Crucial lessons from COVID-19

28 May 2020 | 5 mins

Professor Patricia Dudgeon (pictured) and Dr Kate Derry from UWA’s School of Indigenous Studies have spent recent weeks hard at work investigating the impact of COVID-19 on Indigenous Australians. Their first task was identifying The Road to Recovery plan, along with other leading academics from the Group of Eight (Go8) Australia universities, to guide the Federal Government on charting a way out of social isolation. Now, they have turned their attention to mental health.

Right now Australia can consider itself fortunate and celebrate that, so far, we have averted much of the direct threat from COVID-19 to our vulnerable Aboriginal and Torres Strait Islander communities.

What worked so well in the pandemic response, and what has kept our communities safe, has been the leadership and capabilities of community-controlled organisations and service providers to move first to protect communities against the virus. The potential for devastation has been demonstrated too many times in Indigenous peoples facing pandemics. These organisations and leaders, acting much quicker than Commonwealth and state health departments, gave us a crucial two-week head start on the virus, and saved countless lives as a result.

 

Across Australia, there has been less than 60 COVID-19 cases in the Indigenous population, all in urban areas. This is a testament to the great potential of Indigenous self-determination. In comparison, during the last major pandemic – the 2009 H1N1 influenza – hospitalisation rates of Indigenous Australians were the highest in the world, five times higher than the rate of non-Indigenous Australians. Yet, at a time Indigenous Australians made up less than three per cent of the population.<

In recent weeks, The Roadmap to Recovery report was released. We worked on this, along with Australia’s 100 leading academics from the Group of Eight (Go8) universities, to chart a way out of social isolation restrictions.

Our chapter discussed the care of Indigenous Australians. We applauded the efforts of National Aboriginal Community Controlled Health Organisation (NACCHO) for knowing early on what was needed and moving, even before state and Commonwealth governments, to get clinics ready and prepare to close down entire communities.

We were so lucky that we had NACCHO and the big community controlled health sector to deal with this, otherwise our fate would have been the same as other Indigenous populations around the globe, currently experiencing heartbreak and significant loss.

State and federal governments need to trust and fund Indigenous communities to take action on their own issues, to be supportive and make sure the resources flow accordingly.

Professor Dudgeon

For many years, we have advocated that self-determination and empowerment need to define the governance that happens in Indigenous communities – COVID-19 has shown us the successes of this. So for us, the big take-home message from the pandemic is that state and federal governments need to trust and fund Indigenous communities to take action on their own issues, to be supportive and make sure the resources flow accordingly.

While celebrating the success to date – including some short-term boosts in social and emotional wellbeing during the remote biosecurity lockdown, as Indigenous families enjoy being back in their community and together on their Country, living a more cultural way of life – we must remember that we are not out of the woods yet and we won’t be until they find a vaccine.

To continue to keep up our guard against COVID-19, much remains to be done in Indigenous communities to protect physical and mental health, but also, importantly social and emotional wellbeing.

We need to address the inequalities heightening COVID-19 risk, including overcrowded housing and education, releasing from prison those on minor charges and ensuring unemployment benefits remain at a level that enables families to live above the poverty line.

We need to act on the many important lessons already learnt from the COVID-19 pandemic – about the success that comes from self-determination, empowerment, and community working together to achieve the seemingly impossible.

Professor Dudgeon

Also looming on the horizon for our Indigenous communities is the predicted devastating waves of physical and mental ill health and wellbeing, and high unemployment rates from the COVID-19 lockdown fallout, with modelling indicating a possible increase in the suicide rate of up to 50 per cent and further deterioration in health from delays in treating chronic disease. This is what we are preparing for now in our mental health pandemic response for Indigenous Australians.

We still have a lot of anxiety about protecting our vulnerable populations and the risk of losing our Elders – important cultural foundation stones of families and communities. Some regions have considered setting up ‘arks’, where the Elders would be isolated and kept safe.

Around the world, the COVID-19 pandemic has shone a spotlight on the impact of social determinants and health. When we in Australia finally work our way back to a ‘new normal’, that is the big lesson we need to keep close to our hearts.

We need to ensure we continue to work to do away with social inequalities that cause health inequities, impacting negatively on all Australians, but especially on Indigenous Australians – and this means ensuring needs-based, rather than population-based, funding.

The health gap between Australia’s Indigenous and non-Indigenous population was considered to be around 10 years, yet for the COVID-19 pandemic there is a 20-year gap between the people government authorities recommend should remain isolated at home due to increased risk of severe complications. You were recommended to stay home if you were above 50 years for the Indigenous population, and for the non-Indigenous population it was 70 years old.

Key vulnerable groups within the Indigenous population still lack the basic support of a household or community during the ongoing pandemic.

Sometimes we resign ourselves that things will not change in our generation. COVID-19 has taught us they can.

Professor Dudgeon

We are concerned about the homeless, the LGBTQI+ community, our children in care, and the rate of Indigenous imprisonment. If COVID-19 gets into the prisons, that is a very big worry for our community. Some COVID-19 protective reforms are still needed, including considering the early release of those with minor convictions.

The immediate and long-term effects of COVID-19 on both the physical and mental health of our diverse Indigenous population needs to be adequately monitored, with data collected and shared in a culturally appropriate way.

Already the pandemic has made it difficult to access and monitor suicide statistics over the past two months. We consider suicide to be a reflection of a whole range of issues that need to be addressed in communities including supporting cultural, social and emotional wellbeing, self-determination, self-government, and re-establishing kinship and cultural connections.

Continuing this vital research and making sure the public is aware of what works, through the crisis and recovery period, is the only way we can be as prepared as possible for whatever comes next, be it a second wave of COVID-19 or something else.

A key learning we can take away from COVID-19 so far is – where we see glaring problems in our society, we need to fix them up immediately. Sometimes we resign ourselves that things will not change in our generation. COVID-19 has taught us they can.

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