We're committed to Closing the Gap
As a peak body, the APA has a responsibility to contribute to discussions on Australia’s health and to lead the profession on social justice and equity issues. Accordingly, the APA is a committed member of the Close The Gap (CTG) Campaign Steering Committee, and we stand behind the peak Aboriginal organisations that lead the efforts of the committee.
The Redfern Statement
The Redfern Statement was released to commemorate Prime Minister Paul Keating’s speech in 1992 about the disadvantage faced by Aboriginal and Torres Strait Island peoples and the responsibility of all Australians to address this disadvantage. It is an urgent call for government action and meaningful engagement to address issues in health, justice, violence, early childhood safety and wellbeing and disability for Aboriginal and Torres Strait Islander peoples. Read the statement here.
Close the Gap
The APA supports the Close the Gap campaign and calls on all Australians to recommit to a long-term vision for health equality. We are also calling on governments to commit to a long-term multi-party focus on health equality, to adequate resourcing for health and to genuine partnership with Aboriginal and Torres Strait Islander people and organisations.
Find out more about Close the Gap Day and how to get involved.
Our vision for reconciliation
As a profession, our vision for reconciliation in Australia is a society that values and recognises Aboriginal and Torres Strait Islander cultures, knowledge, connection to land, and ways of healing. We envision a society that is free of institutional racism and where justice and healing has occurred through acknowledgment and acceptance of the wrongs of the past and their intergenerational effects.
As a strong voice in the health community and as a profession of integrity, we acknowledge our responsibility to ensure all Australians participate equally and equitably in all areas of life. The opportunity remains for our profession to become culturally safe in our various roles as physiotherapy professionals, medical experts, researchers, educators, advocates, and collaborators. In turn, we aim to make our collective contribution towards reconciliation in Australia.
Reconciliation Action Plan - Innovate 2017-2019
Building on the foundations laid in the APA’s first Reconciliation Action Plan (RAP), the second iteration, Innovate RAP 2017-19, has at its core the practical steps the profession can take to move towards reconciliation with Aboriginal and Torres Strait Islander communities.
The APA’s Innovate RAP 2017-2019 provides us with the opportunity to create a culturally safe and sensitive profession. The current focus of our efforts to ‘Close the Gap’ in life expectancy is on education of current and future physiotherapists who are culturally safe and sensitive, with the goal of ending any trace of institutional racism present in our profession.
Through the implementation of this RAP, it is our goal to provide physiotherapists with opportunities to help close the gap in their communities, educational institutions and hospital settings.
Aboriginal and Torres Strait Islander Health Committee (ATSIHC)
The Aboriginal and Torres Strait Islander Health Committee (ATSIHC) will play a significant role in guiding the implementation of the Innovate RAP, alongside the APA leadership team, which has stewardship of its key responsibilities. Our ATSIHC comprises Aboriginal and non-Aboriginal clinicians and researchers, and reports directly to the APA Board of Directors. The ATSIHC has ex-officio membership of APA National President Phil Calvert, a champion of the RAP, broad support from APA CEO Anja Nikolic, also a champion of our RAP, and additional members with experience or a passion in Aboriginal and Torres Strait Islander health and wellbeing.
Cultural safety for Australia’s first peoples
In general, cultural safety as a healthcare concept is poorly understood and even more poorly evaluated. Cultural safety is a significant element of culturally responsive care. Considered ‘a matter of priority for any organisation involved in service delivery for Aboriginal and Torres Strait Islander clients’ (Johnstone & Kanitsaki 2007), cultural safety is a framework within which health practitioners and the health service organisation evaluates its work practices and determines methods by which to empower its Aboriginal and Torres Strait Islander stakeholders to obtain culturally responsive care.
The cultural safety of Aboriginal and Torres Strait Islander peoples is promoted and developed first and foremost through the development of cultural awareness and sensitivity. Cultural awareness training (CAT) provides information on pre-colonial Aboriginal peoples’ spirituality, language groups, culture, stories (the Dreaming) and governance (the Lore) and the very healthy lifestyle of pre-Colonial Aboriginal and Torres Strait Islander peoples (often walking 50 km per day to find food, high protein diet, no sugar, no wheat, no dairy and no alcohol). CAT progresses through history providing education in relation to the impact of government policy on Aboriginal and Torres Strait Islander peoples over the last 200 years that has resulted in the Stolen Generations and the inter-generational trauma that we see today demonstrated in poor education and employment outcomes, alcohol abuse, addiction and self-harm, as well as solutions. Cultural sensitivity training educates the practitioner in methods of communication and engagement with Aboriginal and Torres Strait Islander community members so that a quality trusting relationship is developed between the patient and the practitioner.
As an example, if a patient—in this case a young mother—does not keep her physiotherapy appointment on time, a culturally sensitive practitioner will know, or be able to work out, why she did not attend. If the patient has children, does she have anyone to look after the children in a safe environment while she attends treatment? Does she feel comfortable to bring the children to the clinic? The practitioner will also know how far the patient lives from the clinic, and whether she has a car or funds for travel. The practitioner will understand or be sensitive to cultural obligation, whereby the young mum may have to give her car to an Elder and not have any credit on her phone to call and cancel. The culturally sensitive practitioner will understand the Aboriginal and Torres Strait Islander concepts of ‘shame’ and be sensitive to those concepts when the patient returns for treatment. The practitioner may be able to work with the patient to sort out cultural issues that are preventing attendance and compliance.
The benefits of implementing a framework of cultural safety within a physiotherapy service are manifold.
Aboriginal and Torres Strait Islander peoples (indeed people of all culturally and linguistically diverse backgrounds) will more likely feel safe within the healthcare service environment that is culturally sensitive. That is, when their opinion and culture is valued and understood, and their decisions regarding healthcare choices are respected, people will be more likely to engage positively and beneficially with the physiotherapist resulting in improved health outcomes. The flow-on effects to the physiotherapist and the physiotherapy service or business are obvious. As an oral culture, information about your culturally safe physiotherapy service will be recognised by your patients, and your business can thrive as a result.
Cultural awareness, sensitivity and safety training also ensures that the practitioner feels safe when engaging and treating Aboriginal and Torres Strait Islander patients. Part of cultural safety training is to also educate the practitioner on how not to be caught up with political correctness or fear of offending the Aboriginal and Torres Strait Islander patient, or their family, and be able to get on with the business of getting better.
- Undertake cultural awareness training
- Be familiar with the APA Reconciliation Action Plan 2017–19
- Develop their own Reconciliation Action Plan
- Provide an inviting environment for Aboriginal and Torres Strait Islander clients (eg, the clinic has culturally relevant art or a plaque acknowledging the Traditional Owners).
This free online program provides a ‘scaffold’ to help health professionals deepen their understanding of Aboriginal cultural values, beliefs and practices. It consists of five self-directed learning modules:
- Culture, self and diversity
- Aboriginal history
- Working with Aboriginal people
- Providing clinical services
- Improving cultural security.
Our monthly InMotion magazine and Flagship e-newsletter regularly provide updates on our reconciliation journey and the members who are helping shape our plan, incorporate its tenets into educational and professional realms and those who are committed to improving the health and wellbeing outcomes of Indigenous communities.
National Reconciliation Week
National Reconciliation Week (NRW), which occurs between 27 May–3 June, offers us an opportunity to reflect on our individual and collective commitment to reconciliation. The 2018 theme 'Don’t keep history a mystery' invited all Australians to learn more about Aboriginal and Torres Strait Islander cultures and histories, and to share that knowledge to help us grow as a nation.
The date of NRW each year commemorates two significant milestones in our reconciliation journey—the successful 1967 referendum and the High Court Mabo decision. Visit the Reconciliation Australia website for more information.
You can also visit the get involved webpage for ideas and to see what activities are planned in your local area to commemorate the NRW.
How you can get involved:
- download the poster and print the poster at your local printer
- place the poster in your waiting room
- participate in the APA’s free online cultural awareness training and encourage your staff and co-workers to also take part
- find who the traditional owners are of the land on which you practice and invite local elders to speak with your staff
- talk to your staff about the importance of culturally safe practice
- celebrate and participate in Close the Gap Day (15 March) and National Reconciliation Week (27 May – 3 June) and create opportunities to build and maintain relationships with Aboriginal and Torres Strait Islander peoples
- learn about events near you and how you can get involved, by visiting Reconciliation Australia’s NRW website.