Student Number: n8587655
Tutor Name: Michelle Newcomb
Name: Kate Gardiner
Reflections:
FGM
"Desires out of Wires"
'A Tree Without Roots'

The Importance of Cultural Safety Within the Healthcare System



wordle.jpg
THE ARTEFACT

The above image is what is known as a ‘wordle’ where one main subject, in this case ‘Cultural Safety’ is surrounded by accompanying words that combine with the subject to evoke an interesting and eloquent message. Each significant term holds their own identity within our cultural world, however, when presented in a cultural safety context, each term works with the others to further define cultural safety as a public health issue and its importance within the Australian health care context.

THE PUBLIC HEATH ISSUE

The cultural significance of the artifact outlined above is the simplistic representation of what cultural safety is all about. As Williams’ definition explains, cultural safety is;
‘an environment that is safe for people; where there is no assault, challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience, of learning, living and working together with dignity and truly listening (Health Q. F., 2012).”
As a topic covered in the public health context, the issue outlined is concerned with the growing multiculturalism within the Australian community and such a complex social landscape has created an obligation for all Australians to better understand their own individual identity as well as their collective identity.


LITERATURE REVIEW

Research undertaken on the 9th of February 2012 by Dennis McDermott from the Poche Centre for Indigenous Health and Well-being department of Flinders University in Adelaide delivered a study entitled “Politics, Policy and Closing the Gap” where McDermott outlined the significance of cultural safety when applying this process to his research (McDermott, 2012).

Within this study, McDermott outlined the key target areas specifically focusing on the younger members of the community. He outlined the strategic areas for action as early child development and education and recognized that these were the key components to closing the life expectancy gap and halving the mortality gap for children. To enable safe and supportive communities, an element of cultural safety must be displayed and practiced effectively within this context to ensure the goal is reached (McDermott, 2012).

A thesis written by Lesley P Seaton from the school of Philosophy at the University of Technology in Sydney outlined the multicultural significance of the Australian population. According to the Bureau of Statistics 2007, one in four Australians was born in, or has a parent born in a country other than Australia (Seaton, 2010). Multiculturalism requires that each culture is considered equal to the other and cultural diversity is tolerated and respected, therefore forming the argument that cultural safety is an important tool in delivering appropriate health care to all ethnic communities (Seaton, 2010).
Current literature states that cultural safety promotes a more critical and inclusive perspective of culture (Gerlach, 2012). As an analytical lens in occupational therapy practice and research, it has the potential to reveal and generate broader understandings of occupation and health from individuals or groups in society who are traditionally silenced or marginalized (Gerlach, 2012). In relation to Aboriginal peoples, it clearly situates health and health inequities within the context of their colonial, socioeconomic and political past and present (Gerlach, 2012).
Whilst the clarity and generality of cultural safety remains contentious, there is emerging evidence of its capacity to promote a more critical discourse on culture, health, and health care inequities and how they are shaped by historical, political, and socioeconomic circumstances (Gerlach, 2012).

The current methodologies in place to control cultural safety are appropriate frameworks that are easily followed and taught to ensure the understanding and appropriate practice of cultural safety. As mentioned previously, literature states that cultural safety promotes a more “critical and inclusive perspective of culture and has the potential to reveal and generate broader understandings of occupation and health from individuals or groups in society who are traditionally marginalized or silenced (Gerlach, 2012).” Therefore, the implications of providing one framework for cultural safety cannot simply accommodate all cultural groups. Therefore, the promotion of any appropriate methodologies to control the prevalence of cultural safety within the health care system would need to be detailed and complex to suit the cultural diversity of our growing nation.
There is one framework however, outlined by the Australian Capital Territory (ACT) Government Health Information displayed on the ATC Government health website titled ‘the cultural respect framework’ that does combine cultural safety with cultural awareness and cultural sensitivity and is underpinned by good communication and the recognition of the diversity of views nationally and internationally between ethnic groups. (Health A. G., 2012) There are four basic levels of this framework;

  • Knowledge and awareness
  • Skilled practice and behavior
  • Strong (customer and community) relationships
  • Equity of outcomes

‘The cultural respect framework’ provides the foundation of attainment of changed knowledge and awareness, leading to changes in practice and behaviour, which in turn provides an assurance that cultural safety and healing practices are legitimized (Health A. G., 2012). Simply following these four simple rules may increase the cultural awareness and importance of cultural safety within a health care context and see more health care workers be both culturally safe and culturally competent to build greater trust and honest relationships with our multicultural communities so as to provide better health care and gather greater understandings of their heritage and historical circumstances.

CULTURAL AND SOCIAL ANALYSIS

The phenomenon of human globalization has led to the creation of a new social world, one which is characterized by its cultural diversity (Seaton, 2010). Health care services constitute one of the most fundamental of social organizations, therefore with this evolving modification; there has come a need for health care practitioners to provide relevant and appropriate care to the multiplicity of peoples who now live in contemporary social communities (Seaton, 2010).

Under the Cultural Safety shield, the varied ethnic groups that occupy a larger percentage of the Australian population are the cultures that are mostly benefited by the effective and competent use of cultural safety. It is these cultural groups that effect the way in which cultural safety is brought into practice as it is these people who in turn build positive experiences with the Australian health care system and assert power over their own health care (Health Q. F., 2012).

However, some political movements and demonstrations impede the general publics ability to be sympathetic and accepting of a particular groups’ cultural needs. This in turn lessens a societies understanding of cultural safety issues and understanding.

Example 1: The Muslim community bring fourth their own religious views into the Australian culture and demand appropriate laws and regulations be made to suit their cultural circumstances. An example of this is the anti-Muslim movie clip released on YouTube in America, causing retaliation by the Muslim community in Sydney where members of this religious group damaged property and abused police, which in turn when reported through the media, caused a strain on the relationship between the two cultures. Such strong views by both parties calls for a better system in understanding the cultural background of each ethnic group. Therefore, cultural safety is an effective methodology in the health care system to begin the repair of the damaged relationship (Vasek, 2012).



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Muslim Rioters in Sydney; The Australian September 7 2012


Example 2: The Australian Indigenous community believe they hold land rights over many parts of the Australian landscape, as the first inhibitors of the land. They believe the English invaded their land and it was stolen from them. Their strong views are imaged at public riots and demonstrations throughout the country as they demand recognition of these land rights. The latest Canberra Aboriginal protest was sparked by comments made by Tony Abbott simply making the point that he felt all parties needed to move beyond the continuous anger between the Indigenous and non-indigenous communities. As a result, protesters lined the streets of Canberra inflicting both harm and un-Australian actions such as burning the national flag (Dan Box, 2012). Cultural safety will not eradicate conflict completely, but could however support the need for a growing understanding, tolerance and acceptance of the multiculturalism of Australia today (Dan Box, 2012).


Australian Flag burnt by Aboriginal Tent Embassy Protesters; Channel Ten News January 27 2012

Cultural safety is not specifically for the use of health care professionals. The general population can also benefit from cultural safety training as without it, general populations become resentful because of a lack of understanding of the issue and the cultural forces in play within these ethnic groups. The two exapmles above support this conclusion as a lack of understanding and acceptance is what can contribute to such wounding examples of miscommunication and broken relationships.


ANALYSIS OF ARTEFACT

I entitled this wiki ‘A Tree Without Roots’ based on the premise that people without attained knowledge of their history and orgin of their culture is akin to the uselessness of a tree without roots. The culture would not be able to grow and carry on from generation to generation as it was not allowed to grow effectively. Similarily, a society without cultural safety does not encourage the growth and sustainment of cultures throughout the Australian population.
The aretfact chosen deomstrates cultural safety consicely using creative placement and arrangement of specific words. These words are arranged in such a way to convey the message that all the rquired elements for successful implementation of cultural safety must be implemented appropriately across all health care professions. Therefore there is an urgent need for an approriate framework that suits the cultural needs, health status and wellbeing of every individual.
Throughout my research of this topic, I found it facinating that with the newest advances in technology and the availability of this new technology, that so many health care practitioners are not culturally competent and appropriately trained in cultural safety. Moreover, with the growing multiculturalism among the Australian community, the obligation for a culturally safe health care system is an even more required skill. Another fact that intrigued me was the lack of information on cultural safety, specifically research regarding the use of cultural safety in practice throughout the health care system. I believe I have researched and viewed enough literature to broaden my understanding of the topic and to greater understand the importance of this skill among the health care system.

REFERENCES

Vasek, L. (2012). Tony Abbott has labelled Aboriginal rioters 'un-Australian' . Sydney: The Australian.
Dan Box, H. E. (2012). Extremists seen among Muslim rioters in Sydney protest. Sydney: The Australian .
Gerlach, A. J. (2012). A critical reflection on the concept of cultural safety. The Journal of Occupational Therapy , 79.3, 151-8.
Government, A. (2010, August 9). Autralian Capital Territory Government Health Information. Retrieved September 19, 2012, from The cultural respect framework: http://www.act.gov.au/
Health, A. G. (2012). ACT Government Health Directorate . Retrieved October 4, 2012, from Cultural Safety: http://www.health.act.gov.au/home/
Health, Q. F. (2012). Cultural Safety. Retrieved October 13, 2012, from Cultural Connections for Learning: http://www.intstudentsup.org/diversity/cultural_safety/
Jones, J. (2012). CST . Retrieved October 4, 2012, from What is cultural safety?: http://culturalsafetytraining.com.au/home8/what-is-cultural-safety
News, C. 1. (2012, January 27). Australian Flag Burnt by Aboriginal Tent Embassy Protesters on Australia Day. Canberra , Australia.
Nguyen, H. (2009, December). Theme Indigenous Health. Retrieved September 24, 2012, from Patient centred care - Cultural safety in indigenous health: http://www.racgp.org.au/afp/200812/200812nguyen1.pdf
McDermott, D. (2012). Politics, Policy and Closing the Gap. Adelaide: Flinders University.
Packham, B. (2012, September 17). The Australian. Retrieved October 19, 2012, from News: http://www.theaustralian.com.au/news/nation/immigration-minister-chris-bowen-may-act-against-foreign-protesters/story-e6frg6nf-1226475711462
Seaton, L. P. (2010). Cultural Care in Nursing: A Critical Analysis. Sydney: University of Technology.
Skellett, L. (2012, May). Australian Pharmacist. Health Promotion: Cultural Awareness and Cultural Safety , 382-4.
Reading, D. C. (2012, October 8). University of Victoria: Centre for Aboriginal Health Research. Retrieved September 20, 2012, from Cultural Safety in Healthcare: http://cahr.uvic.ca/programs-research/programs/cultural-safety-healthcare/