Closing the Gap in Australia and Canada: Reflections from an international practicum placement in Saskatchewan
By Lily Aboud + Kimberley Hardwick 3rd Year MMBS, James Cook University, Townsville Australia
Thinking of travelling down under? There’s something a lot scarier than plate-sized spiders and crocs lurking beneath the surface. In a report published by the United Nations (2009) regarding The State of the World’s Indigenous Peoples, it was indicated that the world’s highest life expectancy gaps between Indigenous and non-Indigenous peoples existed in Nepal, a third world country, and Australia. In this land of supposed equal opportunity, Australian Aboriginal and Torres Strait Islander peoples can expect to live between 10-17 years less than non-Indigenous Australians. With many mainstream health services lacking cultural sensitivity, they fail to address the root causes of social, economic, and health inequity. There are clear similarities between Australian and Canadian colonial history, with a historic trend of dispossession and discrimination. The Stolen Generations are part of Australia’s history, in which the forceful removal of Aboriginal children from their families, land and communities scarred the emotional and spiritual wellbeing of generations. As a result of this trauma, Indigenous Australians have some of the lowest education and employment levels, poorest living standards, a deep rooted mistrust in the health system and the worst health outcomes in Australia. The Closing the Gap initiative is an agreed national priority which aims to set concrete targets to close the gap in literacy, numeracy, incarceration rates, employment, infant mortality, and life expectancy. For this to continue in its success, a mutual partnership must continue between Indigenous and non-Indigenous Australians. In the healthcare system, cultural safety and the recognition of traditional medicines and healing practices need to be integrated. In efforts to move toward this goal, Aboriginal Community Controlled Health Clinics support community self-determination in providing quality and culturally safe healthcare. However, there is still much more work to be done in addressing the social determinants of health and employing principles of equity if this gap is to be closed both in here at home in Australia and abroad.
I realised what was so rewarding about this entire experience was how I could compare everything to back home and easily think of ways that I could integrate the skills and knowledge learned here in Saskatchewan to my life at home. While as a second year student my clinical knowledge is limited, I really enjoyed the amount of community based activities we were able to involve ourselves in. I definitely wouldn’t have learned as much from the experience if we were purely doing clinical/ hospital work the entire time. I liked the mix of city and rural/remote locations as each came with their own unique challenges and strengths. What was interesting about this trip was that coming in rather blindly to Canadian Indigenous culture and issues, I had no preconceived notions or prejudices. I was happy to listen to all perspectives and above all, just wanted to learn as much as I could. Accepting my ignorance and taking the steps needed to enhance my knowledge and cultural sensitivity was easy to do in Canada. What potentially will be harder to do (yet completely enriching to my studies, life, and future career), will be to bring that back to the rural and Indigenous communities in Australia. Realising my own prejudices, acknowledging them, and trying to learn and move forward from them is what I have learned from this experience. Showing a willingness to learn, participate, and go beyond what is expected truly goes a long way. I have enhanced my abilities to be open minded, to seek support when confronted, to not blindly accept but question, and to try and understand the complexities and power of a culture so different to my own with the respect it deserves. I can’t wait to share what I’ve learnt about First Nations and Métis culture with my peers and educators.
Lily and Kimberley, third year undergraduate medical students, participated in an international practicum placement, as part of an international exchange partnership between the College of Medicine and Dentistry, James Cook University, Australia and the College of Medicine, University of Saskatchewan. Tom Smith-Windsor and Val Arnault-Pelletier were instrumental in supporting the exchange, among others. The students arrived in Canada on November 20th, 2016 and spent four weeks in Saskatchewan learning from the knowledge and experience of First Nations and Métis Elders, and community members and community partners from across the province. The program’s emphasis on community-engaged, experiential learning allowed the students to explore the area of Indigenous health more in-depth, learning about Indigenous health and social issues, including their historical and social context. Some of the places Lily and Kimberly visited include, the College of Medicine, University of Saskatchewan; Station 20 West, St. Mary’s Wellness and Education Centre, and SWITCH in Saskatoon; All Nations Healing Hospital, Fort Qu’Appelle; Access Place Needle Exchange and Sexual Health Clinic, Prince Albert; Sturgeon Lake Reserve Health Centre; and Île-à-la-Crosse, Patuanak, and Dillon.