Behind every test is a patient with cultural and emotional needs

Over the last several weeks, we have been both spectator and recipient to frequent leadership actions designed to protect and safeguard our communities against COVID-19. The worldwide response to this pandemic has set into motion a swift upheaval of life which has been novel to our collective ‘living’ memory. We have witnessed a range of social restrictions to mitigate viral transmission to ‘flatten the curve’, actions to uphold food security and supply chains, and legislation to protect household incomes. As the dust starts to settle on what is becoming the new short-term ‘norm’ of isolated living, it is opportune to examine how this initial phase of sweeping arrangements has been promulgated among Indigenous communities.

Ask any Aboriginal and or Torres Strait Islander person, the daily grind of ‘life in the colony’ offers up the usual pervading social and cultural challenges, (gaining a meaningful job, racism, having access to appropriate housing, having a platform to voice and determine change, etc., etc.) These challenges and barriers are cultivated by the institutions and structures designed to benefit the masses. This is the reason why so many minority groups find themselves in similar situations on the fringes of society becoming more stressed and increasingly sicker.

There is nothing new or groundbreaking about this and it is happening throughout the world over. This context, however, is what is triggering alarm bells among many Indigenous health professionals around the world.

Concerns of COVID-19 getting into our communities is driven by the knowledge that this virus can cause a lot of harm to those on the fringes already enduring illness or disease in an alarmingly short period of time.

As alluded to, it is well understood the widespread plight of illness and disease endured by Indigenous Peoples. The ways of community life, the burden of disease and the successive lack of social and economic infrastructure released to Indigenous peoples sees a looming set of circumstances that is difficult to ignore.

Yet despite this proverbial situation, modelling to effectively understand the implications of ‘containment’, social distancing and accessing health care for Aboriginal and Torres Strait Islander Peoples during a pandemic has been reactive, rather than a proactive measure. There is good evidence both locally and internationally, that clearly describes the requirements surrounding planning for pandemics among Indigenous communities.

The reinvigoration of jurisdictional public health units with a clear Aboriginal and Torres Strait Islander remit may be a needed consequence from this pandemic. This has not been however, the main message voiced by Indigenous health leaders at this time, and nor should it be.

Indigenous leaders have instead focused their energies to safeguard their communities through the capacities and resources available to them. At an individual level, leaders have not sat back waiting for directives, modelling or strategy. They have not expected anyone from government or elsewhere to ‘come to save’ or inform their communities about how to prepare for this pandemic. We have seen many examples of individual leadership through social media platforms and the like. Many Indigenous doctors, nurses, allied health workers, Aboriginal health workers, and CEO’s of peak organizations sending their messages broadly. Other peak organizations like the NACCHO and AIDA, have advocated for national and strategic responses such as restricted access to remote communities, release of low risk incarcerated Indigenous inmates and shoring up remote food and supply chains.

It has been heartening to see our leaders execute their skills and attributes in preparing their communities. They have done this by staying true to Aboriginal ways of knowing, being and doing.

Peoples social and emotional wellbeing, including promoting strong connectiveness as a community, has been a large part of this holistic response. Such efforts have been particularly fundamental during these times of needing physical distance.

Many Indigenous Australians who have limited control over the challenges ahead are watching with anticipation as to how the government will use their systems and powers to protect the vulnerable from an influx of COVID-19. We cannot implement the social and cultural safeguards in the present moment to protect our communities from the impacts of this pandemic. The benefits of implementing such measures were required generations ago.

Instead as an Aboriginal doctor, I say to my colleagues, as the health system stands and waits for the ill, remember – be culturally safe and responsive! Remember the unique needs and challenges faced by my People and their communities. Let us not be distracted by the pressing needs for acute care; instead let us keep close to our hearts the humanistic principles of medicine that we should all live by, and that is, that at the end of every swab, every test, every ventilator is a patient with generations of history that we all need to be culturally, emotionally and professionally respectful of so that we can continue to provide the gold standard care to all of our patients no matter the crisis that is unfolding around us.