A new program in central Australia is training the Aboriginal people to manage their own health care. The difficulties of providing medical attention to these isolated and scattered groups have been complicated by cultural and linguistic differences. Aboriginal technicians are now being trained to administer to the needs of their own groups, using methods that draw on both traditional and Western medicine.

Prior to 1975, the very few Aboriginal workers employed in health centers were usually assigned only menial tasks. Today, 120 Aboriginal Health Workers [AHW] diagnose and treat patients from their own communities, both in well-equipped urban health centers and from sheds and trailers in remote areas. One AHW, Johnny Briscoe, described the extent of his involvement in health care as a result of this training.

I feel that I am really helping my people. Through the training program I have learned many skills and new ways of looking after people. I can do dressings, give injections of penicillin, use an auriscope, take blood for testing, check blood pressure, suture a wound, and many other things. I look after the common troubles like bad eyes, bad chests, cuts and boils, scabies, diarrhea, and so on. Recently I have been training in dental care.

The involvement of Aboriginal communities in planning this program has helped to make it successful. In the early seventies, rural doctors, missionaries and linguists consulted Aboriginal medical specialists to learn ways to combine traditional curing and Western medicine. The medical staff came to understand and appreciate the importance of traditional culture and authority structures in the delivery of health care. It was clear that Aboriginal workers, trained in health care, would be most effective working within these structures.

In 1977, a program was established to train an AHW from each kinship group (of approximately 100 people), to administer to the needs of the Aborigines. Communities were asked to select individuals to study at a training center at Alice Spring. The creation of the center assured the Aborigines of the professional nature of the training. That same year, the first six-month training program graduated 10 AHWs. Graduates return to the center for in-service training several times a year.

The training program is based on the concept of "two-way medicine," which incorporates traditional and Western medical techniques. In addition to more conventional Western training, shamans, tribal elders and midwives give seminars on traditional medicine. Both Aborigines and whites attend these training sessions.

Plans are now underway to develop a five-step career ladder that will allow the Aboriginal population even more control over their own health care. After receiving training in managerial skills, health care workers will be qualified to administer health care delivery systems. These plans, when approved by the Department of Health, will be another major step toward indigenous self-determination.

In the final analysis, the success of this program, and other like it, depends on the continued support and involvement of the Aboriginal groups. The AHWs act as liaisons between two cultures, a highly political situation that demands acceptance from two very different groups. While the difficulties AHWs face are extreme, it is encouraging that a program such as this is being started. Perhaps it can be a model for similar programs for indigenous peoples throughout the world.

Article copyright Cultural Survival, Inc.

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