Indigenist perspectives in cancer-, cardiovascular- and socially determined disease services.

Abstract Nr.1: "Gurdurlu Birrjilda - Feeling Good in the Hearth"

The Indigenous Cardiac Outreach Program (ICOP) is a tertiary service that consists of a multi-discipline team delivering point-of-care, diagnostic and consultation in cardiovascular disease CVD screening. We currently service 40 marginalised and disadvantaged communities across rural and remote Queensland, Australia.

In an Australian context the continual undermining and deterioration of Aboriginal & Torres Strait Islander cultural values, traditions and practices/rituals has amplified local community irritation. This frustration is being further exacerbated by the ethnocentric & xenophobic behaviours of those whom provide health services to Aboriginal & Torres Strait Islander communities. This evidently results in disengagement and overwhelming disparities in healthcare thus compounding the prevalence of disease burden.

Given the contradictions between Aboriginal & Torres Strait Islander culture and that of the totalitarian society, it is essential that service deliverers provide determinants for genuine economic development, opportunity for self-governance and reconciliation to be applied in accordance with Indigenous Australians diverse world-view, where the imperative is on “wellness” rather than sickness.

The Indigenous Cardiac Outreach Program (ICOP) is making a difference with its focus on dialogical, methodological and interrelationships, reiterating a model of care that is endogenous, rhythmic and people centred. That is based on inherent cultural values, innovative approach doing old business in a new way and priorities built on community & family relationships.

Due to ICOP’s innovative service delivery framework which is being guided by 4 phases within a 10 year plan that enables rural & remote communities to undertake a journey from engagement to self governance

Abstract Nr.2: "Working together: Aboriginal and non-Aboriginal workers achiving change in cancer service"

The presentation presents findings of a large qualitative inquiry which explored the processes and practices of collaboration as experienced by a group of Australian multidisciplinary Aboriginal and non-Aboriginal health workers and social workers. Each of the 41 workers had participated in a 5 year Australian Government funded health project that aimed to improve access to cancer services to Aboriginal people living in a large rural region of South Eastern Australia.  In the area of cancer, the disparity between the health of Aboriginal and Torres Strait Islander and non-Indigenous Australians is significant with Aboriginal and Torres Strait Islander people more likely to be diagnosed with more advanced cancers, and particularly cancers with higher mortality rates.

Through a range of project funded initiatives, Aboriginal and non-Aboriginal service providers and workers became partners in the delivery of cancer services within this region.  Initiatives which addressed poor access to cancer screening, and engagement with cancer treatment were developed through the formation of close working relationships between Aboriginal and non-Indigenous workers. These relationships were regarded as personally and professionally transformative. Through the sharing of cultural, medical and professional knowledge, new ways of knowing, being, and doing emerged.  The research highlights the critical ways in which collaboration has not only the potential to address complex health problems but can also facilitate fundamental transformations in professional practices

Abstract Nr.3: "Socially determined diseases and factors that affect to their spread in the Northern Indigenous People"

Due to a high social and psychological vulnerability, low adaptive capacity to environmental changing, globalization and migration strengthening led to destroying traditional lifestyle an occurrence of serious health problems and spreading of socially-related diseases such as tuberculosis and HIV-infection among Northern indigenous people is increasing and becoming a crucial issue. According to the medical and demographic statistics, the life expectancy of Russian aborigines for 10-11 years shorter than of general population. LI Abryutina shows, that general morbidity prevalence and incidence, including tuberculosis in North indigenous peoples from 1998-2007 are increased significantly. In Murrmansk Region in 2015 the TB prevalence in minorities was abnormally higher than among general population, 6192.0 vs 85.6 per 100 000.  Moreover, at the period of migration increase the HIV-infection is becoming uncontrolled threat for indigenous people because of their sociocultural and ethno-psychological features.

The TB situation in Northern indigenous people mostly was evaluated at the soviet period when the TB situation was relatively better and the HIV epidemic was just beginning. Publications related to HIV-infection in aborigines is extremely limited, only 1-2 studies evaluate the HIV epidemic situation among minorities living in the Yamalo-Nenets Region.

 In our opinion, at the era of industrial civilization and globalization, high prevalence of drug-resistant TB and HIV-infection, not only clinical and epidemiological component is important, but it is emergency to study the causes and routs of socially significant diseases spreading among indigenous people in relation with their preserved cultural, psychological, and social features

"Creating an injury free community toolkit"

Vehicular accidents are the leading cause of death of Indigenous children, youth, and young adults under the age of 25 in Canada. The nation's Original Peoples are more than twice as likely than the general population to require medical attention when injured in a vehicle accident, creating a major concern for First Nation, Inuit, and Metis community members. It is, therefore, essential that Indigenous people lead the way in planning, developing, and assessing how best to achieve an injury free community.  Using a Community-based Participatory Research (CBPR) approach, teams comprised of Indigenous people and university-based researchers from across Canada engaged in a process of reducing the risk of vehicle injuries and fatalities. The creation of a "toolkit" on creative and practical interventions, developed by Indigenous people from across the country, provides a series of promising practices which can be shared and transferred across First Nation, Inuit, and Metis communities. The toolkit is an effective way to encourage empowerment within Indigenous communities on the strengths of working together to create their own injury prevention solutions.  Reducing the risk of injury and fatalities is an ever-present challenge facing Indigenous communities. Realizing solutions to complex sociocultural, economic, and political struggles requires a renewed refocusing effort on things that work and are community-generated. The collaborative foundation for effective change calls researchers to rethink how the work they do impacts and transforms community wellbeing. Research with Indigenous communities must ensure that outcomes, programs, and services are sustainable for and meaningful to the community.