Special Articles / Fredrik Velander, Andreia Schineanu / Community Work : Theories, Experiences & Challenges
This chapter explores community development from a vantage point where culture is essential in empowering communities and unlocking the full potential of self-efficacy for successful and sustainable change. We approach the concept of culturally secure community development from the context of Indigenous communities across the world; however, for the purposes of this chapter, we have considered the situation of Aboriginal and Torres Strait Islander communities in Australia.
The chapter begins by providing an overview of the current situation of Indigenous populations across the world, and specifically in Australia. Within this context we present a brief overview of the Aboriginal and Torres Strait Islander history of colonisation and dispossession and concurrent racism and how they gave rise to the current discrepancy in life expectancies and socio-economic status.
The concepts of community, health and healing from an Aboriginal perspective are used to highlight differences between Aboriginal and Western worldviews and values, and how they define wellbeing. Culturally secure community development can only occur when strength-based practice is used and we move away from the notion of best practice towards a concept of wise practice, which is more appropriate for Aboriginal communities.
The chapter concludes with a case study of the Norseman Aboriginal Community to illustrate aspects of wise practice and culturally secure community development and to exemplify the process undertaken to empower the community to address their health issues.
Keywords: Aboriginal and Torres Strait Islander, culturally secure, wise practice, community development, health promotion
The social and health disparities among Indigenous peoples around the world are well documented. Even in developed countries such as Australia, Canada and USA, Indigenous populations suffer higher rates of social and economic issues, non-communicable chronic conditions and lifestyle-related diseases than the rest of the population. The long history of colonisation of Indigenous peoples with its associated land dispossession and racism has contributed significantly to their disadvantaged position within these countries.This is where community development can play a prominent role by its collaborative virtues and holistic nature, by approaching these disparities from a strength-based perspective utilising existing resources within communities. Also by working with the entire community we are moving towards culturally secure practice, particularly if we seek to hear the voices of all community members and give enough time for consensus to develop. Within the framework of community development it is possible to address social and health disparities at a macro level rather than implementing individual-based interventions.
The Current Situation of Indigenous People
There are almost 400 million Indigenous people worldwide on every inhabited continent (Nettleton, Napolitano, & Stephens, 2007). Many are easily identifiable such as the Australian Aborigines or the Native Americans, while others are less easily recognisable such as the Sami people of Scandinavia. Despite the great diversity of Indigenous peoples, their health status and the determinants of their health and illnesses are sufficiently similar to enable a generic discussion on the subject.
Numerous research papers and government reports have emphasised the poor state of affairs in Indigenous communities around the world, in terms of high infant, child and maternal morbidity and mortality, high rates of malnutrition and heavy infectious disease burdens, as well as higher rates of chronic diseases and social problems, mental health problems and lower educational levels when compared to their non-Indigenous counterparts (Gracey & King, 2009; Stephens, Nettleton, Porter, Willis, & Clark, 2005).
Indigenous people are over-represented among the poor and disadvantaged and the poor living conditions, inadequate access to fresh food, clean water and adequate health services exacerbate the Indigenous people’s susceptibility to disease.
For example, more than twice as many Australian Indigenous people experience unemployment asnon-Indigenous people and Indigenous household incomes are approximately 40% less than those of their non-Indigenous counterparts (ABS & AIHW, 2005). The conditions of some Indigenous households, especially those in remote areas, are detrimental to good health, with overcrowding being a major issue.
Australian Aboriginal children are significantly more likely to be admitted to hospital, stay longer and are more likely to die in hospital than non-Aboriginal children (Carville et al., 2007). Infections such as acute and chronic ear disease, dental caries, trachoma, parasite infestations, respiratory and urinary tract infections cause a heavy burden of disease in Indigenous children and contribute to the development of cardiovascular disease, renal disease, diabetes and other metabolic diseases in adulthood (DeBoer et al., 2012; Gluckman, Hanson, & Pinal, 2005).
Malnourishment is also a common feature of Indigenous populations that have lost access to traditional food supplies. Insufficient access to fresh food and inadequate facilities to store and keep food uncontaminated are exacerbated by dependence on processed western-type foods that tend to be high in sugar, fats and salt and low in nutritional value(Monteiro, Levy, Claro, de Castro, & Cannon, 2010).Chronic infections, particularly gastrointestinal and parasite infestations, are especially important because they impair intestinal digestion and decrease absorption of nutrients, minerals, and vitamins, exacerbating states of malnutrition (Gorospe & Oxentenko, 2012).
The cycle of malnourishment and ill health continues with each generation. Many Indigenous women become pregnant at a very young age and have multiple pregnancies, both of which adversely affect maternal and foetal outcomes (Brennand, Dannenbaum, & Willows, 2005). This is coupled with several other risk factors that are common to Indigenous women, namely:
A recent trend in Indigenous health is associated with the rapid urbanisation occurring all around the world and which affects Indigenous populations more severely due to the relatively recent exposure to western lifestyles. Even in developed countries such as Australia, the majority of the Indigenous population has lived relatively traditional lives as little as 50 years ago. Since then, urbanisation with its high kilojoule, high fat, high salt and low fibre diet, decreasing levels of breastfeeding and physical activity and overcrowding has led to a surge in chronic lifestyle diseases such as obesity, hypertension, cardiovascular disease, type 2 diabetes, chronic renal disease, and renal failure. Some studies suggest that Indigenous peoples may have a genetic predisposition to these diseases and prevalence rates are aggravated by the rapid social and environmental changes experienced by many Indigenous peoples (Gracey, 2007; Pavkov et al., 2007; Rodríguez-Morán et al., 2008).
This disadvantage experienced by Indigenous populations across the world contributes to the high rates of behavioural risk factors that affect health such as misuse of alcohol and other drugs, smoking and environmental risk factors such as exposure to violence (ABS & AIHW, 2005).
Alcohol misuse by Indigenous peoples is one of the major social and health issues of current generations and has enormous negative impact at individual, family and community level. Several surveys have shown that, while North American and Australian Aboriginal and Torres Strait Islander peoples are less likely than non-Indigenous Australians to consume alcohol, those who do so are more likely to drink at hazardous levels(Allsop, 2008; Gray & Saggers, 2005; Waldram, Herring, & Young, 2006). Alcohol is a major risk factor for liver disease, pancreatitis, diabetes and some types of cancer, frequently contributes to motor vehicle accidents, injuries and suicide, and increases anti-social behaviour and domestic violence (ABS & AIHW, 2005; Calabria, Doran, Vos, Shakeshaft, & Hall, 2010). Rates of alcohol-related harm among Indigenous males in Australia are three times higher than in the general Australian population and for Indigenous females are seven times higher than for general population females (Calabria et al., 2010).
Exposure to violenceis a health risk factor and can result in disability, trauma and death and also increases the risks of other behavioural problems such as depression, anxiety, suicidal behaviour and substance misuse (ABS & AIHW, 2005). Nearly one-quarter (24%) of Aboriginal and Torres Strait Islander people reported being a victim of physical or threatened violence, with more than a third (36%) of young men being victims of violence. This rate is more than twice the non-Indigenous rate of exposure to violence(ABS & AIHW, 2005). The effects of exposure to violence are that victims have higher rates of long-term health conditions and disabilities and higher rates of smoking and substance misuse, thus contributing to Aboriginal and Torres Strait Islander peoples’ higher burden of illness.
The high rates of violence also result in high rates of incarceration and alienation from families and society, a feature shared by Indigenous peoples in all developed countries and which affect Aboriginal and Torres Strait Islander men’s health in particular, (King, Smith, & Gracey, 2009).
It is clear from this brief overview that Indigenous people carry a much higher burden of disease than their non-Indigenous counterparts.It is important for practitioners to have an idea of the health issues facing communities they practise in,as these may impact any proposed community development work.
Colonisation, Dispossession and Racism
In order to appreciate the current situation of Aboriginal and Torres Strait Islander peoples we need to understand their cultural ways of life (Dudgeon, Wright, Paradies, Garvey, & Walker, 2010). In Australia, archaeological evidence suggests that Aboriginal peoples have been present for more than 40,000 years, and Torres Strait Islander peoples for more than 70,000 years (Flood, 2006).
Prior to the arrival of the British if an Aboriginal or Torres Strait Islander person survived infancy they kept on living a relatively fit and disease-free life. Physical fitness came out of living a life on the move, while the lack of lifestyle-related diseases was related to a nutritious balanced diet of protein and vegetables, with adequate minerals and vitamins, and low level intake of salt and sugar (Flood, 2006).
Mental wellbeing resulted from a range of strong reinforcing factors such as a sense of self, culture, kinship, spiritual belief system and customs. Aboriginal and Torres Strait Islander sense of self was not born in an individual context but from a collective sense, which in turn was closely linked to all aspects of life, such as community, spirituality, culture and connection to country (Dudgeon et al., 2010). Connection to the land was and still is fundamentally important to Aboriginal and Torres Strait Islander people. A person belonged to the land and it was experienced symbolically and spiritually rather than merely as a physical environment (Dudgeonet al., 2010). A strong common culture set the framework for rules and relationships and kinship filled the vital function of establishing social roles in the community and within the family (Parker, 2010). Sense of meaning came out of a strong connection to country and their Dreaming.
Box 1. Dreaming
The Dreaming for Australian Indigenous people (sometimes referred to as the Dreamtime or Dreamtimes) is when the Ancestral Beings moved across the land and created life and significant geographic features. The Dreaming, or ‘Tjukurrpa’, also means to ‘see and understand the law’ as it is translated from the Arrernte language. Dreaming stories pass on important knowledge, cultural values and belief systems to later generations. Through song, dance, painting and storytelling which express the dreaming stories, Aborigines have maintained a link with the Dreaming from ancient times to today, creating a rich cultural heritage.
As in many other cultures, spirituality provided guidance and comfort, particularly in distressful times, and added to a sense of belonging and connectivity. Tribal elders played a hugely important role as the keepers of the Lore, or the knowledge and history that defined the culture, and it was their role to forward this onto the younger generations so thatthe culture was kept alive (Parker, 2010).
When the British first landed in Australia they declared it ‘terra nullius’ or land not belonging to anyone, despite the fact that they were aware of the existence of Aboriginal people on the land (Dudgeon et al., 2010; Eckermann, Dowd, Chong, Nixon, & Gray, 2010). This meant that the newcomers could take and use the land as they desired, which was often opposed by the Aboriginal groups living in those areas, however this opposition was squashed by the British using their superior military power, equipment and warfare knowledge. Reprisals for incursions such as stealing of livestock consisted of campaigns of indiscriminate hunting of any Aboriginal people in the area, resulting in mass fatalities (Eckermannet al., 2010). As the farming and pastoralist industries of the newcomers expanded further inland, the Aboriginal people were forced off the land they had lived on for centuries.
From a community development perspective we need to consider not only the issues facing Indigenous peoples and communities but also the underlying causes and determinants of disadvantage. In the coming sections we focus mainly on the Aboriginal and Torres Strait Islander populations of Australia, but also draw on the experiences of North America and New Zealand. By using the Australian experience as an example to explain the causes of Indigenous social and health disadvantage,we hope to enable readers to better understand how processes for other Indigenous groups occur and, whilst specifics vary across cultures, the principles are the same. The main argument of this section is that Indigenous social and health inequalities are the result of a combination of classic socioeconomic shortfalls as well as Indigenous-specific factors related to colonisation, loss of language and culture, land dispossession, racism and globalisation.
So what happened in the span of a couple of hundred years to result in a 17-year gap in life expectancy at birth between Aboriginal and Torres Strait Islander people and non-Indigenous people and left the Aboriginal and Torres Strait Islander population with such poor health and social conditions?
It is without a doubt that many if not most of the problems facing Aboriginal and Torres Strait Islander peoples can be directly linked to the colonial process and the colonialism that is expressed through existing policies and practices, including human services practice (Crawford, Dudgeon, &Briskman, 2007).
Aboriginal and Torres Strait Islander peoples like most other Indigenous populations have a strong mental and spiritual relationship with the land. This is clearly demonstrated by a study which found that Aboriginal people that had a sense of responsibility for and were involved in the management of traditional lands improved their self-esteem, fostered self-identity, maintained cultural connection and enabled relaxation (‘Yotti’ Kingsley, Townsend, Phillips, & Aldous, 2009). Thus the loss of land has significant detrimental effects on the mental health of the Aboriginal and Torres Strait Islander peoples and is manifested in the current high rates of self-medication with alcohol and other drugs, social instability and family breakdown.
Along with the often violent and fatal displacement, the British also decimated the Aboriginal populations through the introduction of infectious diseases to which the Aboriginal people had no immunity, such as chicken pox and measles.
Aboriginal society was forced to accommodate to the very different worldview of the British, to their understandings of economy, religion and social structure, and any resistance was interpreted as ‘laziness’ and ‘mental inferiority’(Eckermann et al., 2010). With much of their land destroyed or occupied andtheir social structure and traditional life disrupted, many Aboriginal people migrated towards the fringes of European settlements where they encountered alcohol, tobacco and food that was significantly different fromwhat they had consumed until then. Eventually Aboriginal people became institutionalised and dependent on ‘handouts’ to meet most of their daily needs (McDonald, Bailie, Grace, & Brewster, 2010). In the later years, many Aboriginal people found work as labourers or as farm hands but the mechanisation of much of this type of work in the 1970s led to job losses and dependence on welfare(Schineanu, Velander, & Saggers, 2010). These changes in culture, diet and activity were the first steps on the path to the current problems in health and wellbeing of the Aboriginal people that we see today.
These initial processes were exacerbated by experiences of racism and discrimination that still continue today, albeit in a covert form (Dudgeon et al., 2010). Discrimination against the Aboriginal and Torres Strait Islander people existed in every sphere; the law considered them wards of the state not citizens, and instead of rights many punitive and restrictive laws applied (Dudgeon et al., 2010; Eckermann et al., 2010). For example, the state and its representatives determined where they could live, how much they could earn, whether they were fit parents or not and so on. In other words, discrimination and racism against Aboriginal and Torres Strait Islander people became institutionalised. Various policies and legislations were enacted over the years, supposedly for the good of the Aboriginal people, but they resulted in a form of cultural genocide through the loss of language, family dispersion and the cessation of cultural practices (Dudgeon et al., 2010; Haebich, 1992).
Of particular importance are the Western Australian Aborigines Act 1905,which severely eroded the rights of Aboriginal people, led to the forcible removal of children, today known as the ‘Stolen Generations’ and placement of people in reserves, and the Native Administration Act 1936, which consolidated the absolute rights of the State over Aboriginal people.
In the first half of the 20th century, approximately 10% of all Aboriginal and Torres Strait Islander children were forcibly removed from their families and communities, but this varied and in some communities this figure was much higher with most families being affected (Cox,Young, & Bairnsfather-Scott, 2009; Dudgeon et al., 2010; Eckermann et al., 2010). The systematic removal of children, particularly part-white children, was justified as giving them the opportunity to assimilate into the white world, and to improve their welfare. However the practice of removing Indigenous children from families and communities was common in all colonised countries such as Australia, Canada, New Zealand and the USA, and was carried out to enhance assimilation and to hasten the breakdown of Indigenous communities, and their relationship with their environment (Sissons, 2005).
This period of colonisation and the trans-generational consequences of the ‘Stolen Generations’ has resulted in high levels of emotional distress and trauma, as well as early disruption in social and cultural attachment of the Aboriginal and Torres Strait people of Australia. Those directly affected have higher rates of emotional distress, depression, anxiety, heart disease and diabetes and are more likely to smoke and to misuse alcohol and other substances (ABS & AIHW, 2005).
Major changes have occurred since these events; in 1967 the National Referendum granted Aboriginal and Torres Strait Islander people the same rights as the rest of the population, and in 2008 then Prime Minister Rudd acknowledged the wrongs carried out by the State through an official apology. However,the effects of the Aboriginal and Torres Strait Islander peoples’ history still persist in what is sometimes described asa cycle of ‘grief, anger and despair’ that results in substance abuse, violence, suicide and poor nutrition and the significant social and health disparities we see today (Aboriginal Medical Services Alliance Northern Territory,AMSANT, 2001). In remote communities, where a large proportion of the Aboriginal and Torres Strait Islander people reside, the legacy of past government policies has disempowered people and made them suspicious and distrustful of outsiders, preventing efforts to bring about change (Baum, 2007; McDonald, et al., 2010; Scougall, 2006).
More recently inappropriate research methods and practices used to acquire knowledge about health in Indigenous communities have exacerbated the powerlessness of the Indigenous people and have not significantly improved their health status.Historically, Aboriginal and Torres Strait Islander people in Australia have been subjected to a range of inappropriate, unacceptable, and degrading research and intervention methodologies. Of concern was the extraction of knowledge from Aboriginal communities that benefited individual researchers or organisations, but provided little benefit to the community. The approaches used to research or attempt change, their meanings and purpose, were usually unfamiliar to the Aboriginal people and the outcomes were as often as not misguided and harmful (Castellano, 2004). The common factor in these activities was the patriarchal top-down approach used which resulted in a one-sided relationship, with Aboriginal communities being denied autonomy and self-determination.
Aboriginal Perspectives of Community, Health and Healing
Now that we have an understanding of the current situation of the Aboriginal and Torres Strait Islander peoplesand their health status as well as the historical events that have contributed to their disadvantage we can focus on the practice of community development. The first step of community development in an Aboriginal context is to understand the Aboriginal worldviews and how they define concepts of community, health and healing. A worldview can be defined as the set of ideas andbeliefs which a group of people hold about the world and the people and things in it.
In Aboriginal and Torres Strait Islander tradition, community is not a geographical boundary; instead it is about relationships and a kinship system, a concept shared with other Indigenous peoples in other countries. Community is about family relationships and the spiritual connection to the country, a connection that does not diminish with distance. The kinship system links people together not only through bloodlines, but through the different levels of responsibility each member has in the community and towards country (Cummins, Gentle, & Hull, 2008). The concept of a historical community bound together by kinship is clearly alien tothe western view of community as a geographical and visibly defined entity.
The Aboriginal view of health is also different fromthe western view. What we have in Aboriginal communities is a situation where harms have been caused at multiple levels: individual, community, cultural and spiritual. The Aboriginal perception of health and illness is strongly related to culture and identity and goes beyond the physical wellbeing of the individual. Most would agree that this requires a holistic approach that encompasses the whole individual, including his or her context in terms of culture, spirit, belonging to land, family, community and so on. Unfortunately western culture has a long history of not only developing services based on a western agenda but also services that are compartmentalised. Currently there are services that attempt to address housing issues, unemployment, physical health, art, alcohol and other drug use, mental health, agriculture, education, and so on, but there is very little communication and collaboration between the agencies providing these services. Sometimes they do not even know that they are servicing the same area. This results in a significant waste of resources, human as well as financial, and fragmented and culturally inappropriate interventions. Therefore, compartmentalising interventions is not only culturally inappropriate; it also runs the risk of being highly ineffective and counterproductive (DeVerteuil & Wilson, 2010).
Culturally Secure Community Development
Irrespective of what the aims of the community development initiative are, whetherit be health promotion, disease prevention or any other objective, generic programs developed for the general population appear to be less effective when implemented in Aboriginal and Torres Strait Islander communities. This is particularly so in more remote communities where it is difficult to communicate information through more than one channel, that is, face-to-face communication, and so it becomes problematic to saturate the target group with the desired message. In addition, resources developed for the general population, and sometimes for the Indigenous population, often contain information written in inappropriate language (Rowley et al., 2000).
The cornerstone of culturally secure community development is a high level of cultural competence. One reoccurring problem with the concept of cultural competence relates to the requirement to obtain the necessary skills to be deemed culturally competent. To become competent necessitates a learning process and therecognition that one is not the expert, but a facilitator, and therefore oneshould approach any cultural group with a background different fromone’sown with an open mind and sound curiosity, being willing to listen and learn.
There are numerous definitions of cultural competence and they differ in clarity of what is expected of an individual in order to be culturally competent. In this particular context and for its relative simplicity we have chosen to use the Australian National Health and Medical Research Council’s (NHMRC) four principles for cultural competence as a framework for further discussion.These are:
Being aware of different cultures and practising tolerance is only the first step towards cultural competence; in order to be a culturally competent practitioner you need to have the ability to identify and challenge your own cultural assumptions, values and beliefs (Fitzgerald, 2000). Furthermore, ‘It is about developing empathy and connected knowledge, the ability to see the world through another’s eyes, or at the very least to recognise that others may view the world through a different cultural lens’(Walker & Sonn, 2010). In order to do this and utilise existing resources in communities we should adhere to Saleebey’s six principles underpinning strength-based practice, which are:
Entry into a community to provide therapeutic services should be prefaced by a series of consultations with as many community people as possible and preferably by the invitation of community members who are familiar with the provider’s work. This is not always possible so there needs to be a process of introduction and familiarisation that goes some way towards overcoming the potentially limiting effects of previously failed interactions.(Atkinson, Nelson, & Atkinson, 2010)
In order to work effectively with Aboriginal communities practitioners also need to familiarise themselves with a range of national and community-based ethical guidelines, protocols and principles that encourage practitioners to develop an understanding of local history, customs and ways of working. For example, regions of Western and Central Australia are not accessible to outsiders while communities are doing men’s and women’s ceremonies and rituals;therefore community development activities need to occur outside those times of the year (Walker & Sonn, 2010).
Progression of ‘Best Practice’ into ‘Wise Practice’
One aspect of professional practice, whether it is community development or any other intervention is the notion of ‘best practice’ or evidence-based practice. While often criticised by critical theorists as a post-modernistic tool for oppression, others state that it is an expression of hierarchical order of society. Few have explored the implications that this critique brings with it and attempt to develop alternative epistemological foundations for practice (Pease, 2009).
Before we explore the critique of ‘best practice’, it is useful to investigate the current notion of what constitutes ‘best’ in practice. For Wilson et al., it is ‘the development and implementation of policy and practice based on the best evidence available, including that from research and other sources such as the views of service users, professionals and other stakeholders’ (2011, p. 98)
Evidence-based practice has become more and more popular within social work and human service practice with its origin firmly grounded in evidence-based medicine. It has been argued that evidence-based practice is founded upon the following principles (O’Connor, Wilson, Setterlund, & Hughes, 2008):
There are some problematic issues with the notion of ‘best practice’. One lies in the definition itself as there are multiple views on what constitutes ‘best’ in best practice, particularly when moving between different cultures. In social work, for example, this is often discussed as there is limited ‘evidence’ of particular interventions’ effectiveness in order to label thembest practice. This limitation often comes down to quantitative evidence, which in itself is contrary to Aboriginal perceptions of evidence, but there is also a strong culture within social work that holds qualitative evidence as equally important, if not of higher importance. This discussion raises two more questions, namely,what constitutes evidence and when do we know we have enough evidence to determine whether something is best practice or not?
There is also an underlying danger when ‘best practice’ is indiscriminately implemented in different situations and contexts as it opens up to the assumption that what works in one situation, be it a particular culture or context, will work in another (Krajewski & Silver, 2009). This is particularly so when attempting to transfer ‘best practice’ between non-Indigenous and Indigenous communities and indeed between different Indigenous communities. The standard for successful outcomes may differ quite substantially between various cultural contexts and the concept of best practice may lead to a deterioration of some of the fundamental groundings of human services practice as, for example, social justice and the common good (Cornell, 1987; Wesley-Esquimaux & Calliou, 2010).
We need to acknowledge that many theories related to community development have their origin in a western-based theoretical framework and many of those theories that have been promoted from themid-1900s have been proven to be ineffective, mainly because the general premise was that Aboriginal peoples should discard their culture and traditions and assimilate more evolved, or ‘modern’ ways of thinking and acting (Hofstede, 1993; Ife, 2002).
One aspect of community development that has been lost in many settings is the importance of culture and how it impacts on the effectiveness of various types of interventions. Whether working in a remote mining community, an inner city group or with an Aboriginal community, culture is an essential aspect of community development,particularly in traditional communities. Taiaiake Alfred, a Mohawk scholar, identified eight characteristics of such communities:
UNESCO (UNESCO, 2002)has established a definition for ‘wise practice’ as: ‘locally-appropriate actions, tools, principles or decisions that contribute significantly to the development of sustainable and equitable social conditions (p. 51). Or as Davis (1997) states,‘wise practice, by its very nature, is idiosyncratic, contextual, textured, and probably inconsistent. It is not standardised, not off-the-shelf, and not a one-size-fits-all concept’ (p. 4).
As such, ‘wise practice’ cannot be driven by external ‘experts’; it only begins from a position within the community where there is a common understanding, internally generated and culturally appropriate knowledge. Furthermore, ‘wise practice’ can only take place if people/communities are given ample time to internalise choices in order to reach a consensus about what needs to happen in their community and nobody can be left behind. This in turn will give Indigenous leaders the opportunity to bring culture back into community leadership (Wesley-Esquimaux & Calliou, 2010).
What sets ‘wise practice’ apart from other types of practice are the following six elements:
As in any other model for community development there is a need for communities to overcome barriers.Most Aboriginal communities have a sound understanding of what is likely to work in their environment, and they are more often than not open and receptive to learning from their environment as well as from new ideas. What are often required are the tools to mobilise inherent knowledge and leave behind imposed restrictions. A resilient sense of efficacy requires experience in overcoming obstacles through perseverant efforts. Failure and setbacks occur only when an attempt for change is made; therefore, it is important to see failure as a learning opportunity. When people see that they have what it takes to succeed, they are more likely to keep on trying even when obstacles occur, quickly rebound from setbacks and find a way around these obstacles (Bandura, 1994).
Finally we also need to understand that work, including human services work, with Indigenous people does not go untainted because of the negative image portrayed by media that very rarely broadcast positive stories of resilience and strength; instead we get stories of recipients of welfare, excessive alcohol and drug use and a general description of deterioration and hopelessness. Obviously, negative stories appear to have a significant higher market value than positive stories, but as researchers, practitioners and community members we must not stop our efforts to promote stories of hope, success, strengths and power that exist in many Aboriginal and Torres Strait communities around Australia.
In order to achieve this it is necessary to work on multiple levels, but this work cannot take place without acknowledging the impact whiteness (both at an individual and organisational level), colonisation and racism play, and move beyond, not forgetting, what has been and work towards human rights forAboriginal and Torres Strait Islander peoples. As community development workers we need to ask ourselves a number of critical questions related to our own values and beliefs, including those of the profession, and to keep a critical eye on the implementation of policy and practice applications.
Another fundamental aspect for the implementation of wise practice is training of Aboriginal leaders and managers in leadership and management, training that is often missing when handing over the control of resources to communities. It has to be acknowledged that Aboriginal cultures and communities have unique issues that are very different from non-Aboriginal communities. For example, these leaders have to deal with issues related to colonisation, and dispossession from lands and resources (Wesley-Esquimaux, 2009).
We should also acknowledge that it is not all doom-and-gloom as shown by positive developments in Aboriginal communities around the world. For example, First Nation, Métis and Inuit people(s) have made great advances on the path towards reclaiming and invigorating their leadership, languages, cultures, techniques and community practices. This is also where we see progression away from ‘best practice’ towards ‘wise practice’, where the unique knowledge present in these communities is brought to the forefront and merit is ascribed to what comes out through oral histories and lived experiences, a body of knowledge that has been largely ignored by the social and humanist sciences to date. From this we can clearly see the need to return to and invigorate ancestral ‘wise practice’ and engage all community members, youth and elders, men and women, Aboriginal and non-Aboriginal, in the endeavour to reassert fundamental belief structures, values and ceremonial practices for the betterment of all communities (Wesley-Esquimaux&Calliou, 2010).
From Theory to Practice
Thus community development in the broader context using principles of wise practice that aim to address a range of interrelated issues simultaneously (e.g. alcohol and other drug use, mental health, wellbeing) and are community driven appear to be more suitable to how Aboriginal and Torres Strait Islander communities are structured.
In the earlier sections we discussed the theoretical foundation of community development and some of the ‘wise practice’ strategies and ethical issues that practitioners need to familiarise themselves with prior to commencing a community development activity in an Aboriginal or Torres Strait Islander community. In this section we demonstrate how theory is put into practice by using the Norseman Aboriginal Community as an example.
Box 3. Case Study –The case of Norseman Aboriginal community
Norseman is located 724 kmeast of Perth, 190km south of Kalgoorlie-Boulder and 200km north of Esperance in the Goldfields region of Western Australia. According to the Australian Bureau of Statistics (ABS, 2011), Norseman has a population of 777 people with approximately 13.4 per cent being Aboriginal, although the population can increase to over 1,200 at times due to fluctuation of the mining industry. It is serviced by various government and non-government organisations including police, a district school, shopping facilities, district hospital and various sporting facilities.
The Ngadjunmaia Aboriginal people that live in Norseman belong to the Wankai or Wongai group which occupies the Southern Goldfields and Nullarbor regions of Western Australia and were affected by European settlement from 1845 onwards (Bates, 1938; Tindale, 1974). According to community elders, the Ngadju people lived a nomadic hunter/gatherer lifestyle and had their own language which is still in use today.
Verbal history tells that in the mid-1920s two female missionaries opened a mission in Norseman. Some Aboriginal people moved to the mission voluntarily, while others were brought there as children. The arrival of the missionaries is viewed as a positive event in the memories of many Norseman Aboriginal people.
Local informants talked about the segregation of men’s and women’s work until the late 1960s when Aboriginal women used to work as housewives, taking care of the children and the men used to work the land, travelling around with their families wherever the work was. The men were mostly employed as manual labour such as clearing land for farming and laying railway sleepers.
In the 1970s, the introduction of machinery to carry out the physically demanding work resulted in most of the Aboriginal men being left unemployed, idle and ‘without a sense of purpose’. Around the same time, Aboriginal people across Australia were given the right to purchase alcohol. Coupled with the change in employment status, alcohol use became more common among the Norseman Aboriginal community, ultimately leading to the current host of health and social problems.
Population Health, the public health division of WA Country Health Services (WACHS) were aware of the high rates of chronic illness, mortality and social issues that occurred in the Norseman Aboriginal community. In 2005Population Health approached the Norseman Aboriginal community and initiated conversations around chronic diseases and the local situation. It is important to mention here that WACHS and Population Health have served the community of Norseman for many years delivering various health services. In addition, through the employment of local workers, such as Aboriginal Health Workers,Population Health had a good working relationship with the Norseman Aboriginal community. If there is no relationship between a practitioner or their organisation and the Aboriginal community they intend to practise in, then the first step would be the development of a relationship through introduction to the community by someone that already has a relationship with the community and its members, followed by regular visits, attendance at community events, and hosting community meetings on the issue to be addressed.
Population Health staff built on this existing relationship and facilitated several community meetings to inform the community about their current health situation by providing local statistics on hospitalisations, deaths and chronic disease rates. The aim of this step was to raise awareness of the problem in the community, and enable them to commence thinking of strategies to resolve the issues. In the later parts of these awareness-raising activities, information on evidence-based initiatives that had shown success in other communities was provided. Much discussion ensued and, to assist the community in developing an action plan, a search conference was carried out. The basic concept of a community search conference is that responsibility for change is located with the people who have to live with the consequences of their actions and the plan. During the planned event, community members explored the external social environment, the issues to be addressed and then they integrated these into a set of strategies and detailed action plans to achieve the most desirable future. The result of this search conference was that members of the Norseman Aboriginal community identified alcohol as the main instigating factor for chronic disease, such as renal failure, liver disease, and chronic infections.
This process of developing the capacity of the community to acknowledge their problems as well as come up with the solutions ensured that the Norseman Aboriginal community had ownership of the issue and thus were the driving force behind the entire process.
Over a three-year period, 2005-2007, Population Health was in ongoing discussions with both individual families and the community at large about alcohol harm reduction strategies. As a response the Norseman Aboriginal community developed a range of strategies, including ‘drying out’ houses for men and women, a resolution to eat before drinking, monitoring and supporting members of the community to seek medical assistance. This may appear to be very modest interventions but we need to remind ourselves that this is a community with a very long history of extremely high levels of alcohol use and related harm.
It proved problematic to maintain sustained periods of less harmful drinking and relapse became a significant issue. As a result the community concluded that stronger measures were necessary in order to maintain their decision to change their drinking behaviour. In an attempt to reduce both levels of alcohol consumed andalso the types of packaged beverages consumed a proposal was developed with restrictions on hours of sale of these products and put forward to the West Australian Drug and Alcohol office at a meeting where the Norseman Aboriginal community and Population Health also were present. The rationale behind this proposal was that it would assist in supporting the changes that the community wanted to make and prevent opportunistic purchasing of these several most harmful products identified.
There have been a range of attempts to reduce alcohol-related harms in Aboriginal communities across Australia; usually they have followed two main paths: either by declaring ‘dry’ (alcohol-free) areas or by using liquor licensing legislation to control the availability of alcohol (Loxley et al., 2004). The Norseman Aboriginal community have used a different approach for their liquor restrictions as they do not involve the declaration of ‘dry’ areas, liquor licensing authorities or the implicit threat of imposed restrictions on licensees.
It is important to highlight here that Population Health staff were quite aware that national and international research evidence showed that many of the initial strategies implemented by the community were not likely to be successful or sustainable in the long term. However, the Norseman Aboriginal community chose the interventions that they felt most comfortable with and were most likely to support and Population Health staff respected their decision, continuing to provide support and encouragement. Attempting to impose liquor sales restrictions as the first strategy would likely have taken the ownership of the issue out of the Aboriginal people’s hands, the community would not have supported the intervention and the outcome would have been failure. Through this process of trying out and discarding less severe alcohol-related interventions the community became more accepting of the idea of stricter restrictions as a necessity to success. Thus when they finally decided to implement restrictions on the sales of alcohol the entire Aboriginal community was committed and supportive of the strategy.
In November 2007 a meeting was held between representatives of Norseman Aboriginal community, Population Health, West Australian Drug and Alcohol Office, local Police and the only licensee in Norseman licensed to sell packaged liquor. At this meeting negotiations took place with the licensee to voluntarily restrict the sale of packaged liquor products identified by the community and to provide a supportive environment for a community that wished to reduce alcohol consumption and to implement sustainable change. The licensee was supportive of the changes and willing to support the community in their path towards change. The commitment of the Aboriginal community to these restrictions was demonstrated when they undertook to stop purchasing the restricted items from the date of the meeting in November 2007, even though the restrictions did not come into effect until March 2008.to allow for the changes to be advertised to the broader community for feedback, objections or support of what was suggested. The alcohol sales data supplied by the licensee for the purposes of evaluation shows a dramatic drop in the sales of the restricted products that coincides with November 2007 not March 2008.
The broader community consultations brought no objections and one community member lodged a letter in support of the restrictions, restrictions that were to impact the entire community and not only Aboriginal community members.
This step highlights the importance of involving not only the target community in the negotiations but all other stakeholders that may be affected by the proposed changes. The term ‘negotiations’ itself is also important as it implies that all parties have a say in the matter and discuss the issue until a consensus is reached; thus no participant is disadvantaged, dismissed or left out from having an input.
To get from the point where the community had identified alcohol as the main source of health and social problems to an established liquor licensing agreement had taken three years of sustained effort by everyone involved. What separates this intervention from others is that no external funding was required, nor did it require the involvement of the liquor licensing authorities. It was sustained by strong local ownership of both the prevailing issues and a strong will to identify and implement a sustainable solution that would move the process forward. There was also strong support from the wider community as well as from all the government and non-government agencies involved.
The Norseman Voluntary Liquor Agreement came into effect on 1st March 2008: Between 12 midday and 6pm, Monday to Sunday, red and white Lambrusco wine was limited to one 5 litre cask per person per day, port wine was limited to one 2 litre cask per person per day and non-fortified wine was limited to one 4 litre cask per person per day. No sales of the above mentioned products were permitted at any other time.
Independent researchers evaluated the restrictions twelve months after they came into effect. Quantitative and qualitative data were gathered from a number of sources to evaluate the effect of the restrictions including: alcohol-related emergency department and hospital admission data; alcohol-related offences; alcohol sales data; and the views of community members and other key stakeholders about the restrictions.
Key quantitative findings of the evaluation included a 17.5% reduction in assaults and a 15.3% decrease in domestic violence incidences, a 60.5% decrease in the number of alcohol related hospital admissions and a decrease in per capita consumption of alcohol of 9.84% from 21.39L to 19.29L, with the majority of the decrease observed in cask red wine, fortified wine and ready-to-drink alcohol-pops (Schineanu et al., 2010).
Key qualitative findings included an increase in voluntary and early health care seeking behaviour (flu vaccine, regular blood glucose testing), improvements in nutrition (eating breakfast and healthy home-cooked food regularly, making financial arrangements for children’s school lunches), an increase in participation in family, community and sporting activities, attempts to become self-reliant (seek employment, start-up businesses, growing own food), a decrease in violence and arguments and decrease in public drunkenness (Schineanu et al., 2010).
As demonstrated by the events in Norseman, sustainable and effective changes are possible as long as the principles of culturally secure community development are used. What makes this case unique is that various government agencies worked together with the Norseman Aboriginal community in a flexible and collaborative manner over a reasonably long period of time (3 years +).
Aboriginal peoples’ history of colonisation, land dispossession and racism have had a lasting and ongoing effect on their social, emotional and physical well-being as demonstrated by their poor health indices, higher rates of illnesses and their social situation.
From an Aboriginal and Torres Strait Islander perspective, community development has to encompass all aspects of life, including spiritual, emotional, physical and family aspects as well as connection to land in order to be respectful and culturally secure.
This requires practitioners to approach community development without preconceived ideas and plans. There are systemic issues such as restrictions by funding bodies, time frames and evaluation practices that have to be reviewed and transformed in order for this de-compartmentalisation to happen. As such, a paradigm shift is required where we acknowledge that ‘traditional’ western practice may not be sufficient, and that there are significant lessons to be learned from traditional Aboriginal and Torres Strait Islander practice.
Liberating ourselves from the shackles of ‘best practice’ and accepting the more dynamic concept of ‘wise practice’ will allow us to think outside the confinement of ‘traditional’ western practice where focus has been on compartmentalising problems and solutions. This would then make it possible to engage communities in a more holistic, all-of-community, way where everyone’s voice gets heard and decisions are made in a truly informed way, where sufficient time has been given for consensus to develop:consensus both in terms of defining and identifying relevant issues and developing tailored interventions to resolve identified issues in a way that is supported by the community itself. This is also likely to result in a more cost-effective and sustainable way of working with community development in Aboriginal communities around the world.
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