Palliative care for indigenous populations

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A unique partnership between nurses and the Australian government is closing the gap in cancer care between indigenous and non-indigenous populations by training aboriginal health care workers in palliative medicine.

With 111 indigenous workers trained in palliative care techniques and working in their communities in just a few years, the program now serves aboriginal communities throughout Australia and Torres Strait Islanders. Working through The Program of Experience in the Palliative Approach (PEPA), an initiative of the Australian Government Department of Health and Ageing and funded through the National Palliative Care Program, nurses go into aboriginal communities and train indigenous people to work in palliative medicine. Emphasizing cultural respect, the outreach to aboriginal is always facilitated by indigenous people.

“Aboriginal people take the lead,” explained Australian nurse Maggie Stowers, adding that indigenous communities in Australia also lag behind the rest of the country in treatment and patient referral. The Australian indigenous population, which makes up 2.5% of the total Australian population, has a life expectancy about 17 years less than the non-indigenous population, with a 40% higher morbidity rate for cancer. The cancer rate in Rural and Remote Australia is higher for some cancers, including lung and prostate cancers.

In her presentation on the PEPA initiative delivered at the 16th International Conference on Cancer Nursing in Atlanta, Dr. Patsy Yates attributed higher cancer rates and higher rates morbidity among indigenous people to poorer access to specialized services, higher prevalence of co-morbidity factors, and Australia's “post-colonial history” of discrimination and inequality.

Speaking after her presentation, Yates, the Director for Queensland Health's Centre for Palliative Care Research and Education, extolled the virtues of the partnership between nursing and government in Australia. “Governments are looking for solutions,” she said, “and nurses are well placed to develop and implement solutions.” The impact of these partnerships can be “immediate and wide-ranging,” she said, and the research produced in the field can affect policy.

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