, or are soon
to be, making a real impact on many people’s lives. However,
the media continues to portray a narrative that there are
only a few well-educated Aboriginal or Torres Strait Islander
people. Australia’s history of Aboriginal and Torres Strait
Islander people is still poorly taught in schools. Not only this
but key Aboriginal and Torres Strait Islander people in the
past who have formed a better path for our people are either
unheard of or undervalued in our society.[5] This is reflected
in the medical curriculum, where education about Aboriginal
and Torres Strait Islander culture and cultural safety is often
poor, undervalued or realistically done too late to change
some attitudes and beliefs.[6]
broader society, particularly in how we value Aboriginal and
Torres Strait Islander lives, challenge racism and become
more culturally aware. At this year’s AIDA conference,
it was encouraging to see many of the medical college
representatives understand the need for more Indigenous
doctors, and the need for cultural change to challenge racism
and improve cultural awareness within their own colleges.
Medicare exclusions for prisoners is a key issue that
highlights systemic racism and contributes to health
disparities. Currently, prisoners in Australia are excluded
from Medicare and the Pharmaceutical Benefits Scheme
subsidies. This limited access to good healthcare is
shortening life expectancy and decreasing the quality of life
of many people who are incarcerated.[11] Aboriginal and
Torres Strait Islander people are over-represented in prisons
and are 13 times more likely to be incarcerated.[12] This is
not closing the gap but in fact, widening the existing chasm in
health disparities.[13]
The beautiful but complex aspect to Aboriginal and Torres
Strait Islander people and culture is that there are many
communities, languages and cultural protocols; in improving
Indigenous health there is no “one size fits all” approach. The
best outcomes at a grass-roots level are when a community
is meaningfully involved, a lengthy but essential strategy to
drive improvements to Indigenous health.[14] Targeting the
social determinants of health are also key, however tackling
systemic racism, the lack in cultural awareness and creating
a cultural change in society to value Aboriginal and Torres
Strait Islander lives should be our focus for enduring change.
All medical students and medical schools in Australia
The question then arises: is the problem really about the
lack of teaching about Aboriginal and Torres Strait Islander
culture, when racism (both institutional and interpersonal) is
known to be associated with poorer health and poorer health
outcomes?[7] Should the curriculum entail teachings on
racism, both identifying it and stopping it? This conference
asked whether it is the job of Indigenous people to educate
non-Indigenous people on racism itself. The term “hidden
curriculum” – the values and attitudes that medical students
see around them – highlights the importance of lecturers,
tutors, administrators and academics in showing strong
leadership and changing the culture of our universities to
stop racism and strongly value Aboriginal and Torres Strait
Islander culture and health.[8]
It is not just universities that need to step up. The United
Nations (UN) recently described Australia’s progress in
Closing the Gap as “woefully inadequate”.[9] Hearing this
in a room full of people who are driving positive change
and having real impacts on lives can be very disheartening,
especially when Aboriginal and Torres Strait Islander people
make up only 2.8% of Australia’s population.[10] However,
this highlights the importance for all Australians to unite to
make Indigenous health an absolute priority amongst many
key stakeholders. There needs to be a cultural change in
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