Academic literature on the topic 'Aboriginal Australians Diseases Western Australia Perth'

This study examined the prevalence of the intestinal spirochaetes Brachyspira aalborgi and Brachyspira pilosicoli in different Western Australian (WA) populations. Faecal samples included 287 from rural patients with gastrointestinal symptoms, comprising 142 from non-Aboriginal and 145 from Aboriginal people; 227 from recent healthy migrants to WA from developing countries; and 90 from healthy non-Aboriginal individuals living in Perth, WA. DNA was extracted from faeces, and subjected to PCR assays for both species. B. pilosicoli-positive individuals were confined to the rural Aboriginal (14·5%) and migrant (15·0%) groups. B. aalborgi was detected at a lower but similar prevalence in all four groups: rural non-Aboriginals, 5·6%; rural Aboriginals, 6·9%; migrants, 7·9%; controls, 5·6%. In migrants and Aborigines, the presence of B. pilosicoli and B. aalborgi was associated (P<0·001), suggesting that colonization by B. pilosicoli may be facilitated by colonization with B. aalborgi. Amongst the Aboriginal patients, logistic regression identified both spirochaete species as being associated with chronic diarrhoea, failure to thrive and being underweight. Both species may have pathogenic potential, but B. aalborgi appears more host-adapted than the opportunistic B. pilosicoli.

Many policy interventions have attempted to address the entrenched disadvantage of Aboriginal Australians1; however, sustained improvement in social, cultural, physical, and emotional well-being is not evident. This disadvantage is compounded by paternalistic practices which do not promote Aboriginal self-determination or empowerment. This article presents the lived experience and voice of Aboriginal Australians spending time in parks in Perth, Western Australia. A community-based participatory action research approach informed by critical Indigenous methodologies involving collaboration between Aboriginal and non-Aboriginal service providers was used. Participants experienced disconnection from kin and country, serious risk to personal safety, homelessness, and problematic health; all related to, and intersecting with, time spent in the parks. The participants’ narratives highlight the enduring impacts of colonization, dispossession, and racism. These lived experiences are situated within contexts of rising moral panic from politicians, residents and mass media, and siloed policy and service delivery responses.

Background:Aboriginal and Torres Strait Islander Australians experience stroke and traumatic brain injury (TBI) with much greater frequency than non-Aboriginal Australians. Acquired communication disorders (ACD) can result from these conditions and can significantly impact everyday life. Yet few Aboriginal people access rehabilitation services and little is known about Aboriginal peoples’ experiences of ACD. This paper describes the protocol surrounding a study that aims to explore the extent and impact of ACD in Western Australian Aboriginal populations following stroke or TBI and develop a culturally appropriate screening tool for ACD and accessible and culturally appropriate service delivery models.Method/Design:The 3-year, mixed methods study is being conducted in metropolitan Perth and five regional centres in Western Australia. Situated within an Aboriginal research framework, methods include an analysis of linked routine hospital admission data and retrospective file audits, development of a screening tool for ACD, interviews with people with ACD, their families, and health professionals, and drafting of alternative service delivery models.Discussion:This study will address the extent of ACD in Aboriginal populations and document challenges for Aboriginal people in accessing speech pathology services. Documenting the burden and impact of ACD within a culturally secure framework is a forerunner to developing better ways to address the problems faced by Aboriginal people with ACD and their families. This will in turn increase the likelihood that Aboriginal people with ACD will be diagnosed and referred to professional support to improve their communication, quality of life and functioning within the family and community context.

Despite dedicated government funding, Aboriginal Australians, including children, experience more dental disease than other Australians, despite it being seen as mostly preventable. The ongoing legacy of colonization and discrimination against Aboriginal Australians persists, even in health services. Current neoliberal discourse often holds individuals responsible for the state of their health, rather than the structural factors beyond individual control. While presenting a balanced view of Aboriginal health is important and attests to Indigenous peoples’ resilience when faced with persistent adversity, calling to account those structural factors affecting the ability of Aboriginal people to make favorable oral health choices is also important. A decolonizing approach informed by Indigenous methodologies and whiteness studies guides this article to explore the perceptions and experiences of Aboriginal parents ( N = 52) of young children, mainly mothers, in Perth, Western Australia, as they relate to the oral health. Two researchers, 1 Aboriginal and 1 non-Aboriginal, conducted 9 focus group discussions with 51 Aboriginal participants, as well as 1 interview with the remaining individual, and independently analyzed responses to identify themes underpinning barriers and enablers to oral health. These were compared, discussed, and revised under key themes and interpreted for meanings attributed to participants’ perspectives. Findings indicated that oral health is important yet often compromised by structural factors, including policy and organizational practices that adversely preclude participants from making optimal oral health choices: limited education about prevention, prohibitive cost of services, intensive marketing of sugary products, and discrimination from health providers resulting in reluctance to attend services. Current government intentions center on Aboriginal–non-Aboriginal partnerships, access to flexible services, and health care that is free of racism and proactively seeks and welcomes Aboriginal people. The challenge is whether these good intentions are matched by policies and practices that translate into sustained improvements to oral health for Aboriginal Australians. Knowledge Transfer Statement: Slow progress in reducing persistent oral health disparities between Aboriginal and non-Aboriginal Australians calls for a new approach to this seemingly intractable problem. Findings from our qualitative research identified that structural factors—such as cost of services, little or no education on preventing oral disease, and discrimination by health providers—compromised Aboriginal people’s optimum oral health choices and access to services. The results from this study can be used to recommend changes to policies and practices that promote rather than undermine Aboriginal health and well-being and involve Aboriginal people in decisions about their health care.

AbstractCryptosporidium is a protozoan parasite that causes the diarrhoeal disease, cryptosporidiosis. Although many species have been identified, the majority of human disease worldwide is caused by two species; Cryptosporidium parvum and Cryptosporidium hominis. In Australia, data from the National Notifiable Diseases Surveillance System (NNDSS) show that cryptosporidiosis outbreaks occur every few years. To better understand the transmission, trends and nature of cryptosporidiosis outbreaks in Western Australia, epidemiological and genomic data from three cryptosporidiosis outbreaks in 2003, 2007 and 2011 were reviewed. The 2007 outbreak was the largest (n = 607) compared with the outbreaks in 2003 (n = 404) and 2011 (n = 355). All three outbreaks appeared to have occurred predominantly in the urban metropolitan area (Perth), which reported the highest number of case notifications; increases in case notifications were also observed in rural and remote areas. Children aged 0–4 years and non-Aboriginal people comprised the majority of notifications in all outbreaks. However, in the 2003 and 2007 outbreaks, a higher proportion of cases from Aboriginal people was observed in the remote areas. Molecular data were only available for the 2007 (n = 126) and 2011 (n = 42) outbreaks, with C. hominis the main species identified in both outbreaks. Subtyping at the glycoprotein 60 (gp60) locus identified subtype IbA10G2 in 46.3% and 89.5% of C. hominis isolates typed, respectively, in the 2007 and 2011 outbreaks, with the IdA15G1 subtype was identified in 33.3% of C. hominis isolates typed in the 2007 outbreak. The clustering of cases with the IdA15G1 subtype in the remote areas suggests the occurrence of a concurrent outbreak in remote areas during the 2007 outbreak, which primarily affected Aboriginal people. Both the C. hominis IbA10G2 and IdA15G1 subtypes have been implicated in cryptosporidiosis outbreaks worldwide; its occurrence indicates that the mode of transmission in both the 2007 and 2011 outbreaks was anthroponotic. To better understand the epidemiology, sources and transmission of cryptosporidiosis in Australia, genotyping data should routinely be incorporated into national surveillance programmes.

Background: Aboriginal Australians are disproportionately affected by homelessness, with traditional housing models failing to recognise the importance of kinship obligations and ongoing systemic racism. The Wongee Mia project is a pilot initiative emerging out of a Housing First project tackling homelessness among Perth’s most vulnerable rough sleepers. The project takes a different approach to working with and providing long-term housing to Aboriginal families in Perth, Western Australia. Methods: The Wongee Mia project is centred around one person “Robby” and his family to prevent eviction. Data are collected from monthly action research meetings, yarning sessions with family Elders, and case notes. Results: The project identified 32 family members who had potential to place “Robby’s” tenancy at risk. As at December 2019, 29 members of Robby’s family have been supported by the Wongee Mia case workers, and five have been housed. Key elements of Wongee Mia are the broader links to end homelessness initiatives (the Housing First program), the cultural backgrounds of the case workers and their ability to connect in a meaningful way with the family, Elder involvement (including the co-production of this paper), and an underlying action research model enabling program delivery improvements. Conclusion: The Wongee Mia project offers an innovative way of working with families to prevent unnecessary eviction by working through the whole family’s needs rather than those of an individual in relation to housing.

Objectives The aim of the present study was to provide descriptive planning data for a hospital-based Aboriginal Health Liaison Officer (AHLO) program, specifically quantifying episodes of care and outcomes within 28 days after discharge. Methods A follow-up study of Aboriginal in-patient hospital episodes was undertaken using person-based linked administrative data from four South Metropolitan hospitals in Perth, Western Australia (2006–11). Outcomes included 28-day deaths, emergency department (ED) presentations and in-patient re-admissions. Results There were 8041 eligible index admissions among 5113 individuals, with episode volumes increasing by 31% over the study period. Among patients 25 years and older, the highest ranking comorbidities included injury (47%), drug and alcohol disorders (41%), heart disease (40%), infection (40%), mental illness (31%) and diabetes (31%). Most events (96%) ended in a regular discharge. Within 28 days, 24% of events resulted in ED presentations and 20% resulted in hospital re-admissions. Emergency readmissions (13%) were twice as likely as booked re-admissions (7%). Stratified analyses showed poorer outcomes for older people, and for emergency and tertiary hospital admissions. Conclusions Future planning must address the greater service volumes anticipated. The high prevalence of comorbidities requires intensive case management to address case complexity. These data will inform the refinement of the AHLO program to improve in-patient experiences and outcomes. What is known about the topic? The health gap between Aboriginal and non-Aboriginal Australians is well documented. Aboriginal people have significantly higher hospital utilisation rates, as well as higher rates of complications, comorbidities and discharges against medical advice (DAMA). Aboriginal patients receive most of their specialist services in hospital; however, detailed person-based analyses are limited and planning is often based on crude data. What does this paper add? This is the first analysis of linked data focusing on Aboriginal patient flows and volume and 28-day health system outcomes following hospital admission for all causes in a large metropolitan setting. Because the data were linked, admissions belonging to a single episode of care were combined, ensuring that transfers were not counted as re-admissions. Linkage also allowed follow up across time. The results highlight the main disease groups for which Aboriginal patients are admitted, how this varies by age and the high proportion of patients returning to (any) hospital within 28 days, either through EDs or as booked (pre-arranged) admissions. These data aid in the planning of hospital-based Aboriginal health liaison services. What are the implications for practitioners? The paper outlines the complexity with which many Aboriginal patients present to hospital and the risk of DAMA and re-admission. Clinical and organisational strategies can be put in place in hospitals to address these risks and ensure improved continuity of care with community-based primary health services. The Western Australian South Metropolitan Health Service is reviewing these data and will monitor the impact of the hospital-based AHLO program.

ABSTRACTBackground:A quality dementia-screening tool is required for older remote Aboriginal Australians who have high rates of dementia and limited access to appropriate medical equipment and clinicians. The Kimberley Indigenous Cognitive Assessment (KICA Cog) is a valid cognitive test for dementia in Aboriginal and Torres Strait Islander peoples. The KICA cognitive informant questionnaire (KICA Carer) had yet to be analyzed to determine validity alone or in combination with the KICA Cog.Methods:The KICA Carer was completed by nominated informants of 349 remote-living Aboriginal Australians in the Kimberley region, Western Australia. Validity was assessed by comparing KICA Carer with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and International Classification of Diseases (ICD-10) consensus diagnoses based on a blinded specialist review. KICA Carer and KICA Cog were then compared to determine joint validity.Results:A KICA Carer score of ≥3/16 gave optimum sensitivity (76.2%) and specificity (81.4%), area under curve (AUC) 0.89 (95% CI = 0.85, 0.94) with positive predictive value (PPV) of 35.8%, and negative predictive value (NPV) of 96.2%. A KICA Cog score of ≤33/39 gave a sensitivity of 92.9% and specificity of 89.9%, AUC 0.96 (95% CI = 0.94, 0.98), with PPV of 55.6% and NPV of 98.9%. Cut-off scores of KICA Cog ≤ 33/39 and KICA Carer ≥ 2/16 in series indicate possible dementia, with sensitivity of 90.5% and specificity of 93.5%. In this setting, PPV was 66.5% and NPV was 98.6%.Conclusions:The KICA Carer is an important tool to accurately screen dementia in remote Aboriginal Australians when the KICA Cog is unable to be used for a patient. It is readily accepted by caregivers.Key points:•For the best practice in the cognitive assessment of an Aboriginal Australian aged over 45 years, KICA Cog should be utilized.•In cases where Aboriginal patients are not assessed directly, KICA Carer should be conducted with an informant. A cut-off score of ≥3/16 should be used (these tools can be downloaded fromwww.wacha.org.au/kica.html).

Despite decades of evidence showing that institutional and interpersonal racism serve as significant barriers to accessible healthcare for Aboriginal and Torres Strait Islander Peoples, attempts to address this systemic problem still fall short. The social determinants of health are particularly poignant given the socio-political-economic history of invasion, colonisation, and subsequent entrenchment of racialised practices in the Australian healthcare landscape. Embedded within Euro-centric, bio-medical discourses, Western dominated healthcare processes can erase significant cultural and historical contexts and unwittingly reproduce unsafe practices. Put simply, if Black lives matter in healthcare, why do Aboriginal and Torres Strait Islander Peoples die younger and experience ‘epidemic’ levels of chronic diseases as compared to white Australians? To answer this, we utilise critical race perspectives to theorise this gap and to de-center whiteness as the normalised position of ‘doing’ healthcare. We draw on our diverse knowledges through a decolonised approach to promote a theoretical discussion that we contend can inform alternative ways of knowing, being, and doing in healthcare practice in Australia.

The following article is in response to a research project that took the form of a road trip from Perth to Lombadina re-enacting the journey undertaken by the characters in the play Bran Nue Dae by playwright Jimmy Chi and Broome band Kuckles. This project was facilitated by the assistance of a Creative and Research Publication Grant from the Faculty of Communications and Creative Industries, Edith Cowan University, Western Australia. The project was carried out by researchers Kara Jacob and Margaret Hair. One thing is plainly clear. Aboriginal art expresses the possibility of human intimacy with landscapes. This is the key to its power: it makes available a rich tradition of human ethics and relationships with place and other species to a worldwide audience. For the settler Australian audience, caught ambiguously between old and new lands, their appreciation of this art embodies at least a striving for the kind of citizenship that republicans wanted: to belong to this place rather than to another (Marcia Langton in Watson 191). Marcia Langton is talking here about painting. My question is whether this “kind of citizenship” can also be accessed through appreciation of indigenous theatre, and specifically through the play Bran Nue Dae, by playwright Jimmy Chi and Broome band Kuckles, a play closely linked to the Western Australian landscape through its appropriation of the road trip genre. The physical journey taken by the characters metaphorically takes them also through the contact history of black and white Australians in Western Australia. Significantly, the non-indigenous characters experience the redemptive power of “human intimacy with landscapes” through travelling to the traditional country of their road trip companions. The road trip genre typically places its characters on a quest for knowledge. American poet Gary Snyder says that the two sources of human knowledge are symbols and sense-impressions (vii). Bran Nue Dae abounds with symbols, from the priest’s cassock and mitre to Roebourne prison; however, the sense impressions, which are so strong in the performance of the play, are missing from the written text, apart from ironic comments on the weather. In my efforts to understand Bran Nue Dae, I undertook the road trip from Perth to the Kimberley myself in order to discover those missing sense-impressions, as they form part of the “back story” of the play. In the play there is a void between the time the characters leave Perth and reach first Roebourne, where they are locked up, and then Roebuck Plains, not far from Broome, yet in the “real world” they would have travelled more than two thousand kilometres. What would they have seen and experienced on this journey? I took note of Krim Benterrak, Paddy Roe and Stephen Muecke’s Reading the Country, a cross-cultural and cross-textual study on Roebuck Plains, near Broome. Muecke talks about “stories being contingent upon place … Aboriginal storytellers have a similar policy. If one is not prepared to take the trouble to go to the place, then its story can only be given as a short version” (72). In preparing for the trip, I collected tourist brochures and maps. The use of maps, seemingly essential on any road trip as guides to “having a look at” country (Muecke ibid.), was instantly problematic in itself, in that maps represent country as colonised space. In Saltwater People, Nonie Sharp discusses the “distinction between mapping and personal journeying”: Maps and mapping describe space in a way that depersonalises it. Mapping removes the footprints of named creatures – animal, human, ancestral – who belong to this place or that place. A map can be anywhere. ‘Itineraries’, however, are actions and movements within a named and footprinted land (Sharp 199-200). The country journeyed through in Bran Nue Dae, which privileges indigenous experience, could be designated as the potentially dangerous liminal space between the “map” and the “itinerary”. This “space between” resonates with untold stories, with invisibilities. One of the most telling discoveries on the research trip was the thoroughness with which indigenous people have been made to disappear from the “mapped” zones through various colonial policies. It was very evident that indigenous people are still relegated to the fringes of town, as in Onslow and Port Hedland, in housing situations closely resembling the old missions and reserves. Although my travelling companion and I made an effort in every place we visited to pay our respects by at least finding out the language group of the traditional owners, it became clear that a major challenge in travelling through post-colonial space is in avoiding becoming complicit in the disappearance of indigenous people. We wanted our focus to be “on the people whose bodies, territories, beliefs and values have been travelled though” (Tuhiwai Smith 78) but our experience was that finding even written guides into the “footprinted land” is not easy when few tourist pamphlets acknowledge the traditional owners of the country. Even when “local Aboriginal” words are quoted, as in the CALM brochure for Nambung National Park (i.e., the Pinnacles), the actual language or language group is not mentioned. In many interpretive brochures and facilities, traditional owners are represented as absent, as victims or as prisoners. The fate of the “original inhabitants of the Greenough Flats”, the Yabbaroo people, is alluded to in the Greenough River Nature Walk Trail Guide, under the title, “A short history of Greenough River from the Rivermouth to Westbank Road”: The Gregory brothers, exploring for pastoral land in 1848, peacefully met with a large group of Aborigines camped beside a freshwater spring in a dense Melaleuca thicket. They named the spring Bootenal, from the Nyungar word Boolungal, meaning pelican. Gregory’s glowing reports of good grazing prompted pastoralists to move their flocks to Greenough, and by 1852 William Criddle was watering cattle for the Cattle Company at the Bootenal Spring. The Aborigines soon resented this intrusion and in 1854, large numbers with many from surrounding tribes, gathered in the relative safety of the Bootenal thicket. Making forays at night, they killed cattle and sheep and attacked homesteads. The pastoralists retaliated by forming a posse at Glengarry under the command of the Resident Magistrate. On the night of the 4th/5th July they rode to Bootenal and drove the Aborigines from the thicket. No arrests were made and no official report given of casualties. Aboriginal resistance in the area was finished. The fact that the extract actually describes a massacre while purporting to be a “history of Greenough River” subverts the notion that the land can ever really be “depersonalised”. At the very heart of the difference lie different ways of being human: in Aboriginal classical tradition the person dwells within a personified landscape which is alive, named, inscribed by spiritual and human agents. It is a ‘Thou’ not an ‘It’, and I and Thou belong together (Sharp 199-200). Peter Read’s book Belonging: Australians, Place and Aboriginal Ownership contains a section titled “The Past Embedded in the Landscape” in which Read discusses whether the land holds the memory of events enacted upon it, so forming a tangible link between the dispossessed and the possessors. While discussing Judith Wright’s poem Bora Ring, Read states: “The unlaid violence of dispossession lingers at the sites of evil or old magic”, bringing to mind Wright’s notion of Australia as “a haunted country” (14). It is not surprising that the “unlaid violence of dispossession lingers” at the sites of old prisons and lock-ups, since it is built into the very architecture. The visitor pamphlet states that the 1890s design by George Temple Poole of the third Roebourne gaol, further up the great Northern Highway from Greenough and beautifully constructed from stone, “represents a way in which the state ideology of control of a remote and potentially dangerous population could be expressed in buildings”. The current Roebourne prison, still holding a majority of Aboriginal inmates, does away with any pretence of architectural elegance but expresses the same state ideology with its fence topped with razor wire. Without a guide like Bran Nue Dae’s Uncle Tadpole to keep us “off the track”, non-indigenous visitors to these old gaols, now largely museums, may be quickly led by the interpretation into the “mapped zone” – the narrative of imperialist expansion. However, we can follow Paul Carter’s injunction to “deepen grooves” and start with John Pat’s story at the Roebourne police lock-up, or the story of any indigenous inmate of the present Roebuck prison, spiralling back a century to the first Roebuck prison in settler John Withnell’s woolshed (Weightman 4). Then we gain a sense of the contact experience of the local indigenous peoples. John Withnell and his wife Emma are represented as particularly resourceful by the interpretation at the old Roebourne gaol (now Roebourne Visitors Centre and Museum). The museum has a replica of a whalebone armchair that John Withnell built for his wife with vertebrae as the seat and other bones as the back and armrests. The family also invented the canvas waterbag. The interpretation fails to mention that the same John Withnell beat an Aboriginal woman named Talarong so severely for refusing to care for sheep at Withnell’s Hillside Station that “she retreated into the bush and died of her injuries two days later”. No charges were brought against Withnell because, according to the Acting Government Resident, of the “great provocation” by Talarong in the incident (Hunt 99-100). Such omissions and silences in the official record force indigenous people into a parallel “invisible country” and leave us stranded on the highways of the “mapped zone”, bereft of our rights and responsibilities to connect either to the country or to its traditional owners. Roebourne, and its coastal port Cossack, stand on the hauntingly beautiful country of the Ngarluma and seaside Yapurarra peoples. Settlers first arrived in the 1860s and Aboriginal people began to be officially imprisoned soon after, primarily as a result of their resistance to being “blackbirded” and exploited as labour for the pearling and pastoral industries. Prisoners were chained by the neck, day and night, and forced to build roads and tramlines, ostensibly a “civilising” practice. As the history pamphlet for The Old Roebourne Gaol reads: “It was widely believed that the Roebourne Gaol was where the ‘benefit’ of white civilisation could be shown to the ‘savage’ Aboriginal” (Weightman 2). The “back story” I discovered on this research trip was one of disappearance – indigenous people being made to disappear from their countries, from non-indigenous view and from the written record. The symbols I surprisingly most engaged with and which most affected me were the gaols and prisons which the imperialists used as tools of their trade in disappearance. The sense impressions I experienced – extreme beauty, isolation, heat and sandflies – reinforced the complexity of Western Australian contact history. I began to see the central achievement of Bran Nue Dae as being the return of indigenous people to country and to story. This return, so beautifully realised in when the characters finally reach Lombadina and a state of acceptance, is critical to healing the country and to the attainment of an equitable “kind of citizenship” that denotes belonging for all. References Aboriginal Tourism Australia. Welcome to Country: Respecting Indigenous Culture for Travellers in Australia. 2004. Benterrak, Krim, Stephen Muecke, and Paddy Roe. Reading the Country. Perth: Fremantle Arts Centre Press, 1984. Carter, Paul. The Lie of the Land. London: Faber & Faber, 1996. Dalton, Peter. “Broome: A Multiracial Community. A Study of Social and Cultural Relationships in a Town in the West Kimberleys, Western Australia”. Thesis for Master of Arts in Anthropology. Perth: University of Western Australia, 1964. Hunt, Susan Jane. Spinifex and Hessian: Women’s Lives in North-Western Australia 1860–1900. Nedlands, WA: U of Western Australia P, 1986. Read, Peter. Belonging: Australians, Place and Aboriginal Ownership. UK: Cambridge UP, 2000. Reynolds, Henry. North of Capricorn: The Untold History of Australia’s North. Sydney: Allen & Unwin, 2003. Reynolds, Henry. Why Weren’t We Told? Ringwood, Victoria: Penguin Books Australia, 1999. Sharp, Nonie. Saltwater People: The Waves of Memory. Sydney: Allen & Unwin, 2002. Shire of Greenough. Greenough River Nature Walk Trail Guide. 2005. Tuhiwai Smith, Linda. Decolonizing Methodologies. Dunedin, New Zealand: U of Otago P, 1999. Watson, Christine. Piercing the Ground. Perth: Fremantle Arts Centre P, 2003. Weightman, Llyrus. The Old Roebourne Gaol: A History. Pilbara Classies & Printing Service. Wright, Judith. The Cry for the Dead. 1981. 277-80. Citation reference for this article MLA Style Hair, Margaret. "Invisible Country." M/C Journal 8.6 (2005). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0512/09-hair.php>. APA Style Hair, M. (Dec. 2005) "Invisible Country," M/C Journal, 8(6). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0512/09-hair.php>.

[Truncated abstract] Indigenous Australians suffer cardiovascular disease (CVD) at a rate six times greater than the general population in Australia and while the incidence of CVD has been reduced dramatically amongst the majority of non-indigenous Australians and amongst Indigenous populations in other countries in the last 30 years, there has been little change in the figures for Aboriginal Australians, showing that heart health campaigns have little impact, for this group of people. Aims : The principal aims of this study were firstly, to determine and record the barriers to the development and delivery of CVD prevention programs amongst Indigenous Australians and secondly, to develop an alternative, effective and culturally sensitive method of delivering heart health messages. Methods and results : The study was qualitative research undertaken in three South-West towns of Western Australia where the incidence of CVD was high amongst the Aboriginal community members. The use of semi-formal interviews, informal individual consultation, observation, and focus groups were methods implemented to obtain information. The first phase of the research was to identify the barriers which affected the Aboriginal Health Workers’ ability to deliver specialist educational programs. Questionnaires and interviews with the Aboriginal Health Workers and other health professionals in the towns, and community focus groups were undertaken in this phase of the study. The second phase of the research was aimed at developing an alternative strategy for delivering heart health messages. The focus changed to adopt more traditional ways of passing on information in Indigenous communities. The idea of small gatherings of friends or family with a trusted community member presenting the health message was developed. The third phase of the research was to implement this new approach. Lay educators who had been identified within focus groups and by Aboriginal Health Workers were trained in each of the towns and a protocol involving discussions of health issues, viewing a video on CVD, produced by the National Heart Foundation, sharing in a ‘heart healthy’ lunch and partaking in a ‘heart health’ knowledge game which was developed specifically for the gatherings. Several of these gatherings were held in each of the towns and they became known as ‘HeartAware parties’.

This project is comprised of a creative work and accompanying exegesis. The creative work is a collection of poetry which examines the history and ecology of the wetlands and river systems of the Swan Coastal Plain, and which utilises the practice of walking as a research methodology. For the creative practitioner walking reintroduces the body as a fundamental definer of experience, placing the investigation centrally in the corporeal self, using the physical senses as investigative tools of enquiry. As Rebecca Solnit comments in her history of walking, ‘exploring the world is one of the best ways of exploring the mind, and walking travels both terrains’ (Solnit, 2000, p. 13). The context for my poetic walking project Swamp, is a local and global environment undergoing an unprecedented loss of biodiversity, mainly due to the destruction of habitat and changes in climatic conditions (Reid, Partha Dasgupta, Robert M. May, A.H. Zakri, & Henk Simons, 2005, pp. 438-442). The loss of species and ecosystems that have been a part of our earth home results in the human experience of ‘homesickness’ — a longing for the home places that we have known and which have diminished or disappeared. Before the arrival of the British colonists in 1829, the Swan River and adjacent wetlands were an integral part of the seasonal food source for the original inhabitants, the Noongar (Bekle, 1981). In addition wetland places were, and are, deeply embedded in the spiritual and cultural life of the Noongar people of the Swan Coastal Plain (O'Connor, Quartermaine, & Bodney, 1989). In less than two hundred years since the establishment of the Swan River Colony (Western Australia), the lakes and rivers of the Swan Coastal Plain have undergone extreme changes, often resulting in complete draining and in-filling of wetland areas as the city and its suburbs spread beyond the original town limits. This re–engineering of the landscape has had a dramatic and detrimental impact upon biodiversity, water quality and the sense of place experienced by residents. Swamp is a project that has three main facets: a) a body of original poetry which interprets the historical relationship between the British, European, and Chinese newcomers to Noongar country, and the wetlands lakes of the Swan Coastal Plain. The poetry contained in this thesis is copyright to the author, Anandashila Saraswati (Nandi Chinna). b)An essay which contextualises the project within the sphere of walking art, psychogeography, and the philosophical idea of ‘Homesickness’. c) A website, www.swampwalking.com.au, which displays photographs documenting the walks I have carried out over the three year period of the project from February 2009 to February 2012. The exegetical part of this project looks at the notion of ‘homesickness’ as a philosophical condition that can be seen as a motivating force in the practice of writing on walking. I use Debord’s theory of the dérive as a starting point for my walking methodology and examine nostalgia within the Situationist International (Debord, 1958) and subsequent psychogeographical movements. I also investigate the role of homesickness in the work of other writers who walk and who write about their walking practice. Finally I discuss homesickness in the epoch of the Anthropocene (Crutzen & Schwägerl, 2011), the era in which the earth’s biosphere is characterised by human interventions which have changed the meteorological, geological and biological elements of our earth home. In the Anthropocene, the wilderness view of nature needs to be re-evaluated. I posit that walking is a way of reconnecting with the physical landscape and building relationships with small wilds that exist in our home places, and that writing about the walking allows these relationships and encounters to ripple out to readers, contributing to and enabling the development of an ethic of care for ecosystems and beings other than human.