In Australia, the life expectancy of Aboriginal and Torres Strait Islander Peoples is around 17 years lower than that of non-Indigenous Australians. The infant mortality rate for Aboriginal and Torres Strait Islander Peoples is twice that of all Australians. And Aboriginal and Torres Strait Islander Peoples are three times as likely to report some form of diabetes than non-Indigenous Australians.
The Federal Government has committed to improving the health of Aboriginal and Torres Strait Islander Peoples and closing this life expectancy 'gap' within a generation. Our research proves that the government's one-size-fits-all solutions and blanket policies cannot deliver these results.
"If we move out somewhere else we forget about bush medicine. It's important for us to know. Bush medicine help both way."
Joycie Jones Pitjara
Instead, an integrated human rights solutions - one that empowers people and engages people to take responsibility for the solutions - is required. The success of this approach is shown by the Urapuntja Health Service, a community-controlled Aboriginal health service provider on the Utopia homelands in remote Australia.
Over a period of three years, we worked with the Alyawarr and Anmatyerr Peoples in Utopia. Our publication, Two ways to health (PDF 1.2Mb) highlights our key findings and case studies exemplifying this "two way" approach to closing the gap on health in the Northern Territory.
The right to health under international law
All people have the right to the highest attainable standard of physical and mental health under Article 12 of the International Covenant on Economic, Social and Cultural Rights. The right to health does not necessarily translate as a right to be healthy, but states do have obligations to provide the conditions and services to ensure that people have the best chance to be healthy.
The Committee on Economic, Social and Cultural Rights defines how this right should be implemented:
- The state has a duty to make available adequate healthcare facilities, with trained professionals and essential medicines.
- Health facilities, goods, services and information on health must be physically and economically accessible to everyone, without discrimination.
- Health facilities, goods, services and information on health must also respect medical ethics, be culturally appropriate and sensitive to gender and life-cycle requirements.
- Delivery of health services requires, among other things, skilled medical personnel, scientifically-approved and unexpired drugs and hospital equipment, safe and potable water and adequate sanitation.
Indigenous Peoples right to health
Under international law, Indigenous Peoples have rights to specific measures to improve their access to health services and care. This includes:
- Services need to take traditional preventive care, healing practices and medicines into account. They need to recognise and protect the vital medicinal plants, animals and minerals necessary for the full enjoyment of health for Indigenous Peoples.
- In Indigenous communities, the health of the individual is often linked to the health of the society as a whole and has a collective dimension. Any displacement of Indigenous Peoples from their traditional lands against their will denies them sources of nutrition and breaks their connection with the land. This has a deleterious effect on their health.
- Resources should be provided for Indigenous Peoples to design, deliver and control health services.
Urapuntja Health Service demonstrates ‘two way’
The Urapuntja Health Service is an Aboriginal Community Controlled Health Service that was established at Utopia in the Alyawarr homelands in 1978. It services approximately 1,400 Alyawarr people living on their traditional homelands across more than 3,000 square kilometres in the central desert region of Australia. The clinic is overseen by a board of elders and community leaders who govern the clinic and appoint staff including the CEO, doctors, nurses, Aboriginal community health workers, administrators and drivers.
Protecting, respecting and fulfilling the human rights of Aboriginal Peoples is fundamental to the philosophy of the health service and informs how health services are delivered in the Utopia homelands. The Alyawarr Peoples describe it as ‘two way’.
Two way reflects a genuine partnership between Aboriginal people and health service providers. It combines Western, scientific and Aboriginal knowledge of health and healing, using both modern and traditional medicines. Services are delivered by doctors, nurses and Aboriginal community health workers in a way that reflects the reality of Aboriginal lives in remote Australia and respects Aboriginal culture and law.
Two way also refers to the control of health services beingm shared between Aboriginal governance structures and the health service providers. This model is the embodiment of a rightsbased approach to healthcare delivery.
To learn more, read through Two ways to health below, or download the report (PDF 1.2Mb).