Embedding Indigenous ways of knowing into medical education

Using evidence from research into the ways Indigenous Australians engage with the healthcare system and experience health, a new educational resource has been introduced in the Melbourne Medical School to embed Indigenous ways of knowing into health communication and training of medical students and the medical workforce.

The Wurru Wurru Health Unit was formed through the First Nations Health Team in the Department of Medical Education and draws its name from the Wurundjeri term that translates as ‘Sky Country’, and also the sacred Kingfisher bird. It stems from a story referring to the six layers of country. ‘Sky country’ is the Country in which the create spirit Bunjil lives and symbolises the overarching connectedness of all things.

Permission was sought from Wurundjeri Elders to use the name and elements from the story. Uncle Ringo Terrick, a Wurundjeri, Gunnai Kurnai Elder gave the Welcome to Country at the Unit’s launch during NAIDOC Week 2022, expressing his excitement to be in an environment where people were taking interest in First Nations knowledge and processes.

The Unit’s aim is to inform and improve the medical workforce’s understanding of the challenges and opportunities of the health of Indigenous Australians, who, despite recent progress, persistently experience an inequitable burden of ill-health relative to the Australian population as a whole.

The Unit is led by Dr Ngaree Blow, a Noonuccal, Goreng-Goreng and Yorta Yorta medical doctor who heads up the First Nations Health Team for the MMS.

The Wurru Wurri Health Unit’s approach is modelled on the six layers of country and meaning: Biik Ut (Below country); Biik Dui (On Country); Baanj (Waterways); Murnmut (Wind country); Wurru Wurru (sky Country) and Tharangalk (Star country/Spiritual connection).

The Unit incorporated the ‘six layers of country’ into a communication tool that illustrates connections between country and physical and societal health. There is also a ‘river model’ and other tools, that have been developed to connect and embed Indigenous knowledges with health messages.

Speaking at the launch of the Unit, Head of the Department of Medical Education Professor Steve Trumble said the launch of the Wurru Wurru Unit unit provided a solid foundation on which so much more work would be done.

“This team comprises some of the most effective educators I’ve ever encountered in my whole career,” he said. “The First Nations team has taken our medical course, in my view, to one of the most comprehensive, integrated and effective Indigenous health programs in the country.”

Dr Blow has spent the last few years working to combat COVID-19 in the community but her substantive research remains in understanding contexts for Indigenous health.

A 2020 article in the Australian Medical Journal demonstrated urgent need for further investment in the health of Aboriginal and Torres Strait Islander adolescents, as a critical step on the journey to ‘Bridge the Gap’.

The Australian First Nations population is a relatively young cohort, with around one third being adolescents aged 10-24 years. Because of the unequal status of these young people’s health ­they are over-represented in serious conditions including diabetes, mental ill health, pneumonia, skin ailments and heart issues that are more typical of adults.

“As a result,” she and her co-authors wrote, “adolescence is where disparities in mortality widen between First Nations and other Australians. However, more than 80 per cent of mortality among First Nations adolescents is potentially avoidable within the current health system, providing an important opportunity for health gain.”

Through helping young people access healthcare in which primary providers are well-informed and able to care for patients in a culturally safe way, it’s hoped the Wurru Wurru Unit will contributing to securing a health for Indigenous populations now and into future generations.

Related publication:

Peter Azzopardi, Ngaree Blow, Tara Purcell, Ngiare Brown, Tirritpa Ritchie, Alex Brown, ‘Investing in the health of Aboriginal and Torres Strait Islander adolescents: a foundation for achieving health equity’. Medical Journal of Australia, 2020

DOI: 10.5694/mja2.50500

First published on 4 August 2022.

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