While much has been said and done about the potential risk of COVID-19 for remote Aboriginal communities, arguably the bigger threat is for First Nations people living in our towns and cities.
So, what’s at stake for us?
With a higher mortality rate than other Australians, simply put, we could lose more lives. We also stand to lose irreplaceable cultural knowledge, language and leadership.
As a Gundungurra and Wiradjuri man -- and trained epidemiologist -- I am frightened at what this means for our next generation.
Once COVID-19 hits our urban and regional communities, it will spread like wildfire. And while many people associate First Nations people only with remote communities, in fact more than 80 percent of us live in cities or regional towns.
The disease will spread faster among Aboriginal and Torres Strait Islanders living in cities and towns than among the general public due to multiple factors, such as overcrowded housing, intergenerational households, lower health literacy, and less access to hand sanitiser, gloves, masks and disinfectant.
And because our people suffer higher rates of chronic disease, and these chronic conditions emerge earlier, younger Aboriginal people will die in greater numbers. Lifestyle risk factors like alcohol, smoking, poorer nutrition, and stress also compromise immunity.
Further, about a quarter of all homeless people are First Nations; a third of the prison population is First Nations; and one in six Indigenous children is in out-of-home care and foster homes. All these groups are at risk.
So far, the government has demonstrated great leadership and commitment in partnership with the National Aboriginal Community Controlled Health Organisation (NACCHO) by investing $57.8 million in remote Aboriginal communities to combat potential outbreaks and ease socio-economic impacts.
Still, we need urgent measures to protect urban and regional populations. Unable to isolate from the pandemic, high rates of infection are likely.
Remote First Nations groups may be easily identifiable, but urban Indigenous families are the “invisible communities” hidden in large metropolitan populations, presenting a different and more complex challenge.
Here are three things the Government must do to address the looming crisis:
- Use the Medicare database to identify First Nations people with chronic diseases in urban, regional and remote communities who are most at risk and give them targeted support and treatments. This could include health check-ups, the provision of personal protective equipment, high-nutrition food packages, and prioritised access to medical support, including ventilators where required. If these vulnerable individuals cannot self-isolate, alternative quarantined accommodation should be offered. This data-driven, targeted approach would be more effective and efficient than broad-brushed community responses.
- Bolster the Aboriginal Health Workforce to prevent the spread of COVID-19 and manage existing health conditions among First Nations people. Hospitalisation rates are already more than twice as high for First Nations people, so we will be disproportionately affected by an overburdened health system. It will be important to proactively manage health issues to reduce stress on the health system and this is best done by building on existing relationships between Aboriginal health workers and their clients.
- Complement the focus on physical health with culturally safe mental health support, again using the Aboriginal Health Workforce. For First Nations people, mental health is not considered separate from physical health or culture, and in a similar way Australia’s response to COVID-19 must be holistic. This includes minimising disruptions to the support networks of First Nations communities, including schools, playgroups and youth groups.
World Vision Australia is supporting the social and emotional wellbeing of Indigenous young people through its youth empowerment development programs like Young Mob. Normally held in small school groups, Young Mob has shifted online in response to social distancing, and hygiene messages have been integrated into World Vision’s work with First Nations communities across Australia.
We’re also exploring models for continued support of play groups and community kitchens run through church groups.
We must urgently protect vulnerable First Nations people for their own safety and for the protection of cultural knowledge and practices. The custodians of this priceless cultural treasure are the very people at grave risk from COVID-19.
- Dr Scott Winch is a Gundungurra and Wiradjuri man, World Vision Australia’s senior First Nations policy advisor, with training and expertise in epidemiology and public health