Education and income are inextricably linked to positive health outcomes. Australian Aboriginal people are known to have higher rates of unemployment than non-Aboriginal Australians and poorer health. In the Victorian regional town of Echuca, the local health service, Echuca Regional Health (ERH) has developed an Aboriginal Employment Plan (AEP) targeted to reach 2% employment of Aboriginal people by 2020.
Learning how to strengthen local employment opportunities at ERH for Aboriginal people was the aim of this study.
Hunting and Gathering
A qualitative research protocol was designed. Four distinct population groups with a strong interest in the growth of Aboriginal employment at ERH agreed to participate in focus groups and individual interviews: Yorta Yorta Elders, past and present Aboriginal employees, key community stakeholders and ERH Executive Officers. Conversations from the interviews and groups were thematically analysed with careful consideration of cultural meaning.
Twenty four people participated in the study. Learnings were gathered from the past, present and the future.
Local Aboriginal Elders recall birthing on the verandah of the health service, testament to a recent history of cultural inequality. In the face of segregation, Elders shared the memory of approaching the Matron to seek and subsequently achieve employment at the health service. Healing shifted from outside the building to within. First steps toward cultural inclusion.
A contemporary rebuild of the health service provided an opportunity to physically demolish the old verandahs, powerfully symbolic of reconciling the wrongs of the past with a focus on building a culturally safe healing environment. Successes to date include:
• the use of visual representations of culture;
• leadership through Aboriginal Board membership;
• mandatory online Cultural Awareness Training (CAT);
• the development of Aboriginal employment pathways and strengthened relationships with the community;
• the signing of a Memorandum of Understanding (MoU) with two local Aboriginal Community Controlled Health Organisations (ACCHOs).
Participants urged ERH to acknowledge the Aboriginal past on the ERH historical timeline and heal the future by remaining focused upon strengthening cultural respect and safety.
ERH was not immune to the Commonwealth Segregation Policy that spanned sixty years. Preliminary steps toward cultural inclusion came from local self-determined Aboriginal people whom, in the face of cultural inequity, were able to achieve employment at the health service. Physically, a new health service exists today, built with a noteworthy level of collaboration with the local Aboriginal community. Multiple strategies have achieved significant progress toward a new vision of cultural respect, safety and inclusion.
Cultural healing is more than the responsibility of an individual, rather a collective commitment from the organisation in partnership with the community at large. Reconciling the past through acknowledging historical events and continually adapting through cultural learnings, demonstrates leadership and an opportunity to teach future generations that healing is possible. Culturally safe environments promote both healing and employment opportunities for Aboriginal people. Continued efforts that advance toward Aboriginal cultural inclusion may indeed mangan dunguludja ngatan (build strong employment).
Authors’ present study findings as valuable insight into the cultural significance of the past and how healing has emerged on a continuum to reconcile the history, to benefit the future. Recommendations have been proposed in the hope of informing success in mangan dunguludja ngatan (build strong employment) at ERH and a vision for reconciliation, cultural respect and safety.
1. Consider employing an Aboriginal Human Resources (HR) Coordinator to strengthen cultural relations with the community;
2. Commence recording Aboriginal status for all employees during the HR onboarding process, allowing rates to be monitored over time;
3. Consider the development of a formal mentoring program to strengthen cultural respect;
4. Consider formalising Cultural Competency Training (CCT) for Managers and key staff working alongside Aboriginal employees;
5. Develop an Aboriginal Staff Network to engender support and cultural safety within the workplace;
6. Consider including significant Aboriginal events on the ERH historical timeline;
7. Continue to develop partnership arrangements (with local training agencies and education providers) utilising skill matching based upon the needs identified in a workforce analysis across the community;
8. Foster opportunities for dual positions with ERH and local ACCHOs;
9. Build upon Aboriginal acknowledgement through promoting ERH as a culturally safe place (employee posters/biographies on ERH website);
10. Consider developing a Reconciliation Action Plan (RAP) or an updated AEP that reflects the Cultural Respect Framework to continue to strengthen the narrative around cultural safety;
11. Formally engage and celebrate culture with the Aboriginal community at every opportunity e.g. National Aborigines and Islander Day Observance Committee (NAIDOC) events.||