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A Review of 'Traditional' Aboriginal Health Beliefs Aust. J. Rural Health (1999) 7, 229–236 Original Article A REVIEW OF ‘TRADITIONAL’ ABORIGINAL HEALTH BELIEFS Patrick Maher Northern Rehabilitation Network, Royal Darwin Hospital, Casuarina, Northern Territory, Australia ABSTRACT: Western health professionals often experience difficulties in service delivery to Aboriginal people because of the disparity between Aboriginal and Western health belief systems. This article reviews the literature which considers ‘traditional’ Aboriginal health beliefs and medical systems. The traditional Aboriginal model of illness causation emphasises social and spiritual dysfunction as a cause of illness. Supernatural intervention is regarded as the main cause of serious illness. There are gender divisions in Aboriginal society that impact on the delivery of Western healthcare. Management strategies such as preventative care, bush medicine, and the role of traditional healers are discussed. These belief systems are considered with particular reference to their interactions and implications with regard to the Western medical system. This information provides a framework to allow improved understanding by health professionals of the health-related decisions made by Aboriginal people. KEY WORDS: Aboriginal health, health beliefs, traditional medicine. INTRODUCTION The ‘traditional’ beliefs of Aboriginal people have adapted to the changing circumstances in which they live. Health professionals often experience difficulties with While Aboriginal viewpoints of treatment have changed providing care to Aboriginal people because of the cul- over this time, there has been less change in beliefs tural distance between mainstream culture and Aboriginal regarding the cause of illness.2 This may be because the culture, particularly in regard to health belief systems. health beliefs continue to play a role in providing meaning The disparity between Aboriginal culture and mainstream to events and thereby helping people to cope with serious Western culture appears to magnify the difficulties illness and death.2 encountered in any cross-cultural health service delivery This review will consider many of the aspects of tradi- setting. tional health beliefs and practices of Australian Aborig- In the 200 years since colonisation, the lifestyles of ines reported in the literature with a view to aiding Australian Aborigines have undergone significant change. understanding by health professionals of their present Despite the immense changes and stress forced upon attitudes and behaviours in regard to health care. The vast Aboriginal people, they have been very successful in majority of the literature considers the health beliefs of maintaining much of their culture despite periods of cul- tural suppression. In particular reference to health care, it Aboriginal people from rural and remote regions rather is evident that Aboriginal people have passively resisted than metropolitan locations. It is likely, therefore, that the many Western beliefs and practices.1 information presented will have more relevance to health professionals working with Aboriginal people in rural and remote regions. The Aboriginal model of illness causation, Correspondence: Patrick Maher, Northern Rehabilitation Net- including supernatural intervention and treatment work, Royal Darwin Hospital, PO Box 41326, Casuarina, NT methods, and the interaction and dissonance of the 0811, Australia. Email: [email protected] health-related beliefs of Aboriginal people and Western Accepted for publication June 1999. health professionals will be discussed. 230 AUSTRALIAN JOURNAL OF RURAL HEALTH TRADITIONAL ABORIGINAL HEALTH Rather, it provides an overview with specific examples of BELIEFS the way Aboriginal people have categorised illness (natural, environmental, direct supernatural, indirect There is a variety of health-related beliefs held by supernatural and emergent or Western causes). It is Aboriginal people throughout Australia and the material important to recognise that these categories are not mutu- presented is a representative sample which highlights the ally exclusive, indeed there may be beliefs relating a differences between Western and Aboriginal health- single clinical entity to multiple possible causes.13 related beliefs. It is based on literature describing the An alternate model divides people into four broad cat- ‘traditional’ culture of Aboriginal people from a variety of egories in regard to their health: (i) the strong — normal locations across Australia. There is a lack of material condition, able to cope mentally and physically with daily which describes the health beliefs of Aboriginal people tasks; (ii) the weak — minor illness that requires rest and living in urban settings. For these reasons this paper pro- specific treatment for condition (e.g. headaches, tooth- vides information about the foundation on which present aches, etc.); (iii) the wounded — have cuts, bruises and beliefs have (or have not) been incorporated. There is lim- wounds from fights or accidents; and (iv) the sick — spiri- ited information regarding the specific health beliefs of tual and supernatural influences cause illness that does Aboriginal people today or of the variety of health beliefs not resolve without assistance.21 within the general Aboriginal population. Both models regard supernatural intervention as the There is a danger of generalising from the anthro- main cause of serious illness. The belief in causation is pological literature and applying this information to divided into ultimate causes (e.g. breach of a taboo) and specific individuals or communities. The literature may be proximate causes (e.g. motor vehicle accident) of illness, based on a different group of Aboriginal people and even injury or death.2,4,22 within a specific group culture there will be different These models provide a basis for the understanding of levels of belief expressed by individuals.2 The cultural specific Aboriginal health beliefs and the differences diversity, particularly in regard to health beliefs, between between Aboriginal and Western models of health. Under- Aboriginal groups and communities has been acknowl- standing of the traditional Aboriginal models of illness edged by many.3,4 The information presented, however, causation will assist in clinical interactions by Western provides a framework which should allow improved health professionals. understanding by health professionals of the health- related decisions made by Aboriginal people. Supernatural intervention Sorcery and supernatural intervention are part of the per- Aboriginal model of causation ceived reality of Aboriginal life,11 and in Aboriginal soci- The traditional health beliefs of Aboriginal people are ety explanations in terms of sorcery are often used. The interconnected with many aspects of Aboriginal life such deaths of infants or the very old or chronically ill are con- as the land, kinship obligations, and religon.5 The sidered to be in the normal course of events, while deaths sociomedical system of health beliefs held by Aboriginal outside these groups may have a supernatural influence, people places emphasis on social and spiritual dysfunc- especially if they are regarded as premature, unexpected tion causing illness. This approach emphasises that ‘indi- and sudden.23 It is important to note that the belief in vidual wellbeing is always contingent upon the effective supernatural causes of illness may not be restricted to discharge of obligations to society and the land itself’ Aboriginal communities in rural and remote regions.24 (p.598).6 A person’s social responsibilities and obligations There are many beliefs associated with supernatural may take precedence over their own health because of the interventions and sorcery: sorcery exists in many forms, priority given social relationships in this model. its effect is to manipulate and alter behaviour and cause Many of the Aboriginal medical belief systems morbidity and mortality; sorcerers can be specialists or described in the literature have similarities despite being non-specialists; distant groups have the most virulent sor- from different parts of the country.2,4,5,7–11 The integration cery and are the most feared; many diseases come from of information from multiple sources can be compiled dangerous, secret sacred sites — they are manifestations within the framework used by Mobbs (see Table 1).12 of the forces or power emanating from those sites; This framework is not meant to represent any defini- unskilled or uninitiated people may release forces from a tive picture of beliefs in any particular Aboriginal com- dangerous site, by disturbing the site; sorcery is carried munity as there will be variation between and within out in secrecy; retribution sorcery is directed serially at communities, and these categories will shift with time. members of a family or lineage therefore the serious ill- ‘TRADITIONAL’ ABORIGINAL HEALTH BELIEFS: P. MAHER 231 TABLE 1: Framework outlining ‘traditional’ Aboriginal health beliefs Categories of illness Causes of illness Examples of resultant conditions causation Natural Emotions (resentment, sulking, shame, Loss of appetite, weight loss, listlessness, (part of everyday life, worry, homesickness, grief, jealousy, pain, suicide or attempted suicide generally result in temporary anger, anxiety) Diarrhoea, coughs and lung complaints, headaches states of weakness) Dietary factors Physical injuries Physical assault and injury Environmental Winds Pain, stomach ache, diarrhoea, chills The moon
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