Cultural Orientation Handbook Funded by the Australian Government Photographs used in this handbook were taken in the Northern Territory communities of Ampilatwatja, Ti Tree, Imanpa and Galiwin’ku. Permission was sought from these communities and from all individuals or guardians of individuals, before photography commenced. All photographs are copyright of the Remote Area Health Corps. © Copyright - Remote Area Health Corps, RAHC, 2013 Contents Welcome ..........................................4 Working within the Dying, death and kinship network ...........................27 sorry business .............................. 35 Introduction to this handbook ........................................5 The kinship network Dying Roles and responsibilities Death Your first days .................................7 Avoidance and Poison relationships Sorry business Permits Where do you fit in? Other cultural considerations Forbidden areas and sacred sites When offered a skin name relating to treatment ................ 39 Alcohol Working with the right members Blame and payback Introductions of the kinship network Curses Adjusting to your role Reciprocity — sharing Traditional healers Working with Elders Working within the Use of ochre Aboriginal community ..............11 Birth and childhood .................. 33 Treatment arising from The Aboriginal community Birth ceremonial activity Factionalism and politics Childhood Hair and clothing Engaging with the community Men’s and Women’s business Personal presentation Treatment compliance ............. 43 and conduct ..................................17 Medication Attitude Informed consent Conduct Travel for treatment Safety References ................................... 45 What to wear What to take with you Useful resources ........................ 46 Greeting and addressing people Communication Where can I walk? Buying artwork Taking photographs Remote Area Health Corps | Cultural Orientation Handbook | 3 Welcome to the Remote Area Health Corps (RAHC) Thank you for your interest and willingness to experience the rewards and challenges of working in remote communities. The opportunity to provide service, work with teams of dedicated health professionals and contribute to improving health outcomes for Aboriginal Australians should be fulfilling and beneficial to you and the community you will work with. At RAHC we recognise that for this to happen we must provide information and training that will prepare you for the unique challenges and opportunities that lie ahead and importantly, for achieving a successful placement as a health professional. This RAHC Cultural Orientation Handbook is the first part of the training and orientation program you will undertake. It aims to provide an introduction to working with and living in remote Aboriginal communities and to the cultural issues you will need to be aware of in providing health services. Critical issues such as the role of the Aboriginal Health Practitioner and working among kinship networks are discussed in order to help you work effectively and safely as a health professional. However, we must also emphasise that it is impossible to cover these and similar issues completely and you should always be open and alert to the situations that are unique to the community you are working in. We recommend you regularly seek the advice of colleagues including Aboriginal Health Practitioners and your Health Centre Manager. RAHC would like to acknowledge and express gratitude to the Aboriginal people of the Northern Territory, who have so generously shared aspects of their culture and great wisdom for use in this handbook and in other RAHC training materials. The first versions of this handbook were prepared for RAHC by The Echidna Group and we acknowledge and thank Dr Terri Farrelly and Ms Bronwyn Lumby for their contribution. RAHC also acknowledges the contribution of Mr Don Christophersen whose local knowledge and years of experience in working on cultural orientation have enriched the handbook. For later editions we have drawn upon feedback and suggestions from staff of the Aboriginal Medical Services Alliance Northern Territory (AMSANT) and Katherine West Health Board. As you read and work with this handbook, go on to participate in other RAHC training programs and most importantly, experience work and life in remote communities, we encourage you to provide feedback and advice on how we can continue to develop and strengthen our orientation and training programs. We look forward to hearing from you and wish you the best in your RAHC experience. Philip Roberts General Manager 4 | Remote Area Health Corps | Cultural Orientation Handbook Introduction to this handbook The information has been compiled • Franks C. and Curr B. (1996), This handbook provides through a review of available literature Keeping company — an intercultural and consultations with members of conversation, Wollongong, NSW: you with information Aboriginal communities in the Northern University of Wollongong. specific to working Territory. Two existing texts were of Both these texts are now available in particular use: revised editions — details are provided at within an Aboriginal • Eckermann A., Dowd T., Martin the end of this handbook. community such as M., Nixon L., Gray R. and Chong E. (1992), Binan Goonj: bridging cultures personal conduct, in Aboriginal health. Armidale, NSW: appropriate methods University of New England Press. of communication and cultural factors you need to consider when providing healthcare. Remote Area Health Corps | Cultural Orientation Handbook | 5 Remember: there are no hard and fast rules. Every cultural group and community is different. Your first days The key to being culturally competent and being able to deliver a culturally Forbidden areas and Alcohol appropriate health service in Aboriginal sacred sites Many Aboriginal communities and bush communities, is to: camps are dry — alcohol is prohibited. The very first thing you should do on • be respectful These laws are typically enforced strictly. arrival is determine where you can and • be observant and willing to learn cannot go in the community or bush camp Some communities may have a permit system where residents can apply to • ask for advice. area — don’t wander about until this has been confirmed, because there may be have a nominated amount of alcohol numerous forbidden areas or sacred sites with them in the community area. Other Even other Aboriginal people who travel in and around the community or camp. communities may have restrictions on to different regions have to be aware of availability of takeaway alcohol from clubs These forbidden areas are vital spiritual the cultural protocols that apply to the and pubs. particular community they are in. and cultural places which link Aboriginal people to their cultural traditions and It is strongly recommended that you Your first days within an Aboriginal the land. They may be places linked to do not bring alcohol with you into the community as a health professional are ceremonial activity, such as men’s and community to ensure you do not breach important, as this is where first impressions women’s business, or to spiritual beliefs. any laws that may be in place. Once you are made. These first impressions can They may or may not be sign-posted. have arrived and are familiar with the determine both your satisfaction in particular restrictions applicable in that Accidentally or intentionally entering your role and placement, as well as the area you can then act accordingly. satisfaction of the communities and camps such areas will offend Aboriginal people you are working with and ultimately in the area and may even result in your impact on their health outcomes. immediate removal from the community or camp. Even other Aboriginal Please respect the wishes of the Permits traditional owners by avoiding and people who travel to respecting these areas. If you want to visit or work on Aboriginal different regions have land in the Northern Territory, you must To learn more about sacred sites, go by law have a permit to do so. to the Northern Territory Aboriginal to be aware of the Areas Protection Authority website at You should already have a permit www.aapant.org.au. cultural protocols. organised for you by the health service where you will be working, however it is important that you understand it is likely this permit will only allow you to be in a specific area. It is also important to note that it is likely your permit won’t allow you to fish or camp at any time during the job — this will require additional permits. If you wish to venture to other areas, you will need to apply for additional permits via the relevant NT Aboriginal Land Council. Remote Area Health Corps | Cultural Orientation Handbook | 7 Introductions Adjusting to your role As a health professional, it’s vital that You must at all times remember that you spend your first few days being you are there to do a particular job. You introduced to members of the community must also be aware of your position as and, where appropriate, bush camps. a newcomer to the community. You This includes being introduced to the may encounter situations where you Board of Directors of the health service wish to intervene, change or control (where applicable) and other Aboriginal matters, or take particular actions as you organisations in the area. would normally do in non-Aboriginal Sometimes if Aboriginal people have environments. It is important that you not been introduced to new health step