LEARNING OUTCOMES
By the end of
this lecture students should be able to:
Explain the
terms "Indigenous people" and "Orang Asli".
Describe the
unique health risks and determinants of health related to Indigenous
populations.
Explain the
disparity in health status between the Orang Asli and the non-Indigenous
Malaysian population.
Explain the
disparity in health status between the Indigenous population and Aboriginal and
Torres Strait Islander People and the non-Indigenous Australian population.
Outline key
government initiatives related to Indigenous Health in Malaysia and Australia.
Explain the
impact of social factors on the health of Indigenous Australians.
RESOURCES
Refer to further information in this link to examine the available resources in Monash - Monash University Library Guide: Indigenous Health.
Take time to read these resources to strengthen your learning:
Nicholas C, Baer A. Health care for the Orang Asli. Consequences of paternalism and non-recognition. In: Chee HL, Barraclough S, editors. Health Care in Malaysia The dynamics of provision, financing and access2007. p. 119-36. Also available at: https://ebookcentral.proquest.com/lib/monash/detail.action?docID=293003&pq -origsite=primo
ABOUT INDIGENOUS HEALTH
INDIGENOUS HEALTH DISPARITIES
The dearth of Indigenous health information notwithstanding, disturbing health disparities between Indigenous and non-Indigenous people persist worldwide. The predictors of poor health outcomes among Indigenous people are attributed to four broad factors: genetic vulnerability, socioeconomic disadvantage, resource alienation, and political oppression(1).
Political oppression of Indigenous
people has a historical context of colonialism, land appropriation, and
displacement(2), which continues to this day in many countries.
ADDRESSING SOCIAL INEQUITY
To redress this situation, Indigenous
people reiterate the importance of autonomy and self-determination. They have
also emphasized the need to prioritize developing an indigenous health
workforce that embodies professional and cultural competence(1).
Notably, they advocate integrating Indigenous health perspectives, including
spirituality and traditional health approaches in current bio-medical health
systems. They also privilege a strength-based model of building strengths and
resilience over a deficit-based model of addressing pathology or social
problems alone.
In this regard, understanding the broader structural, socioeconomic and cultural determinants of Indigenous health by doctors is vital to averting problems of misdiagnosis and unintended adverse health outcomes in clinical practice.
A CONCEPT FOR INDIGENOUS HEALTH
Mindful of the above issues, the World Health Organization, in its 1999 Declaration on the Health and Survival of Indigenous Peoples, proffered the following concept for Indigenous health (Part II)(3):
Indigenous Peoples' concept of health and survival is both a collective and individual inter-generational continuum encompassing a holistic perspective incorporating four distinct shared dimensions of life. These dimensions are the spiritual, the intellectual, physical and emotional. Linking these four fundamental dimensions, health and survival manifests itself on multiple levels where the past, present and future co-exist simultaneously.
For
Indigenous Peoples, health and survival is a dynamic equilibrium, encompassing
interaction with life processes and the natural laws that govern the planet,
all life forms, and spiritual understanding.
REFERENCES:
1. Durie MH. The health of indigenous peoples. BMJ (Clinical research ed). 2003;326(7388):510-1.2. Axelsson P, Kukutai T, Kippen R. The
field of indigenous health and the role of colonisation and history. Journal of
Population Research. 2016;33(1):1-7.
3.
Committee on Indigenous Health.
The Geneva Declaration on the Health and Survival of Indigenous Peoples 1999.
WHO, Geneva. (WHO/HSD/00.1.)
WHO ARE INDIGENOUS PEOPLE?
We start our exploration of Indigenous
health by learning to identify Indigenous people. There is no single
authoritative definition of Indigenous people. However, they share some broad
common characteristics identifying them as distinct from non-Indigenous people.
INDIGENOUS PEOPLE OF MALAYSIA
Now that we have understood the identifying
characteristics of Indigenous people in general, let us get to know the
Indigenous people of Malaysia.
APPROACHES OF THE STATE IN COLONIAL AND POST-COLONIAL TIMES
The
introduction to Indigenous health above emphasized the importance of the
broader historical, political, socioeconomic, and cultural contexts of
disenfranchisement and dispossession experienced by Indigenous people. In this section, we will explore these issues
in the Malaysian context. Please do not forget to read the E-Book by Dr.
Maithri for the Australian context.
DETERMINANTS OF INDIGENOUS HEALTH
Aside from the conventional social
determinants of health that impact most populations that endure social
inequalities, Indigenous people's historical experience of colonization, the
dispossession of their lands, and racism in health care create unique
vulnerabilities and risks that impact their health. This video uses the case
example of the Orang Asli to delve into this issue.
BEYOND THE MICROSCOPE AND STETHOSCOPE: LEARNING ABOUT HEALTH THROUGH ART Our Featured Orang Asli Artist, SHAQ KOYOK
IMPLICATIONS FOR CLINICAL PRACTICE
As always, we end by asking what our
learning of Indigenous health means for the professional practice of medicine.
This last of the lecture videos focuses on the concepts of cultural competence
and cultural safety and invites us to examine our world views and disposition
toward these issues.
DROP YOUR QUESTION
TOGGLE TIME
As always, you may toggle your memory now
or later by taking the quiz below.
We hope you enjoyed learning about
Indigenous health. See you at the tutorials! 