for several months this was what my workplace every morning I’d get up and
workplace every morning I’d get up and
workplace every morning I’d get up and I’d walk through this gate into naka
I’d walk through this gate into naka
I’d walk through this gate into naka Valley Hospital in a very rural area of
Valley Hospital in a very rural area of
Valley Hospital in a very rural area of Uganda walking through this gate changed
Uganda walking through this gate changed
Uganda walking through this gate changed my life and it brought me to where I am
my life and it brought me to where I am
my life and it brought me to where I am today here in this area of Uganda
today here in this area of Uganda
today here in this area of Uganda malnutrition was so common among
malnutrition was so common among
malnutrition was so common among children that it wasn’t even viewed as a
children that it wasn’t even viewed as a
children that it wasn’t even viewed as a health condition it was just seen as
health condition it was just seen as
health condition it was just seen as part of the way that children grow up
part of the way that children grow up
part of the way that children grow up but we know that if it’s left untreated
but we know that if it’s left untreated
but we know that if it’s left untreated malnutrition has serious consequences
malnutrition has serious consequences
malnutrition has serious consequences and worldwide a child dies of
and worldwide a child dies of
and worldwide a child dies of malnutrition every six seconds we know
malnutrition every six seconds we know
malnutrition every six seconds we know that every single one of these deaths is
that every single one of these deaths is
that every single one of these deaths is preventable so we worked with hospital
preventable so we worked with hospital
preventable so we worked with hospital staff to set up a malnutrition treatment
staff to set up a malnutrition treatment
staff to set up a malnutrition treatment center at the hospital to try to avoid
center at the hospital to try to avoid
center at the hospital to try to avoid these preventable deaths one of the
these preventable deaths one of the
these preventable deaths one of the first patients that came into the clinic
first patients that came into the clinic
first patients that came into the clinic was Ronnie when his parents brought him
was Ronnie when his parents brought him
was Ronnie when his parents brought him in Ronnie was so weak and malnourished
in Ronnie was so weak and malnourished
in Ronnie was so weak and malnourished that he could hardly move and his
that he could hardly move and his
that he could hardly move and his parents didn’t think he’d survive even a
parents didn’t think he’d survive even a
parents didn’t think he’d survive even a few more days the nurses started him on
few more days the nurses started him on
few more days the nurses started him on an infant feeding program and he started
an infant feeding program and he started
an infant feeding program and he started to gain weight and he was discharged
to gain weight and he was discharged
to gain weight and he was discharged from the hospital within a few weeks so
from the hospital within a few weeks so
from the hospital within a few weeks so a few months later we walked through the
a few months later we walked through the
a few months later we walked through the villages to visit Ronnie and his family
villages to visit Ronnie and his family
villages to visit Ronnie and his family to see how he was doing we brought along
to see how he was doing we brought along
to see how he was doing we brought along rations of Plumpy’nut
rations of Plumpy’nut
rations of Plumpy’nut a therapeutic food to keep him
a therapeutic food to keep him
a therapeutic food to keep him continuing on his treatment outside of
continuing on his treatment outside of
continuing on his treatment outside of the hospital when we did a health
the hospital when we did a health
the hospital when we did a health assessment of Ronnie we saw that he
assessment of Ronnie we saw that he
assessment of Ronnie we saw that he still did have signs of malnutrition but
still did have signs of malnutrition but
still did have signs of malnutrition but that he was absolutely on the path to
that he was absolutely on the path to
that he was absolutely on the path to recovery and he’d completely turned
recovery and he’d completely turned
recovery and he’d completely turned around from just a few weeks earlier
this experience changed my course it was
this experience changed my course it was absolutely heart-wrenching seeing
absolutely heart-wrenching seeing
absolutely heart-wrenching seeing children so young lose their lives in
children so young lose their lives in
children so young lose their lives in the hospital knowing that each one of
the hospital knowing that each one of
the hospital knowing that each one of those deaths could have been prevented
those deaths could have been prevented
those deaths could have been prevented and I knew that there were thousands of
and I knew that there were thousands of
and I knew that there were thousands of children like Ronnie out there who might
children like Ronnie out there who might
children like Ronnie out there who might not have a chance at a healthy childhood
not have a chance at a healthy childhood
not have a chance at a healthy childhood but the success we saw in children like
but the success we saw in children like
but the success we saw in children like Ronnie was inspiring and empowering and
Ronnie was inspiring and empowering and
Ronnie was inspiring and empowering and from that experience I learned that I
from that experience I learned that I
from that experience I learned that I wanted to pursue a career in public
wanted to pursue a career in public
wanted to pursue a career in public health so that brought me to the
health so that brought me to the
health so that brought me to the Australian National University where
Australian National University where
Australian National University where I’ve been doing population health
I’ve been doing population health
I’ve been doing population health research focused on improving the health
research focused on improving the health
research focused on improving the health and
and
and well being of Aboriginal and Torres
well being of Aboriginal and Torres
well being of Aboriginal and Torres Strait Islander children so before I go
Strait Islander children so before I go
Strait Islander children so before I go any further I’d just like to follow to
any further I’d just like to follow to
any further I’d just like to follow to acknowledge the traditional owners of
acknowledge the traditional owners of
acknowledge the traditional owners of the land on which we meet the Ngunnawal
the land on which we meet the Ngunnawal
the land on which we meet the Ngunnawal people and I’d like to pay my respect to
people and I’d like to pay my respect to
people and I’d like to pay my respect to elders past present and future I like to
elders past present and future I like to
elders past present and future I like to acknowledge all Aboriginal and Torres
acknowledge all Aboriginal and Torres
acknowledge all Aboriginal and Torres Strait Islander people who are with us
Strait Islander people who are with us
Strait Islander people who are with us today I’d also like to take a moment to
today I’d also like to take a moment to
today I’d also like to take a moment to recognize my colleague and friend ray
recognize my colleague and friend ray
recognize my colleague and friend ray Lovett who’s contributed to the ideas
Lovett who’s contributed to the ideas
Lovett who’s contributed to the ideas that I’ll be speaking about today each
that I’ll be speaking about today each
that I’ll be speaking about today each color here represents a distinct
color here represents a distinct
color here represents a distinct Aboriginal or Torres Strait Islander
Aboriginal or Torres Strait Islander
Aboriginal or Torres Strait Islander nation each with their own unique and
nation each with their own unique and
nation each with their own unique and distinct cultures and languages many of
distinct cultures and languages many of
distinct cultures and languages many of these languages are still spoken today
these languages are still spoken today
these languages are still spoken today and these cultures are among the oldest
and these cultures are among the oldest
and these cultures are among the oldest continuing cultures in the world but
continuing cultures in the world but
continuing cultures in the world but these strengths aren’t what we hear
these strengths aren’t what we hear
these strengths aren’t what we hear about in the media today so today I’ll
about in the media today so today I’ll
about in the media today so today I’ll be talking to you about how we currently
be talking to you about how we currently
be talking to you about how we currently report on Aboriginal health and
report on Aboriginal health and
report on Aboriginal health and well-being how we define success and
well-being how we define success and
well-being how we define success and what we might do instead so when you
what we might do instead so when you
what we might do instead so when you think about Aboriginal health the first
think about Aboriginal health the first
think about Aboriginal health the first thing that probably comes to mind is
thing that probably comes to mind is
thing that probably comes to mind is closing the gap you might think of all
closing the gap you might think of all
closing the gap you might think of all the areas in which we see deficits
the areas in which we see deficits
the areas in which we see deficits shortfalls and gaps in Aboriginal health
shortfalls and gaps in Aboriginal health
shortfalls and gaps in Aboriginal health compared to the non-indigenous
compared to the non-indigenous
compared to the non-indigenous population and that’s what we hear in
population and that’s what we hear in
population and that’s what we hear in the news that’s what’s always in the
the news that’s what’s always in the
the news that’s what’s always in the media and what we tend to hear seems to
media and what we tend to hear seems to
media and what we tend to hear seems to always be about the negatives and so
always be about the negatives and so
always be about the negatives and so some researchers went out and tested
some researchers went out and tested
some researchers went out and tested this so they analyzed media articles
this so they analyzed media articles
this so they analyzed media articles about Aboriginal health to see how many
about Aboriginal health to see how many
about Aboriginal health to see how many we’re talking about Aboriginal health in
we’re talking about Aboriginal health in
we’re talking about Aboriginal health in a positive way a negative way or neutral
a positive way a negative way or neutral
a positive way a negative way or neutral so what they found is probably no
so what they found is probably no
so what they found is probably no surprise overwhelmingly what we hear in
surprise overwhelmingly what we hear in
surprise overwhelmingly what we hear in the media about Aboriginal health is
the media about Aboriginal health is
the media about Aboriginal health is negative more than three-quarters of the
negative more than three-quarters of the
negative more than three-quarters of the stories focus on Aboriginal health in a
stories focus on Aboriginal health in a
stories focus on Aboriginal health in a negative way only 15 percent highlighted
negative way only 15 percent highlighted
negative way only 15 percent highlighted any positive elements of Aboriginal
any positive elements of Aboriginal
any positive elements of Aboriginal health so what does it matter what does
health so what does it matter what does
health so what does it matter what does it matter that we keep hearing about
it matter that we keep hearing about
it matter that we keep hearing about these negatives in the media first this
these negatives in the media first this
these negatives in the media first this perpetuates a negative stereotypes about
perpetuates a negative stereotypes about
perpetuates a negative stereotypes about Aboriginal and Torres Strait Islander
Aboriginal and Torres Strait Islander
Aboriginal and Torres Strait Islander people and this can fuel discrimination
people and this can fuel discrimination
people and this can fuel discrimination and racist behaviors second Aboriginal
and racist behaviors second Aboriginal
and racist behaviors second Aboriginal people can lose self-esteem and can lose
people can lose self-esteem and can lose
people can lose self-esteem and can lose have negative impacts to the social and
have negative impacts to the social and
have negative impacts to the social and emotional well-being from always hearing
emotional well-being from always hearing
emotional well-being from always hearing about that people told about in a
about that people told about in a
about that people told about in a negative
negative
negative way they might start to feel shame about
way they might start to feel shame about
way they might start to feel shame about being Aboriginal based on the way that
being Aboriginal based on the way that
being Aboriginal based on the way that it’s crip trade in the media and what
it’s crip trade in the media and what
it’s crip trade in the media and what this means
this means
this means both of these can then impact negatively
both of these can then impact negatively
both of these can then impact negatively on factors that we know protect against
on factors that we know protect against
on factors that we know protect against our protect our health if you’re afraid
our protect our health if you’re afraid
our protect our health if you’re afraid of experiencing discrimination you might
of experiencing discrimination you might
of experiencing discrimination you might avoid accessing our service or if you do
avoid accessing our service or if you do
avoid accessing our service or if you do go to the health service you may be
go to the health service you may be
go to the health service you may be treated unfairly and not receive
treated unfairly and not receive
treated unfairly and not receive recommended treatment or maybe as a
recommended treatment or maybe as a
recommended treatment or maybe as a coping strategy to deal with your stress
coping strategy to deal with your stress
coping strategy to deal with your stress and your races experience of the racism
and your races experience of the racism
and your races experience of the racism maybe you smoke or use alcohol so that
maybe you smoke or use alcohol so that
maybe you smoke or use alcohol so that in turn all of these factors then lead
in turn all of these factors then lead
in turn all of these factors then lead to poor health outcomes so this constant
to poor health outcomes so this constant
to poor health outcomes so this constant focus on the negatives and the gaps only
focus on the negatives and the gaps only
focus on the negatives and the gaps only serves to make these gaps wider and to
serves to make these gaps wider and to
serves to make these gaps wider and to repair away this inequality so when we
repair away this inequality so when we
repair away this inequality so when we think about the closing the gap strategy
think about the closing the gap strategy
think about the closing the gap strategy we define success as when Aboriginal
we define success as when Aboriginal
we define success as when Aboriginal health matches that of the
health matches that of the
health matches that of the non-indigenous population this is
non-indigenous population this is
non-indigenous population this is undeniably an important goal and
undeniably an important goal and
undeniably an important goal and something to work towards but this
something to work towards but this
something to work towards but this shouldn’t be the only way that we define
shouldn’t be the only way that we define
shouldn’t be the only way that we define success we could just define success as
success we could just define success as
success we could just define success as a time in which we see improvement in
a time in which we see improvement in
a time in which we see improvement in Aboriginal health and well-being without
Aboriginal health and well-being without
Aboriginal health and well-being without looking and focusing on this comparison
looking and focusing on this comparison
looking and focusing on this comparison first so I’ll go through two examples of
first so I’ll go through two examples of
first so I’ll go through two examples of when this goal of closing the gap
when this goal of closing the gap
when this goal of closing the gap doesn’t actually align with the school’s
doesn’t actually align with the school’s
doesn’t actually align with the school’s working goal of health improvement so
working goal of health improvement so
working goal of health improvement so this graph shows that that that closes
this graph shows that that that closes
this graph shows that that that closes over time if you look in the 1990s the
over time if you look in the 1990s the
over time if you look in the 1990s the gap between the two lines is bigger than
gap between the two lines is bigger than
gap between the two lines is bigger than the gap is in the 2000s so we take it
the gap is in the 2000s so we take it
the gap is in the 2000s so we take it closing the gap frame we see this as
closing the gap frame we see this as
closing the gap frame we see this as success we see that we’ve closed we’re
success we see that we’ve closed we’re
success we see that we’ve closed we’re working towards closing this gap what if
working towards closing this gap what if
working towards closing this gap what if I told you that this gap was showing the
I told you that this gap was showing the
I told you that this gap was showing the prevalence of gestational diabetes among
prevalence of gestational diabetes among
prevalence of gestational diabetes among Aboriginal mothers and non-indigenous
Aboriginal mothers and non-indigenous
Aboriginal mothers and non-indigenous mothers then is this really what success
mothers then is this really what success
mothers then is this really what success looks like what this graph shows us is
looks like what this graph shows us is
looks like what this graph shows us is that both Aboriginal mothers and
that both Aboriginal mothers and
that both Aboriginal mothers and non-indigenous mothers are getting worse
non-indigenous mothers are getting worse
non-indigenous mothers are getting worse off we see that the gaps closing over
off we see that the gaps closing over
off we see that the gaps closing over time but that’s only because the health
time but that’s only because the health
time but that’s only because the health of non-indigenous mothers is getting
of non-indigenous mothers is getting
of non-indigenous mothers is getting worse more quickly than the health of
worse more quickly than the health of
worse more quickly than the health of Aboriginal mothers so in relative terms
Aboriginal mothers so in relative terms
Aboriginal mothers so in relative terms we see that the gap is closing but in
we see that the gap is closing but in
we see that the gap is closing but in absolute terms both groups are worse off
absolute terms both groups are worse off
absolute terms both groups are worse off so to me this is certainly not what
so to me this is certainly not what
so to me this is certainly not what success looks like
success looks like
success looks like so let’s try another example this graph
so let’s try another example this graph
so let’s try another example this graph shows the prevalence of smoking among
shows the prevalence of smoking among
shows the prevalence of smoking among Aboriginal dots and the total Australian
Aboriginal dots and the total Australian
Aboriginal dots and the total Australian population in 1994 2004 and 2014 so we
population in 1994 2004 and 2014 so we
population in 1994 2004 and 2014 so we can see that the prevalence of smoking
can see that the prevalence of smoking
can see that the prevalence of smoking has dropped from over 50 percent in 1994
has dropped from over 50 percent in 1994
has dropped from over 50 percent in 1994 down to about 40 percent in 2014 for our
down to about 40 percent in 2014 for our
down to about 40 percent in 2014 for our Aboriginal adults in the total
Aboriginal adults in the total
Aboriginal adults in the total Australian population smoking stops from
Australian population smoking stops from
Australian population smoking stops from about 30 percent down to 15 percent when
about 30 percent down to 15 percent when
about 30 percent down to 15 percent when we focus on the gap between these lines
we focus on the gap between these lines
we focus on the gap between these lines we see that it hasn’t changed much over
we see that it hasn’t changed much over
we see that it hasn’t changed much over the past two decades I each of these
the past two decades I each of these
the past two decades I each of these three time points the prevalence of
three time points the prevalence of
three time points the prevalence of smoking is about 25 percent higher among
smoking is about 25 percent higher among
smoking is about 25 percent higher among average and little adults so when we
average and little adults so when we
average and little adults so when we look at this in terms of closing the gap
look at this in terms of closing the gap
look at this in terms of closing the gap we might say that there’s been little if
we might say that there’s been little if
we might say that there’s been little if any progress made but what if we told
any progress made but what if we told
any progress made but what if we told this story a different way what if
this story a different way what if
this story a different way what if rather than focusing on the gap we
rather than focusing on the gap we
rather than focusing on the gap we focused on the health of our Aboriginal
focused on the health of our Aboriginal
focused on the health of our Aboriginal and Torres Strait Islander Australians
and Torres Strait Islander Australians
and Torres Strait Islander Australians what if we take away the gap and we take
what if we take away the gap and we take
what if we take away the gap and we take away the comparison then what we see is
away the comparison then what we see is
away the comparison then what we see is a 14 percent prevalence reduction of
a 14 percent prevalence reduction of
a 14 percent prevalence reduction of smoking among Aboriginal adults what
smoking among Aboriginal adults what
smoking among Aboriginal adults what this means is that there’s 50,000 fewer
this means is that there’s 50,000 fewer
this means is that there’s 50,000 fewer Aboriginal smokers today than they would
Aboriginal smokers today than they would
Aboriginal smokers today than they would have been if the prevalence stayed the
have been if the prevalence stayed the
have been if the prevalence stayed the same so what this means is that tens of
same so what this means is that tens of
same so what this means is that tens of thousands of prevent from people through
thousands of prevent from people through
thousands of prevent from people through the smoking reduction so to me that’s
the smoking reduction so to me that’s
the smoking reduction so to me that’s what success looks like when we focus on
what success looks like when we focus on
what success looks like when we focus on the gaps when we focus on the
the gaps when we focus on the
the gaps when we focus on the inequalities we lose sight of the people
inequalities we lose sight of the people
inequalities we lose sight of the people that these statistics represent when all
that these statistics represent when all
that these statistics represent when all we do is look at the gap we lose sight
we do is look at the gap we lose sight
we do is look at the gap we lose sight of these ten thousands of lives that
of these ten thousands of lives that
of these ten thousands of lives that have been saved so of course there’s
have been saved so of course there’s
have been saved so of course there’s often times where it’s valuable and
often times where it’s valuable and
often times where it’s valuable and important to compare populations and
important to compare populations and
important to compare populations and there’s absolutely value in the closing
there’s absolutely value in the closing
there’s absolutely value in the closing the gap campaign these comparisons and
the gap campaign these comparisons and
the gap campaign these comparisons and budget marks help us to see how things
budget marks help us to see how things
budget marks help us to see how things are going to see areas where we might
are going to see areas where we might
are going to see areas where we might need extra work and to see where things
need extra work and to see where things
need extra work and to see where things are going well but this shouldn’t be the
are going well but this shouldn’t be the
are going well but this shouldn’t be the only way we define success and this
only way we define success and this
only way we define success and this shouldn’t be the only side of the story
shouldn’t be the only side of the story
shouldn’t be the only side of the story that we hear we shouldn’t only hear
that we hear we shouldn’t only hear
that we hear we shouldn’t only hear these negatives in the media we should
these negatives in the media we should
these negatives in the media we should be looking and listening to positive
be looking and listening to positive
be looking and listening to positive stories of progress and success and
stories of progress and success and
stories of progress and success and valuing these stories
valuing these stories
valuing these stories so today I challenge you to question the
so today I challenge you to question the
so today I challenge you to question the negatives and the comparisons you hear I
negatives and the comparisons you hear I
negatives and the comparisons you hear I challenge you to find the other side to
challenge you to find the other side to
challenge you to find the other side to that story I challenge you to find what
that story I challenge you to find what
that story I challenge you to find what strengths and successes might have been
strengths and successes might have been
strengths and successes might have been left out of the story that you’re
left out of the story that you’re
left out of the story that you’re hearing so to me the goal is not to
hearing so to me the goal is not to
hearing so to me the goal is not to improve the health of one population
improve the health of one population
improve the health of one population relative to the other to me the goal is
relative to the other to me the goal is
relative to the other to me the goal is to improve health . so to bring us back
to improve health . so to bring us back
to improve health . so to bring us back to the beginning at the end of my time
to the beginning at the end of my time
to the beginning at the end of my time in uganda there was a knock at the door
in uganda there was a knock at the door
in uganda there was a knock at the door of the hospital this time it was ronnie
of the hospital this time it was ronnie
of the hospital this time it was ronnie in his family had come to visit us
in his family had come to visit us
in his family had come to visit us ronnie was walking and talking and
ronnie was walking and talking and
ronnie was walking and talking and smiling this time rather than us
smiling this time rather than us
smiling this time rather than us bringing ronnie his therapeutic food
bringing ronnie his therapeutic food
bringing ronnie his therapeutic food Ronnie’s family had brought us a basket
Ronnie’s family had brought us a basket
Ronnie’s family had brought us a basket of food from their own very limited
of food from their own very limited
of food from their own very limited supply to thank the hospital for
supply to thank the hospital for
supply to thank the hospital for changing Ronnie’s life to me this is
changing Ronnie’s life to me this is
changing Ronnie’s life to me this is what success looks like Ronnie’s success
what success looks like Ronnie’s success
what success looks like Ronnie’s success shouldn’t be discounted compared to
shouldn’t be discounted compared to
shouldn’t be discounted compared to other children who might be doing better
other children who might be doing better
other children who might be doing better and his progress shouldn’t be forgotten
and his progress shouldn’t be forgotten
and his progress shouldn’t be forgotten about just because the malnutrition is
about just because the malnutrition is
about just because the malnutrition is still common in his community to me
still common in his community to me
still common in his community to me Ronnie’s progress and any other health
Ronnie’s progress and any other health
Ronnie’s progress and any other health improvement is something to be
improvement is something to be
improvement is something to be celebrated
”
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