A Charles Sturt First Nations leader said the effect of COVID-19 on First Nations communities is a direct result of a bigger problem plaguing First Nation Australians – racism. She argues that colonisation continues in Australia has contributed dramatically to the poorer health status of First Nations Australians. She, like others, are deeply concerned about the impact COVID-19 will cause out First Nations communities in regional and remote NSW.

By Charles Sturt Pro Vice-Chancellor First Nations Engagement Professor Juanita Sherwood.

The Maari Ma Aboriginal Health Service pleaded with the government in March 2020 for help delivering care to First Nations communities during COVID-19.

It has been 18 months and not only has that plea gone unanswered but the situation in areas, such as Wilcannia and Walgett, has worsened to a point it is threatening entire First Nations communities

Communities are scared and vulnerable and we, as health care professional and advocates, are frustrated that the health crisis could become this dire in these areas.

But the response, or lack thereof, for First Nations people during the latest outbreak of COVID-19 is a continuation of systemic racism and colonisation that has threatened our people’s health and livelihood for centuries.

Understanding First Nations history to understand the current situation

When Captain Arthur Philip landed more than 200 years ago, marine officer, Watkin Tench, stated that “the Natives of this new land were among the healthiest he had ever seen”. Fast forward to today, First Nations people’s health has seriously suffered through ongoing ill-informed policy and sub-standard treatment. Chronic diseases such as diabetes, heart disease, kidney failure and respiratory diseases are now killing our people.

A hundred years of fighting to survive, followed by 100-plus years of horrific violence targeting our people has had significant impact on our physical health and social and emotional wellbeing. Two hundred years of stolen generations, a fundamental disregard for First Nations peoples, our cultures, and the lack of access to heathy food are challenges our people face to this day.

It is important that it is acknowledged that we were unable to access free health care until 1972, when the first Aboriginal medical service was established in Redfern.

All of that has exacerbated inter-generational trauma and this increases our health issues. Two hundred years of that trauma is ensuring our cortisol levels are high and this has resulted in the development of many life-threatening chronic diseases.

Why are the sickest people in the country, who are also not recognised in the constitution, not getting the care they need? We aren’t represented as ourselves as the First Peoples of this country.

Racism and colonisation: a systemic problem with 200-year-old effects

There is still strong racism focused upon Aboriginal and Torres Strait Islander people across the country. We are dealing with issues that people don’t realise or acknowledge because they are not visible. We are devastated and we are scared about what will come next.

Wilcannia is an example of how COVID-19 has highlighted the lack of resources and support for First Nations people, especially during this outbreak. It’s a critical community that I think could be wiped out by COVID-19. If they don’t have the vaccines, they can’t provide the care. They should not be blamed when in fact they have been asking for help and showing leadership since the pandemic began.

The way we see health is very different to the western mainstream health model. We view it from a holistic viewpoint. It is broader than just being well, it is about our community and having access to the many things that enable our wellbeing and connection to country. It’s not just about me, it’s about my family, my country, my community.

Swan and Raphael define the Aboriginal concept of health as ‘holistic, encompassing mental health and physical, cultural and spiritual health. Land is central to wellbeing … Critically it must be understood that when the harmony of these inter-relations is disrupted, Aboriginal ill-health will persist’.

COVID-19 is a good example of the leaky tap, of First Nations people not getting the care they need. And I really believe it is due to systemic racism.

Our people are being blamed for our poor health outcomes during COVID-19. They want us to isolate but due to poor housing we have overcrowding with many sharing houses that have up to 17 to 23 family members. They want us to get vaccinated but there is short supply of vaccines to the community or a shortage of staff to administer them. The hesitancy regarding vaccinations is not on our behalf.

We are refugees in our own country but are not supported in that way. We need to roll back the many horrible things that colonisation has caused for our people. Australian governments must listen to our community health experts and leaders to provide the services we have asked for, not just 18 months ago but many years before this crisis.

How do we address a long-term problem for short-term solutions in COVID-19?

COVID-19 is not just a health issue, it encompasses our peoples physical, social and emotional wellbeing too.

There is no quick fix for the issues of the past 200-plus years that have plagued First Nations people, but we need a short-term solution, so our people don’t get wiped out from COVID-19 in large numbers.

Our people need to be listened to. We need to give people an opportunity to share what they want in a safe environment and we need to respond to what the community want.

Organisations such as the Marri Ma Health Service, Orange Aboriginal Medical Service, the National Aboriginal Community Controlled Health Organisation and Charles Sturt’s First Nations Governance Circle are here to advocate for the communities. It is our responsibility to approach government and health bodies with the concerns of First Nations people. But these services are already overworked and cannot afford to have their concerns fall on deaf ears.

COVID-19 just may be the tipping point in initiating the change needed to get better long-term health care to First Nations people.