With the diversity of Aboriginal and Torres Strait Islander Peoples, there can be no simple set of rules for improving communication. It is suggested that Aboriginal and Torres Strait Islander patients be treated on a case-by-case basis due to the diversity in communities.
The following cues provide a starting point for communicating in a culturally respectful way.1
Communicating with individuals
❖ Accept that you are in another social and cultural world
❖ Acknowledge the experience of two-way learning
❖ Anticipate barriers in intercultural communication because of the opposing conceptual systems
❖ Be aware of body language, both your own and that of the other individual
❖ Check frequently that your message has been understood and that you have understood the other person— asking ‘do you understand’ is not a valid way to assess comprehension (try asking the person to tell you what they think you mean in their own words). To check if your understanding is accurate, summarise what you think the person means
❖ Endeavour to be open, honest and sincere
❖ Listen to the other person’s views and take them seriously, keep in mind that your perspectives and concepts may differ
❖ Meet on equal ground — sitting next to each other or diagonally opposite is non-confrontational and will help the other person feel more comfortable
1. These cues are adapted from Mina Mir Lo Ailan Mun – Proper Communication with Torres
Strait Islander People and Working with Aboriginal People. A Cultural Guide: For
Community-based Health and Home Care Services in Wakefield, Gawler and Mid North Areas of Rural South Autsralia.
Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples A Guide for Health Professionals
56 Toolkit 1 – Cultural competency
❖ Provide opportunities for people to use their preferred communication style eg ask them to tell their story rather than using question and answer routines, which can be uncomfortable/ unfamiliar / ineffective
❖ Recognise the importance of the family and of family elders
❖ Respect people’s customs, culture, values, religion, dignity and feelings
❖ Understand sensitivities around gender issues — because of strong gender distinction in Aboriginal and Torres Strait Islander societies, it is more appropriate to discuss certain matters between men or between women
❖ Talk in a style that is clear, understandable, free of jargon and
acronyms — if you must use medical terminology make sure that you explain what it means — and don’t use metaphors that are culturally specific eg clock and calendar references to time, quantifying in terms of percentages, grams etc
❖ Wait — pause times are different across cultures; some people
might need a few minutes before they are ready to respond to a request or question or to continue a story
❖ Work with appropriate interpreters, cultural mentors and/or
Aboriginal Health Workers where necessary (see below)
Communicating with communities
Principles for communicating with individuals apply when
communicating with community groups. In addition, take the following principles into consideration.
❖ Adopt a participatory role rather then a controlling role
❖ Allow time for people to think about ideas and proposals and to discuss them informally among themselves in their own language
❖ Appraise each meeting or contact as it happens — no two meetings are alike
❖ Build enduring relationships with community groups
❖ Develop healthy working relationships with councils, communities, organisations and individuals — promote goodwill and
understanding between all parties
❖ Disseminate information or ideas broadly across all stakeholders in a fair and equitable manner — ensure that no-one is
disadvantaged
❖ Dress appropriately — some people may find exposure of body skin offensive and your dress and appearance play an important role in how communities perceive you
❖ Encourage participation in discussions, meetings and forums
❖ Expect resistance to ideas and proposals that are incompatible with Aboriginal and/or Torres Strait Islander values
❖ Familiarise yourself with the sociopolitical profile of the community in which you are working
Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples 57 Toolkit 1 – Cultural competency
❖ Identify key stakeholders in the community including
Chairpersons, Council members, Elders — both men and women, and respected younger people
❖ Promise only what you can or are capable of achieving
❖ Understand cultural and community dynamics — stereotyping should be avoided as each community is unique and each has its own individual needs
Communicating with Indigenous health services
The principles outlined above also apply when you are contacting Aboriginal Community Controlled Health Services.
As well, familiarise yourself with the organisation you are contacting and take into consideration its size, staffing and infrastructure. Aboriginal Community Controlled Health Services range from multidisciplinary clinics with a number of clinical and administrative staff to small
community clinics run by an Aboriginal Health Worker and a nurse. With the high workload of staff members, the person you need to speak to may be unavailable. If so, explain what you need and ask whom you should contact and when (see margin).
Using appropriate terminology
The use of accurate and non-offensive language is an essential
component of Aboriginal and Torres Strait Islander cultural respect and effective communication. Acceptable usage is likely to vary with location. If you are unsure about using a particular term, ask the community with which you are working to identify preferred terms.