Social, Economic And Political Processes

The Indigenous health workforce (doctors, nurses etc.) remains disproportionately low when compared to the number of Aboriginal and Torres Strait Islanders that make up the Australian population.

Nursing Council New Zealand (2011) defines cultural safety as the effective nursing of a person from another culture by a nurse who has undertaken a process of reflection and recognizes the impact of the nurses culture on own nursing. Irihapeti Ramsden (1946-2003) introduced the term ‘cultural safety’ into the education requirements of New Zealand nursing during the year 1990 (Wepa, 2012). As a result of this, Ramsden produced a document named Kawa Whakaruruhau. The document outlined concerns surrounding Maori health within New Zealand. In response to the publication of Kawa Whakaruruhau the Nursing Council of New Zealand amended, in 1990, the standards of nursing and curriculum assessment processes to include cultural safety (Wepa, 2012). Ramsden and Spoonley (1994) discuss that during the

“The status of Indigenous health in contemporary Australia is a result of historic factors as well as contemporary socio-economic issues” (Hampton & Toombs, 2013, p. 1).

Midwifery has been practiced in several communities of the world since time immemorial. A midwife is a trained person, mostly a woman, who assists in the pregnancy, delivery and post-partum care of an infant. In most countries of the world, the act of midwifery has been neglected for more modern and westernized medical practices deemed safer. In the First nations community, midwives have always been an integral part of the health system assisting expecting women during delivery. In the mid nineteenth and twentieth century, midwifery was outlawed in many communities and reserves ‘for the sake of the health of the country’ (Parkland Memorial Hospital School of Nurse Midwifery). With the outlaw of midwifery in First nation reserves, expectant mothers were transported to hospitals and clinics in urban centers for delivery. With this came several new challenges for expectant first nations women and mothers including, ‘increased maternal newborn complications, increased postpartum depression and decreased breast-feeding rates’ (O’Neil et al., 1990, Smith, 2002 and Klein et al., 2002a. The relegation of first nations midwifery has done more harm than good because it makes the birth process more medical, has led to the inflict of new post natal diseases and has led to the neglect of the traditional and spiritual roles in child

The social determinants of health are described as the condition of daily living in which determines the individual’s chances of maintaining optimum health (Department of Health and Human Services 2015). In Australia, the health inequality between indigenous and non-indigenous Australians is noted by the World Health Organization (WHO) to have the largest disparity in the world (Markwick et al. 2014). Statistically, the life expectancy for indigenous Australians who are born in 2010-2012 is estimated to be 10.6 years lower when compared to non-indigenous Australians (Markwick et al. 2014). Social determinants such as employment and social exclusion may contribute to the major difference in the health status between the indigenous and non-indigenous Australians (Markwick et al. 2014). This essay will focus on discussing how having employment and social exclusion has led to the health inequalities between indigenous and non-indigenous Australians, and how indigenous healthcare nurses can address these determinants in the care they provide in the indigenous community setting.

The inequalities in today’s indigenous communities are still strongly evident. Heard, Khoo & Birrell (2009), argued that while there has been an attempt in narrowing the gap between Indigenous and non Indigenous Australians, a barrier still exists in appropriate health care reaching indigenous people. The Indigenous people believe, health is more than the individual, it is

Participation requires Māori to be involved at all levels of the health and disability sector, including in decision-making, planning, development and delivery of health and disability services.

A general understanding of the history of midwifery is important when considering why it would have such a positive effect on indigenous women’s health. Acculturation diminished the traditional midwifery practices and there is evidence that the health of indigenous women has suffered. Midwifery was an old indigenous tradition that was gradually eliminated throughout acculturation. The Skye article states that in the 20th century, there were laws passed that made midwifery illegal and punishable by law. (Skye, 2010) This caused negative effects on health because there was no longer a focus on the overall wellbeing of the individual and the loss of culture was a traumatic experience for indigenous populations in Canada. The article also states that midwives were highly respected in indigenous culture and midwives shared a spiritual connection with the mother, child, family and whole community. It outlines that midwives coached the mother and community throughout all stages of pregnancy. They ensured that all of the needs of the mother were met nutritionally, physically, and spiritually. Midwives also performed the role of educators to their communities and they passed on many traditions and aided in spiritual development and healing. Throughout the process of acculturation, knowledge of health and traditional medicine was lost. (Skye, 2010) The Caroll article talks about the historical

This essay will discuss the key aspects of the health models Fonofale and Te Whare Tapa Wha, and describe how the key principles of these models relate to the everyday health of Maori and Pasifika peoples’. The principles of these models need to be recognised by paramedics, and acknowledge the cultural diversity of patients and the holistic way that Maori and Pasifika peoples’ approach different aspects of their health and well-being.

This essay will discuss about the medical dominance, how power and hierarchy have influence on both patient and medical professionals in the Australian health care system, especially in the field of midwifery. The general concepts of power and the hierarchy in health care setting and how it has closely interwoven with the health sociology would be investigated throughout the essay. The social determinants of health in terms of social justice and equality, moreover, are significant factors in accessing appropriate health service and achieving better health outcome with the patient. It would also utilise the conflict theory to illustrate historical, structural, cultural and critical factors on supporting the power structure, agencies related

This encounter referred to as biculturalism, is an important aspect of cultural safety. This means that the interaction between a nurse and a patient is always considered bicultural as this involves the nurse’s culture and that of the patient’s. In this contact there is hidden power structure and a dominant culture (Henderson, 2003; Jarvis, 2012; Papps & Ramsden, 1996). As stated earlier, in New Zealand the colonisation British enabled them to dominate over all aspects of New Zealand’s way of life and culture, hence in the health care setting, the non-Maori culture prevails. As a culturally safe practice, nurses should learn to respect and acknowledge the culture of the care recipient whether it similar or different from them. Recipients of cares should be encouraged to participate and utilize their culture in managing their health and treatment (Papps & Ramsden, 1996). The nurse’s self awareness of one’s culture while acknowledging and respecting another’s is a fundamental requirement in order to practice cultural safety in nursing (Papps & Ramsden, 1996; Polaschek, 1998; Robinson et al., 1996).

The arrival of the Europeans caused many changes to the Māori society between 1642 and prior to the signing of the Treaty of Waitangi. The Europeans brought with them many things to trade; however, they contributed to fatal impact in New Zealand as they brought with them weapons which killed a lot of people and enslaved many more as more and more Māori competed for weapons. By 1830 the Māori had learnt a lot about the world. They had learnt the skills of trade with Europeans and the Māori had missionaries that taught them how to read, write and communicate with the outside world. New Zealand was no longer an unknown and isolated land

The Maori, “Children of Heaven”, are the indigenous people of New Zealand. It has been thought that Polynesian navigator Kupe, discovered New Zealand in 950 AD, and named the island Aotearoa, “Land of the long white cloud”.1 The Maori migrated to New Zealand from the tropical islands of

Throughout New Zealand history, historical roots have played a significant role in the development of modern Aotearoa New Zealand. The historical past has shaped various forms of present social dimensions within the nation today. This essay intends to discuss the controversial racial inequality in regards to the relationship between Maori and Pakeha within contemporary New Zealand society. This essay will explore two readings; “Plunder in the Promised Land: Māori Land Alienation and the Genesis of Capitalism in Aotearoa New Zealand” by Wynyard, Matthew and “Stereotypical Construction of the Maori ‘Race’ in the Media” by Wall, Melanie. This essay will also further discuss a brief summary on my personal reflection

Te Tiriti o Waitangi is an agreement made between groups of people representing the British crown and Māori chiefs in 1840 (Orange, 2004). The Treaty of Waitangi has four elements: kawanatanga, tino rangatira, oretitanga and tikangatanga. This essay will focus on oritetanga element of the treaty in relation to socio-political contexts and social justice with examples. It will then go on to the current views of Maori in health experiences in relation to existing clinical and community health/disability services. It will then apply the knowledge of Maori health to everyday professional practice. Finally, this essay will have a brief discussion of nursing practice in relation to oritetanga.