A guest blog by Professor Sally Kendall, Centre for Research in Primary and Community Care
|Near Roebourne, Western Australia|
|Professor Sally Kendall at a "welcome to the country" |
smoking ceremony, a traditional Aboriginal
greeting ceremony to their land
For example, babies born to Indigenous women in Western Australia were more than twice as likely to be of low birthweight (LBW) than were those born to all women in the region (13.6% compared with 6.1%, Australian Indigenous HealthInfonet).
Fetal Alcohol Spectrum Disorder (FASD) is reported to have a prevalence of 27.6 per 10,000 among Aboriginal communities in Western Australia compared with 1.8 per 10,000 in the general population (Bower et al, 2000). Among Indigenous people living in Western Australia, almost two-thirds (65%) reported having experienced low to moderate levels of psychological distress, and 33% reported high to very high levels of psychological distress in the previous 12 months [Australian Institute of Health and Welfare, 2013]. Indigenous people in Western Australia experienced high to very high levels of psychological distress at almost three times the rate reported by non-Indigenous people.
The research team consists of Professor Rhonda Marriott and a multi-disciplinary group of midwives, nurses, social scientists, epidemiologists, anthropologists, a paediatrician and community development workers. Rhonda is unique as an indigenous nurse and midwife with a Professorial university appointment. Some team members are themselves Aboriginal and/or have worked with Aboriginal communities for many years.
My role in the team is as a UK Professor with a background in child public health and health visiting, and a research track record in parenting and community health nursing. Whilst here I have presented at numerous events and conferences and disseminated and discussed many aspects of my research and comparative health services.
|Original artwork that describes the journey of the Pijarra People|
|The town of Roebourne, Western Australia|
|The red rocks |
|Original Aboriginal artwork |
on the red rocks
|A "Yarning Circle" - with Mary talking about TLC|
What is apparent throughout meetings with Aboriginal women is that whilst a 150 year history of displacement, abuse, genocide, removal of children and extreme marginalisation has left a deep intergenerational trauma, there is a strong sense of cultural identity, of family and community and of the need to pass on the stories, language and the culture to the next generation.
|Boys in Roebourne|
|Lorraine with her 'grannie' (grand-daughter) in Roebourne|
The research team was there to work with them, to identify issues that were of concern and to support strategies that could be evaluated. However, one of the challenges is that there are quite literally hundreds of programmes available to 'help' Aboriginal communities, from many different funding sources often with competing aims. The women are rightly frustrated with having so many programmes and meetings but not seeing direct effects or improvements. It is then a real challenge to researchers not to be just another programme, but to be able to achieve something that has meaning and impact.
The Triple WRAP research project aims to support parenting and early motherhood through Participatory Action Research. One outcome of this will be a DVD that invites women to talk about what mothering means for them in Roebourne - what is the experience of being a Mum? The methodology is based on the history of yarning and will therefore be of value in passing the positive experiences of motherhood to the young women of the town but also to highlight the challenges they face and to consider local strategies to address these.
Another project is concerned with how grandmothers can give greater support to young mums. With such projects comes a need for good evaluation and part of my contribution is to discuss how the team can use outcome measures such as the Tool to measure Parenting Self Efficacy (TOPSE, Kendall and Bloomfield, 2005 www.topse.org.uk). We will be looking at how this measure developed in the UK could be 'translated' into a style and format that would be acceptable to Aboriginal women. The approaches that necessarily need to be used among the communities do present a challenge to the typical white, educated UK researcher.
Yarning circles do not feel like research in the traditional sense, or even like a focus group as there is little moderation or guidance. There is a sense of a lack of hard data to go back and analyse, and a feeling of underachievement or of having disappointed the women. This requires a change in oneself, to think differently about what research means for these women and what it could potentially lead to that might eventually make a difference to the health gap.
|Successful in major research grant|
Whilst I was there we were informed that we had been successful in a major research grant from the National Health and Medical Research Council in Australia, for just under $1m.
I am excited to be an associate applicant on the grant, the purpose of which is to explore and promote cultural security for Aboriginal women during pregnancy, childbirth and early parenthood. There are 14 partners on the grant and I feel proud that University of Hertfordshire is one of them. It also means that I will be a 'Boomerang researcher' for the next four years, returning to Western Australia annually to develop the research tools and methods and to hopefully make my small contribution to improving the health and wellbeing of Aboriginal women and children.