Cultural Bias

Uluru / Ayers Rock

• Holds sacred and spiritual significance to Aboriginal people.

• The local Anangu do not climb Uluru and request visitors not to climb the rock. There is a track
crossing of Dreamtime pathway. (The Anangu are the traditional owners of Uluru-Kata Tjuta and the
surrounding land.)
“The visitors guide says “…the climb is not prohibited, but we prefer that, as a guest on Anangu
land, you will choose to respect our law and culture by not climbing."
• William Gosse first saw the rock in 1873. He named it Ayers Rock after the Chief Secretary of South
Australia, Sir Henry Ayers.
• In 1993, name changes occurred, and a dual naming policy was adopted: official names of both the
traditional Aboriginal name and the English name. It was renamed “Ayers Rock / Uluru”.
• In 2002, the order of the names was officially reversed to "Uluru / Ayers Rock” by Alice Springs
Tourism.

Cultural Bias
What is “cultural bias”?
“…the tendency for people to judge the outside world through a narrow view based on their own culture.”
• Why do we do this?
• We develop an opinion based on misinformation and stereotypes. This can come
from history, family, media etc.
• Why is it a problem?
• Leads to health disparities. E.g.: non-compliance, mental health, not seeking medical
assistance
• Reduces quality of care provided
• How do we overcome this?
• Identify and understand own cultural biases
• Develop cultural knowledge, competence, awareness and sensitivity.

Cultural Diversity: Activity

Instructions:
• In small groups, discuss and write down definitions for the following terms:
Terms:
• Cultural competence
• Cultural knowledge
• Cultural awareness
• Cultural sensitivity
What is….
• Cultural competence:
• Having a strong awareness of one’s own culture, without letting this influence the
care of patients from another culture.
• Cultural knowledge:
• Understanding details of a particular culture.
• Cultural awareness:
• Awareness of the similarities and differences between two cultures and using
respectful and sensitive communication.
• Cultural sensitivity:
• Awareness of the cultural differences and similarities between your culture and your
patient’s culture, but not considering this a problem.

Developing Cultural Competence

Step 1 Understand your own culture.

Step 2 Identify your cultural biases of the Aboriginal and/or

Torres Strait Islander people.
• This may make you feel a little
uncomfortable because we are taught
not to be racist.
• However, if we do not realise we have a
negative opinion of a group of people,
then we cannot begin to fix any bias we
have.

Step 3 Develop cultural awareness.

Step 4 Provide inclusive care for Aboriginal and/or Torres Strait

Islander people.

Cultural Awareness: Activity

Instructions: Sit with people of the same culture. Discuss and answer the questions below.
Questions:
1) What is your culture? / Who do you identify as?
2) What do you do when you meet someone new?
3) What is a comfortable distance to stand when you are talking to a friend?
4) What is the most important thing to your culture?
5) How do you feel when you are asked to participate in class?
6) How did your parents feel about different ethnic, racial, or religious groups?

Cultural Bias and Awareness: Activity

Instructions:
• Group or Individual activity (based on how comfortable you are to talk about this).
• Think about your knowledge of Aboriginal people before commencing this course and
honestly answer the questions below.
Questions:
1) What was your general opinion of Aboriginal and/or Torres Strait Islanders?
2) How does the media portray Aboriginal and/or Torres Strait Islanders?  
3) Do you believe that the Aboriginal and/or Torres Strait Islanders culture is superior or inferior
to your own? Why?
4) Where did you get this information about Aboriginal and/or Torres Strait Islanders (parents,
media, school, friends etc)?
Cultural Safety
What is “Cultural Safety”?
“…an environment that is spiritually, socially and emotionally safe, as well as, physically safe for people; where
there is no assault challenge or denial of their identity, of who they are and what they need. It is about shared
respect, shared meaning, shared knowledge and experience of learning together.”

• Concept of cultural safety has beginnings in the late 1980s in New Zealand.
• Nursing Council of New Zealand 2002 defines ‘cultural safety’ as:
o “The effective nursing practice of a person or family from another culture and is
determined by that person or family. Culture includes, but is not restricted to, age
or generation; gender; sexual orientation; occupation and socioeconomic status;
ethnic origin or migrant experience; religious or spiritual belief; and disability. The
nurse delivering the nursing service will have undertaken a process of reflection on
his or her own cultural identity and will recognise the impact that his or her
personal culture has on his or her professional practice. Unsafe cultural practice
comprises any action which diminishes, demeans or disempowers the cultural
identity and wellbeing of an individual.”
• Provides a framework for the delivery of more appropriate health services, particularly in the health
setting of Indigenous peoples.
• The important principle of cultural safety is that it does not expect nurses to focus on all cultural
differences.
• Instead, cultural safety is mainly about examining our own cultural attitudes and being open-minded
and flexible in our attitudes towards people from cultures other than our own.
• Identifying what makes someone else different is simple.
• Understanding our own culture, and its influence on how we think, feel and behave is much harder.
• However, in the increasingly multicultural environments in which we all live and work, the importance
of being culturally safe in what we do cannot be underestimated.
• Cultural safety refers to the “…the accumulation and application of knowledge of Aboriginal and/or
Torres Strait Islander values, principles and norms” …is about overcoming the cultural power
imbalances of places, people and policies to contribute to the improvements in Aboriginal and Torres
Strait Islander health.”
• “…views cultural safety on a continuum of care with cultural awareness being the first step in the
learning process (which involves understanding difference), cultural sensitivity being a next step
(where self-exploration occurs) and cultural safety being the final outcome of this process. This is a
dynamic and multidimensional process where an individual’s place in the continuum can change
depending on the setting or community.”

Cultural Safety: Activity

Instructions:
Working in small groups, discuss the topic you have been allocated. Present your findings to the class.
Topic 1 What strategies will you use to provide culturally safe care to Aboriginal and/or
Torres Strait Islander patients?

Topic 2 How will you develop a culturally safe environment in the work place?

Topic 3 How can we ensure that Aboriginal and/or Torres Strait Islanders know that they will
feel culturally safe when they come to hospital?

Topic 4 How can be strengthen Aboriginal and/or Torres Strait Islander engagement in
developing culturally safe health services?

Cultural Safety – Strategies

• Reflecting on one’s own culture, attitudes and beliefs about ‘others’
• Clear, value free, open and respectful communication
 • Developing trust
• Recognising and avoiding stereotypical barriers
• Being prepared to engage with others in a two-way dialogue where knowledge is shared
• Understanding the influence of culture shock
• Display of Aboriginal and/or Torres Strait Islander artwork
• Display posters of Aboriginal and/or Torres Strait Islander people
• Provide cultural safety training for all staff
• Using Aboriginal and/or Torres Strait Islander languages in the naming of health services building and
programmes
• Developing partnerships with the Aboriginal and/or Torres Strait Islander individuals, communities
and organisations.
• Asking your patient if they identify as Aboriginal and/or Torres Strait Islander in a respectful manner
• Being aware of and participating in events that celebrate the culture of the Aboriginal and/or Torres
Strait Islander peoples such as NAIDOC week

NAIDOC
• National Aboriginal and Islander Day Observance Committee
• Origins can be traced to the emergence of Aboriginal groups in the 1920′s which sought to increase
awareness in the wider community of the status and treatment of Indigenous Australians.
• NAIDOC Week is held in the first week of July.
• It is a time to celebrate Aboriginal and Torres Strait Islander history, culture and achievements and is
an opportunity to recognise the contributions that Indigenous Australians make to our country and
our society.
• We encourage all Australians to participate in the celebrations and activities that take place across the
nation during NAIDOC Week.
• Past themes of NAIDOC week
• 2016: Song lines: The living narrative of our nation
• 2017: Our language matter
• 2018: Because of her, we can!
• Do you know the 2019 NAIDOC theme?

Summary
Aboriginal Culture
• Strong connection to the land – generations passed down lore’s of how to live. Land is central to
identity.
• Kinship and community is central to all behaviour
• Elders are respected and held in high esteem
• Respect is show through:
• Minimal eye contact
• Silence
• Agreeing with what is being said.

• Mental health issues:

o Loss of Identity
o Loneliness
o Low self-esteem
Impact of history o Depression
o Self-harm/suicide
o Victims of sexual, physical and
psychological abuse
• Colonisation • Poor physical health – diabetes, heart disease,
• Stolen Generations cancer, renal failure resulting in shorter life
• Racism expectancy
• Avoidance of Western health care
• Alcoholism
 CAUSED

Moving towards improving Aboriginal and/or Torres Strait Islander Health and Wellbeing
• Reconciliation is about unity and respect between Aboriginal and/or Torres Strait Islanders and non-
Indigenous Australians.
• It is about respect for Aboriginal and Torres Strait Islander heritage and valuing justice and equity for
all Australians.

Reconciliation
• The reconciliation movement started with the 1967 referendum where 90.77% of Australians voted to
remove clauses in the Australian Constitution which discriminated against Indigenous Australians.
• As a result of the referendum:
• Aboriginal people were to be counted in the census
• Established citizenship status
• Voting rights for all Indigenous Australians
• The right to vote for Aboriginal people was legislated:
– For Federal Elections in 1962; and
– In all States by 1965 (Queensland was the last state to give Aboriginal and
Torres Strait Islander peoples the right to vote)

Referendum
• 27 May 1967 Referendum
• This referendum changed the Australian Constitution (which originally came into effect on 1 January
1901): amended Section 51(xxvi) and repealed Section 127
• Aboriginal peoples could be included in the census count and the Commonwealth could make laws
with respect to Aborigines as a race.
• Its intent was to end discrimination against Indigenous Australians.
• The referendum provided the Federal government with a clear mandate to implement policies to
benefit Indigenous Australians. Also, counting Indigenous Australians in population statistics made the
desperate state of Aboriginal health apparent.

Constitution – Before 1967 Referendum

Section 51 (xxvi)
The Parliament shall, subject to this Constitution, have power to make laws for the peace, order, and good
government of the Commonwealth with respect to the people of any race, other than the aboriginal people in
any State, for whom it is deemed necessary to make special laws.
Section 127
In reckoning the numbers of the people of the Commonwealth, or of a State or other part of the
Commonwealth, aboriginal natives should not be counted.

Section 127, Commonwealth of Australia Constitution Act 1900 (UK)

Constitution – After 1967 Referendum
Section 51 (xxvi)
The Parliament shall, subject to this Constitution, have power to make laws for the peace, order, and good
government of the Commonwealth with respect to matters in respect of which this Constitution makes
provision until the Parliament otherwise provides.
Section 127 Repealed
***Importantly, both Indigenous and non-Indigenous citizens living in the NT and ACT were only allowed to
vote until after section 128 was amended by the 1977 Referendum.

Treaty
• A treaty is an agreement recognised by international law
• Binding obligations between parties that reinforce and recognise a relationship
• “Treaties contain articles which outline the points of agreement between the parties.”
• A treaty is a type of contract - both parties usually agree to take on certain responsibilities and duties
that are legally binding.
• The British never signed a treaty with the Indigenous peoples of Australia
• “Almost 200 years later, Australia remains the only Commonwealth country to have never signed a
treaty with its Indigenous people”.

Did you know…

 • The MCG area was a traditional meeting place for local tribes
• Mission stations were at Warrandyte and Mordialloc in the 1850’s
• Indigenous tribes camped at Bulleen along the Yarra River
• The Queen Victoria market was the site of the Old Melbourne Cemetery and many Aboriginal people
are buried there

Our role as nurses in Promoting Aboriginal and/or Torres Strait Islander Cultural Safety
• Self-reflection:
• Understand your own culture
• Understand your cultural biases and why they exist
• Learn about other cultures:
• Courses
• Speak with other students of different cultures
• Work with and care for people of other cultures – ask questions
• Create a culturally safe workplace:
• Artwork
• Cultural training for staff
• Understanding protocols
• Utilise Aboriginal Liaison Officer
• Role model appropriate behaviour
• Know if your patient identifies as an Aboriginal and/or a Torres Strait Islander.