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Almost every society includes various cultural groups that often have disputes with each other. Australia is one of such countries where white people live with Aborigines and Torres Strait Islander people. The sorest field of discrimination is healthcare system where indigenous and CLAD people receive unprofessional and slow treatment. Hence, indigenous and CLAD people suffer much from racism; however, social workers play a major and significant role in reducing the level of racism towards cultural minorities in Australian healthcare system.
Indigenous and CLAD People in Australian Health Care System
One of the most crucial spheres where such people are discriminated is the healthcare system. It is important to note that law does not regulate everything in the healthcare system. A lot of of actions depend on doctors, nurses and other medical workers. It is not a secret that white doctors often prefer treating a white person rather than an Aborigine, especially if that doctor is a racist (Durey, 2012). Furthermore, doctors often do not put enough efforts to make an ill Aborigine healthy again.
There are three types of racism. The first one is systematic or as it is often called – institutionalized racism (Arabella, 2013). Such form of racism creates certain limitations and obstacles for a discriminated person in having access to hospitals and medical services, housing, resources, special jobs, employment in general, education, resources, income, information, living conditions, and so on. The second type is called interpersonal racism (Fionek, 2015). Such form is spread almost in every society where diverse groups are living together. Australia as a home country for both white and indigenous people is a perfect field for interpersonal racism development. It can be visible through indifference, prejudice, devaluation, mistrust, discrimination, and disrespect. Such type of racism is highly complicated to eradicate from the nation since it requires the change in several generations. The last type of racism is called internalized one. Negative self-images are the display of that type of racism (Grigga, 2015). People feeling that they are not the same as others can discriminate themselves though helplessness, self-devaluation, reinforced inadequacy, and resignation. The last type is directly connected with the two previous types since a person can discriminate him/herself only if the society does the same.
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The absence of medicines and donors of organs for Aborigine people can be considered as institutionalized racism due to the limited access of indigenous people to medical services (Paradies, 2015). They often have to buy drugs themselves since hospital can run out of them or give them all to white people. It is not a secret that indigenous people are put on the bottom of donor list so that few of them get the organ they need.
The limited access of Aborigines to education in medical colleagues and the refuse of medical facilities to hire graduate indigenous doctors is also considered to be institutionalized racism. Since there are different patients, it would be wise if there are different doctors – both white and Aborigines (Hutchinson, 2012). It could have solved the discrimination in healthcare system. Nevertheless, it is impossible since indigenous doctors cannot find a job in a good hospital in spite of his/her professionalism.
The trust among indigenous people and CLAD towards doctors is only 60% (Paradies, 2015). It means that those people do everything to avoid attending a doctor. More than a third is sure that they will not get professional help in the hospital but instead – only bad treatment (Hutchinson, 2012). Having such biases towards doctors is the result of bad experience there.
Indigenous people are also often sent to inexperienced doctors or non-Australian ones who speak English as the second language. The best doctors often treat only white people and transmit indigenous patients to their younger colleagues. Hence, indigenous patients are considered less important than white patients are. Another example of institutionalized racism is the fact that not all indigenous people asking help in the hospitals get it. According to the survey, only 73% of people that come to the hospital get the help they required while others are refused due to various reasons (Grant, 2016). Medical workers often neglect indigenous people’s health because of racism, so that it is not strange that many people do not trust governmental hospitals.
The absence of doctor’s ethics is interpersonal racism. There are many people living in Australia who do not like indigenous population since they consider them people of lower class. It is not right according to moral principles but there are such people in Australia, and they do not hide their attitude towards black people. Hence, many doctors being racists can act impolitely with their patients so that those no longer want to be in the hospital and can get stress that is harmful for their health.
The example of internalized racism is the broken fate of many children. Due to the bad experience of discrimination and insults, children grow up with the inferiority complex (Arabella, 2013). Those children are always depressive and prone to alcohol or even drug addiction. Children under 12 years are the most vulnerable, and such discrimination affects much their health in the future.
The other result of internalized racism and doctors’ bad attitude towards indigenous patients is different physical and mental illnesses such as hypertension (high blood pressure) or different heart diseases, anxiety, and often depression (Vichealth, 2014). Due to many stresses a person experiences because of racism, all those illnesses can be developed or even caused by racism in Australian healthcare system. Therefore, racism can not only prevent from proper curing but also cause dangerous illnesses.
One of the consequences of such racist healthcare system is a 17% gap in life expectancy between white people and indigenous population (Paradies, 2015). Such a great gap in one country is not the result of different lifestyles; the core reason of it is the different treatment of those groups of population. Taking into consideration cultural diversity, Aborigines and CLAD people do not want to talk about their problems with doctors since they do not understand them in cultural way. Furthermore, there can be some linguistic diversity that harms the process of treatment. Therefore, indigenous people ask doctors for help only when there is a threat of life.
Role of Social Workers
The rights and opportunities of social workers are described in Australian Association of Social Workers. According to it, the role of the social worker in reducing the rate of racism in Australian healthcare system is significantly important. The most important instrument a social worker should operate is knowledge (AASW, 2010). They should precisely learn and, what is more important, understand the cultural features of all sides of the conflict: white people, Aboriginal and Torres Strait Islander people and those from culturally and linguistic diverse population. It is crucially important to know everything about the people they are working with starting from customs, beliefs and values and ending with cultural and racial affiliations (Grant, 2016).
A major investigation should be conducted by the social worker in pursuit of understanding difference between two or more different cultures. Social workers should analyze family structure, interfamily relations, community needs, and individual features (AASW, 2010). All those factors should be considered for the successful comparison of variable cultures, finding out key differences between them, and accordingly the sources of all problems.
Despite the fact that social workers cannot solve the problem of racism in Australia, they can help a lot of people to live a happy life and foster a good relationship between different cultures. First, it is important to differentiate between two terms that social workers use in their work: cultural competence and cultural response. Those terms differ much: “cultural response” is preferred as it is more precise and narrow than “cultural competence” and it is used on the legislature level (Herrings, 2013; Indigenous Allied Health Australia, 2015). Cultural competence only estimates cultural values and intercultural relations while cultural response “…describes the capacity to respond to the healthcare issues of diverse communities” (Victorian Government, 2009, p.12). Therefore, the term cultural response is a much better instrument of a social worker.
Social workers should understand that different cultural groups in one country often belong to different religions. Religion is often the most important part in culture for some people. That is the reason why social workers should know the religion of each group, their rituals, and spiritual beliefs to strengthen the relations between different groups since religion also can play a crucial role in the desire of an indigenous person to go to the hospital, for instance. Social workers should forget about their own religion and understand the religions of groups they are working with (CAAC, 2015).
Social worker also should ascertain the behavior of indigenous and non-indigenous individuals under different cultural conditions. It is important to maintain confidentiality, self-determination, and how they are applied in different conditions, both normal and stressful (Indigenous Allied Health Australia, 2015). Social workers should also understand that they are working with diverse groups of people; thus, not only cultures but also languages may differ. That is the reason why a social worker should involve an independent interpreter if needed. Nevertheless, it is important to always apply cultural features while translating since the context can be lost. Social workers also work in educational facilities or political bodies where they can foster the spread of information about different groups that live in the region or the whole country. As the result, each group of people can learn something new and understand the different culture that fosters good relations and dispraises racism.
Social workers are those people who should create and develop a practice of work for themselves and younger generations. This practice should be sensitive and consider all cultural, religious, and linguistic features of the researched groups. It is important for social workers to share their experience with their colleagues working in other regions since those colleagues, in their turn, can also give some useful advice to social workers (Herring, 2013). Furthermore, it is important for social workers to get feedbacks from the community to determine whether they work well or there is an urgent need in practice sample change.
The main aim of a social worker is providing each child, woman, and man with equal opportunities through the creation of culturally safe society. Different cultural groups are taught how to interact with each other with understanding and respect. It is not right that a group of social workers of one culture is working with different cultural groups (Victoria Government, 2009). That is the reason why social workers should also closely cooperate with their colleagues from different cultures. Social workers should know how to communicate with different cultural groups before teaching it other people. Special anti-oppressive and anti-racist practices should also be applied in the combat against racist actions between different cultural groups. Therefore, the main aim of each social worker it to create culturally safe society with spreading the mutual understanding between different cultural groups.
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It is important to notice that social workers are often limited due to the reasons they do not control. First, no social worker can fully understand the foreigner for him culture. Despite the fact that all social workers show their deep respect towards other cultures, they still cannot fully understand the core cultural reason why some people act like they do (AASW, 2010). That is the reason why many people of other cultures do not want to cooperate with social workers due to a great cultural gap so that Aborigines are not happy to cooperate with social workers, too. Second, social workers should always take the initiative to work since cultural groups never ask for help. Probably it is connected with the fact that many indigenous and CLAD people accept the fate of being object of racism.
There is a golden rule for each social worker who wants to help other people. Cultural responsiveness has three main ingredients that include being, knowing, and doing. Being means that a social worker should have his/her own values and beliefs at the same time being neutral and respect others’ values and beliefs without any discrimination. Knowing means having some skills, knowledge, and experience that are essential for successful work of each social worker, especially when it touches foreign cultural groups. Doing is the most important step since a social worker should use both being and knowing to achieve some success cooperating with individuals or groups (Indigenous Allied Health Australia, 2015).
In conclusion, indigenous and CLAD people are discriminated in all spheres of life but the most crucial one is the healthcare system. Those people do not receive professional medical help every time they need it; as result, there exists 17% life expectancy gap that is too high for one country. Social workers cannot remove racism at all but they play a significant role in its reduction through working directly with all cultural groups.