View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Queensland University of Technology ePrints Archive Us Speaking about Women’s Health: Aboriginal women’s perceptions and experiences of health, well-being, identity, body and health services Bronwyn Lea Fredericks Thesis Submitted to Central Queensland University for the Degree of Doctor of Philosophy School of Health and Human Performance Faculty of Arts, Health and Sciences 2003 Abstract When compared to other women in Australia Aboriginal women are considered the most socially and economically disadvantaged and have the poorest health status. Aboriginal women in Rockhampton, Central Queensland are not excluded from this lived reality. This research has explored Aboriginal women’s perceptions and experiences of health and health services in Rockhampton. Drawing on these experiences, and centring the voices of these women, the study reports on findings concerning cross-cultural issues, communication, policy, practice and service delivery. Importantly, the study has built new knowledge identifying the complex relationship between identity, body and well-being. In undertaking this study, I have developed a ‘talkin’ up’ research process in collaboration with other Aboriginal women. That is, by asking what Aboriginal women in Rockhampton wanted me as an Aboriginal woman researcher to explore and what type of process I would work through with Aboriginal women as the participants. The research has been informed and guided by these Aboriginal women and thus has witnessed the articulations of a more accurate portrayal of Aboriginal women’s perceptions and experiences of health services. I take the witnessing to be partly personally empowering, partly sharing and partly a taking of ownership of experience. As those women interviewed explained, our story here is told ‘by us’. In undertaking such a research process, I needed to ask what it means to be an Indigenous researcher and what is a good Indigenous research process? These are addressed at length within the thesis. This research process has not involved examining health services with regards to their service provision or their implementation of more empowering practices to improve health outcomes for Aboriginal women. This remains to be done. This research, has instead attempted to answer the question ‘how the relationship between health services and Aboriginal women can be more empowering from the viewpoints ii of Aboriginal women?’ The assumption underpinning this study is that empowering and re-empowering practices for Aboriginal women can lead to improved health outcomes. The study found : Aboriginal women had requirements of health services relating to cultural comfort of health service environments Aboriginal women did not access one health provider for all their health needs, they ‘shopped around’ to meet their general health, Women’s Business and relationship and privacy requirements Aboriginal women’s health is impacted upon by stereotypes held of Aboriginal women around skin colour and Aboriginality Aboriginal women have an understanding of what is required to improve the interactions between health service providers and Aboriginal women iii Table of Contents Abstract ii Table of Contents iv List of Attachments ix Dedication x Acknowledgements xi Declaration xiii Glossary xiv Abbreviations xvi Chapter 1. Preparation is Everything 1 Introduction 1 Geographic Location of the Research 6 Language Usage 7 Theoretical Frameworks 8 Significance of the Research 12 Positioning Myself in the Research 14 Overview of the Thesis 15 Conclusion 18 Chapter 2. Travelling a Pathway 19 Introduction 19 The Broader Landscape of Aboriginal Research 21 New Travellers in the Landscape 32 Challenging the Landscape 39 Living in the Landscape 49 Constructing a Pathway 56 Thinking out the Pathway: Methodologies 56 Guides in the Journeying: Supervision 68 iv Talkin’ Up the Pathway: Developing the Research Process 72 Talkin’ Straight: Interviews 79 Crossing a Gully: Confirmation Seminar 85 Recognising and Interpreting the Tracks: Data Analysis 89 Travelling in a Good Way: Ethics 92 My Dilly Bag’s Full: Data Storage 96 Keeping the Secrets: Confidentiality 98 Imprinting the Journey: Writing the Thesis 99 Recognised Obstacles in the Journey: Limitations 101 Conclusion 105 Chapter 3. Not “Just a little black bastard” 108 Introduction 108 A Label 109 Australian Aboriginal Identity 117 Aboriginal Women 124 Aboriginal Women and Feminism 139 Attempts to Re-instate, Re-Claim and Re-empower 148 Conclusion 152 Chapter 4. What ‘em thing call’d ‘ealth? 155 Introduction 155 Broader Health Talk 157 What do Australian Aboriginal people mean by the English word, Health? 166 From Colonisation to now, a look back at Aboriginal Health 170 (Dis)Empowerment in Practice? 182 Rockhampton Women’s Health and the Lived Experience 196 Conclusion 205 v Chapter 5. “Some politicians come and go, promises come and go, but we, we’re still here” 207 Introduction 207 What is Health Policy? 209 A Glimpse at some Historical Reflections on Health Policy and Aboriginal Peoples 211 The National Aboriginal Health Strategy (NAHS) 221 Taking Stock after NAHS 231 Lots of Action, but how effective is it? 240 Current Trends 247 Conclusion 252 Chapter 6. Talkin’ Straight 255 Introduction 255 Who are the Women who were Interviewed? 258 Themes, What is Happening Now? 262 General Issues and Experiences 262 Generational Issues 265 Body 269 Skin Colour and Aboriginality 271 Woman Specific Health Services 276 Woman Doctors, do they make a difference? 278 Family Planning Queensland 279 Mammography Unit 281 Rockhampton Women’s Health Centre 286 Ngua Gundi, Aboriginal Health, Queensland Health 290 Girls Time Out 291 Bidgerdii Community Health Service 292 Kay’s Story 296 Conclusion 303 vi Chapter 7. Which Way? 305 Introduction 305 What can be Done? 306 Privacy and Confidentiality 306 Positive Communication 307 Knowledge of Culture 309 Accessibility 310 Cross-Cultural Awareness Training 313 Aboriginal Women’s Voices 321 Can it Bring About Change? 325 Educating for Cross-Cultural Knowledge 326 From Cultural Awareness and Cultural Sensitivity Training to Anti- Racism Action 329 Aboriginal People Employed in Health 335 Sense of Place and Space 342 Towards Empowerment 350 Conclusion 357 Chapter 8. “…and this is what I’ve decided to tell you after everything I’ve already shared…” 359 Introduction 359 Research Highlights 360 Suggested Strategies 362 Background to the Research 363 Establishing Myself within the Research 365 Aboriginal Women in Rockhampton 366 Women’s Services 369 General Conclusions Drawn 372 Postscript 376 Conclusion 380 vii References 383 Attachments 442 viii List of Attachments List of Attachments Attachment A. Interview Schedule for Research Attachment B. Consent Form for Interview Participants ix Dedication I dedicate this thesis to Darumbal women and to the other Aboriginal women who have resided within Rockhampton in these post-invasion times. Those women that have passed before us, those that are with us today and those of the future. I additionally dedicate this thesis to Joan Marion Brady who passed away during the production of this research. Joan was a dynamic community activist who fought hard for Aboriginal rights, women’s rights, justice and equity. Joan was a dear friend, colleague and comrade. I know that as I submit this finished thesis she is with me in spirit. x Acknowledgments I acknowledge the Darumbal people as the Traditional Owners of the area known in these post-invasion times as Rockhampton. I offer honour to the Darumbal peoples for allowing me to reside in their precious Country and to undertake the work I do, including this research work. I give honour to the Darumbal spiritual ancestors who care for the Darumbal peoples and to those of us who also live, dwell and pass through their Country, their responsibility area. I give honour to my grandfather and I hope that his words and those of all my ancestors flow through me to you with integrity. I ask that all my ancestors and the ancestors of the Darumbal people, allow and assist me to express in a most sincere way what I need to express within this thesis. I further ask that the words on these pages place a challenge to you, along with giving you a greater understanding of issues that not only need to be reflected upon, but acted upon. I say to you that if you are not prepared to accept the integrity, sincerity and the honour bound within these pages, then please do not consider reading this thesis for you do not come to the thesis with respect. I would like to dearly thank Daniela Stehlik for her supervision over the course of this research. Dani ‘picked me’ up as a student when I was ‘lagging behind’. I know that I may not have reached this point at Central Queensland University without her support and guidance. Dani provided practical advice and feedback at times when I needed it most and a prod in the arm when I needed that too. I thank Ron Labonte for his steadfast understanding and encouragement over the years. I thank Priscilla Iles for her friendship and support over the time of this research work and my time in Rockhampton. I thank Kerrie Hand and Ruth McKillop for their editing skills. I offer recognition to the Indigenous people who made the varied research tracks and footsteps ahead of me and those who have written over the years, providing a rich source of literature. xi I thank the Governing Board and staff of the Bidgerdii Aboriginal and Torres Strait Islanders Corporation Community Health Service Central Queensland Region for their encouragement and support. The Bidgerdii mob provided me with space when I most needed it. I thank Amy Lester, Margaret Hornagold, Mitzi Jarvis, Sam Kawane and Edward Chubb for their supportive words along the way. I thank the Board of Management of the Aboriginal and Islander Community Resource Agency (AICRA) for their encouragement and support. Thank you Elaine Williams, Judy Tatow and Priscilla Iles.