NCSEHE Student Equity Snapshots Forum — Dr Andrea Simpson
Pathways to allied health: Insights from Indigenous health professionals
The NCSEHE is hosting a series of lightning talks and online discussions presented by the 2019/20 Equity Fellows on 26–30 October 2020.
Since 2016, the NCSEHE has supported 12 Equity Fellows to conduct targeted research projects, advancing student equity research, policy and practice. The 2019/20 cohort have each undertaken major year-long projects, variously focusing on regional and remote students, students with disability, mature age students, and Aboriginal and Torres Strait Islanders.
Participants at this year’s Student Equity Snapshots Forum have gained unique insight into current student equity issues, delivered by the six Fellows, followed by live online discussions related to their projects.
In her lightning talk, Andrea Simpson draws upon her NCSEHE Equity Fellowship research which asked, why do Indigenous students choose to study health; what is their student experience, and would they recommend their choice to others?
Closing the workforce “gap” between Indigenous and non-Indigenous Australians is an important national priority, one which feeds into an overarching policy of reducing evidenced socioeconomic disparities. Yet only 0.4 per cent of university-qualified allied health professionals identify as Indigenous. This Fellowship considered how Indigenous allied health professionals arrived at their chosen professions and explored their individual career narratives.
Andrea is joined for Q and A by Research Officer Kim Alley (La Trobe University) and Professor James Smith (Menzies School of Health Research).
Lightning talk recording
Full recording (including Q and A)
Full transcript (including Q and A)
Lightning talk transcript
“I would like to begin with an acknowledgement of country. I am speaking to you today from the lands of the Kulin Nation. I would like to recognise their ongoing connection to the land and value their unique contribution to Australian society. I would also like to pay my respects to Elders, past and present, and the Elders from other communities who may be watching today.
I myself am a non-Indigenous researcher who lives and works on the lands of the Kulin Nation. I first arrived in Australia almost 20 years ago.
I had just graduated and flew into Townsville from Johannesburg excited to take up my first clinical position. At the time, Townsville was short on audiologists—hence importing me in—and my introduction to the working world was a flurry of activity.
Shortly after settling in, I was booked for my first trip to Palm Island.
In case you don’t know it, Palm Island is home to the Mun-burra people located about 65 kilometres northeast of Townsville. To get there, I boarded a small chartered plan. There were only 10 seats and aside from the pilot my fellow travellers looked much like me, young, European descent and holding various professional types of equipment.
I don’t know if you’ve ever been lucky enough to fly low over parts of Northern Queensland. They say powerful images stay in your memory and I have never forgotten the beauty of the blue ocean and the green islands below us that day. This year, without the ability to travel easily I have often thought back to that experience.
I tested 10 children that day—all of them with severe hearing loss due to chronic middle ear infections—a condition common in Indigenous communities. On Palm island, 75 per cent of children suffer hearing loss due to chronic ear infections. Without effective treatment, language and schooling is inevitably affected.
Only 12 per cent of children in Palm Island go on to complete Year 12. Antibiotics are available on the island through the GP clinic, but all these children would need specialist treatment. Treatment that is only available on 3 visits per year.
At the end of the day I packed up my bag and joined the others flying back home. All the health and education professionals I met had similar stories to me — we would fly in and do what we could but always flew back out again.
To the community, at best we were well-intentioned strangers but there was no opportunity to build relationships, to build trust, to build continuity of care.
It was this experience which got me thinking about diversity in the health professions and how this could influence quality of care.
Did you know that only 0.5 per cent of doctors identify as Indigenous and only 0.4 per cent of allied health professionals? In real terms, that’s less than 400 doctors, 50 Speech Pathologists, 20 Dieticians, 10 audiologists, and 10 optometrists.
In 2018, Indigenous enrolments accounted for just over two per cent of the student body. However, within allied health, only one per cent of student enrolments identified as Indigenous.
Although Indigenous participation in higher education has increased over the past decade, access to certain professions is still a long way off from reaching parity.
I was interested in finding out more about the national profile of Indigenous students enrolled in allied health study. I was also curious how Indigenous students and graduates entered their chosen professions, and what their experiences were.
These questions were part of a larger project which looked at best practice in the recruitment and retention of Indigenous students into allied health careers.
When we compared the socio-demographic profile of Indigenous students to non-Indigenous students in allied health, we found that Indigenous students differed from their non-Indigenous peers on several key indicators. These indicators made some professions within allied health more accessible to Indigenous students than others.
For example, the presence of regional study options and multiple entry pathways was also correlated with higher numbers of Indigenous students.
These findings were supported by qualitative data. We spoke with several Indigenous students and graduates about their experiences and I’d like to share one of these stories with you today.
Cathy is a qualified Social Worker. She grew up in a small regional community. Her father was part of the stolen generation and both her parents worked in physical labouring jobs to make ends meet and provide for their children. She completed Year 12 and started university but left after her 2nd semester. She felt far from community and life took her in a different direction.
Whilst raising a young family she completed several short qualifications through TAFE in Community Services. As Cathy tells it convenience was the main reason for her choice. Community services was offered across the road and she didn’t have a driver’s licence at the time. To her surprise she really enjoyed it and the experience built up her confidence.
When her daughter chose to go to university sometime later, Cathy decided to join her, enrolling as a mature aged student into a Social Work degree.
Her time at university wasn’t smooth sailing. She had significant caring responsibilities. She was surviving on ABStudy and had no place to study at home. She had no internet and relied on the Indigenous support unit as a place to study and feel connected. And yet, she persisted and qualified with her Social Work degree after 4 years.
Cathy’s story has several similarities with other graduates that we spoke with. All were motivated in their career choice by wanting to make a difference. All expressed a strong sense of responsibility to their family and wider community. All felt that the sense of belonging and practical supports offered by Indigenous support units were essential in getting them through their studies.
What is also striking is that some health professions allow for 2nd chances. In the case of Cathy, she was able to use her TAFE qualifications and working experience to enter university and get credits for her first year of study. However, her choice of degree was limited in that there were only a handful of programs which offered this degree of flexibility.
Safety—and its presence or absence—was a theme which was expressed many times by participants. Safety was something many graduates felt was lacking outside of the University’s Indigenous support unit, particularly when on clinical placement.
Many graduates were the only Aboriginal student in their study program and once employed surrounded by predominately white colleagues. Many participants mentioned that working in a predominantly white profession was exhausting at times and did not feel like a safe place to be.
Attracting and retaining students in the professions requires cultural safety practices embedded throughout the curriculum and is not just the responsibility of the Indigenous support unit.
Graduates mentioned small, yet important gestures which made them feel seen and heard. An acknowledgement from a lecturer, understanding from a peer, or an image of Aboriginal heritage on campus.
I would like to share one final story before closing. Laila, an Aboriginal woman studying Audiology shared with me her dream after qualifying was to set up a mobile clinic and travel back to her community in Western Australia.
It is young people such as Laila who can provide the shared cultural narrative so important for quality healthcare provision. Not just to service Indigenous communities but also to educate non-Indigenous professionals in delivering culturally competent care.
Lightning talk slides (accessible)