Current CEO of Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) and recipient of UniSA Alumni Award, Janine Mohamed provides an insightful overview of how her work, culture and identity go hand in hand.
Starting as a student at UniSA to the CEO of CATSINaM, how has your journey been? Could you tell us more about it?
I am a Nurrunga Kaurna woman, which means I am from the Adelaide area, but I grew up at Point Pearce mission in South Australia. I realised I wanted to become a nurse at quite a young age, after I witnessed the traumatic experiences my family members endured at the hands of the health system.
After graduating, I worked clinically in hospital-based paediatrics, and medical, surgical, and cardiac care, as well as in Aboriginal aged care programs. Along with that, I coordinated care and hearing programs and also contributed to a national Aboriginal palliative care project, and conducted research into birthing on country.
I moved to Canberra in 2007 to work in senior positions for National Aboriginal Community Controlled Health Organisation (NACCHO), as coordinator for a range of programs in hearing, governance, medicines and national tobacco control. I also helped to establish the Close the Gap campaign and was part of an Indigenous peoples’ delegation that participated in the United Nations Permanent Forum on Indigenous Issues in 2011 and 2012.
Underpinning my work in all of these roles is my passion for self-determination and the community controlled health sector. Since taking up my current role at CATSINaM in 2013, I have focused on growing the organisation and its relationship with members. I am proud to be an advocate for the unique and powerful roles that Aboriginal and Torres Strait Islander nurses have in the health system and their communities, as agents of change.
What were some of the significant struggles that you’d faced and how did you overcome them?
When I first went into nursing, it was something of a shock. The culture of nursing stands in stark contrast to my culture. Nursing history has a strong emphasis on hierarchy and being regimented. Your importance—and therefore your power—is based on where you are, in both the nursing, and the health system structure.
In contrast, my culture, or our ‘Indigenous knowledges’, places value on what I can achieve—as a connected individual within a family and community. I am respected for how I contribute to the family and community, not just my position in it.
But like many Aboriginal people, I am very well versed in moving between two worlds.
I am also very familiar with the ongoing nature of colonisation; how it continues to have a devastating and ongoing impact upon the cultural, spiritual and emotional and social well-being and health of Aboriginal and Torres Strait Islander people. Over many years, I have learnt ways to avoid and manage the racial profiling and microaggressions that are part and parcel of everyday life for Aboriginal and Torres Strait Islander people.
The questions that we get asked and the comments we hear usually say FAR MORE about the person asking them than about us.
I’m thinking about comments like these:
‘You’ve done well for yourself’
‘Aboriginal people get so much given to them’
‘You’re too pretty to be Aboriginal’
‘Yes, but you’re not like the rest of them, you’re different’
These sorts of comments reveal just how deeply the deficit view of Aboriginal and Torres Strait Islander people is embedded into the psyche of mainstream Australia.
What and who has been your greatest support or an inspiration?
When you ask this question, I think of all the Aboriginal and Torres Strait Islander nurses and midwives who have come before me. Aboriginal and Torres Strait Islander people undertook the roles of nursing and midwifery for tens of thousands of years before the first Western nursing and midwifery school was set up.
I might also add that effective systems of regulation have been embedded in our cultural knowledges and practices over many tens of thousands of years. Importantly, these systems have supported and sustained our holistic world-views of health and social, emotional, spiritual and cultural wellbeing.
In Aboriginal and Torres Strait Islander paradigms, health is not perceived narrowly as “the absence of disease” or as an outcome of healthcare. Instead, we centre the importance of self-determination and connection to country and culture.
We recognise that the social, emotional, spiritual and cultural wellbeing of the whole community is paramount in determining the health and wellbeing of individual members. The holistic nature of our knowledges and cultures locates health in culture, community and kinship networks.
This cultural knowledge and connection to culture sustains me in my work, as does the knowledge that I am walking in the footsteps of so many others who have come before me.
I pay my respects to our Elders, past and present, whose wisdom inspires and informs my work. I also acknowledge Elders from other cultures – about two years ago I had the privilege of meeting Professor Moana Jackson, from Aeoteroa. He is truly an inspirational Maori leader. He challenged us at CATSINaM to ‘see beyond the mountain’, to envision our future at all costs, and to be brave because that is the way of our people.
He also reminded us that we are storytellers – Moana inspires me in my work, as I am often telling stories with the aim of achieving change.
Could you also let us know a little more about CATSINaM and how it has been helping Indigenous nurses and midwives?
We are the peak body representing Aboriginal and Torres Strait Islander nurses and midwives across Australia, but we are also Aboriginal and Torres Strait Islander Peoples before we are nurses. This means we are on a lifelong journey together to fulfil our cultural obligations and commitments to our communities, families and ourselves.
We now have over 3,000 Aboriginal and Torres Strait Islander nurses and midwives. We are only about one percent of the nursing and midwifery workforce — although we punch weight far above our numbers in terms of our impact at all levels of the health system, from service delivery to research, education and policy-making.
Would you say that empowerment one of the key aims of CATSINaM?
I’d prefer to put it slightly differently. One of our key aims is to promote and embed a framework of cultural safety in health care. This will improve the recruitment, retention, and wellbeing of Aboriginal and Torres Strait Islander students, nurses and midwives, as well as improving access and quality of care for Aboriginal and Torres Strait Islander patients.
Cultural safety is as important to quality care as clinical safety. It includes regard for the physical, mental, social, spiritual and cultural components of the patient and the community. Cultural safety represents a key philosophical shift from providing care regardless of difference, to care that takes account of people’s unique needs.
Culturally safe and respectful practice requires having knowledge of how one’s own culture, values, attitudes, assumptions and beliefs influence interactions with patients or clients, their families and the community.
It is very difficult to empower people if they are working in, or seeking treatment from systems that are culturally unsafe.
What are some projects you’re involved in currently?
Much of the work that I do is around advocating for cultural safety to be embedded into our systems and services. For example, at CATSINaM, we are campaigning to have the Health Practitioner Regulation National Law Act 2009 amended so that it clearly identifies cultural safety as a priority.
Other issues that I am advocating on include:
1. I want to see the nursing and midwifery professions make a formal apology to Aboriginal and Torres Strait Islander people, following the example recently set by the Australian Psychological Society.
2. Establishment of a National Aboriginal and Torres Strait Islander Health Authority to lead development of national Aboriginal health policy and be “the watchdog for all expenditure on Aboriginal health and matters impacting on Aboriginal health”.
3. A properly funded Leaders in Indigenous Nursing and Midwifery Education Network, through which universities and health services can develop and share good practice in culturally safe health care.
4. A dedicated National Aboriginal and Torres Strait Islander Nursing Workforce Strategy to fast track workforce increases.
5. Continued funding for CATSINaM past June 30, 2018.
Any messages to aspiring nurses and midwives?
Yes! We need you. We are working hard to increase the number of Aboriginal and Torres Strait Islander Nurses and Midwives. To do this, we need the support of ALL members of the nursing and midwifery workforces.
If you are an Aboriginal and/or Torres Strait Islander nursing or midwifery student — please consider joining us at CATSINaM. Your membership will be free, and it will be a great opportunity for you to develop networks, to participate in our events, to access our resources –- and to inform our work going forward.
If you are a non-Indigenous nursing or midwifery student, we also welcome you to join us as an affiliate member. It’s a great way for you to learn, develop networks and to support your Aboriginal and Torres Strait Islander colleagues.
Lastly, where do you see yourself in five years’ time?
Never mind five years! I’ve put some thought into where I’d like to be in 20 years’ time. You might like to read my vision for Australia in 2037, which I presented in a keynote address to the National Rural Health Conference in Cairns recently. It’s on www.croakey.org website. That speech reflects my dream for Australia in the future – it is a place where my descendants never experience racism, where all Australians are proud of the world’s oldest living culture and have a shared understanding of history, and where there are many Aboriginal and Torres Strait Islander Members of Parliament in all jurisdictions.
As told by Janine Mohamed.
Images by CATSINaM.