Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander Peoples’ Cultures and Their Links to Health and Wellbeing

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Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing

A literature review

Prepared by Minette Salmon, Kate Doery, Phyll Dance, Jan Chapman, Ruth Gilbert, Rob Williams and Ray Lovett. For Mayi Kuwayu and The Lowitja Institute ABOUT THE ARTWORK

Artist: Krystal Hurst, 2017

Mayi Kuwayu – The Journey

This artwork shows the importance of culture as central to Aboriginal and Torres Strait Islander peoples’ health and wellbeing. The colours red, yellow, black, green, blue and white are drawn from the Aboriginal and Torres Strait Islander flags, and their communities.

The blue represents water and its healing powers to nourish the mind, body, spirit and our lands, symbolic of the interrelationship our people have with Country.

Red, white and yellow ochre are used to illustrate the importance of ceremony, dance, stories and spirituality within our diverse cultures, and the strong connection with the land.

The centre represents the sun radiating warmth, positivity and connectedness. The pathways and meeting places speak of the long journey that the Mayi Kuwayu Study and our mob will embark on together to yarn, make decisions and create a meaningful and positive future. Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing

A literature review

Prepared by Minette Salmon, Kate Doery, Phyll Dance, Jan Chapman, Ruth Gilbert, Rob Williams and Ray Lovett.

For Mayi Kuwayu and The Lowitja Institute © Mayi Kuwayu & The Lowitja Institute 2019

Second edition published September 2019

ISBN: 978-1-921889-61-5

First edition published in 2018 by the National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, ACT, Australia. Available at: https://openresearch-repository.anu.edu.au/handle/1885/148406?mode=full This paper forms part of the Mayi Kuwayu Study development. The Mayi Kuwayu Study is a national Aboriginal and Torres Strait Islander wellbeing study initiated in response to a research roundtable hosted by the Lowitja Institute in 2014. The development of Mayi Kuwayu is funded by the Lowitja Institute (Research Activity 1344) and hosted at The Australian National University. The findings and views we report are the authors’ and should not be attributed to the Lowitja Institute or the ANU. This edition is published and disseminated as part of the activities of the Lowitja Institute, Australia’s national institute for Aboriginal and Torres Strait Islander health research, incorporating the Lowitja Institute Aboriginal and Torres Strait Islander Health CRC (Lowitja Institute CRC), a collaborative partnership funded by the Cooperative Research Centre Program of the Australian Government Department of Industry, Innovation and Science. This work is copyright. It may be reproduced in whole or in part for study or training purposes, or by Aboriginal and Torres Strait Islander community organisations subject to an acknowledgment of the source and no commercial use or sale. Reproduction for other purposes or by other organisations requires the written permission of the copyright holder. Both a PDF version and printed copies of this report may be obtained from: www.lowitja.org.au

The Lowitja Institute National Centre for Epidemiology and Population Health PO Box 650 Research School of Population Health ANU College of Health and Medicine Carlton South VIC 3053 The Australian National University Australia Florey Building, 54 Mills Road t: +61 3 8341 5555 ACTON, ACT 2601 f: +61 3 8341 5599 e: [email protected] e: [email protected] w: mkstudy.com.au w: www.lowitja.org.au

For citation: Salmon, M., Doery, K., Dance, P., Chapman, J., Gilbert, R., Williams, R. & Lovett, R. 2019, Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander Peoples’ Cultures and Their Links to Health and Wellbeing, Aboriginal and Torres Strait Islander Health Team, Research School of Population Health, The Australian National University, Canberra. Keywords: Aboriginal, Torres Strait Islander, culture, cultural determinants, health, wellbeing Corresponding Author: [email protected] Terminology: For the purposes of this paper, ‘Indigenous’ is the preferred term and ‘indigenous’ has only been utilised when used in a quotation. Spelling: While there may be different spellings for some of the Aboriginal words used, we have used the spelling of authors cited. Managing Editor: Cristina Lochert Editor: Cathy Edmonds Design and Layout: Hyve Creative

ii Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing iii Contents

Acknowledgments...... iv Abbreviations...... iv Preface...... v Introduction...... 1 Indigenous concepts of health and wellbeing...... 1 Review objectives...... 2 Methods...... 3 Information sources...... 3 Eligibility criteria...... 3 Search strategy...... 3 Search metrics...... 4 Results...... 5 Connection to Country...... 5 Spiritual connection...... 5 Health and traditional foods...... 6 Living on Country...... 6 Land rights and autonomy...... 8 Caring for Country...... 9 Impacts of tourism...... 11 Indigenous beliefs and knowledge...... 12 Spiritual and religious beliefs...... 12 Traditional knowledge...... 14 Traditional healing...... 14 Knowledge transmission and continuity...... 16 Indigenous language...... 18 Impacts of language on health...... 19 Language revitalisation...... 20 Indigenous language education...... 20 Family, kinship and community...... 21 Family and kinship...... 21 Community...... 22 Sport...... 23 Social determinants of health...... 24 Cultural expression and continuity...... 24 Identity...... 25 Cultural practices...... 26 Arts and music...... 26 Self-determination and leadership...... 27 Cultural safety...... 28 Self-determination and wellbeing...... 29 Leadership...... 29 Summary of cultural indicators...... 31 Conclusion...... 32 References...... 33

We acknowledge the traditional owners from all the lands of Aboriginal and Torres Strait Islander peoples. We pay our respects to the children, their families and their Elders past, present and future.

Minette Salmon (Yuin people), Jan Chapman (Taungurong people), Ruth Gilbert (Wiradjuri people), Rob Williams (Ngunnawal people) and Ray Lovett (Wongaibon and Ngiyampaa people) are Indigenous researchers (along with Kate Doery and Phyll Dance) at the National Centre for Epidemiology and Population Health at The Australian National University (ANU) on Ngunnawal Country (Canberra).

We are very grateful to Songhuizi Peng and Lachlan Russell from the National Centre for Epidemiology and Population Health at the ANU for their expert and cheerful support. Finally, we offer our sincere thanks to the referees whose comments have strengthened this review.

Abbreviations

ATSIHF Aboriginal and Torres Strait Islander Healing Foundation

ILM Indigenous Land Management

IPA Indigenous Protected Area

WHO World Health Organization

In recent years, interest in understanding the relationship between Aboriginal and Torres Strait Islander peoples’ cultures and how culture relates to health and wellbeing has been growing. The first step in understanding this relationship is to identify what is described in the literature as ‘culture’ and then to describe how the literature reports the relationship between culture and health and wellbeing.

Some people argue that culture is not definable or that it is intangible. However, all people are born into and grow, work and live within a culture or cultures. Cultures are maintained or modified when they are passed on and are reinforced and practised in both specific and general situations. The many definitions encompass culture- specific knowledge, attitudes, beliefs and behaviours (including within cultural variations according to rules), and all human life is culturally bound.

Much work in epidemiology and public health focuses on the presence (or absence) of disease and not on the culture within which illness and wellbeing manifest. We need to understand both wellbeing and culture to have effective public health. This work stems from the desire of many Aboriginal and Torres Strait Islander people to achieve that understanding in order to improve our health. Culture (the maintenance, revitalising, embracing, nurturing and growth of it) is important to our happiness and wellbeing and for improving health outcomes.

This review provides insights into what Indigenous peoples across the world describe as culture. However, much more knowledge is likely to be held by cultural leaders and others who have not engaged in what is often non- Indigenous-led research. This also means that what is described as culture is largely viewed through the lens of people from non-Indigenous cultures. The content of this review is not intended to be a tool to measure indigeneity or cultural proficiency for individuals or groups and should not be read or interpreted as such.

The Lowitja Institute Aboriginal and Torres Strait Islander Health CRC funded this review under project 16- SDH-0503. Our aims were to identify from the literature the broad domains (and additional sub-domains) of Indigenous peoples’ cultures and describe how these relate to health and, more broadly, wellbeing.

We mainly restricted our review to literature published between 1990 and 2017 and used an iterative search process that initially returned many thousands of results from five online databases and through hand searching. We included grey literature to ensure as much material as possible was included.

We identified six broad, frequently cited cultural domains or themes, each with a number of sub-domains (see ‘Summary of cultural indicators’ at the end of Chapter 3). The broad domains were:

• Connection to Country • Indigenous beliefs and knowledge • Indigenous language • Family, kinship and community • Cultural expression and continuity • Self-determination and leadership. This revised edition of the literature review has been published by the Lowitja Institute as part of the project completion process.

iv Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing v vi Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 1 Introduction

In Australia, limited data and 500 dialects and ‘Groups had establish or define the their own distinct history and culture’ (Dudgeon et al. 2014:4 Our aim was to help relationship between health, synthesising several sources). us understand the wellbeing and culture and the Both groups share similarities as mechanisms through which well as great diversity within and cultural factors that Aboriginal and Torres Strait between groups. These similarities are important to and differences—including strong Islander cultural determinants spiritual beliefs that connect Aboriginal and Torres impact health and wellbeing. people to their land and sea, that Strait Islander peoples There is increasing attention are rich in songs and storytelling, and how these factors on the relationship between art, a multiplicity of languages and a collective identity (ABS 1994; relate to health and culture, health and wellbeing Elkin 1979)—encompass origin, in this population. We culture and language, as well as wellbeing. conducted this literature individual distresses originating review as preliminary work for from colonisation. the Mayi Kuwayu Study—Mayi Our aim was not to be prescriptive Kuwayu broadly means “to in defining culture but to let the whole of life view and it literature define those cultural follow Aboriginal people over also includes the cyclical elements considered important a long time” in Ngiyampaa and distinct for Indigenous peoples. concept of life-death-life. language (language of the Broadly, culture—in the sociological Wongaibon people of New context—is the ideas and self- Aboriginal and Torres Strait Islander concepts of health are conceived South Wales, Australia)’ (Jones concepts (for example, artefacts, attitudes, beliefs, customs, norms, of as holistic, encompassing et al. 2018:2). symbols and values) of a group. mental, physical, cultural and spiritual health, and land is Our aim was to help us understand It includes historical events and standards of behaviour that evolve central to wellbeing. This holistic the cultural factors that are concept does not merely refer to important to Aboriginal and Torres and change over time (Berndt & Berndt 1952:39). the ‘whole body’ but is steeped Strait Islander peoples and how in the harmonised interrelations these factors relate to health that constitute cultural wellbeing, and wellbeing. We examined the Indigenous concepts of including spiritual, environmental, Australian literature, as well as ideological, political, social, literature from countries that have health and wellbeing economic, mental and physical experienced colonisation events In 1989 the National Aboriginal factors (e.g. Swan & Raphael 1995; similar to those of Australia— ATSIHF Development Team 2009). primarily Aotearoa (New Zealand), Health Strategy Working Party Canada and the United States. (1989:x) provided the following Throughout Australia, the definition of ‘health’: Aboriginal outlook on life and Australia’s Indigenous peoples the universe is formed through a ‘Health’ is not just the comprise two similar but distinct distinctive and subtle conception traditional cultural groups— physical wellbeing of the known in English as the Dreaming. Aboriginal and Torres Strait Islander individual but the social, In keeping with the many language peoples. For example, at the time emotional and cultural groups, there are many different of colonisation in 1788, there were wellbeing of the whole approximately 260 language groups community. This is a

vi Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 1 Aboriginal names for the Dreaming. strong and healthy person. and empowerment as important For example, Dreaming is known One of the main teachings components of wellbeing, with by the Pintupi people of Western of the medicine wheel is health and happiness as essential Australia as ‘tjukurrpa’ (Myers components (Nettleton & Stephens that balance between all 1991:47) and as ‘Alcheringa’ by the 2003). ‘Health’ within the Indigenous Arrernte people of Central Australia four elements is essential context is defined differently to the (Nicholls 2014). As described by for maintaining and non-Indigenous context, so illness Andrew Peters (2017:31), a Yorta supporting good health. may also be interpreted differently. and Taungurong man: (Wilson 2003:87) For example, most cultures recognise mental illness such as ‘distressed The concept of Dreaming Likewise, for the northern Woodland and disturbed behaviours’. However, is a complex yet vitally Cree, the term ‘Mitho-pimatisiwin’ the underlying cause is likely to important feature of means ‘the good life’—a holistic be interpreted differently (Swan & Aboriginal people and view that sees all things as Raphael 1995). Thus Indigenous peoples’ ideas of sickness or illness culture… To attempt interconnected, in which health is seen as a balance between the tend to refer to an absence of to phrase it in terms of physical, mental, emotional and wellbeing or an imbalance (King, Western understanding, spiritual aspects of a person’s Smith & Gracey 2009). it is the foundation of survival and wellbeing (Beatty & Aboriginal education, Weber-Beeds 2013). religion, laws and Review objectives Connections, relations and family behaviour. (as in the Māori concept of Whānau, We aimed to identify from the or extended family) are among literature frequently described In Canada, the Anishinabek the many essential components of cultural factors seen as enabling (Ojibway) term ‘mno bmaadis’ wellbeing. Māori perspectives of or related to producing good translates to: health take ‘a holistic interpretation; health and wellbeing. We also good health is seen as a balance aimed to contribute to Indigenous ‘living the good life’ [which] between mental (hinengaro), knowledges and Indigenous encapsulates beliefs in the physical (tinana), family/social knowledge penetration of the importance of balance. (whänau), and spiritual (wairau) Western epistemological frames The concept of health or dimensions’ (Durie 2004:1141), of health and culture literature. living the good life is a with all four regraded as essential With these aims, we conducted an iterative review of domestic and complex notion and its components. international Indigenous health and basic tenets are explained Contrasting with First Nations’ wellbeing literature. Although each through the medicine definitions, in 1948 the World Health cultural determinant we identified wheel… According to Organization (WHO) defined health warrants its own investigation, an beliefs, all four elements as ‘a state of complete physical, exploration of the significance of of life, the physical, mental and social wellbeing and each cultural factor’s relationship not merely the absence of disease with health and wellbeing is beyond emotional, mental and or infirmity’ (WHO 1948). This the scope of this paper. Our purpose spiritual, are represented in definition is still current (WHO 2014). is not to discuss the effects of the four directions [north, Indigenous health and wellbeing culture on wellbeing but, instead, to south, east and west] expand on the WHO definition as identify the cultural determinants of the medicine wheel. communities identify additional that appear in the literature and These four elements are components. These include to let the literature describe the family connections, community association. intricately woven together relations, peace, spirituality, and interact to support a environment factors, autonomy

The importance of the Information sources Search strategy literature review includes We conducted the review by Based on previous knowledge making sure that ‘you know searching five large online and initial investigations, a list enough about your topic international databases and relevant of preliminary search terms was that you can ask important smaller subject or organisation- developed. To best realise cultural questions and then make specific databases (detailed below). factors and cultural determinants A manual search of reference of Indigenous health and wellbeing, solid decisions about how you lists from key references was also targeted search strings using might answer them’ (Leedy conducted to identify additional these terms were searched online & Ormrod 2015:66). We relevant literature. in academic databases and peer- searched for literature that reviewed journals. These search strings used a combination of terms specifically discussed cultural Eligibility criteria beginning with the core search determinants of Indigenous term (for example, Aboriginal or health and wellbeing. Both published and unpublished Indigenous or First Nations, or Koori, (grey) English language literature or Murri, or Māori) followed by an Our review was undertaken at and studies were included, spanning operator (for example, AND, OR) the international level but covers almost three decades of research, and ancillary terms such as culture, literature primarily written about from 1990 to 2017. Criteria used to language or spirituality, and health Indigenous peoples from Aotearoa assess the relevance of sources for or wellbeing. When additional key (New Zealand), Australia, Canada inclusion or exclusion are indicated terms emerged during the initial and the United States. We are below. review of articles, we added them to grateful to a reviewer who, in this the search strings. context, directed us to Osumare’s Inclusion criteria: First search string: (2001:172) concept of ‘connective • published material including marginalities’, which are: peer-reviewed journal articles, • (Aborigin* OR Indigenous OR social resonances between reports and reviews Torres Strait Islander OR Koori OR Murri) AND (Culture OR Law OR black expressive culture • material published between 1 January 1990 and 31 July 2017 Country OR Community OR Elders within its contextual OR Spirituality OR Language) political history and similar • contained information relevant AND (Health and Wellbeing) to Indigenous cultural factors dynamics in other nations. Second search string: Connections or resonances and health and wellbeing can [include] the form of • contained empirical (primary • (First Nation OR Native OR culture itself… class [or] or secondary) or theoretical Inuit OR Māori OR Metis) AND (Culture OR Law OR Country historical oppression. evidence related to the topic OR Community OR Elders OR • full text available. Spirituality OR Language) AND (Health and Wellbeing) Exclusion criteria: Given the broad nature of the • conference presentations search terms used, the initial search • newspaper, magazine and returned tens of thousands of results editorial articles across the five online databases. Even after refining the terms and • opinion pieces search strings, the amount of • full text unavailable. peer-reviewed and full-text articles

2 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 3 numbered in the tens of thousands. additional relevant literature when • Indigenous language (48) Due to the number of articles, the examining the entire contents of • Family, kinship and community results from each database were an article or identifying relevant (60) screened manually until saturation literature by checking the reference was met (that is, where the lists. All resources were individually • Cultural expression and reoccurrence of article duplicates assessed for relevance, and 284 continuity (63) and relevant articles was no longer resources (some cross multiple • Self-determination and being identified). themes/domains and are counted leadership (76). in each theme) were included in the review. Although we focused our search on Search metrics literature published between 1990 Resources resulting from the and 2017, we occasionally refer to The first stage of screening database search were then grouped other publications. This is either identified 62,421 resources across by theme: because they are seminal works, or all databases. Snowballing and because we were following up on • Connection to Country (68) manual searching based only on key secondary sources then including references was also undertaken and • Indigenous beliefs and primary sources. returned a further 280 results. This knowledge (73) primarily involved either identifying

Figure 1 Review article inclusions

Resources identified: Resources identified: online databases and journal searches reference lists and manual searches (n = 62,421) (n = 280)

Resources after heading and Resources excluded abstract screening (n = 62,701) (n = 62,298)

Full-text resources reviewed Resources excluded for relevance (n = 403) (n = 163)

Studies included in the review (n = 284)

In this chapter we discuss the 252 identified resources—grouped by domains and sub-domains—that explore cultural factors that are important to Aboriginal and Torres Strait Islander people in relation to health and wellbeing.

Spiritual connection physical knowledge of Country and of spiritual and cultural beliefs For Aboriginal and Torres Strait associated with Country. Islander peoples, the land is conceptualised as a mother and a Connection to Country refers to source of identity and spirituality, emotions, culture and spirituality Connection with identity, cultural practices, where Aboriginal and Torres Strait systems of authority and social Islander peoples have positive to Country control, traditions and concepts connections, such as the ability of spirituality all being tied to the to ‘get answers from nature’ and Country is an important connection land (Ganesharajah 2009). An have a ‘sense of welcome’, as told to for Aboriginal and Torres Strait important part of Pintupi social life, Kingsley and colleagues (2009:295). Islander peoples. It brings an which is linked to ‘tjukurrpa’ (the There may also be other intuitive identity, a sense of belonging and Dreaming) is ngurra, which refers feelings such as a ‘warning not to be a place of nurturing qualities, to camp, Country or place (Myers there’ or ‘sadness’ when referring to which, along with cultural activities 1991). Connection to Country burial sites, damaged sacred places, conducted on Country, provide involves a person’s spirit, which and men’s and women’s sites. This empowerment (Trzepacz, Guerin & comes from Country, becoming encompasses connection to an Thomas 2014; Ganesharajah 2009). the central identity of that person individual’s ancestry, pulling people For Aboriginal and Torres Strait and, as they grow, the protector and back to land and giving a sense Islander peoples, the connection/ guardian of his or her Country. When of belonging, identity and pride, disconnection with their lands has a person passes, the spirit returns which empowers and promotes historically resulted in a number of to its Dreaming place to become a health (Kingsley et al. 2009:295). determinants of ill health, including: child spirit again, awaiting another Connection to Country is critical to spiritual rebirth, thus connecting the wellbeing of Aboriginal children. • destruction of traditional Country with people, their Dreaming Although many urban Aboriginal economies through place, language, kinship systems, people are not physically located dispossession and law and culture (Dwyer 2012). on their Country, they are able to • undermining of identity, maintain a sense of connection spirituality, language and culture Following their investigation of through teaching children about the through establishing missions Victorian Aboriginal peoples’ ‘geographical boundaries of their and residential schools connection to Country, Kingsley and Country, visiting Country, telling colleagues reported that there was a stories about experience of previous • destruction of traditional forms connection to the natural world that generations, and teaching children of governance, community ‘goes beyond words and is steeped about significant places or plants organisation and cohesion in spiritual orientation to that for medicine and tools’ (Priest et al. through imposition of Western locality’ (Kingsley et al. 2013:689). 2012:186). government Research by Trzepacz, Guerin and • the breakdown of traditional Thomas (2014) among the Nukunu Connection to Country is also an patterns of individual, family and people (from the coastal region of important aspect of the culture community life. South Australia) revealed a holistic of Inuit and First Nations people attachment to the land that involved from northern Labrador in Canada.

4 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 5 Recurring themes when Inuit spoke Western Australia) who had chronic protocol could—indeed to Durkalec and colleagues (2015) diabetes returned to their lands should—be translated into about being on land were ‘freedom’ and traditional practices of hunting the research context that (for example, pp. 21, 23), a place and gathering, they experience focused on the sharing they ‘love’ (p. 21) and a place they health improvements. F. H. Johnston ‘live for’ (p. 23). ‘[Just] being on the and colleagues (2007) conducted and consumption of food land is healthy’, while ‘going off on research in the coastal Aboriginal in order for us to build the sea ice is ‘medicine’, a ‘better way of community of Maningrida. They foundations of a trusting living’, and something that is ‘good’ reported that the people they working relationship. for them’ (p. 23). These comments interviewed were very well aware of demonstrate that just being on their how much healthier traditional foods Following their research with land or ice is integral to the health were than Western foods. They cite Torres Strait Islander people on the and wellbeing of Inuit (Durkalec et al. ‘one woman with diabetes who liked sociocultural benefits and costs 2015). being in the bush because she was of traditional hunting of dugong, “away from Balanda [white people] Delisle and colleagues (2018:256) Research examining how connection food, lot of sugar”’ (Johnston et al. reported that the ‘Individual benefits to Country relates to Western 2007:494). They also found wider encapsulated health benefits but concepts of health (often expressed health benefits, since people always also acknowledged that hunting as rates of physical and mental saved some food to fulfil wider gives men an opportunity to illnesses) has identified several major cultural obligations of sharing bush demonstrate their skills which is and often overlapping themes. These food with relatives and owners of the important to their sense of identity’. include the stresses and constraints land where it came from. Materials of living in large settlements and for arts and crafts were also often being torn between the demands of collected, ‘most of which will enter Living on Country urbanised and traditional lifestyles, the cash economy via the Aboriginal Being born on Country connects an and how these tensions may affect a art market’ (Johnston et al. 2007: Aboriginal or Torres Strait Islander person’s sense of wellbeing. Nukunu 494–5). person to the land and community in people reported to Trzepacz, Guerin a deeply cultural way. This has been and Thomas (2014) that it was This is how Felecia Watkin Lui identified as pivotal to identity and painful living in the city away from (in Watkin Lui, Kiatkoski et al. a holistic sense of being. Being born Country. They said that they were 2016:1270) explained the wider ‘off Country’ potentially disengages unhappy and unfulfilled when away benefits of food: and disconnects a person from the from their land, whereas at home privileges of belonging and also from Growing up as a Torres they felt comfortable, ‘like walking the responsibility to care for Country into open arms’ (Trzepacz, Guerin & Strait Islander, I had been and the culture, traditions, law and Thomas 2014:44): immersed within a family people belonging to that Country and community setting (Felton-Busch 2009). A New South [A] 50-year-old female where food was central Wales study that explored Aboriginal participant spoke of the to the cultural narrative. women’s experiences of having to uplifting feeling she had leave their rural communities to give Feasting, whether in a when on Country: ‘Country birth found that the women ‘had community or home is a powerful place and by a strong desire for their babies to setting, embodied being there you absorb be born on traditional lands so the hunting and gardening, connection to all that is significant this energy. This energy is preparation, cooking, could be maintained’ (Dietsch et al. our ancestors talking to blessing, eating, and 2011:59). us and teaching us about communicating. Drawing Country’. Biddle and Swee (2012) analysed on this cultural frame of data from the 2008 National reference, I understood Aboriginal and Torres Strait Islander Health and the centrality of protocol Social Survey to identify and assess traditional foods in governing the way factors associated with land, language and culture. They found In her paper, O’Dea (1984) reported things should be done, that living on one’s homelands or that, when Aboriginal people from recognising that this traditional Country was associated the Mowanjum Community (in Derby, same sense of cultural with a higher level of self-reported happiness. According to Dwyer

F. H. Johnston and colleagues Part of the pressures of living on The land and waters is (2007:494) acknowledged identity, Country involve food insecurity in a a living body. We the culture and spirituality as key changing world. Research by Skinner Ngarrindjeri people are a motivators for Aboriginal people to and colleagues (2013) among hunt and gather: Canada’s Métis and Inuit peoples part of its existence. The revealed that hunting, consuming, land and waters must be the gathering of traditional preserving and storing traditional healthy for the Ngarrindjeri food reinforces identity, foods has remained part of their people to be healthy. We not only because the culture. These traditional ways, as are hurting for our Country. well as food sharing—especially with food is so different from The Land is dying, the family—were significant ways of Balanda [European] foods adapting to food shortages. River is dying, the Kurangk but because the very action (Coorong) is dying and the of harvesting and eating Indigenous hunting and food Murray Mouth is closing. is linked to specific places, gathering is affected by outside What does the future hold sources. Research conducted on stories, and ceremonial the Nambucca River estuary (the for us? events. food source for the Gumbaynggirr For Inuit, influences on cultural people of New South Wales) found wellbeing from going out on the sea Ferguson and colleagues (2017) that trace metals in the estuary ice include connections to identity, investigated the consumption of (due to the influence of derelict history, traditions and ancestors. traditional foods in 20 Northern mines, agriculture, cattle dips Access to Country is an integral Territory communities. They found and mineralisation) may lead to part of wellbeing. Participants in a that Aboriginal people living in these an exceeded tolerable intake of study by Durkalec and colleagues communities frequently consume cadmium but were within the (2015:23) were concerned about native land animals, seafood, tolerable intake level for copper and how climate change could affect witchetty grubs, and native fruits, selenium (Russell, Sullivan & Reichelt- their culture, which is evident in a berries and yams. Fishing was, and Brushett 2015). This suggests a need comment from a participant who continues to be, an essential aspect for further investigation to minimise said that, ‘if she could not go out on of life for many Aboriginal and any possible health risks. Torres Strait Islander communities the ice, she would be losing part of throughout Australia. Its importance Some reports have highlighted her culture and “wouldn’t feel good lies not only in its dietary sustenance the effects on Aboriginal health as an Inuk”’. but also in its deep social, cultural and wellbeing when Country An investigation among First Nations and economic significance. It plays has changed. Research by Willis, and Inuit communities across Canada a fundamental role in maintaining Pearce and Jenkin (2004) among found that the role of the physical group cohesion, transferring cultural the Ngarrindjeri people living environment on health could not knowledge and affirming identities in the Murray region of South be separated from culture and (Russell, Sullivan & Reichelt-Brushett Australia revealed their belief that that environmental dispossession 2015). they are part of the existence and resulted in negative health outcomes, the living body of the land and particularly in the social environment The benefits of Aboriginal and Torres waters. Traditional knowledge and (Richmond & Ross 2009). Kaspar Strait Islander peoples living on activities closely connected with (2014) analysed data from more than Country and maintaining traditional the river system have been affected 13,000 Aboriginal people in Canada practices—such as hunting—have by settlements, river regulation, to investigate the lifetime effects considerable external benefits. water quality decline, river system of residential school attendance Garnett (2010) found that hunting degradation, and the introduction on health status. She found that non-native and invasive species of exotic species. Authors of the being placed in residential schools; (such as buffalo) in Kakadu Murray–Darling Basin Commission being dislocated from Country, National Park not only contributes (2002:ii) report The Murray Mouth— communities and parental influences; to sustaining the community and Exploring the Implications of Closure protecting the environment from and being prohibited from speaking

6 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 7 Aboriginal languages or expressing Land rights and autonomy [The High Court] inserted cultural and spiritual beliefs were Everything about Aboriginal and the legal doctrine of Native associated with poorer health status. Title into Australian law. In A 2012 national household survey Torres Strait Islander society is recognising the traditional of First Nations peoples aged 15 interconnected with land or sea. and older found that those who Mikhailovich and Pavli (2011) rights of the Meriam lived off-reserve were less likely to argue that Native Title and land people to their islands in report high levels of overall health claims have led to a greater level the eastern Torres Strait, (49%) when compared with the of spiritual, political and economic autonomy for Aboriginal and Torres the Court also held that total Canadian population (62%). native title existed for all The survey also found that living in Strait Islander peoples. They argue Indigenous peoples in houses in need of repairs and food that improving the processes of insecurity were predictors of poor native title and land claims should Australia who held rights health and wellbeing for people from be seen as critical for strengthening in their lands under their First Nations who lived off-reserve cultural heritage protection. Edward own laws and customs (Rotenberg 2016). Koiki Mabo was a Meriam man from the island of Mer (Murray Island) in prior to the assertion of Research among the Nukunu people the Torres Strait. He was an activist British sovereignty and of South Australia found that they in the 1967 referendum campaign establishment Colonies should return to Country when and a founder of the Townsville across the continent from experiencing any illness, since that Aboriginal and Islander Health 1788. (AIATSIS 2017) has clear benefits for psychosocial Service. In 1982 Mabo and four wellbeing (Trzepacz, Guerin & other plaintiffs from Mer started The possession of legal rights Thomas 2014). Studies have also their seminal claim for ownership of over traditional lands in the identified that returning to Country, their islands (AIATSIS 2017). Mabo’s Northern Territory was transferred particularly to die, is essential for passion is captured in this quote to Aboriginal peoples under the the elderly, because the spirit of the from the manifesto on what is now Aboriginal Land Rights (Northern deceased can have an impact on referred to as the Mabo case: Territory) Act 1976 (Cth), with a the place or Country connected with system of 99-year leases over their spirit (McGrath & Phillips 2008). My name is Edward Mabo, Aboriginal townships being Place of death is very important for but my island name is introduced with the Aboriginal Aboriginal and Torres Strait Islander Koiki. My family has Land Rights (Northern Territory) patients, with many prioritising their occupied the land here for Amendment Act 2006 (Cth). Research spiritual and cultural needs over their hundreds of years before on the implications of land rights physical distress, forfeiting the time has found that the amended leasing Captain Cook was born. gained by life-prolonging treatments scheme is detrimental to health in order to return to Country for They are now trying to say I outcomes. Effects described in their final days. Therefore, a core cannot own it. The present the literature include depriving consideration for end-of-life care Queensland Government traditional owners of control over for elderly Indigenous Australians is a friendly enemy of the lands, which usurps authority and (Waran et al. 2016) or for those with black people as they like to instils powerlessness; this in turn terminal illness who wish to die on affects their health and wellbeing give you the bible and take Country must be to ensure that they (Watson 2007). It has been argued can return. away your land. We should that ‘Achieving recognition of land stop calling them boss. We rights is a necessary step on the In their New South Wales study, must be proud to live in path to wellbeing’, as those that are Dietsch and colleagues (2011:63) dispossessed are unlikely to achieve looked at Aboriginal women’s ties to our own palm leaf houses health (Devitt, Hall & Tsey 2001:6). Country for birthing. They concluded like our fathers before us. Ganesharajah (2009) suggested that, where possible, women should (Graham n.d.) that recognition is insufficient since have a choice as to whether they what is required is that people have remain on Country to give birth or Ten years after Mabo and his fellow the right to use land as they wish. transfer from their Country and kin plaintiffs made the initial claim, the Research has shown that, for some to give birth somewhere else. High Court of Australia decided in people, simply being on Country is favour of this claim: sufficient to make them feel better. However, for others, wellbeing is contingent on carrying out activities

8 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 9 on Country that are perceived as generate some status for Native Observing sacred sites is not just worthwhile. The critical factor is Americans in their relationships with obligatory for Aboriginal peoples: autonomy over self and control the ‘invading’ Europeans (Ring & when someone is injured or when over Country (Ganesharajah 2009; Firman 1998). damage is caused to Country from Watson 2007). an outsider, it is considered that Caring for Country Country has not been cared for Positive relations with Country properly. As a result, it is believed fostered through caring for and Land and sea management by that the spirits will punish people being on Country help to develop key Aboriginal and Torres Strait for not taking proper care of their skills and knowledges, increasing a Islander peoples—caring for Country. sense of self-worth and autonomy. Country—involves a wide range of Individuals who participate in environmental, natural resource The Commonwealth Scientific and caring for Country are able to and cultural heritage management Industrial Research Organisation (Hill shift from being looked after to activities. These centre on the et al. 2013; Putnis, Josif & Woodward caring for others and for Country. holistic relationships between 2007) reports that Indigenous land Frustrations often occur when Aboriginal and Torres Strait Islander management (ILM) programs have a individuals are unable to develop societies and their connection to wide range of benefits for Aboriginal their autonomy, and identity (often Country for at least the past 65,000 people and communities. Caring for compounded with pressures of years (Clarkson et al. 2017). This Country is linked to the maintenance town life) may be expressed through connection includes their lands, of cultural ties, identity, autonomy use of alcohol and other drugs waters, plants, animals, heritage, and health. This results in benefits and violence (Burgess et al. 2009, culture, ancestors, laws and religions for the socio-political, cultural, Garnett & Sithole 2007). Increasing (Rose 1996). economic, and physical and Aboriginal and Torres Strait Islander emotional wellbeing of Aboriginal management of Country helps to Citing several experts in the field, and Torres Strait Islander peoples foster a collective development Altman and colleagues (2007:37) state (Altman & Whitehead 2003; Burgess capacity in line with Aboriginal and that: et al. 2009; Garnett & Sithole 2007; Torres Strait values and priorities, Altman 2003; Preuss & Dixon 2012; delivering outcomes people actually ‘Caring for Country’ Green & Minchin 2014). want to see (Hunt & Campbell 2016). refers to more than the physical management of ILM programs are achieving a Mortality rates for Native Americans broad range of environmental, and Māori have fallen substantially a geographical area—it cultural, social, educational, since the 1970s. However, in 1994 encompasses looking health, employment and economic mortality rates for Aboriginal and after all of the values, development outcomes. With Torres Strait Islander Australians places, resources, stories, strategic government and private were at, or above, rates observed and cultural obligations investment, the sector has potential 20 years previously for Native associated with that area, to grow further, both providing Americans and Māori (Ring & Firman income for communities and 1998, Pulver et al. 2010). A decisive as well as associated reducing healthcare associated costs factor that has been linked to the processes of spiritual (Putnis, Josif & Woodward 2007; poor performance of Aboriginal renewal, connecting with Burgess et al. 2009; Campbell et al. and Torres Strait Islander health ancestors, food provision, 2011; Campbell 2015, 2016). and mortality rates is the absence and maintaining kin Formal involvement of Aboriginal of a treaty recognising First Nations relations. peoples. The adoption of treaties in and Torres Strait Islander people in New Zealand, Canada and the United environmental management has Contributing to caring for Country grown in recent decades, with cross- States have played a significant is the observation of sacred sites. role in better health and social cultural engagement following the Sacred sites and Dreaming places, advent of non-Indigenous land and economic development for where life and law continue to be Indigenous peoples (Ring & Firman management and ILM programs brought into being, are often nesting (Hill et al. 2013). Research by Watkin 1998). Ring and Firman (1998) state or breeding places. As a result, that the Treaty of Waitangi was Lui and colleagues, which was hunting is prohibited in those areas, conducted with Torres Strait Islander fundamental to fostering positive effectively creating refuge in which relationships between Māori and people living in the Australian the particular species, and other mainland cities of Brisbane, Cairns other New Zealanders, and in the species that use the area, are safe United States treaties were able to from human predation (Rose 1996).

8 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 9 and Townsville, found that 70 per traditional owners were receiving site-based, rather than species- cent of respondents considered that for their work in land management based, management was also protecting the environment was an (Gilligan 2006). These programs recommended, thus framing weed important value for them (Watkin have re-established traditional land management as promoting healthy Lui, Stoeckl et al. 2016:351). management practices, and have Country rather than destroying also increased peoples’ willingness plants (Bach 2017). Caring for Country has always to co-operate with government involved fire. According to Rose conservation agencies to address The IPA programs have been (1996:65), ‘All over Australia, when contemporary environmental issues successful, with both direct Aboriginal People speak English, they (Ens et al. 2012; Gilligan 2006). economic and financial benefits describe their burning practices as and considerable social and “cleaning up the Country”’. Aboriginal Indigenous ranger projects are cultural outcomes from promoting practices of patch burning with low- funded by the federal government conservation activities for Aboriginal intensity fires over a number of years to create employment, training and communities. These include to create a mosaic of habitats has career pathways for Aboriginal and land management employment been necessary, as many Australian Torres Strait Islander peoples in land opportunities, contribution to social plants require fire in order to flower and sea management. Indigenous cohesion within communities, an or for their seeds to germinate. Many Rangers combine traditional increased sense of worth and an animals also depend on, or respond knowledge with conservation improvement in social outcomes well to, the effects of fire (Rose 1996; training to protect and manage vast for early childhood development, Moorcroft et al. 2012). Today, ILM areas of Australian land, sea and early school engagement, reduction activities involve Aboriginal and culture (DPM & C 2016). of alcohol and other drug use, Torres Strait Islander people using restoration of relationships, and traditional approaches to land and The growth in the number and reinforcement of family and water management, including fire extent of IPAs and ranger projects, community structures (Gilligan management, feral animal and weed including Ngadju Conservation, 2006; Preuss & Dixon 2012). control, biodiversity monitoring Dhimurru Aboriginal Corporation and threatened species protection and Olkola Aboriginal Corporation, ILM programs assist people to work in (Putnis, Josif & Woodward 2007). has been widely noted as a order to maintain the health of their Environmental benefits of ILM also demonstration of commitment to Country, which has benefits for the extended to the public—for example, looking after Country. Woinarski environment, but they also benefit the bio-sequestration of greenhouse and Lewis (2017:180) comment the physical, mental and cultural gases, soil stabilisation, and the on the ‘commitment to looking health of the people involved (Garnett mitigation of dust storms and excess after Country, and of the particular et al. 2009). Aboriginal and Torres smoke from bushfires (Campbell applicability and fit of Indigenous Strait Islander peoples have distinct 2015). knowledge to land management in relationships between law and Australia’; they add, ‘These programs culture, language and Country. This In 1997 the Australian Government have nurtured land, communities is apparent in the ‘Healthy Country, established the Indigenous and culture and have contributed to Healthy People’ concept—Griffiths Protected Area (IPA) program to far better governance across large and Kinnane (2010:3) report that support Aboriginal and Torres Strait areas of the Outback.’ ‘Kimberley people commonly speak Islanders with the management in terms of healthy Country, healthy of their own Country, combining Following the analysis of the people. If you look after Country, traditional knowledge with Western ranger programs, rather than the Country will look after you.’ This science. IPAs are vital components imposing mainstream ecological is seen as a reciprocal relationship of Australia’s National Reserve paradigms on the categorisation necessary for the land as well as System of recognised parks, reserves of weeds, it was recommended the people (Dwyer 2012; Griffiths and protected areas. The IPA that rangers should be allowed to & Kinnane 2010; Rigby, Rosen et al. program was initiated to address base their weed management on 2011; Kingsley et al. 2009; Moorcroft shortcomings in the recognition that culturally embedded perspectives, et al. 2012). Aboriginal and Torres Strait Islander integrating it into other aspects of their work. A greater emphasis on

1. In earlier versions, we used the word ‘remote’ before ‘Northern Territory’. We are grateful to a reviewer who shared with us advice from an Elder, who indicated that, in his world, Sydney was remote and that the term had negative consequences for people living in these locations. With the benefit of this insight, we have removed all instances of the word ‘remote’ from the main body of this document.

10 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 11 Thompson, Chenhall and Brimblecombe 2013; Anderson • not being asked permission for Brimblecombe (2013) explored & Kowal 2012; McDermott et al. access local perspectives, experiences and 1998) • not being advised of where meanings of physical activity in • direct health impacts, including visitors are going and what they two Northern Territory Aboriginal reduced morbidity and extended are doing communities.1 They found that: life expectancy, which are • lack of respect being and walking on associated with the use of both traditional foods and medicine • tourism activities causing Country and regular (Rowley et al. 2008; Campbell damage to Country participation in associated 2015; Johnston et al. 2007) and • the disturbance of sites of activities are central to the decreased smoking (Johnston & Aboriginal importance cultivation of Indigenous Thomas 2008), and alcohol and health [in Aboriginal other drug use (Johnston et al. • visitors going to places they should not go communities]. These kinds 2007; Schultz & Cairney 2017; Hill et al. 2013) of physical activity allow for • visitors not following cultural the maintenance of social • psychosocial determinants of protocols. and cultural traditions health, which include identity and This resulted in stresses because the cultural continuity (Burgess et al. community did not know what was that are seen to provide 2009; Kingsley et al. 2009; Preuss a link between health, happening on Country, approval was & Dixon 2012), meeting cultural not sought to access Country, and the environment and responsibilities (Campbell 2015), burial sites and sacred places were economics. (Thompson, social cohesion, self-esteem and being disturbed (Smith, Scherrer Chenhall & Brimblecombe mental health (Trzepacz, Guerin & Dowling 2009). It has also been 2013:9) & Thomas 2014), relaxation found that, in order to address and stress reduction (Guerin et disadvantages experienced by Following their research with al. 2011), autonomy and self- Aboriginal and Torres Strait Islander participants in the Indigenous determination. people in the mental healthcare Cultural and Natural Resource These results indicate that caring system, concepts such as ‘Country’ Management sector, Burgess and for Country may offer a means of and ‘connection to Country’ need to colleagues (2009) concluded that improving the current poor health be understood by non-Indigenous there were positive associations status of Aboriginal and Torres Strait practitioners. This will enable them between caring for Country activities Islander peoples. to provide a quality service that is (which people perceived as beneficial to their health) and health outcomes. Several benefits have been associated Impacts of tourism with caring for Country, including: An investigation by A. J. Smith, Scherrer and Dowling (2009) on • building self-esteem; fostering impacts of Aboriginal spirituality self-identity; maintaining and culture on tourism in the coastal cultural connection and enabling waterways of the Kimberley region relaxation and enjoyment in north-west Australia found that through contact with the natural private vessels and expedition environment (Kingsley et al. cruise vessels regularly visit sites of 2009; Schultz & Cairney 2017; Aboriginal significance, including Trzepacz, Guerin & Thomas 2014; rock art and burial sites. Many Weir, Stacey & Youngetob 2011; commercial operators use Aboriginal Campbell 2015) aspects in their marketing. Concerns • physical health benefits, including raised by the communities about increased physical activity; tourism activities along the coast lower rates of obesity, diabetes, relate to: renal disease and cardiovascular • uncontrolled access disease; and less psychological stress (Garnett & Sithole 2007; • the number of visitors Burgess et al. 2009; Johnston et • lack of consultation with al. 2007; Thompson, Chenhall & traditional owners

10 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 11 culturally appropriate (Bishop et al. Spiritual and his work in northern Australia, Clarke 2014). religious beliefs (2007:148) found that: Aboriginal and Torres Strait mortuary rituals and Indigenous Islander spirituality is complex, name-avoidance customs with differing cultural traditions are still routinely practiced. beliefs and across Australia. Concepts and In part, these are aimed experiences of spirituality can be knowledge found in the Dreaming, storytelling, at ensuring that during art, ceremonies, and songs and the transition of the spirit The Western medical approach dance, as well as in values and social to the ‘Land of the Dead,’ centres on the biological processes structures with a strong connection involved with illness. Limited sometimes called the to land and place (Poroch et al. 2009; attention is placed on social, ‘Skyworld,’ there are no Burgess et al. 2009). emotional and spiritual aspects ghosts left behind in the of health and wellbeing. This In research in Victoria among the land of the living. has resulted in the development Bangerang, Boonwurrung and of systems or viewpoints that Yorta Yorta peoples, Kingsley and A study of Aboriginal palliative attempt to address these facets. colleagues (2009:295) found care conducted among healthcare In Australia, New Zealand, that ‘This spiritual and cultural providers and patients in the Canada and the United States, relationship to land increased Northern Territory found a traditional healers and Elders have identity, pride and self-esteem’. multiplicity of spiritual perspectives been prevented from providing The authors add that this spiritual on death and dying that juxtaposed ceremonies and other healing connection to nature is often Christian and cultural beliefs. interventions, sometimes through referred to as reconnecting Perspectives included those of spirit punitive and legislative methods. individuals to their ancestry, animals, strong beliefs in traditional This has resulted in medicines ‘meaning they were pulled to healers and an importance of and treatments developed over land which gave them a sense of returning to Country to die where the centuries being discounted belonging’ (Kingsley et al. 2009:295). a person’s spirit can re-enter the as superstition and quackery Mikhailovich and Pavli (2011) Dreamtime (McGrath & Phillips (Anderson & Olson 2001; Hopkirk & have argued that it is misleading 2008). Mikhailovich and Pavli (2011) Wilson 2014). to try to separate traditional found that, although Christianity is Australian Aboriginal and Torres more prevalent, spiritual traditions Recently, however, there has been Strait Islander peoples’ religious have persisted and are sometimes growing recognition of the holistic or spiritual experience from other combined with other religious approach of First Nations groups. In aspects of life, culture and history, traditions. They concluded: this approach, health and wellness since their economic, physical, are seen not only as the absence of social and emotional wellbeing Everything about disease—the spiritual, emotional are interconnected with spiritual Indigenous society is and cultural dimensions of a wellbeing. person’s life, which extend beyond inextricably woven with, and connected to land healthcare and into the community, Ancestral creators are spirits who are also acknowledged. This formed the world. Their presence, or sea. Understanding intersects with, and complements, indicated by what they left behind the importance of this many Aboriginal and Torres Strait in the creation—often through connection is important for Islander views and value systems physical form (for example, all Australians if freedom (Anderson & Olson 2001; Arnott et mountains rivers etc.)—may no of religion is to be realised al. 2010; Bishop et al. 2014; Biddle longer be apparent. Other spirits for Indigenous Australians. & Swee 2012; Colquhoun & Dockery exist alongside humans. These can 2012; Dew et al. 2015; Durie 2004; take the form of animals, plants, (Mikhailovich & Pavli Ganesharajah 2009; Johnston et al. landmarks, water, or whirlwinds 2011:no page nos) 2007; Trzepacz, Guerin & Thomas and mists. They can be good or bad 2014; Yap & Yu 2016; ATSIHF spirits and can affect health and In Native American tradition, the Development Team 2009; National wellbeing (Clarke 2007). When a medicine wheel encompasses four Aboriginal Health Strategy Working person dies, his or her spirit is torn components of health—physical, Party 1989). between the desire to stay with loved emotional, mental and spiritual— ones and the desire to return to and balance between and among all Country to rest with the ancestors. In four components is required for good

12 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 13 health and wellbeing (Anderson & the perception of shamanism being experience of their place of Olson 2001). For the Yup’ik people in decline. Oosten, Laugrand and origination. of Alaska, strength comes from Remie (445) concluded that, instead, connection to the land of their today ‘shamanism is for many Inuit Poroch and colleagues (2009) ancestors. The teachings, practices part of a wider cosmology that is concluded that there is a and knowledge of the ancestors are dynamic, open to innovation, and relationship between spirituality and important in keeping individuals, marked by strong continuity’. health and wellbeing, coping and families and communities safe. The building resilience in those suffering In their summary of a workshop Yup’ik people believe the spirit of the mental health disorders. universe, Ellam Yua, gave life to all addressing health inequalities in people, animals and plants on the Indigenous communities, K. M. Fonda (2009) examined the extent land and water, thus all living things Anderson and Olsen (2001:39), to which Canadian Aboriginal created must be respected. Healing the workshop rapporteurs cite this spirituality is practised on-reserve is also incorporated into this belief. comment by Nia Aitaoto, one of the and its effects on wellbeing. He Woodworking is considered to have workshop participants: ‘For many found that ‘Revitalising traditional healing power and ‘if a man became Pacific Islanders… a person’s spirit Aboriginal religions could be another deranged, he would be put to work has many parts, including shame, means by which individuals and on wood so that he could recover’ fear, forgiveness, and repentance, cultures can locate themselves in (Ayunerak et al. 2014:5). and Western medicine does not time, which can improve personal address these aspects of the spirit’. and cultural continuity and increase Oosten and Laugrand (2002:27) Aitaoto’s comment was, inferentially, wellbeing’ (Fonda 2009:76–7). This quote the first recommendation of based on research she and is because it provides motivation for the Nunavut Social Development colleagues conducted on diabetes integration into traditional societies Council regarding spirituality, among the people of the United and social healing, thus having shamanism and customary law: States Associated Pacific Islands* benefits for community continuity ‘Traditional Inuit laws, practices and (Hosey et al. 2009). and wellbeing (Fonda 2009). Other beliefs, including those pertaining research with Canadian First Nations One priority identified as part of to spirituality and shamanism, need adults has also found that a high a Cooperative Research Centre to be researched, recorded and level of spirituality was associated for Aboriginal Health roundtable shared’. The beliefs and practices with a decreased likelihood of to identify priorities for research of shamanism reflect values with smoking among adult Métis (Ryan et around social and emotional respect to people, the land and al. 2015). animals (animals are also said to wellbeing was spirituality and have tarniit—shades or souls). its connection with social and Australian research reached similar According to Elders, respectful emotional wellbeing. The review by conclusions. It was found that, relationships with animals and Poroch and colleagues (2009:2)— for Aboriginal people, community spirits are to be preserved and which was instigated by this wellbeing is strongly linked to maintained in an appropriate way roundtable—found that: components of spirituality and in order to uphold the social order. culture, which have an impact Hunters, therefore, have to respect Spirituality is a dynamic, on positive identity, including animals and not abuse them. evolving, contemporary storytelling, ceremonies, ancestors, Shamanism has always and will expression of Indigeneity. sacred sites and tribal areas continue to play an important part Spirituality connects (McLennan & Khavarpour 2004). in preserving social order. In modern past, present and future. An analysis of the strengths of Australian Aboriginal cultural society it is paramount to find a Spirituality emphasises balance between useful elements practices in family life and of shamanism practice with Inuit people’s relationships with childrearing found that: Christian beliefs. Further study by each other, the living (other Oosten, Laugrand and Remie (2009) entities—animals) and • spirituality helps families cope with challenges found that focusing too much on non-living (mating season, the person of the shaman and tides, wind and mythology) • families and communities that underestimating the importance life forces premised by engage in spiritual practices and strength of the ideological benefit from a greater sense of an understanding or system and values involved led to identity

* The United States Associated Pacific Islands include American Samoa and Guam, the Commonwealth of the Northern Mariana Islands, the islands of Chuuk, Kosrae, Pohnpei and Yap, the Republic of Palau and the Republic of the Marshall Islands.

12 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 13 • individuals are more likely to the impact of climate change feeding) resulted in strong and connect with, and support and and the relationship between the resilient children, and traditional help protect, each other (Lohoar, environment and health in the Inuit medicines for teething and Butera & Kenned 2014). population of northern Canada. swaddling were directly linked The study showed continued to oral health, particularly the Successful Aboriginal-led programs traditional practices and sea ice use development of healthy deciduous for youth in Queensland use culture, had a positive impact on health, teeth. The researchers concluded connection and community, as well particularly mental, spiritual, social that opportunities to share the as practical work and life skills, to and cultural health. One Inuit Elder traditions of infant feeding were set young people up for a better described his wellbeing, which has essential in order to restore skills future and ensure that they do not arisen from his expert knowledge of and pride and that these traditions spend time in detention. The focus is how to use ice, as: were a mechanism for building on restoring the pride of the young family and community relationships. people, with spiritual guidance and ippigusutsianik, which In addition, they provided support provided by Elders and intergenerational support. mentors (Amnesty International translates to being aware and conscious of your 2016). It has been recommended that the surroundings, being Australian government invest in Traditional knowledge of sound mind, having cultural knowledge centres as a way knowledge of what to increase the capacity to share Inuit Qaujimajatuqangit (Inuit could happen, and being and transmit cultural knowledge traditional knowledge) encompasses prepared for what may (ATSIHF Development Team 2009). passing Qaujimajatuqangit from These centres would be developed to occur. Ittulak described Elders down to the younger document and display Aboriginal and generations. This knowledge how knowledge prevents Torres Strait Islander culture, histories includes a philosophy and way health impacts and and stories to benefit Aboriginal and of living; knowledge of wildlife, promotes benefits, like Torres Strait Islander people, as well hunting and migratory patterns; the feeling of freedom: as non-Indigenous people (ATSIHF survival skills; traditional healing Development Team 2009). and counselling; an understanding ‘There’s a lot of freedom of family relationships; and a system when you go out on the of laws, values and consultations land, especially by yourself, Traditional healing for the community. Research with without nobody telling you The Aboriginal and Torres Strait Inuit Elders on ways of integrating what to do or what not to Islander concept of health is holistic, Qaujimajatuqangit into methods do, especially if you know with spirituality being a central of social control to address social the land… That’s one of aspect of wellbeing and where ill problems of unemployment, health is more than physical illness. alcohol and other drugs, domestic the biggest part (sic) of It is a manifestation of other factors, violence and suicide found that freedom in a person’s life, including spiritual and emotional there was a close relationship in an Inuk’s life. As long alienation from land, family and between the preservation of as you know the land, if culture (Mikhailovich & Pavli knowledge and the maintenance you’ve been gone for a few 2011). In a section on the nature of of social order. However, there days all on your own, you healing the Aboriginal and Torres was also considerable concern Strait Islander Healing Foundation that the traditional knowledge of know the land and you feel (ATSIHF) Development Team Inuit societies was rapidly eroding. so free’ (Durkalec et al. (2009:4) cite Phillips and Bamblett Therefore, acknowledging and 2015:23). (2009) who define Aboriginal recording tradition is of the utmost healing as ‘a spiritual process importance (Oosten & Laugrand Research by Cidro and colleagues that includes addictions recovery, 2002). (2014) on the traditional and therapeutic change and cultural cultural approaches to childrearing renewal’. The Aboriginal and Torres Canadian First Nations peoples have in the Cree Nation of Canada Strait Islander Healing Foundation described how having the knowledge found that traditional knowledge Development Team (2009:4) also and capacity to survive on the land sometimes conflicts with primary refer to a publication by Phillips, who makes them feel good, or brings healthcare advice. However, documents the following personal them a sense of wellbeing. Durkalec they also found that traditional communication with an Elder of the and colleagues (2015) explored methods of childrearing (including Brisbane community:

14 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 15 Aboriginal people believe smoke rituals, counselling, healing and beliefs about disease causation, that the spirit child comes circles, bush trips to special sites, type of illness, success of biomedical from the earth... we are painting and other forms of art treatment, and accessibility to therapy, vision quests, massage and traditional healers and bush born from the earth. We residential treatment are examples medicines (Oliver 2013). Research believe that the whole of of methods that are often used among Aboriginal people in Western life is a spiritual experience in various combinations (Swan & Australia on the use of bush and that… Aboriginal Raphael 1995; Arnott et al. 2010; medicine for the treatment of cancer people are actually more Devanesen 2000; Dobson 2007; found that some people preferred spirit than matter...The Dudgeon & Bray 2018; Oliver 2013). traditional healing processes. This Ngangkari (traditional Australian was because they helped reconnect spirit cannot be in balance Aboriginal healers of the Western them with their heritage, land, if it is out of balance with Desert) deal with spirit causes culture and the spirits of their the body. If you’re spiritually of illness—including thought ancestors, thus bringing peace of unwell, you can’t help but disturbances, headaches, blocked mind during their illness (Shahid et affect the whole of your ears and lost spirit—by ‘singing’ al. 2010). Similarly, in New Zealand, being… (Phillips 2003:25). people to make them well, making alternative approaches to Western trips to the bush, and gathering bush medicine were used more among The Native American concept of foods and medicine. Some modern Māori people than non-Māori but healing incorporates traditional adaptations have been added to were usually used in combination practices, spiritual values, traditional these traditional ways (Swan & with Western medicine (Dew et al. knowledge and culture. It rests Raphael 1995; Poroch et al. 2009). 2015; Durie 2004, 1999). on the idea that the health and Ngangkari healers work with the spirit, or karanpa, by using a psychic Healing traditions for Canadian wellbeing of individuals, families, First Nations peoples often engage communities and nations requires medicinal tool called a mapanpa. This removes bad spirits, or mamu, supernatural or spiritual forces with the restoration of the balance of two possible aims: the four components of health: from the body, returns a lost karanpa to the body or strengthens the physical, emotional, mental and • transformative healing, which spirit, thus restoring its vitality spiritual (Anderson & Olson 2001). is a continuous, developmental (NPY Women’s Council 2003; An Australian study found that process in which a patient Dudgeon & Bray 2018). Minyma Westernised treatments are centred undergoes changes in physical, Ngangkari (traditional women around medication, counselling and behavioural, cognitive, healers) are leading a renaissance hospitalisation, while traditional emotional, social, spiritual and/or of cultural healing within Australian Aboriginal treatments focus more on existential functioning methods that build resilience against communities. This indicates the • restorative healing, where the spirits (Vicary & Westerman 2004). enduring strength of traditional goal is to return the patient from Australian Aboriginal medicine healing. Ngangkari women healers the illness status to the preceding seeks a deeper understanding of usually focus on women’s health psychological or physiological illness, seeing health as holistic, issues—a practice aligned with state (Waldram 2013). with illnesses explored not only at traditional gendered healing the individual level but at the level practices where women healers treat Contemporary healing traditions of underlying family and community women and their male counterparts involve continued processes of issues, which may have contributed treat men (Dudgeon & Bray 2018). cultural education, which subtly to how the person became sick A review of spirituality and wellbeing transform the individual or (Devanesen 2000). Traditional found that traditional Ngangkari community (Waldram 2013). The medicines incorporate traditional healing, bush food and bush Aboriginal healing movement in beliefs and recognise social, physical medicine are more likely to be used Canada—which aims for individual, and spiritual dimensions of health in rural rather than urban locations. family and community healing—has and life, rather than a single illness However, there is also evidence of consisted of a variety of programs (Vicary & Westerman 2004). healing programs in urban settings and activities. These include participation in traditional healing Medicinal plants are often an generally, where traditional healing is used in combination with Western and cultural activities, culturally important component of healing based wilderness camps and methods (Clarke 2008; Galles medicine (Poroch et al. 2009; Holmes 2016). The variation in practising programs, treatment and healing 2011; Packer et al. 2012, 2015). programs, counselling and group Ceremonies, chants, cleansing and traditional medicine across Australia depends on association with culture work, and community development

14 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 15 initiatives. Many of these programs Several commentators have also deprivation of songs, spiritual and centre on ‘culture as treatment’ emphasised the need for healthcare cultural heritage, and spiritual and include arts, fishing, hunting providers to acknowledge traditional connection with Country. These and food gathering, storytelling, knowledge, be respectful of beliefs are known to be major contributors songs, history and activities that and practices, and accept that to the resulting intergenerational promote connection to the natural these can be important additions to trauma and poor health and world, cross-cultural understanding, healing and can also complement wellbeing of Aboriginal and Torres healthy self-identity and sense of Western medical treatment regimes Strait Islander peoples (HREOC respect for one’s own and other (Shahid et al. 2010; Swan & Raphael 1997). Intergenerational trauma has cultures (Lane et al. 2002; Day, Silva 1995; Arnott et al. 2010; Baba, been defined as ‘The tendency for & Monroe 2014). Brolan & Hill 2014; Durie 2004; trauma to be passed down through Holmes 2016; NPY Women’s Council generations… Intergenerational The Akeyulerre Healing Centre, 2003; Oliver 2013; McLennan & trauma creates lasting emotional run by the Arrernte people in Alice Khavarpour 2004). effects on future generations Springs in the Northern Territory, of Indigenous people’ (Hellsten conceptualises healing in terms of: Researchers and practitioners 2014:208). have recommended that, when spiritual, social, physical treating Aboriginal and Torres Strait Institutional racism occurs when and emotional wellness Islander peoples, the holistic nature there are ‘conditions, practices, that is connected to of health and wellbeing must be policies or processes that maintain family, culture, language considered. Holistic care includes and reproduce avoidable and unfair an acknowledgment of social– inequalities across ethnic/racial and Country. Healing historical–political factors such as: groups’ (Paradies, Harris & Anderson is achieved through a 2008:4). Racism towards Indigenous combination of what on • the impact of colonialism patients in health services has a the surface may seem to be • trauma, loss and grief history of being institutional and simple activities, such as interpersonal (Durey & Thompson • separation of families and bush trips, collecting bush 2012). Lovett (2014) writes about children the historical impacts of colonisation medicines and bush tucker, • the taking of land and discriminatory practices, such as barbecues, story-telling, treating Indigenous people outside singing and dancing. • explicit attempts to remove on verandas, which continued However, surrounding culture and identity until the 1970s. Other examples of these activities is a • lateral violence (explained below) institutional racism include funding inequalities, different performance spiritual dynamic that is • the impact of social inequity, criteria for medical services and expressed through the stigma and racism (Vicary & different streams of money for Westerman 2004; Swan & work of Angangkeres health conditions (Henry, Houston Raphael 1995) [healers], in ceremonies, & Mooney 2004). According to and in the transmission • intergenerational trauma, Sherwood (2013:37): of knowledge from one specifically related to colonisation continues generation to the next. It institutional racism within the healthcare system (explained today both politically is about keeping culture further below) (Henry, Houston & and through the health strong, reconnecting with Mooney 2004). service provision, research Country, and building a and scholarship. This sense of belonging. (Arnott Knowledge transmission is because the context et al. 2010:vi) and continuity of causal agents that However, trust in the ‘medicine man’ The National Inquiry into the have impacted upon the can be accompanied by a distrust Separation of Aboriginal and health of Indigenous of clinical medicine (Dew et al. Torres Strait Islander Children Australians be they from their Families described 2015). An individual’s response to children, mothers, father, traditional healing depends on his the process of forced removal as and grandparents… have or her beliefs about the cause of the cultural and spiritual genocide. The illness (McGrath & Phillips 2008; process of forced removal results been maintained through Shahid et al. 2010). in the destruction of culture and problematic constructions

16 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 17 of Aboriginal people that sideways (laterally) the younger generations. The study were established when the towards peers and, in found that adults considered that concept of terra nullius was particular, use accusations returning to Country was a powerful way to educate young people and applied to this continent. of inauthenticity as a deepen respect for their traditional mechanism of social culture, as adults believe that Models developed by Aboriginal and exclusion. Lateral violence youth are ‘missing their culture’ Torres Strait Islander people to assist is prevalent among many (Johnston et al. 2007:495). One those affected by the forced removal interviewee expressed it in this way: programs include family tracing and Indigenous groups, ‘It might be they [youth] lose their reunion services and the Marumali although it is not exclusive culture and they might lose their Journey of Healing, which seeks to Indigenous people Country’ (Johnston et al. 2007:495). to restore connections to identity Chandler and Lalonde’s studies on and social and emotional wellbeing The Aboriginal and Torres Strait suicide among First Nations youth through a grounding in traditional Islander Social Justice Commissioner in Canada revealed that, despite the knowledge systems, thus restoring (2005:8) adds that ‘While lateral national high rate of suicide, more connections to spirit and spirituality violence has its roots in our than half of the communities they (Peeters, Hamann & Kelly 2010). history, it thrives today because studied had no youth suicides over of power imbalances, control by the past 15 years. The researchers One barrier identified as impacting others, identity conflict, negative noted that knowledge about on the continuation of knowledge stereotypes and trauma’. transition and continuity is lateral youth suicide prevention is well violence. Lateral violence is According to an Aboriginal woman established in these communities summarised in the Social Justice quoted in a study by Y. Clark and and that this needs to be preserved, Report 2011 as having its roots Augoustinos (2015:26): shared, nurtured and incorporated in colonisation and control of by governments (Chandler & Aboriginal and Torres Strait Islander [Lateral violence is] just Lalonde 2004). people through: a normal sort of thing for Oral history—the telling of a Aboriginal people. We • creating a sense of powerlessness story through words, culture and didn’t have the term, didn’t identity—is a part of Aboriginal • the diminishment of traditional know anything about and Torres Strait Islander culture roles, structures and knowledge lateral violence… what is that comes with the recognition • attacking and undermining this and I thought ‘that is of the complex responsibilities involved with receiving oral Aboriginal and Torres Strait so true’ about our mob. Islander culture and humanity knowledge. Oral records are records of Aboriginal and Torres Strait Another Aboriginal woman said: • creating conflict about Islander knowledge. The knowledge Aboriginal and Torres Strait If I had a wish list I would holder dictates the use and access. Islander identity (Aboriginal Cultural practices involve the make lateral violence more & Torres Strait Islander Social reinterpretation of knowledge in Justice Commissioner 2011:8). of a household name cos relation to each generation and Gorringe, Ross and Fforde (2011:8) [we are] naming it. It’s like the passing on of that knowledge state: domestic violence that to the next, thus affirming cultural gets a name; it gets a name practices and affirming knowledge [Lateral violence is] a range and people understand through respecting the past (Vickery, Clarke & Adams 2004; of damaging behaviours well hang on yeah these Vickery et al. 2007). As knowledge expressed by those of things are happening, its a minority oppressed is traditionally transmitted orally, domestic violence, it’s not older Aboriginal and Torres Strait group towards others of on. (Clark & Augoustinos Islander people play a fundamental that group rather than 2015:27) role in situating a traditional towards the system of sense of place within the world oppression. Although the A major theme identified in a study and instilling a sense of self and behaviours result from of the connection to Country in community through educating the experience of oppression, northern Australia was a concern young in their culture (Warburton for the loss of understanding and & Chambers 2007). Three avenues they are expressed respect for traditional culture by identified for providing children

16 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 17 with cultural experiences and These promising findings suggest knowledge are family interactions, that knowledge sharing has resulted community collaborations and in indications of improved individual school influences such as NAIDOC and organisational capacity, (National Aboriginal and Islander implying that existing resources Day Observance Committee) Week of traditional knowledge within activities (Crowe et al. 2017). Aboriginal communities may have Indigenous been overlooked or underdeveloped. A review of the IPA programs found Likewise, the support and transfer of language that not only did they provide childbearing knowledge facilitated One pivotal aspect of culture and direct economic and financial by the kinship system among identity is language (Biddle & Swee benefits to the communities, but Aboriginal women in New South 2012; Dorais 1995; Setee 2008; there were also considerable social Wales has been identified as a Standing Committee on Aboriginal and cultural outcome, including mediating factor on the negative and Torres Strait Islander Affairs their use as a means to facilitate impact of perinatal health outcomes 2012; Bougie & Senecal 2010; the transfer of knowledge and due to the closure of rural maternity Marmion, Obata & Troy 2014). Two engage young people in positive units (Dietsch et al. 2011). educational experiences centred on Australian writers highlight: the equitable exchange of Western Traditional healing in Canada science and traditional knowledge provides a vehicle for traditional [There is a need] to provide (Gilligan 2006). McCalman and knowledge to be maintained creative resources for the colleagues (2009:S63) investigated and developed. Although First survival of the languages the efforts of an Aboriginal men’s Nations’ knowledge systems in traditional and dynamic group in Yarrabah, Queensland, still encounter obstacles, they hybrid forms, not least to facilitate and support the are today being applied to help because Aboriginal empowerment of young people in communities and individuals their community and found that: recover from intergenerational peoples’ individual and pain and suffering endured during collective resilience Yarrabah men developed colonisation and forced assimilation and, indeed, survival are locally appropriate (Robbins & Dewar 2011). Other uniquely dependent upon strategies to strengthen research from both North America connectedness to and and Australia found that not only social norms towards the regeneration of their do cultural practices involving ‘bringing back respect’, traditional knowledge maintain languages… (Regan & Troy which resonate closely that knowledge, they also provide 2014:120–1) with strategies for coping restoration of skills and pride in with stress described culture, build community capacity If a culture loses or has restrictions in the international and are a mechanism for building placed on language use, it is a loss that the culture is unlikely to survive literature for Aboriginal family and community relationships and intergenerational support, all of (Hallett, Chandler & Lalonde 2007; spiritual renewal, cultural which have positive effects on health Walsh 2014; Dorais 1995; Posey 1999; belonging, promoting and wellbeing (Cidro et al. 2014; Oster et al. 2014). Land, language and values and traditions, Chandler & Lalonde 2006; Ayunerak culture are related—the maintenance reconciliation and the et al. 2014; Anderson & Kowal 2012; of each helping to protect the other— generation of ‘hope for Anderson & Olson 2001; McDermott so sustaining languages is essential et al. 1998). (Biddle & Swee 2012). Language is healing’. both part of culture and can be the most central means of expressing culture—communicating it to others and transmitting it to the next generation (McConvell & Thieberger 2001; Posey 1999; Inuit Circumpolar Council 2012).

Of the 200 to 300 Aboriginal and Torres Strait Islander languages spoken prior to white settlement, by 1990 only 20 remained strong and

18 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 19 were being spoken by all age groups 2009). Aboriginal and Torres Strait 2006). For Canadian First Nations regularly. By 1996, 13 per cent of Islander people growing up on peoples, the ability to converse in Aboriginal and Torres Strait Islander missions were prohibited from their own languages produces a peoples spoke Indigenous languages. speaking their languages (Standing strong sense of self and thus reduces Both ‘the number of Indigenous Committee on Aboriginal and Torres rates of suicide among youth. It languages, and the percentage of Strait Islander Affairs 2012). Many has been found that, if half of the people speaking [them]… continued Aboriginal and Torres Strait Islander members of a community reported to fall in the period 1986–1996, people were actively discouraged a conversational knowledge of their accelerating over [those] ten years’ from speaking their languages in own language, the youth suicide (McConvell & Thieberger 2001:viii). public (Walsh 1993). rates effectively dropped to zero Post-colonisation, Aboriginal and (Hallett, Chandler & Lalonde 2007). Torres Strait Islander people have This has led to the loss of oral Writing in an Australian context, often had negative experiences culture and intergenerational Regan and Troy (2014:121) state: when they speak their language—for relationships (Walsh 1993; example, there have been negative McConvell & Thieberger 2001; There is a critical implications when dealing with the Simpson, Caffery & McConvell 2009). correlation between the Canadian First Nations children health and justice systems (Eades strength of the languages, placed in the Indian residential 1991, 2015; Lowell et al. 2015; the pride and wellbeing of Goldflam 1997). schools system were prohibited from speaking their own languages or the communities, and the Knowing an Aboriginal and/or Torres expressing and practising cultural mental and physical health Strait Islander language is essential and spiritual beliefs. Residential of individuals. The benefits for the preservation of culture, for school attendance was found to be of teaching Aboriginal identity and to learn where you a significant determinant of health, people, especially children belong (Walsh 1993; Standing with poor health status being more Committee on Aboriginal and commonly reported by those who and youth, the languages Torres Strait Islander Affairs 2012). attended a residential school when include better outcomes in An Aboriginal and Torres Strait compared with those who did not English language education Islander language is a great source of attend (Kaspar 2014). and employment, and knowledge and tradition about the reduced substance abuse environment and culture for both There is a positive relationship and suicide… Aboriginal and Torres Strait Islander between the sustainability of peoples and non-Indigenous people Aboriginal and Torres Strait Islander However, there have been few formal (Biddle & Swee 2012; McConvell & land, language and culture on evaluations or studies of Aboriginal Thieberger 2001). For the Nunavut subjective emotional wellbeing and Torres Strait Islander suicide and Nunavik Inuit, language plays (Biddle & Swee 2012; Marmion, prevention programs, and those a crucial role within contemporary Obata & Troy 2014; Standing that have occurred are inconclusive Inuit culture whereby ‘Inuktitut is Committee on Aboriginal and Torres (Dudgeon, Calma & Holland 2016). highly valued by most of its speakers, Strait Islander Affairs 2012). The loss of language has been linked to the both as the easiest way to express A wealth of research demonstrates loss of environmental knowledge— their feelings and inner thoughts, that learning and speaking in in particular, knowledge of local and as a symbol of who they really language is associated with many biodiversity and natural medicines are’ (Dorais 1995:295). positive outcomes. These include: (McConvell & Thieberger 2001; Posey 1999; Vass, Mitchell & • significantly higher traditional Impacts of language Dhurrkay 2011; Biddle & Swee 2012). food consumption (Galloway, on health Johnson-Down & Egeland 2015; Over several years, Chandler and McConvell & Thieberger 2001; The dismantling and suppression of colleagues studied the protective Posey 1999) Aboriginal and Torres Strait Islander factor of language against the high languages throughout colonialism risk of suicide in Canadian First • improved physical health (Oster has broken links to and between Nations communities. They found et al. 2014; Wham et al. 2015) generations. Since colonisation, that efforts to preserve and promote • improved educational Australia has been regarded as a culture, including language, are monolingual society, with limited performance (Bougie & Senecal associated with dramatic reductions 2010; Berger 2009; Simpson, value placed on Aboriginal and in rates of youth suicide (Chandler Torres Strait Islander languages Caffery & McConvell 2009; & Lalonde 1998, 2006; Chandler et Fiddler 2015; Lowe, K. 2015) (Simpson, Caffery & McConvell al. 2003a, 2003b; Chandler & Proulx

18 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 19 • a reduction in mental health have stimulated Aboriginal people to Articulating language subsistence, symptoms and increase in learn their language (Fonda 2009). social and socioeconomic skills and resilience (Bals et al. 2011; practices as parts of an integrated Respondents to the Second whole by presenting language Nystad, Spein & Ingstad 2014; National Indigenous Languages Hallett, Chandler & Lalonde learning as lifelong, holistic and Survey were unanimous about anchored in meaningful and 2007; Chandler & Proulx 2006; wanting Aboriginal and Torres Strait Pearce et al. 2015) safe contexts—including spaces, Islander languages to be strong activities and relationships—is • a higher level of self-reported well into the future, to have their key to achieving and sustaining happiness (Biddle & Swee 2012) languages taught in schools, and bilingualism and bi-literacy (Tulloch for their languages to have better • community interconnectedness et al. 2009). Following their research recognition in Australia (Marmion, on bilingual education for Aboriginal (Bishop, Colquhoun & Johnson Obata & Troy 2014). ATSIHF 2006) peoples in the Northern Territory, concluded that language and its Simpson, Caffery and McConvell • cultural continuity (Bougie & revitalisation are key to healing (2009) concluded that, in order to Senecal 2010; Marmion, Obata from intergenerational trauma give authority to the reclaiming & Troy 2014; Nystad, Spein due to colonial settlement. The of official space for language in & Ingstad 2014; Oster et al. ATSIHF Development Team (2009) schooling, it will be necessary to 2014; Standing Committee on recommended that language be adopt strong bilingual models of Aboriginal and Torres Strait incorporated into cultural renewal education, along with community- Islander Affairs 2012). initiatives with the re-establishment anchored leadership. of song, dance and ceremony. Language revitalisation For Aboriginal and Torres Strait Essential elements for the successful Islander children, a strong family Researchers studying the survival of delivery of language activities are and community focus on storytelling Aboriginal and Torres Strait Islander involvement of, and commitment and book reading, and undertaking languages (Walsh 2005, 2010) and by, community members; adequate activities such as music, art and the Inuit language (Dorais 1995) funding; and access to language craft in Aboriginal and Torres Strait have concluded that the process of resources, including children’s books Islander languages, are major language revitalisation is political and (Marmion, Obata & Troy 2014; parts of the language-learning will take a tremendous commitment McLeod, Verdon & Bennetts Kneebone environment. The Longitudinal on the part of the communities and 2014; Simpson, Caffery & McConvell Study of Indigenous Children those who might assist them if these 2009). Australian and Canadian found that more children used languages are to survive. Following research has shown that radio and an Aboriginal and Torres Strait their survey of Aboriginal and Torres television network broadcasting in an Islander language during oral Strait Islander languages, Marmion, Indigenous language has been crucial storytelling and swimming than Obata and Troy (2014) concluded for raising awareness of Indigenous in any other activity (McLeod, that active use and transmission of languages among the general public, Verdon & Bennetts Kneebone languages is key to strengthening strengthening language use and 2014). Language education also and maintaining them. empowering communities (Minore has important sociocultural and & Hill 1990; McConvell & Thieberger practical implications. It can help Language revitalisation has been 2001). reverse some of the adverse effects led by the younger generation in of colonisation by assisting the Canada with the creation of the Inuit minority language to gain prestige. It Circumpolar Youth Council in 1994 Indigenous language can also be a vehicle for transmitting to develop Inuit youth networks. education history and cultural heritage to Its goals were to instil pride in Education predominantly based on both Aboriginal and Torres Strait speaking the Inuit language, to Euro-Canadian values, curricula and Islander communities and non- motivate youth to learn or speak it pedagogy, privileging English over Indigenous people, thus promoting more often, and to inspire youth to Inuit languages, has been linked to cross-cultural communication respect all dialects (Coley & Tulloch poor academic achievement (Berger and understanding (Dundon n.d.; 2008). Elders in Canada have noted 2009). In Norway, guaranteeing Minore & Hill 1990; Simpson, that ‘involvement in ceremonies education in, and giving official Caffery & McConvell 2009; Standing is an antecedent to learning one’s language status to, the languages Committee on Aboriginal and Torres language’ (Fonda 2009:4). For of its Aboriginal people, the Sami, Strait Islander Affairs 2012; O’Bryan language revitalisation, attendance has had a major impact on Sami & Rose 2015; Perso 2012). and participation in ceremonies, education (Corson 1996). particularly those involving songs,

20 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 21 part of our diversity they biologically related or not, live in. It is [also] a national as kinship and ceremonial concept. ties are binding. This would apply even if I had Family and kinship never met the individual concerned. (Fejo-King Family, kinship The Aboriginal and Torres Strait 2013:76) and community Islander concept of kinship is more than the Western concept The extended kin network has the Aboriginal and Torres Strait Islander of being born or marrying into same connections, responsibilities identity is more than simply family. Christine Fejo-King’s and rights as the Western nuclear biology—it is predicated on descent father was a Larrakia man and her family. Thus a man’s children are and Country or island of origin. It mother a Warumungu woman. She those of his patrilineal line and a is about knowing and being part explains the concept of kinship woman’s children are those of her of a community and perception of in the publication that followed matrilineal line (Morphy 2004; oneself as Aboriginal and/or Torres her research on her peoples. She Dietsch et al. 2011). The kinship Strait Islander. Despite the processes describes kinship as ‘a network of system provides a support network of colonisation, dispossession and social relationships and a form of with defined roles within the dispersal, there is still a strong governance’ (Fejo-King 2013:69), extended family that link people sense of community. Aboriginal and then elucidates further: through duty and care. Kin terms Torres Strait Islander societies are situate a person’s identity and create constructed around communities Kinship and family law is both biological and social networks that have within them strong kinship taught at a young age and (Warburton & Chambers 2007; and family ties. As Nyungar man and reinforced throughout Bishop, Colquhoun & Johnson 2006). academic Ted Wilkes (in Dudgeon et childhood. Family extends Kinship has had positive effects on al. 2002:248) said: beyond a westernised the retention and transfer of cultural The Aboriginal community perspective, with terms like knowledge and overall health and wellbeing of Aboriginal and Torres can be interpreted as mother, father, auntie and Strait Islander peoples, particularly geographical, social uncle carrying different children (Dietsch et al. 2011). and political. It places meanings. The sisters of my Aboriginal people as part mother and all the women Family is defined in Aboriginal and Torres Strait Islander terms as a of, but different from, of her generation, with fluid and complex composition some kinship or ceremony the rest of Australian based on overlapping kinship society. Aboriginal people tie, whether blood related systems and networks and with identify themselves with to her or not, would all adults and children moving between the idea of being part share the same skin name. households (Lohoar, Butera & of ‘community’; it gives The same applies for my Kenned 2014). Connections to family and friends, and volunteering in us a sense of unity and father and his brothers local support centres, are not only and all the men born in strength. Sometimes issues considered important for social based groups are perceived his generation… share the capital, health and wellbeing, but as a community—but same skin name. They are also part of family responsibility that is not the case, it are all my mothers and (Browne-Yung et al. 2013). These is a re-configuration of fathers and we would family and kinship networks have been identified as essential for some parts of the existing have the same obligations the transmission of knowledge of care and reciprocity community. I think of all of about chronic disease and health us together, as a political existing between us as behaviours to young people by older and cultural group. It though they were my family members and Elders (Aspin includes everyone, no literal biological parents… et al. 2012; Oosten & Laugrand matter what ‘faction’ Everyone is treated the 2002). The need for these networks also manifests in the advocacy and or local group they are same within these skin support provided to people with groupings whether they are affiliated with, or which chronic diseases and Elders in the

20 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 21 healthcare system (Aspin et al. 2012; demands placed on individual Aboriginal and Torres Strait Islander Smith, K., Grundy & Nelson 2010; resources (Waterworth et al. 2015; concepts of life balance are deeply Waterworth et al. 2015; Waugh & Johnston et al. 2007), pressure or connected to family and society, Mackenzie 2011). influence on initiating poor health Country and way of life. As health is behaviours (Johnston & Thomas spiritual, emotional, psychological, Similarly, for Māori people, 2008; Warbrick, Wilson & Boulton physical and connected to the extended family or Whānau 2016) and disruption of stability in land and ancestors, it cannot be knowledge is considered crucial family life with changes in the family isolated from the social, economic to supporting the healing of ill membership or household (Ritchie et and historical state of colonisation, family members (Hopkirk & Wilson al. 2014; Zubrick et al. 2010). disconnection from land and kin, and 2014). Extended family networks continuing marginalisation (Baba, and interconnectedness among Findings from research conducted Brolan & Hill 2014; McDermott community members and the by Watkin Lui and colleagues with et al. 1998; Thompson, Chenhall environment appears to strengthen Torres Strait Islander people living & Brimblecombe 2013; Saunders Norwegian Sami adolescents’ in the Australian mainland cities 2014; Pulver et al. 2010; Zubrick et ethnic identity and pride. This of Brisbane, Cairns and Townsville al. 2010). The impact of colonisation strengthening of identity and pride found that ‘Around 90% of on the health and wellbeing of in turn acts as a potential resilience respondents indicated that family Canada’s First Nations peoples mechanism (Nystad, Spein & Ingstad security was very important to them, also affects many aspects of their 2014; Bals et al. 2011). with 36% indicating that it was the lives—a major loss being breakdown most important value in their life’ of the family unit through residential Research on factors that help (Watkin Lui, Stoeckl et al. 2016:351). schooling and assimilation policies build social conditions to ensure Watkin Lui’s earlier (2012:146) (MacDonald, C. & Steenbeek 2015; Aboriginal and Torres Strait Islander work in the Torres Strait led her to Bougie & Senecal 2010; Dyck et al. children are raised in a safe and conclude that ‘Family and kinship 2015; Kaspar 2014; Richmond & happy environment emphasise the connections were the biggest Ross 2009). importance of a socially inclusive influences shaping the narratives approach to raising children of place and home, responsible for where their wellbeing and safety fostering a sense of belonging to a Community is a shared responsibility. Elderly collective, even if the person had Rowley and colleagues reviewed family members providing support, never been to the Torres Strait’. In hospital and primary healthcare and contributions to family a conversation with Watkin Lui, a records and death certificates from functioning is crucial (Lohoar, Torres Strait Islander male in his early 1995 to the end of 2004 for 296 Butera & Kenned 2014; Priest et thirties who lived on the Australian Aboriginal people in the Northern al. 2016; Waugh & Mackenzie mainland expressed this sense of Territory aged 15 years and over. 2011). Childcare and childrearing belonging: The review revealed better than involving extended family and kin expected health for all-cause and are also a significant part of life It’s just funny how most of cardiovascular diseases since rates for Native Americans. Local health the people I’ve met who were 40–50 per cent lower than knowledge and traditions (provided are from the Torres Strait average for Aboriginal adults in by grandmothers and Elders) in the Northern Territory (Rowley et the raising of children have been Islands, most of the young al. 2008). A follow-up analysis of identified as essential for building fellas or the women who anthropological records by Anderson family and community relationships have come down from the and Kowal (2012) showed that, for and for children’s overall health Islands to study, I identify that community, the cultural and (Cidro et al. 2014). with them straight away. I social structures were maintained Research on Aboriginal and Torres know a lot of people from from before colonial occupation Strait Islander and Māori peoples the Islands. I’ve got cousins in the 1930s. This was facilitated has found that, where there is a up there [referring to the by late colonial occupation, intercultural practices of the local strong cultural obligation to family, Torres Strait] so we yarn pastoral industry and the absence of including providing for a large and say do you know such network of people (as a result of a mission or government settlement. the kinship system), there can be and such… (Watkin Lui Maintenance of the Aboriginal social a negative impact on health and 2012:146) and cultural structures strengthened healthy behaviours. These include the psychological and physical

22 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 23 the psychosocial determinants of per cent of respondents indicated Sporting carnivals also health, such as connectedness to that honouring Elders was very provide opportunities culture and land. important, and 22 per cent reported for important cultural that it was the most important value values to be expressed Social support, in the form of in their lives (Watkin Lui, Stoeckl et positive interactions in a social al. 2016:351). and publicly maintained. setting, emotional support and In recent years I have guidance, tangible support, and Research on Indigenous youths from witnessed how families community affection and intimacy Australia, Canada, Norway and the have used these public are strong determinants of health United States has concluded that identified for Canadian First Nations community-based and community- gatherings to pay respect peoples (Richmond & Ross 2009; driven programs for restoring, to those who have recently Richmond, Ross & Egeland 2007) promoting and maintaining health died and, in some ways, and for Australian Aboriginal women are also key to the prevention of extend the ritual of sorry (Holmes 2016). Community support youth anxiety and suicide (Yi et al. business. for mother and child and social 2015; Adermann & Campbell 2007; influences are also essential for Ayunerak et al. 2014; Bals et al. McCoy (2008:149) cites a comment child health and wellbeing, physical 2011; Nystad, Spein & Ingstad 2014; from a participant, which is directly health, building social relationships, Chandler & Proulx 2006; Haswell et related to the importance of football improving resilience and education al. 2013; Kral 2010; MacDonald, J. P. for social and emotional wellbeing: readiness (Amnesty International et al. 2015; McCalman et al. 2009; 2016; Armstrong et al. 2012; Bishop, Thorpe, Anders & Rowley 2014). The only time I see [that Colquhoun & Johnson 2006; Cidro et the men are happy is] when al. 2014; Commission for Aboriginal Sport they play [sport] together. Children and Young People 2013; Goudreau et al. 2008; Yi et al. 2015). For Aboriginal players in Aboriginal [They] come together and sporting organisations, community talk… about other issues Aboriginal and Torres Strait connection, cultural values and and mixing and sharing… If Islander Elders have crucial roles identity have been identified as we come together and talk in their communities, including significant. Social and community a lot about the problems in kinship relationships, support connection is an important for the young and transmission mechanism for maintaining and or things like that, we’ll of cultural knowledge. There is strengthening cultural values and be happy. Our health will also the key concept of respect for identity. Aboriginal sports teams be happy. We know that older people as ‘survivors’. This play an important role in promoting everyone is happy…. essential role is highlighted by the social, emotional and physical time and effort that Elders invest in wellbeing in young Aboriginal men Sports programs are a part of federal their communities. Contemporary and also have the potential to have a initiatives aimed at increasing contributions include sitting on profound impact on the health and school attendance and retention political and cultural rights boards wellbeing of Aboriginal communities among Aboriginal children (Purdie & and visiting prisons, hospitals and (Thorpe, Anders & Rowley 2014). Buckley 2010). Their effects include schools (Warburton & Chambers improvements in: 2007; Waugh & Mackenzie 2011). In 2008 McCoy wrote about As custodians of traditional Australian Rules football in • school retention knowledge, history, culture and particular and its popularity among • attitudes towards learning language, Elders have a vital role Kimberley men for, at that time, in the transfer of knowledge to the more than 20 years. He wrote that • social and cognitive skills ‘It provides an energetic social and younger generation. This knowledge • physical and mental health and geographical space for exercise, provides protective factors for the wellbeing health and wellbeing of the next discussion and male group activity. generation (Larkins 2010). Research It is not surprising to see large • social inclusion and cohesion conducted by Watkin Lui and groups of men travelling to football • validation of, and connection to, colleagues with Torres Strait Islander carnivals’ (McCoy 2008:145). McCoy culture people living in the Australian (2008:150) observed that: mainland cities of Brisbane, Cairns • a reduction in crime (Ware & and Townsville found that almost 80 Meredith 2013; Yi et al. 2015).

22 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 23 Social determinants are those experiences of devastation of health (Dudgeon et al. 2010). ‘Social determinants’ is the term Cultural education comes through used to ‘describe the non-medical passing down languages, dance, and behavioural influences family and cultural history, music on health’ (Anderson, Baum & Cultural and knowledge relating to sites, Bentley 2004:ix). Disadvantages food sources and bush skills. The in the social determinants of expression Dreaming and Dreamtime stories health include having ‘few family and continuity with oral traditions and histories assets, having a poorer education are integral for continuing cultural during adolescence… having Culture is central to identity since practices and recovery for those who insecure employment and living it ‘defines who we are, how we have been misplaced (Vickery et al. in poor housing’ (WHO 2003:10). think, how we communicate, what 2007; Anderson & Kowal 2012). Disadvantage can also include ‘social we value and what is important to Cultural healing or ‘cultural exclusion which results from racism, us’ (Larkins 2010:11). Aboriginal intervention’, reclaiming history discrimination, stigmatization and Torres Strait Islander cultures and therapeutic interventions are [and] hostility’ (WHO 2003:16). For developed over an estimated 65,000 the pillars of healing developed by Aboriginal and Torres Strait Islander years prior to European settlement First Nations peoples in Canada populations, culture is seen as (Clarkson et al. 2017). During this and subsequently by Aboriginal the dominant social determinant time, customs and practices evolved and Torres Strait Islander peoples of their health. Devitt, Hall and into a sophisticated relationship of (ATSIHF Development Team 2009; Tsey (2001:3) explored the social sustainability with the Australian Aboriginal & Torres Strait Islander determinants of health in Northern environment. Aboriginal and Social Justice Commissioner 2005; Territory Indigenous populations Torres Strait Islander cultures are Peeters, Hamann & Kelly 2010). and noted that ‘Cultural change complex and diverse. There is no Aboriginal and Torres Strait Islander powerfully effects the structure of single culture or people (Dockery cultures and spirituality are great social relationships; in particular, 2009; Vickery et al. 2007). Overall, sources of strength and resilience it redefines the things that mark or Aboriginal and Torres Strait for children (Priest et al. 2016; indicate social standing’. Islander cultures can be understood Amnesty International 2016) and as connection to Country and Using data from health and social the foundation for strong positive community; respect for Elders, surveys of the Aboriginal and identities as adults. Cultural healing kinship and family connections; Torres Strait Islander population is, therefore, crucial to health and gender and age roles; identity; between 2002 to 2012–13, Crawford wellbeing (Larkins 2010; Priest et al. language, art and ceremony; and and Biddle (2017) examined 2012; Saunders 2014). Due to the spirituality and storytelling (Priest et the association between social holistic nature of wellbeing, culture, al. 2016; Vickery et al. 2007; Crowe determinants and health and empowerment and community are et al. 2017; The Lowitja Institute wellbeing outcomes. They found essential components for education, 2014). that employment status and housing work, health and wellbeing (Cairney were significantly associated with Colonisation, dispossession, the et al. 2017). a range of health and wellbeing forcible removal of children and A study of Aboriginal parents found outcomes for Aboriginal and Torres the devaluation of Aboriginal that great importance was placed Strait Islander peoples. Crawford and and Torres Strait Islander cultures on education and on children Biddle (2017) concluded that a more have had profound effects on maintaining and learning about detailed analysis of improvements health and social and emotional aspects of their culture for identity in health and wellbeing outcomes wellbeing for individuals, families development, and on the positive outside urban areas—despite and communities (Dockery 2009; experience of culture and the declining opportunities for HREOC 1997; The Lowitja Institute significance of support from the employment—is required to 2014; Dockery 2011; Steering community to which they belong. ascertain whether there are any Committee for the Review of These are all seen as preconditions differences in health outcomes Government Service Provision 2014). for the achievement of success between Aboriginal and Torres Strait However, the history of resistance through education (Colquhoun & Islander people living in urban areas and resilience are as much part of Dockery 2012). Cultural connection and those living in non-urban areas. contemporary Aboriginal and Torres has been identified as a key factor Strait Islander culture and identity as for the health and wellbeing of

24 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 25 Aboriginal and Torres Strait Islander supposed to come near wellbeing of Aboriginal and Torres children, particularly where a child her. My mother was in Strait Islander peoples, it should be has been removed from his or her the compound, huge wire routinely included as part of holistic family or Country (Larkins 2010; care in psychiatric assessments fence, concentration camp ATSIHF Development Team 2009). (Wand, Eades & Corr 2010; Participation in cultural activities fence and the tribal people, Balaratnasingam & Aleksandar and community-led programs old tribal women would 2017; Hinton et al. 2015; Isaacs, involving cultural learning and come up to the fence and Maybery & Gruis 2012; Janca et mentorship have been identified as call the little children al. 2015; Kilcullen, Swinbourne & key strategies to keep Aboriginal over. When the children Cadet-James 2018; Le Grande et al. and Torres Strait Islander youth out 2017; Mares & Robinson 2012). In came over they would of detention and the justice system addition, acknowledging Aboriginal (Amnesty International 2016). hold their little hands and Torres Strait Islander spirituality through the wire and tell is a significant factor for wellbeing Connection to self and culture them who they were, who (McLennan & Khavarpour 2004; can be developed and maintained their mothers were, where Kilcullen, Swinbourne & Cadet-James through a range of activities and 2018). embedded throughout all avenues they’d come from, what of life, including connecting with their skin was, what their In Canada, specific measures the land, learning from Elders totem and dreaming was. have been developed to assess through collecting and eating bush child health and wellbeing. The tucker, fishing and hunting (Crowe Following their interviews with Aboriginal Children’s Health and et al. 2017), and participation in children in three urban Aboriginal Wellbeing Measure was developed Aboriginal sporting organisations communities, Crowe and colleagues intentionally for children so that (Thorpe, Anders & Rowley 2014). (2017) concluded that positive Aboriginal health directors could McCoy (2008:163) found that: emotional health was associated gather local data to guide the with connection and engagement planning and evaluation of health Football provides a with culture, sharing knowledge services, since it was determined contemporary space in and seeking new understanding for that mainstream measures were which some Aboriginal Aboriginal children. not appropriate for use in their men maintain and communities (Young et al. 2017). Participation in cultural activities For this Canadian measure, cultural develop ancient hunting by Aboriginal and Torres Strait relevance was of critical importance techniques. These Islander peoples has been identified in the development process, also experiences provide a as protective against mental health taking into consideration cultural source of energy for men as problems (Bals et al. 2011; Chandler diversity between communities and & Lalonde 1998; Chandler & Proulx they result in personal and involvement of children early in the 2006; Colquhoun & Dockery 2012; research practice. group satisfaction. Currie et al. 2013; Hinton et al. 2015; Kilcullen, Swinbourne & Cadet-James An example of the way that culture 2018; Kirmayer, Simpson & Cargo Identity has been passed on to members of 2003; Larkins 2010; MacDonald, J. Cultural identity may be described the Stolen Generations and their P. et al. 2015). However, an analysis children was reported to Kevin as connection to community, of consultation–liaison psychiatry respect for Elders, kinship and family Gilbert. A female Elder told him that, services found that culture is often despite her mother being stolen connections, gender and age roles, only indirectly and infrequently identity, language, art, and ceremony at the age of six, she had learned documented in clinicians’ ‘enough of her culture to impart it to and connection to Country. Culture is assessments of Aboriginal and critically important—it is the central me, and even the language’ (Gilbert Torres Strait Islander peoples (Wand, 1977:11)—she went on to give a core of Aboriginal child health and Eades & Corr 2010; Balaratnasingam wellbeing. Following their interviews moving explanation of how this had & Aleksandar 2017; Janca et al. happened: with 25 caregivers of Aboriginal 2015). children living in Melbourne, Priest and colleagues (2012:183) It’s incredible what my Several researchers have concluded that culture provided ‘a mother learnt about recommended that, since culture basis for both “Strong Child” and a is a fundamental aspect of the herself when the tribal “Strong Environment”’—they added social and emotional health and people weren’t even that it ‘was seen as the ultimate

24 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 25 source of answers and meaning The role that culture plays in diet new possibilities for the survival, in life and as a supply of strength was shown when participants, who growth and wellbeing of Yup’ik youth for Aboriginal children as they took joy in eating traditional food, (Ayunerak et al. 2014). grow’. In an interview with Watkin associated this with family and Lui (2012:149), a first-generation culture. The role of culture was also Arts and music mainland Torres Strait Islander demonstrated by the influence of in his early sixties explained the families on a participant’s habits Aboriginal and Torres Strait Islander importance of the relationship and beliefs about traditional foods, peoples’ participation in cultural between culture and identity: since those whose families regularly activities, including arts and cooked traditional foods enjoyed crafts, music, dance or theatre, When you practise culture them, ate them more often and and writing or telling stories, are then you understand who assisted in their preparation (Kerpan, important elements of traditions and you are and where you Humbert & Henry 2015). community sustainability, as well as come from and what you spiritual and social wellbeing (ATSIHF Poroch and colleagues (2009) found Development Team 2009; ABS 2010; believe in. That’s why we that ceremony, art and song resulted Ware 2014). Stories, art and dance need to keep it alive and in resilience in the face of racism tell of the creation of Country, the get our children to carry on and generational trauma as a result Dreamtime and the people. They and keep it alive. of colonisation, and resistance to provide communication between the colonising of Aboriginal and ancestors and the natural world and Torres Strait Islander spirituality. are important means of passing on Cultural practices In urban settings, this has been knowledge (Vickery, Clarke & Adams carried on through Welcome to Using data gathered during the 2004; Martin & Mirraboopa 2013; Country ceremonies, Dreaming 2007–2008 Inuit Health Survey, Prout 2012). Singing in language is stories, smoking ceremonies, Galloway, Johnson-Down and part of spirituality and connection artefact making and face painting. Egeland (2015) investigated to Country and ancestors, since ‘it It also manifests in young Aboriginal the socioeconomic and cultural awakens the ancestors and brings people being artists and painters, correlates of diet quality. Their the Country to life’ (Dwyer 2012:12). performing stories through hip-hop logistic regression revealed that Arts, craft, music and dance provide and rap, and playing the didgeridoo age and cultural variables were a strong connection to culture, in both Aboriginal and non- significant predictors of higher diet where participation in these Aboriginal settings. quality. Increased age and use of activities is a measure of cultural activities (Larkins 2010). the Inuit language in the home were Aboriginal women in northern significant predictors of traditional Ontario have been using a hand- Art and art therapy are important food consumption. There were also drumming circle as a means of social for improving mental health and significant regional differences support and cultural revival. This enhancing the emotional and social in total energy intake, as well as has led to several positive outcomes, wellbeing of Aboriginal and Torres percentages of energy intake from including ‘a sense of holistic healing, Strait Islander people. They have saturated fats and high-sugar empowerment, renewal, strength been identified as ways for cultural beverages. Galloway, Johnson-Down and Mino-Bimaadiziwin “good life”’ healing (Allain 2011; Arnott et al. and Egeland (2015) also found that (Goudreau et al. 2008:72). 2010; ATSIHF Development Team traditional food consumption was 2009; Ware 2014; Jersky et al. positively associated with greater For the Yup’ik of Alaska, traditional 2016). Engagement in music and energy from protein and negatively cultural practices such as the arts is linked to mental health and associated with total energy. ‘Qasgiq’ (Men’s House), where boys social and emotional wellbeing were taught survival and hunting because thoughts and feelings can Kerpan, Humbert and Henry skills and where people could go be expressed in less public ways. (2015) found a common theme of for advice and seek healing, were It can also lead to employment ‘Traditions and Sharing’ in their actively shut down by missionaries and access to economic and social ethnographic study examining diets in many communities. This brought resources (Guerin et al. 2011). for urban Aboriginal youth in North about rapid social change and Times of hardship can spur an America. They reported that food- dramatically altered the system and increase in arts and music. An sharing networks were often used structure of communities. Today, effect of prolonged drought on the to acquire traditional food, which however, revitalisation of key Yup’ik health and wellbeing of Aboriginal was believed to be healthy and was activity settings and social networks people living in communities in desired by the study participants. within communities is offering

26 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 27 rural New South Wales was that it organisations in Canada have prompted increased love of, and been found to nurture and support concern for, land. There was also a traditional artistic freedom and renewed enthusiasm for expressing growth. The freedom of self- connectedness to land through all governance provides expressions forms of art, including painting, of cultural sovereignty that enrich printing, photography, film, theatre, the cultural life of broader society Self-determination music and dance (Rigby, Rosen et al. (Foster 2013). Arts also provide 2011). a cultural opportunity for those and leadership who are unable to participate in, Self-determination and involvement Participation in music, particularly or are unprepared for, outside in decision making and control in Aboriginal and Torres Strait employment, to earn income and be over an area or program are both Islander music groups, has many an active and contributing member historical and current topics that health-promoting benefits, of their community (Biddle & Swee are politically charged. They are also including empowerment and 2012; Campbell 2016). Despite the essential for the health of Aboriginal renewal. Additional benefits growth in the Aboriginal art market, and Torres Strait Islander peoples. include a sense of holistic healing the socioeconomic circumstances of The loss of self-determination and a building of strengths that some Aboriginal communities where through dispossession and already exist in the community arts flourish require investigation colonisation has resulted in (Goudreau et al. 2008). Language, (Altman 2005). song and dance, particularly as part the destruction of traditional of ceremonies, not only promote Although participation in cultural governance structures and the cultural learning, the transmission activities is higher among Aboriginal breakdown of traditional and healthy of cultural knowledge and spiritual and Torres Strait Islander people patterns of individual, family and awareness, but are also important living outside of cities and towns, community life. These need to be for the healing process (ATSIHF there is still a large group of people addressed in order to improve health Development Team 2009; Arnott et in urban areas producing art, writing (Mowbray 2007). al. 2010; Dwyer 2012). A Canadian or telling stories, and performing Mowbray’s international review study found that traditional songs, music, dance or theatre (ABS 2010; of the social determinants of particularly those in ceremonies, Biddle & Swee 2012). One strategy Indigenous health cites Article 3 stimulated revitalisation of for embedding Aboriginal and of the (then draft) United Nations language—those attending Torres Strait Islander perspectives Declaration on the Rights of ceremonies had been stimulated in schools is to include art forms, Indigenous Peoples: ‘Indigenous to learn their language in order to song, dance, music and visual arts people have the right of self- understand the songs (Fonda 2009). as a means of traditional knowledge determination. By virtue of that transfer to children (Department of right they freely determine their Aboriginal art centres in Australia Education and Training 2011). have social and cultural benefits, political status and freely pursue as well as positive effects on the Cultural festivals, often with a their economic, social and cultural economic, physical, psychological, ceremonial, dance, music and song development’ (Mowbray 2007:32). spiritual and emotional development focus, provide a strong method A requirement for reversing of people and their whole of cultural transmission and colonisation is self-determination community (Allain 2011; Ware connectivity for Aboriginal and to help people restore control over 2014). They provide a safe place Torres Strait Islander people. They their lives and destinies. In order to to learn new skills, explore and also foster intercultural exchange achieve ‘Political empowerment, deal with personal and community and broader community cohesion for legal and institutional reform’: trauma and dysfunction, build non-Indigenous people (Ware 2014; social networks, counter boredom, Phipps & Slater 2010). [It is necessary to s]top the and reduce crime and antisocial violation of the human behaviour. They also increase civic rights of Indigenous engagement, social inclusion and people; recognize the engagement in cultural maintenance collective rights of and transmission (Ware 2014; Indigenous peoples (e.g. Barraket 2005; Allain 2011; Cooper, Bahn & Giles 2012; Jersky et al. political representation; 2016). Similarly, Aboriginal arts treaties, rights to self-determination;

26 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 27 participation in 2014; Dew et al. 2015; Holmes Strait Islander healthcare workers, institutional processes, 2016; Isaacs, Maybery & Gruis nurses and doctors (Aboriginal land rights); reconciliation 2012). The wellbeing of Aboriginal Nurses Association of Canada 2009; and Torres Strait Islander people Anderson & Olson 2001; Blackman and negotiated has been fundamentally affected 2011; Knibb-Lamouche 2012; settlements; Ameliorate by colonisation, historical trauma, Medical Deans Australia and New the harms caused by grief, loss, and ongoing social Zealand 2016). Recommendations to omission and commission marginalisation (Mathews 1997). reform healthcare include: by the criminal justice and This can result in symptoms not • improving cultural knowledge legal system… (Mowbray identified by ‘standard’ wellbeing assessment instruments (Le Grande and embedding an attitude 2007:27) et al. 2017; Wand, Eades & Corr of cultural sensitivity in the 2010; Mares & Robinson 2012). healthcare workforce (Chong Cultural safety et al. 2011; Blackman 2011; Thomas and colleagues Hopkirk & Wilson 2014; Janca et Policies and practices described (2010) found differences in al. 2015; Knibb-Lamouche 2012; as culturally safe include those symptomatology among young Le Grande et al. 2017; McLennan that bring cultural considerations Aboriginal people in diverse & Khavarpour 2004; McMurray & that have been shown to communities across the Northern Param 2008) benefit communities into policy Territory. Feelings of sadness and • improving access to healthcare development, strategic planning low mood were linked with anxiety, (Chong et al. 2011; Felton-Busch and training (Hunt & Campbell and the expression of anger was 2009; Hinton et al. 2015; Kildea 2016). There are Aboriginal and verified as a unique symptom of et al. 2017) Torres Strait Islander and some depression. The pervasive influence community-based medical services of racism and discrimination in • developing relationships with that enshrine cultural safety as a healthcare may have negative communities (Chong et al. central operational value (ATSIHF results for Aboriginal and Torres 2011; Brascoupe & Waters Development Team 2009; Alford Strait Islander peoples, including 2009; Hinton et al. 2015; Isaacs, 2014; Baba, Brolan & Hill 2014; reduced healthcare-seeking Maybery & Gruis 2012; Lowell et Mares & Robinson 2012; Panaretto behaviour, unhealthy lifestyles and al. 2015) et al. 2014; Pulver et al. 2010; mental health issues (Baba, Brolan • recognising and integrating Smith, K., Grundy & Nelson 2010). & Hill 2014; Brascoupe & Waters Aboriginal and Torres Strait Cultural safety means embedding 2009; Dew et al. 2015; Dudgeon et Islander peoples’ knowledge cultural competence in training al. 2014; Holmes 2016; MacDonald, in healthcare programs and and policies (Bainbridge et al. 2015; C. & Steenbeek 2015). services (Aspin et al. 2012; Day, Parker, McKinnon & Kruske 2014), Silva & Monroe 2014; Dew et al. education (Perso 2012; Rigby, Lyons Culturally appropriate healthcare 2015; Diabetes Western Australia et al. 2011; Clark, L. et al. 2011) involves respect for Aboriginal 2014; Holmes 2016; Hopkirk & and research (Hurst & Nader 2006; and Torres Strait Islander peoples Wilson 2014; Kildea et al. 2017; Martin & Mirraboopa 2013; Lowe, and their cultures. It also involves Lowell et al. 2015) J., Riggs & Henson 2011). Culturally respect for their rights to uphold unsafe practices are those that and strengthen cultural values, • encouraging empowerment adversely affect cultural identity, beliefs, traditions and customs, and self-determination over health (Blackman 2011; McMurray and empowerment to develop their healthcare (Brascoupe & Waters & Param 2008; Williams 1999), institutional structures (Brascoupe 2009; Currie et al. 2013; Dawes government policy and service & Waters 2009) and partnerships et al. 2017; Hinton et al. 2015; delivery. through change at the societal, Kirmayer, Simpson & Cargo professional and individual levels 2003; Mares & Robinson 2012; Culture is a vital part of the lives of (McMurray & Param 2008). McMurray & Param 2008) Aboriginal and Torres Strait Islander peoples. Therefore, healthcare The need for cultural safety in • a commitment to supporting practitioners must incorporate it healthcare is required not only for the workforce, including into their holistic care. If not, health patients but also for healthcare Indigenous health workers problems can be compounded, since workers. This is because a culturally and liaison officers (Aboriginal patients may become reluctant to safe and culturally aware workplace Nurses Association of Canada visit health facilities (Anderson & is necessary for the recruitment and 2009; Anderson & Olson 2001; Olson 2001; Baba, Brolan & Hill retention of Aboriginal and Torres

28 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 29 Blackman 2011; Isaacs, Maybery Leadership In their research on reducing tobacco & Gruis 2012; Knibb-Lamouche exposure in the Gitxsan Territory in 2012; McMurray & Param 2008). Leadership and community control rural British Columbia, Varcoe and are essential components of self- colleagues (2010:155) found that Aboriginal Medical Services are determination. They are necessary leadership was understood as a key acknowledged as being a crucial for the creation and definition role for Elders: part of tackling the negative of successful outcomes. Several impacts on health because they commentators have identified Elders are people provide comprehensive, culturally Aboriginal and Torres Strait Islander knowledgeable about appropriate, community- leadership as critical for positive empowering care (Baba, Brolan & change and successful outcomes in culture and tradition… Hill 2014). Panaretto and colleagues health, education, governance and Elders are not always (2014:649) highlighted the vital community programs (Hunt 2016; persons over a certain need for Aboriginal Community Perso 2012; Phillips & Bamblett age, and not all older Controlled Health Services 2009; Putnis, Josif & Woodward persons are considered specifically and maintain that, 2007; Vickery et al. 2007; Zubrick et Elders. Rather, Elders are ‘To achieve the best returns, the al. 2010). current mainstream Closing the Gap those who have and show investment should be shifted’ to that Sustaining success in a community concern for others and sector. or program means retaining the community and show the right people in leadership leadership. positions—that is, those people who Self-determination and put the community’s interests to wellbeing The leadership role is apparent in the fore. Even with native title and this comment from a young mother Self-determination discourse needs land rights, it is the development who participated in the research: to be led by Aboriginal and Torres of community leadership and Strait Islander people to ensure control that delivers successful I think once our Elders step successful decolonisation in health. and sustainable long-term in and show what needs outcomes (Hunt & Campbell 2016). Communities view control over to be done… even though Community control and leadership their health as highly important our Elders don’t smoke, (Vickery et al. 2007). The Wharerata are required in order to tackle the Declaration—a framework to health problems of Aboriginal and but if they were to enforce develop Indigenous mental health Torres Strait Islander peoples (Parker no smoking here… It would leaders in Canada, the United & Milroy 2014; Purdie & Buckley step up and show that our States, Australia, Samoa and New 2010; Queensland Mental Health Elders are serious… (Varcoe Commission 2016; Thompson, Zealand (Sones et al. 2010)—led et al. 2010: 156) to the development of the Gayaa Chenhall & Brimblecombe 2013) and related problems such as domestic Dhuwi (Proud Spirit) Declaration Findings from a VicHealth (2005:28) violence (Dudgeon et al. 2012; (Dudgeon et al. 2016). Based on the investigation led the authors to Mowbray 2007; Prentice et al. 2014). key principle of self-determination, conclude that leadership is ‘Critical Aboriginal and Torres Strait Islander Communities with local leadership to the long-term survival and growth leadership in mental health is that organise change with of Koori [Aboriginal people from paving the way for improving the consideration for their own cultural New South Wales and Victoria] health and wellbeing of First Peoples needs have significant positive communities’. The VicHealth (Dudgeon & Bray 2018; Dudgeon, impacts (DPM & C 2016; Lowe, K. (2005:53) study authors added: Garvey & Pickett 2000; Dudgeon, 2015; Woinarski & Lewis 2017). Milroy & Walker 2014). Chandler and Leadership not only includes Elders participation in leadership Lalonde’s (1998) studies in Native in a community but also requires projects improved self- American communities found that, that youth leaders, as drivers of esteem and confidence, regardless of economics, those with social change, be developed and facilitated supportive the most self-determination and supported (Diabetes Western relationships and control over the social and cultural Australia 2014; Garnett & Sithole developed skills required institutions in their communities had 2007; Phipps & Slater 2010; Ritchie the lowest suicide rates. et al. 2014; Ware & Meredith 2013). for future growth. The opportunity to gain both

30 Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ cultures and their links to health and wellbeing 31 Summary of cultural indicators Our main findings from this synthesis highlight six main domains for describing culture specific to Aboriginal and Torres Strait Islander peoples in Australia. These domains, along with their corresponding sub-domains, are:

1 Connection to Country 4 Family, kinship and community

spiritual connection family and kinship

living on Country community

land rights and autonomy

caring for Country 5 Cultural expression and continuity

identity

2 Indigenous beliefs and knowledge traditional practices

spiritual and religious beliefs arts and music

traditional knowledge community practices

traditional healing sport

knowledge transmission and continuity

6 Self-determination and leadership

3 Indigenous language cultural safety

impacts of language on health self-determination and wellbeing

language revitalisation leadership

Aboriginal and Torres Strait Islander language education

There appears to be some overlap of these domains in the international context.

We have highlighted the often complex and overlapping factors that affect Aboriginal and Torres Strait Islander culture While we have likely and wellbeing. These factors can operate at the individual or not produced a community level. Importantly, we have identified that, while some practices, processes and beliefs are different in the context succinct definition of of Aboriginal and Torres Strait Islander culture, there are some culture, as a result of universal elements across Australia and internationally. We have this review we have a highlighted in this review that health and more broadly wellbeing better understanding appear to be enhanced when cultural elements and culture more of what things broadly is learnt, practiced and incorporated into people’s lives. constitute the varying While we have likely not produced a succinct definition of culture, as a result of this review we have a better understanding of what things constitute the parts of culture varying parts of culture for Aboriginal and Torres Strait Islander peoples and for Aboriginal and how these relate to health and wellbeing. Torres Strait Islander The authors acknowledge that this review may not include some elements of peoples and how these Indigenous peoples culture however this paper, has for the first time, put in one place the range of factors describing Aboriginal and Torres Strait Islander relate to health and culture from an Australian and international perspective. As a result of the wellbeing. extensive search we have been able to list broad domains of culture and a range of sub themes under each broad cultural domain. This is the first time to our knowledge this has been done.

Through the review we have been able to identify quantitative cultural measures that did not currently exist and this enabled the research team identify areas for data development – the creation of new measures for Mayi Kuwayu, the National Study of Aboriginal and Torres Strait Islander Wellbeing. This review also assisted in informing the modification of existing measures for inclusion in the Study. The Mayi Kuwayu Study commenced data collection in October 2018.

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