New Humanity Movement

Health: Person, Environment

Esperienza Anne Marie Diggins

 

 

 

I am a General Medicine Practitioner with more than 20 years experience. Over 10 years ago I offered my services as a GP, among others, to the aboriginal nursing home fairly near where I work...

By Anne Marie Diggins- Melbourne

I had been aware of the statistics that aborigines have a 20 year shorter life expectancy compared to the rest of the Australian population, with a greater burden of illness and premature death;  and that they face discrimination daily and have a large burden of suffering that is the consequence of colonialisation. 

The aboriginal peoples of Australia have been in the country for 40-50 thousand years with little contact with the rest of the world. They had over 200 different languages and 600 dialects at the time of European discovery of Australia, living in extended family groups in defined territories with a largely hunter-gatherer lifestyle and a very close spiritual relationship with the land. With colonialisation there has been variable disruption depending on where European settlement predominated.  The percentage of aborigines in the population varies from state to state, averaging at 2% nationally.

I also made a conscious decision to move from working in a private general practice to a community health centre in order to work as a member of a multidisciplinary health team, so that I could treat people from disadvantaged backgrounds.

In the northern suburbs of Melbourne where I work, there is the largest number of aborigines in my state. Their ancestry is very mixed between aboriginal and European so it is easy to miss their indigenous identity. It is important to identify aboriginal people since they are at greater risk of complications from illness and there are federal government health programs available to address this gap. 

Therefore it is essential to ask all presenting patients whether they have any aboriginal ancestry. It has also been important to gain cultural awareness to enable engagement with these patients and support an empathic approach to treatment. For example, I have learnt something of the Aboriginal perspective on Australian history and gain an understanding of the loss of their land, family members and that massacres had occurred. 

Just to share one experience that highlights my response to this “wound” in the context of working with others - There was a tragedy involving one of our patients who was being treated for heroin addiction, under the acre of one of my colleagues, though I had also seen her when her doctor was unavailable. Her 13 year old son was killed with 3 others in a car crash. She was devastated by his death and became quite chaotic in her distress with psychotic symptoms. This woman also attended the Victorian Aboriginal Health Service (VAHS) for general medical and psychiatric care (an Aboriginal Community Controlled Organisation). 

One busy Friday afternoon, the aboriginal liaison officer (ALO) emailed me mid-way through the clinic to ask whether I would be able to see this patient at home. I only noticed the email in between seeing patients and initially thought not to reply since I wouldn’t be able to do anything till I had finished.  However, I decided to overcome myself and replied telling her that I couldn’t go to see the patient till later that evening after the clinic finished. She was happy with my response. 

To coordinate this patient’s care and to provide support for the Aboriginal Liaison Office our chief executive officer convened a multidisciplinary group meeting of health care providers including a team leader and manager plus myself to consider questions about her care and support while also supporting the aboriginal liaison officer.

I was able to speak directly to her doctor at the Aborigonal health Centre within professional confidentiality about care and her psychiatric assessment. At the end of our conversation, the doctor commented that it was important to have open communication between our two organizations about shared patients as in this case.  The information also helped guide us in the services we could provide for this patient.  I saw her recently, her psychotic symptoms have settled. She is much more at peace and very happy to be living in a house close to the cemetery where her son is buried.

I often take the step to ring different health care providers about different patients, especially those with complex psycho-social issues on top of their medical issues. I find speaking directly to health professionals creates clarity about the care of the patient and builds a closer working relationship amongst us. Even working within an organisation that values multidisciplinary care there are “silos” and discriminatory attitudes to overcome which have been recognized by management and cultural awareness training has been provided to help address this, resulting in a better service to those who are disadvantaged. 

By building closer working relationships, not only is patient care improved, but we can also support one another in coping with tragic situations. The points of the art of loving help me to help each person, making myself one – “yarning” with them and going the extra mile in stretching appointment times. 

Building up relationships of trust through giving such attention and time to their needs is vital for continuity of care, in that these patients in turn.

 

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