The Aboriginal and Torres Strait Islander Health Workforce

Part of health service workforce and community

Aboriginal and Torres Strait Islander health workers, health practitioners, and liaison officers are the cornerstone for the delivery of health services to Aboriginal and Torres Strait Islander people, particularly in rural primary care settings.

Role of Aboriginal and Torres Strait Islander health workforce

Their role is crucial to the health and wellbeing of Aboriginal and Torres Strait Islander people. They are often the first healthcare worker an Aboriginal or Torres Strait Islander patient would see. They offer cultural expertise and a cultural lens for engaging with Aboriginal and Torres Strait Islander patients and their families. They provide cross-cultural advocacy for patients and families and form a vital part of the interdisciplinary team who care for Aboriginal and Torres Strait Islander peoples. Their involvement, along with the involvement of Aboriginal and Torres Strait Islander doctors, nurses, and allied health workers increases the likelihood of a patient feeling culturally safe in the health service. They also help to ensure that the patient has a good understanding of the diagnosis and treatment advice. They can also help families to coordinate and navigate through the system of health services and procedures needed for their care.

Working with the palliative care team

The key goal of palliative care is to improve the quality of life for people who are sick and not going to get better, and improve quality of life for their families too. The Aboriginal and Torres Strait Islander healthcare workforce can play a pivotal role in achieving this goal for Aboriginal and Torres Strait Islander people, their families, carers, and communities. The Aboriginal and Torres Strait Islander healthcare workforce alongside the broader support workforce such as enrolled nurses and allied health assistants are instrumental in providing quality palliative care to Aboriginal and Torres Strait Islander Peoples.

“Our indigenous health workers . . . if we didn’t have them I just don’t know what we would do. They are just brilliant.”

Quote from Northern Territory health care provider.

Source: McGrath PD, Patton MA, Ogilvie KF, Rayner RD, McGrath ZM, Holewa HA. The case for Aboriginal Health Workers in palliative care (225kb pdf). Australian Health Review 2007;31(3):430-9. Page 436.

“I coordinate the care of palliative care patients. The Medical Officer is in charge of the care and I just bring it all together… People are more comfortable if I’m there, whatever the service is. The protocol here is for a health worker to assist them on the first visit. It makes the job a lot easier – it’s all about building rapport. I think the harmony between the Aboriginal and non-Aboriginal workers really helps. If they see that there’s a good working relationship there, and they can see that I trust them, then they’re going to trust them. It takes a special person to deliver palliative care. Sure, you have to be strong – but also you’ve got to have a heart. People are frightened, it’s really life-shattering to learn you only have a short time to live. My fulfilment is just being there for them. “I’m passionate about what I do. It is an honour and privilege to serve my people and be able to help them.””

Aboriginal Health Worker Paul Munn’s story.

Source: Kate Sullivan and Associates Pty Ltd on behalf of the Australian Government Department of Health and Ageing. Palliative Care for Aboriginal and Torres Strait Islander People. Canberra: Australian Government Department of Health and Ageing, Commonwealth of Australia; 2004. Page 3.

“My job entails looking after the palliative care clients and their family from their first consultation when they’ve been referred to the palliative care unit… My motto is I treat my patients how I want my family to be treated, and I don’t treat any different, whether they are homeless in the river bed or whether they live in a flash house in the community. I’ve seen both sides of the fence, and I think I probably went more out of my way for the guy in the riverbed. The thing that I enjoy most at the end of the day is when I know I’ve done my absolute best for that family, and they come back and tell me that they really appreciate how I’ve helped them. That gives me my greatest pleasure, knowing that I was able to help a family and support them in their time of need.”

Palliative Care Aboriginal Liaison Officer Helen Burns's story.

Source: Kate Sullivan and Associates Pty Ltd on behalf of the Australian Government Department of Health and Ageing. Palliative Care for Aboriginal and Torres Strait Islander People. Canberra: Australian Government Department of Health and Ageing, Commonwealth of Australia; 2004. Page 11.

Palliative care training options

PEPA

The Program for Experience in the Palliative Approach – PEPA offers free workshops to members of the healthcare workforce who are interested in learning about the palliative approach. PEPA provides an opportunity for primary health care providers to develop skills in the palliative approach by undertaking a supervised clinical placement for up to five days within a palliative care specialist service. These placements offer experiential learning and may include visits to various facilities providing palliative care. PEPA also offers tailored workshops on the palliative approach to care for Aboriginal and Torres Strait Islander health professionals. There is also a Learning Guide (2.53MB pdf) that discusses various palliative care issues.

NAATSIHWP provides a video on the PEPA Program for Aboriginal and Torres Strait Islander health workers wanting to know about palliative care and PEPA.

The value of PEPA placements for Indigenous health practitioners has been demonstrated in a recent journal article.

Useful palliative care resources

There are many good quality palliative care resources that can help you in providing care.

The evidence-based CareSearch website has palliative care information and resources for health professionals and health consumers
- CareSearch Education Section, with Whole of Workforce framework and listings of short courses, workshops, and web-based learning
The PalliAGEDnurse app for smart phones helps nurses apply the palliative approach to care in a timely way. The App includes information on medications and managing symptoms, and can be used by health professionals in a variety of health settings. There is also a CareSearchgp App.
Palliative Care Australia (PCA) has a range of resources covering advance care planning, facts about morphine, the dying process and pain management
PCA has a National Service Directory to help you find palliative care services across Australia
palliAGED has produced a series of Practice Tip sheets that support providing palliative care to residents. Practice Tip Sheet booklets are available for both nurses and careworkers working within residential aged care
Australian Indigenous HealthInfoNet website has pages on Palliative Care and pages for Aboriginal and Torres Strait Health Workers/Health Practitioners.

Other resources

Aboriginal and Torres Strait Islander palliative care issues
These resources highlight the essential role played by the Aboriginal and Torres Strait Islander health care workforce in ensuring Aboriginal and Torres Strait Islander patients receive culturally safe and responsive palliative care.
- Watch a video on Aboriginal Palliative Care produced by Ballarat and District Division of General Practice in 2011.
- Palliative Care Victoria has several useful resources in a section on Palliative Care for Aboriginal Australians:
  - Listen to a podcast from Palliative Care Victoria on Addressing the gap in Aboriginal palliative care.
  - Listen to a podcast from Palliative Care Victoria of an Aboriginal Hospital Liaison Officer describing providing culturally appropriate palliative care to Aboriginal people.
- Indigenous Allied Health Australia and Congress of Aboriginal and Torres Strait Islander Nurses and Midwives. Aboriginal and Torres Strait Islander palliative care – How can we close the gap? (2.19MB pdf) Conference Workshop. 13th Australian Palliative Care Conference, Palliative Care Australia, Melbourne, 1-4 September 2015.
Social and emotional considerations
- The National Rural Health Alliance has a fact sheet about Patient Assisted Travel Schemes across Australia that help families with the cost of travel.
- Rising spirits: Grief and Loss is a website from the Aboriginal Health Council of South Australia is an information resource for the Aboriginal community and service providers.
- The Aboriginal and Islander Mental Health Initiative at Menzies School of Health Research has developed the Stay Strong App (for Apple and Android), which uses Indigenous specific content and imagery to address wellbeing issues.
- Australian Indigenous Health InfoNet. Keyfacts – Grief, loss and trauma. Social and emotional wellbeing workers web resource (1.16MB pdf). Perth: Australian Indigenous Health InfoNet, Edith Cowan University; 2013.
- Austin Health. Respecting Patient Choices: Advance care yarning for Aboriginal and Torres Strait Islander people (1.13MB pdf). Austin Health, SA Department of Health; 2010.
- Austin Health. Respecting Patient Choices: Advance care planning with Aboriginals and Torres Strait Islanders (72kb pdf). Canberra: Austin Health and Department of Health; 2006.
- Northern Territory Government Department of Health and Families. A Cancer Journey: A cancer story for remote Indigenous patients in the Northern Territory (1.73MB pdf). Darwin: Northern Territory Government; 2009.
- Aboriginal Health and Medical Research Council. Culture Cancer Caring – Inspiring stories for our mob (3MB pdf). Surry Hills, NSW: AHMRC; 2010.
Care management and treatment considerations
- Remote Primary Health Care Manuals. Medicines Book for Aboriginal and Torres Strait Islander Health Practitioners (7.54MB pdf). 5th Edition. Alice Springs, NT: Flinders University; 2022.
- Remote Primary Health Care Manuals. CARPA Standard Treatment Manual. 8th Edition. Alice Springs, NT: Centre for Remote Health; 2017.
- Remote Primary Health Care Manuals. CARPA Clinical Procedures Manual for Remote and Rural Practice. 5th Edition. Alice Springs, NT: Flinders University; 2022.
- Remote Primary Health Care Manuals. Reference and chance report document for the Remote Primary Health Care Manuals 2022. Alice Springs, NT: Flinders University; 2022.
- Indigenous health resources for health professionals from Kidney Health Australia. They also provide a Kidney Stories Toolkit, including stories of Palliative Care for People with Sick Kidneys.
- Cancer Australia has developed a range of resources for health professionals designed specifically for Aboriginal and Torres Strait Islander Health Workers who work with Aboriginal and Torres Strait Islander communities.
- Cancer Institute NSW. Cancer treatment side effects: A guide for Aboriginal health workers. Sydney: Cancer Institute NSW; 2015 Mar.
- Cancer Institute NSW have produced a video Beginning the Journey – Introduction to radiation & chemotherapy treatment, which provides an overview of chemotherapy and radiation therapy for Aboriginal Health Workers.
- The Northern Territory Department of Health produced a series of very useful resources about palliative care for Aboriginal and Torres Strait Islander patients, including videos and flipcharts on palliative care for sick kidneys part 1 (4.48MB pdf) and part 2 (4.64MB pdf).
- The Aboriginal Health and Medical Research Council as developed The Living Longer Stronger Resource Kit. This kit is very useful for Aboriginal Health Workers in helping patients understand how their body is affected by their chronic conditions.
- Some patients may wish to use traditional medicine and healers as an alternative to or in combination with western medicines. This can be important for a patient’s health and peace of mind, offering spiritual and emotional support to patients and their families. While little is known about the use of traditional bush medicine for illnesses like cancer, it can valuable for health professionals to know if their patients are taking traditional bush medicine in case there may be side effects involved in using both traditional and western medicines. See Shahid S, Bleam R, Bessarab D, Thompson SC. “If you don’t believe it, it won’t help you”: use of bush medicine in treating cancer among Aboriginal people in Western Australia. J Ethnobiol Ethnomed. 2010 Jun 23;6(1):18.

The Patients, Families and Community Journeys section within the Aboriginal and Torres Strait Islander Care section has a range of resources that you can print for your patients and their families on many different topics. You can also suggest that patients and their family and community members visit the section of the CareSearch website themselves.

The Aboriginal and Torres Strait Islander Health Workforce

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