DIABETES – The Indigenous Health Conditions
There are certain diseases that are given less importance commonly, and are unnoticed until they reach a point of seriousness. Among such disease one main common disease is diabetes. Any individual irrespective of age, gender or physical fitness can suffer from diabetes. Though since many years’ scientists and medical concerns are continuously conducting researches to overcome the diabetes issue, but unfortunately till to date no remarkable achievement in this regards has been reported. Diabetes is now a worldwide issue being faced by every nation; it poses a serious challenge to both the individual and society.
What is diabetes?
Diabetes is defined as a disease in which the body does not properly control the amount of sugar in the blood. As such there is no curable treatment for diabetes, but precautions and changing life style can control diabetes to some extent. Diabetes is a common disease in Australia – over 7.1% of the population has diabetes. It’s even higher in indigenous communities where 15-25% of the population has diabetes.
Diabetes Australia is only controllable and treatable but not curable and if once fully treat should not construed to have gained immunity once forever (Sharma, 2011). If this disease is left unattended it damages other body parts and in some cases it is held as a major cause for death. Commonly life style with less physical activities, irregular diet, stress and heredity, are considered as the main causes of diabetes.
Australia is among top nations that has modified from indigenous nation to multi culture nation since last two decades. Before the first white colonizers came to Australia, there were around 300,000 Aborigines living in about 250 tribal groups (Marsh, 2010). These inhabitants respected their culture and environment and were very keen in preserving the same. But with the induction of Europeans and other cultures the whole scenario changed. Aboriginal Australians were deprived off their traditional lands, their actual rights and with the passage of time as more cities were developed and lack of government interest these Aboriginals were limited to specific areas.
Mumma & Smith (2012) stated that the resulting loss of their traditional diet may result in a more processed diet, making people in these communities more susceptible to obesity, diabetes and other health related problems. Indigenous Australians living under much stress, less physical activities and consuming diet that is influenced by socio-economic factors, developed many health problems and on top of it is diabetes.
Subsequent studies found a significant correlation between the development of a ‘westernized’ lifestyle and the levels of type 2 diabetes in the Indigenous population (Bastian, 1979). The westernized culture as well, changed the traditional diet of the Indigenous Australians into less energy food with higher levels of fat and refined sugar, resulting in enhancing obesity among the indigenous Australians. Specific diseases such as trachoma (an eye disease) and yaws (a spirochaete infection) and injuries more generally were conditions that affected community’s prior their contact with Europeans (Hinton, 1997).
Diabetes is related with the state of stress, unbalanced diet and less physical exercise, whereas Indigenous Australians were more exposed to such states and as such were more affected by the disease. As stated by Ansari (2012) the risk factors for diabetes mellitus in Indigenous Australians are more pronounced as compared to non-Indigenous Australians.
Irrespective of original inhabitants of the Australian lands, Aborigines were deprived of their due rights and the government’s malicious policies damaged their traditional family values. Between 1910 and 1970, as many as one in three indigenous children were forcible removed from their families and communities and placed in the care of non-indigenous families or in state or church- run institutions (Diprose, 2002). The worst events of Australia’s history were observed in 1911 and 1924, when the Aboriginal Protection Board established Cootamundra Girls Home and Kinchela Boys Home respectively. In these two events around 100,000 indigenous children were separated from their families. These events are still regarded as “Stolen Generation”. It is very natural that when individuals are comfortable with their job, comfortable within their community and are linked with their family, they have better health conditions (Diprose, 2002). In contrast the indigenous Australians faced the dilemma of family separation and pushed to the level second within the community. All such incidents unfavorably deteriorated the health conditions of indigenous Australians.
We can also mark diabetes as a ‘reticent disease’ due to the reason that in many cases a person might be unaware that he is suffering from diabetes. Quite a significant number of indigenous Australians are ignorant of their suffering of the disease; therefore exact number of indigenous diabetics cannot be defined (Bastian, 1979).
The rising number diabetics among the indigenous Australians are alarming for the government. Though the government developed certain policies and established commissions to control the enhancing of incurable diabetes treatment but they failed to deliver the desired results Singleton (2000).
Secondly, there were health services that were beyond the reach of indigenous natives due to being expensive, not initially planned for non-indigenous natives or were not available in distant indigenous populated areas (Hinton, 1997).
Many aspects like improper diet, affordable medical services, due share among the community and government support, were taken into consideration to steer the uncontrolled disease among the Aborigines (Bastian, 1979). An element of concern and depression, for being deprived of their lands and traditional family values, was found among the senior Indigenous Australians. Such elements became few of many reasons of indigenous Australians getting obsessed to the disease. Besides the health issues, aggressiveness also developed among the new indigenous generation Ansari (2012).
Little, Curthoys and Docker, (2010) stated that, ‘Closing the Gap’, it is quite simply a program that recognizes the difference between Indigenous and non-Indigenous life expectancy in Australia and the huge gaps in all of the factors that falls under the category of social determinants of health like demographics, genetics, overall lifestyle and behavioral along with the bio medical conditions. Considering the various lifestyle factors, the rise in the consumption of alcohol, drugs and reducing the intake of vegetables may result in diseases like obesity and diabetes. The overall living conditions and how the indigenous people interact within their social groups also impact their health. In the early years the European Government betrayed the actual rights of Aborigines but later on it took keen interest in taking serious measures to reducing the gap between indigenous and non-indigenous.
Government assigned senior officers forming committees and allocated special funds for the betterment of overall conditions of Indigenous Australians, unfortunately the committee members were non-indigenous whereas the representatives of indigenous were not competent enough to pursue the dilemma of the real Australian ancestors and the allocated funds were not properly consumed Curthoys and Docker, (2010). Still proper health services are not provided to indigenous people, specially to those living in remote areas.
Combating with health issues will not produce positive results only by focusing on medical support. The desired result could only be attained if the action made to rectify the flaws in the community system and the funds allocated for the indigenous community are managed accordingly (Hinton, 1997).
Portraying its keen interest the Australian government (Commonwealth of Australia) in support of state and territory governments (National Aboriginal and Torres Strait Islander Health Council – NATSIHC), took stern measures to create a scenario that will be beneficial for indigenous health issues. Though there are various effective ways through which diabetes symptoms can be detected, however indigenous people are faced with barriers to access such resources. Programs where medical screening has worked, have used community based medical centers, staffed by indigenous clinicians, and the medical center is promoted as a meeting place.
Australian health care services
Australian health care services are based on primary health care. The same primary health care is not available in some remote areas even in urban areas this system is not accessible by indigenous people. The government also established programs like ‘Medical Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) with a purpose to provide medical assistance to indigenous at half the rate of non-Indigenous Australians (Sharma, 2011). The same service was also utilized by non-indigenous Australians and due to imbalance in funding the indigenous couldn’t benefit from it. The government redefined its policies to enhance the primary health care service accessible to the indigenous. However the overall indigenous heath spending were $4.5 billion in 2010/11FY or $7,995 per person (compared to $5,436 for non-indigenous).
There are various approaches that can be used in order to effectively improve the health conditions of indigenous people. It would be really effective if indigenous people can be involved in culturally sensitive education programs, in the health centers there should be few indigenous health workers as staff member that will make indigenous people a bit more comfortable. Governments and other bodies should and must design health promotional campaigns especially targeting at the indigenous people, in the friendliest manner so that a trust can be developed. This can also be achieved by creating tailored programs according to the specific needs along with individual characteristics of popular communities, while emphasizing on relation ship building and repeat activities.
