Introduction
Human health is an indispensable requirement that enables people to live comfortably. There have been efforts to improve human health although challenges abound in the implementation of recommendations geared towards achieving a healthy society (McKenzie 2012). This is a case study report on indigenous health focusing on the Torres Straight Islander and the Aboriginals of Australia.
Colonisation History and Prevalence of Diseases amongst Aboriginals
The Aboriginals have a long history of drug use dating back to the beginning of the European invasion of Australia. They were paranoid and feared their culture would disappear if they mingled with other people (Goondir Counselling Service 2010). However, the Europeans were determined to change the Aboriginalsâ ways of life and forcefully took some of their children away from their communities. These children formed the âStolen Generationâ of the Torres Straight Islander and Aboriginals.
The forceful removal of children from their communities left their parents with mental and emotional stress. They could not bear the pain of seeing their children taken away from them since they felt they were going to die (Goondir Counselling Service 2010). This led to drug use amongst parents as they tried to fight the psychological and emotional stress they were experiencing. They felt the government together with other colonial forces were not giving the Aboriginals their right to determine their future. They were traumatised and paranoid for fear of more children being taken away from them.
The children forcibly taken from their families experienced emotional and mental stress in the process of being forcefully assimilated into other cultures. Even though the government-initiated programmes to assimilate them back to their community they had already lost their identities and could not fit in with their former families (Brown 2011). Moreover, their parents had already suffered a lot due to the long absence of their children. Men took to alcohol as a way of covering their anger and physically, sexually or emotionally abused their women and other members. Moreover, women were eventually taking drugs like their husbands (Goondir Counselling Service 2010). These separations lowered their self-esteems, hindered their identities and dehumanised their perceptions of social integrations.
Background
This report will refer to the Torres Straight Islander and Aboriginals as the Aboriginal community. The Australian population consists of the urban elites who have advanced in both technology and traditions. They have adopted new skills of production, transport, communication and service delivery and thus shaded off the old Australian traditions. In addition, they are well educated and use sophisticated equipments to do their activities. On the other hand, there is the rural poor Aboriginal community that depicts the lower cadre of Australians (Maville 2012). This group lives in rural areas where access to medical facilities is limited. In addition, their levels of education are low compared to other Australians. Therefore, there is a high risk and prevalence rate of infections due to the nature of their surrounding as well as limited exposure to the outside world (Rogstad 2011). There are attempts by government and volunteer groups to improve the Aboriginalsâ health standards. This is done through fighting against drug abuse and sexually transmitted infections. When the Europeans and Dutch colonised Australia they wanted to interact with the Aboriginals. However, the Aboriginals resisted any attempts to intermarry and have anything to do with foreigners. The Aboriginal community then retreated to forests and secluded themselves from the rest of the population. This put them at high risks of sexually transmitted diseases since they had little knowledge and access to sex education and services. The data obtained from the research done shows a considerable range of figures that depict how the Aboriginals are more susceptible to health risks than non-Aboriginals (Mapfumo, Waples-Crowe and Ware 2010). The data shows that, amongst the Aboriginals, there are 18 % and 8% transmission rates amongst injecting drug users and men who practice homosexuality (Mapfumo, Waples-Crowe and Ware 2010). However, amongst the non-Aboriginals, the figures were 3% and 4% respectively (Mapfumo, Waples-Crowe and Ware 2010). Shocking figures reveal that even though the Aboriginals constitute 2.4 % of the population there is a high rate of transmission of HIV and Hepatitis B. Most youths aged between 21-30 years tested positive on HCV (Mapfumo, Waples-Crowe and Ware 2010). Even though vaccination plays key role in reducing the spread of Hepatitis B, this has not helped the Aboriginals since 2002 (Mapfumo, Waples-Crowe and Ware 2010). On the other hand, there has been a decrease in its prevalence amongst the non-Aboriginals. The results further indicate that there are more male than female infections amongst the Aboriginals (Mapfumo, Waples-Crowe and Ware 2010).
Annex and VACCHO (Victorian Aboriginal Community Controlled Health Organisation)
These are the two main organisations that provide community health services to the Aboriginals to reduce drug abuse and the prevalence of sexually transmitted infections amongst the rural Aboriginals. The Victoria Department of Health provided funds to these groups to finance their projects. VACCHO is the main body responsible for health concerns in the Aboriginal community (Burns 2012). Most of the Aboriginals are drug addicts and use injections without bearing in mind the effects of sharing this equipment. Even though, there were efforts by the government to promote safe sex amongst these people there were few achievements. Therefore, these two groups set out to examine the barriers that hinder the effective use of healthy injections and safe sex practices amongst the population.
Addressing HIV Risks Related to Injecting Drug Use amongst the Victorian Aboriginals
The programme is run by the government through the B.A.D.A.C. Aboriginal Community Centre in Wendouree, Sebastopol and Ballarat Central. Their main aim was to reduce the spread and prevalence of HIV and other opportunistic sexually transmitted infections through developing and initiating healthy and friendly programmes amongst drug users.
Objectives of Annex and VACCHO
These two groups had to step in and assess the reasons behind the failure of previous projects. There was the need to address barriers to the effective implementation of past policies and develop new strategies to solve existing problems.
Aboriginal Community Centre, Ballarate
These groups had two main objectives towards developing safer and convenient strategies to curb risky healthy behaviour amongst the population. The first objective was to examine the emerging and ongoing injecting drug use trends amongst the population.
The second objective was to analyse the effects of injecting drugs and risky sexual activities to the victim, their families and society. On the other hand, it was necessary to consider community participation programmes as necessary tools for this research (Fuchs 2008). These measures were addressed through the formation of groups that highlighted their victimsâ plights, as well as their social and health needs.
Implementation
The first step involved was convening a project advisory team by these two groups in order to seek expert opinion and plan on the effective way of dealing with drug use and sexually transmitted infections (Cannon 2009). These experts came from various organisations dealing with drug use and rehabilitation, health workers handling drug addicts and law enforcement agencies. It was necessary to source experts from this community to enhance acceptance in the community and increase incredibility on the findings. In addition, this played a key role in ensuring the recommendations outlined did not conflict with the ethical and cultural considerations of the Aboriginal (Mapfumo, Waples-Crowe and Ware 2010).
Secondly, these groups submitted a request to the department of health to be granted permission to conduct research on the Aboriginals (Melnyk 2010). The methodology used involved planning, acting, observing and reflecting on the research findings. These groups established a link between drug users, service providers and government agencies to ensure the interests of the concerned groups were incorporated in the research.
These groups conducted a literature review on past research done on the Aboriginal community and other related groups (Trimingham 2010). These reviews involved examining drug abuse amongst the indigenous Aboriginals. These reviews enabled these groups to form a hypothesis and establish variables related to the research (Treviso 2009). The information was obtained from websites, direct interviews with patients and service providers as well as observation.
There were three focus groups through which the research established convenient ways of reaching the affected population. The discussions held by these groups reached an agreement that there was the need to use the family, youths and the older generation in fighting drug use and misinformation. It was necessary to use the family as a basic communication unit since it is through other members of the community who used drugs and alcohol (Jolan 2011).
It was necessary to involve the youths in these programmes since they were at greater risks of drug abuse compared to other people. In addition, the Aboriginal population comprised of youths who occupied the greater percentage of drug users (Rowell 2011). Therefore, to contain future drug use and risky sexual activities it was necessary to educate the youths on the dangers of drug abuse and sexually transmitted diseases.
A key aspect of this focus group approach was the old people who had vast experience in drug injections and sexual activities. Since most youths learnt drug use from their elders it was necessary to educate them on the need to eradicate these problems. There was the need to involve the older population to instil discipline amongst their children as an effective way of curbing these problems. The Aboriginals get involved in the treatment through focus groups, families, youths and the elderly. These groups identified various incentives like offering free food to encourage aboriginals to accept the services offered (Mapfumo, Waples-Crowe and Ware 2010). Moreover, it was necessary to employ indigenous Aboriginals to work in the mainstream programme to encourage more Aboriginals to seek the services offered by the programme (Mapfumo, Waples-Crowe and Ware 2010).
Challenges
The majority of the victims interviewed expressed innocence on the ways sexually transmitted infections spread amongst couples (Goondir Counselling Service 2010). Most couples did not use condoms during sexual encounters; therefore, this was one of the ways through which sexually transmitted infections spread in families. Even though, the Aboriginals have strict marital laws that govern and protect the sanctity of marriage, sharing of injections amongst them was a common way through which sexually transmitted infections spread (Mapfumo, Waples-Crowe and Ware 2010).
Stigmatisation forced the population to fear seeking help from healthcare facilities and other volunteer groups (Anderson 2012). People fear being branded users or addicts in the community. Even though, most people were willing to share their experiences few of them were brave enough to visit healthcare facilities to get injections or condoms (Mapfumo, Waples-Crowe and Ware 2010). There was misinformation on the dangers of sexually transmitted diseases and drug use amongst the population (Smiley 2010). Even though, most people learnt the dangers of sexually retransmitted infections and the effects of drug use they did not pay much attention to the subject due to the belief that drug use is an easy way of solving social and economic problems (Mapfumo, Waples-Crowe and Ware 2010).
Recommendations
This is a social community where sharing of utensils and other personal items is considered a way of strengthening social ties and friendships amongst them. There is no doubt that the indigenous, Aboriginal community is still at higher risk of infections compared to other Australian communities. The government has established institutions to promote the use of safe drug injection kits even though it is yet to bear fruits (Abbey 2009). However, education through peers, friends and friendly home-based approaches seem to be effective ways of combating drug use amongst the population (Mapfumo, Waples-Crowe and Ware 2010). Even though, it will take time before the results are fully realised it is necessary to ensure slow progress is noted.
The community is slowly embracing safe injecting strategies like seeking clean injections and avoiding sharing them. There are counselling and testing centres to enable them to access health services. Moreover, more funds must be allocated to volunteer groups involved in providing essential services to drug addicts and encouraging safe sex amongst the population (Mapfumo, Waples-Crowe and Ware 2010).
Conclusion
Drug use and sexually transmitted infections are world disasters that require effective plans to reduce their prevalence and spread. Governments need to invest in research and fund organisations that support rehabilitation activities. There is a need to include sex and drug awareness in education curriculums to educate the young generation.
References
Abbey, D. (2009). Health Systems for Addicts: An Introduction. New York: Productivity Press.
Anderson, O. (2012). The Drug Addictsâ Formulae: Diet, Breath and Gravity (No Nonsense Health and Fitness). Massachusetts: Wadsworth Publishing.
Brown, J. (2011). Evidence-Based Practice for Nurses: Appraisal and Application Research. Massachusetts: Jones and Bartlett Learning.
Burns, N. (2012). Understanding Nursing Research: Building an Evidence Based Practice. Philadelphia: Saunders Publishers.
Cannon, S. (2009). Introduction to Nursing Research on Drug Abuse: Incorporating Evidence Based Practice. Massachusetts: Jones and Bartlett Learning.
Fuchs, V. (2008). Drug Addictsâ Healthcare, Guaranteed: A Simple, Secure Solution for America. San Francisco: Public Affairs.
Goondir Counseling Service. (2010). The Stolen Generation. Goondir Health Services. Web.
Jolan, J. (2011). The Ultimate Diet Guide: For Drug Addiction! No Starving, No Food Restrictions, No Gym Workouts Required. New York: MakeRight Publishing.
Mapfumo, L., Peter Waples-Crowe and John Ware. (2010). Action Research-Addressing HIV Risks Related to Injecting Drug Use in Victorian Aboriginal Communities. A Report for the Victorian Department of Health. Melbourne: Annex and VACCHO Incorporated.
Maville, J. (2012). Health Promotion in Nursing with Premium Website Printed Access Card. New York: Delmar Cengage Learning.
Melnyk, B. (2010). Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice. New York: Lippincott Williams and Wilkins.
McKenzie, N. (2012). The Sting: Australia’s Plot to Crack a Global Drug Empire. Melbourne: Melbourne University Publishing.
Rogstad, K. (2011). ABC of Sexually Transmitted Infections (ABC Series). London: BMJ Books.
Rowell, A. (2011). Understanding Drug Addiction Health : A Guide to Billing and Reimbursement. New York: Delmar Cengage Learning.
Smiley, K. (2010). Medical Billing and Coding for Drug Addicts. New York: For Dummies.
Trimingham, T. (2010). Not My Family, Never My Child: What to do if Someone You Love is a Drug User. New South Wales: Allen and Unwin.
Treviso, B. (2004). Sexually Transmitted Infections Anatomical Chart. New York: Lippincott Williams and Wilkins.