My Rural Story | Week One | Jacinta Elston

AUSTRALIA’S RURAL, REMOTE AND INDIGENOUS HEALTH #MyRuralStory

Featuring Interviews from the brand new 3rd edition of Australia’s Rural, Remote and Indigenous Health by Janie Dade Smith

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-Week One -

J acinta Elston Professor and Associate Dean of Indigenous Education & Strategy at JCU. Co-Director of the Anton Breinl Centre for Health Systems Strengthening at JCU.

JacintaElston

What is different about working in rural and remote areas?

My name is Jacinta Elston. I’m Professor and Associate Dean of Indigenous Education and Strategy in the Division of Tropical Health and Medicine at James Cook University. I’ve been working in Indigenous health for all of my career and I guess I came to Indigenous health and working in areas relating to indigenous and remote health because I grew up in North Queensland in a regional centre. As a child I spent a lot of time in rural farming and agricultural communities with my family. From this I have a natural attachment to the beauty of being in small, rural communities.

The difference about working in rural and remote communities, from the context that I’m coming at this from, is really to do with the indigenous health aspects of it. It’s the fact that when working in rural and remote communities, you’re going to see Aboriginal andTorresStrait islanderpeople at amuch higher portion than you would if you were working in a large urban centre. In a large urban centre, you might not come across many Aboriginal Torres Strait islander people at all in the hospital care system, but in rural remote communities,

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they’ll make up the large proportion of people that you’ll see and care for.

really important, when you go to these places, to be open to learning about that history and to hear it and understand it. The second thing I think people need to understand, or have some reflection about for themselves, is racism. I think we’ve reached a point in our country where racism is becoming a bigger and bigger issue. We saw through the Adam Goodes saga the impact that this is having on society. You can’t go to a barbeque and have a conversation about things like Aboriginal people without there being comments made. It’s really important when you go to places to be open to learning about that history and to hear it and understand it. Where do you stand on those comments when they come up? A good place to start would be to have a look at Stan Grant’s recent speech and racism IQ seminar series that was held at Sydney University at the end of 2015. He makes some really useful points about how we as Australian’s all embrace our history together. And I guess the last thing is that people do need to be willing to ask for help when they get stuck. When they’re feeling lost or isolated. In rural communities there’s a lot of connection and connectedness, if you feel you’re

What advice would you give to students going on a rural or remote placement? The fist thing I would advise is that they need to really understand the history of the community that they’re going to. Students need to understand what has happened to the Aboriginal Torres Strait Islander people in this country as a whole since settlement. Policies and government processes, the acts of genocide that happened and impacted on people in the communities. Things that have happened at a global or national level. There’s also been things that have happened in communities they’re going to be working in that people have a memory of, people still have connections to, and I think that it’s ‘I think we’ve reached a point in our country where racism is becoming a bigger and bigger issue. We saw through the Adam Goodes saga the impact that this is having on society.’

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settings when there’s a lot of turnover of staff. People who work in these areas are committed to the cause and they’re there for the long term often, so relationships and connections topeople, that’s amazing. In rural communities there’s a lot of connection and connectedness, if you feel you’re outside of that and you don’t understand things look for help; look for a mentor, look to the leaders and ask for advice. And then on top of that you’ve got opportunities to sit, some times in really beautiful places, quietly. At the side of one of the mountains out in the lake Argyle region of Kununurra where

outside of that and you don’t understand things, look for help; look for a mentor, look to the leaders and ask for advice. What has been one of your best experiences working in these remote communities? I think it’s hard to pinpoint my best experience when working in a rural and remote community because there’s been lost of best experiences and lots of really unique opportunities that I’ve had. But if there was one great thing that’s come out of the couple of decades that I’ve been working in this space, it’s the relationships and the connections to people. It’s knowing that all around the country I’ve got relationships, friendships, associations that are real and meaningful. They’re relationships that have lasted the test of time. And I guess that’s more than yougetwhenyou’reworking in largeurban

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there’s nothing in sight except for bush and hills and land and the water, and to be able to just sit and feel the country and hear it breathing around you. So there are those sorts of opportunities. What have you experienced in remote Australia that has changed your world view? One of the big ‘aha’ moments in working in Aboriginal health and rural remote health was probably the first time I went to Thursday Island, to the Torres Strait, and I was only going there from North Queensland but it was a saga to get there. You spent the whole day, you’d be on the plane then you’d be on the bus, then you’d be on the ferry, and it really brought home to me the cost of traveling in rural and remote communities for peoplewho aren’t on the tax payers dollars, who aren’t part of health care systems or service providers who are paying for them to get out there. And so for people in rural remote communities, the cost of getting back and forwards to regional centres for health care, for family community business, for funerals, for bringing somebody’s body home after they’ve passed away - all of those things are immense costs to our communities and they take a toll and people make choices about whether or not they will get care based on those costs often, and based on what their families can afford.

And so we’ve got to remember that a lot of people living in rural and remote communities, particularly the Indigenous people, have poorer education standards, poorer opportunities for employment, often living ingreater situations of poverty. And so their health is worse and that’s a large burden on the health care system. But giving people more help to get to the health service, to be able to engage it, I think is critically important and I think that was one of those ‘aha’ moments for me. The other thing that I’d like to add about working with Aboriginal Torres Strait Islander people is understanding and having a commitment to the principles around self-determination and sovereignty for Indigenous peoples. Aboriginal and Torres Strait Islander people have been really powerless over ‘Out in the lake Argyle region of Kununurra, where there’s nothing in sight except for bush and hills and land and the water, and to be able to just sit and feel the country and hear it breathing around you...’

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the last 200 years in terms of making any decisions about themselves, and so there’s some huge issues that are facing us with AboriginalandTorresStraitIslanderhealth, and if we’re going to see any improvement at all, Aboriginal and Torres Strait Islander people have to be leading that. So working with them, bringing them to the table at the time that programs are designed,decisionsarebeingmade,letting them take the run on delivering on these programs becomes critically important. And so I think that for any health service provider in the future, understanding that you won’t go anywhere, we won’t go anywhere as a country in improving Indigenous health, unless we have this being achieved in partnership with Aboriginal Torres Strait Islander people.

If we’re going to see any improvement at all, Aboriginal and Torres Strait Islander people have to be leading that.

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Featuring Interviews from the brand new 3rd edition of Australia’s Rural, Remote and Indigenous Health by Janie Dade Smith

Share your rural experience now to win a copy of the book @ElsevierAUS #MyRuralStory Please note, the transcripts featured within this publication have been taken from live interviews. Any alterations have been made for the purpose of clarity and do not change the overall meaning of the speaker.

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