Linguistic Barriers in Healthcare for Australia’s Aboriginals

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SEATTLE, Washington — Australia’s indigenous community has called the island continent home for tens of thousands of years. Viewed as traditional custodians of the land, Aboriginal Australians and Torres Strait Islanders are a vital part of the country’s contemporary society. Today, Aboriginal Australians face some of the highest rates of chronic diseases in the country. Although Aboriginals make up only 3% of Australia’s population, their issues with healthcare and disease far surpass that of most other demographic groups. The sad state of Aboriginal health is only exacerbated by the linguistic barriers that these communities face within the country’s healthcare system.

Aboriginal Health in Australia

With the colonization of Australia in the 1700s, Aboriginals on the continent were exposed to a host of new diseases from which they had little to no immunity against. This resulted in a devastating ravaging of the Aboriginal population.

Throughout colonial rule and in the years following it, Aboriginals experienced fierce discrimination and governmental policies that diminished their culture and livelihoods.

And in the decades since colonization, Aboriginal Australians have consistently experienced systematic health issues and problems, both physical and mental, far worse than national standards.

Specific Health Issues for Aboriginals

Within the Aboriginal community, diabetes and high blood sugar are seen at rates more than three times higher than in non-Indigenous communities, while kidney disease is nearly four times as prevalent. Not only that, but circulatory diseases cause a total of 25% of all deaths among Indigenous Australians, followed by 20% due to cancer.

Aboriginals also continue to experience a host of illnesses that have otherwise been eradicated for non-Indigenous Australians. Cases of rheumatic heart disease and bacterial eye infections continue to be reported only in Aboriginal communities and at consistently high rates.

In addition to physical illnesses, Aboriginal Australians also experience severe disparities in mental health issues compared to non-Indigenous Australians. Indigenous suicide rates are currently six times higher than those of non-Aboriginals, with suicide being the second leading cause of death for Aboriginal men.

The suicide epidemic across Aboriginal Australia is one that has received particular concern in recent decades, with Aboriginal children making up 75% of child suicides in the country. Suicide rates continue to climb every year, serving as a testament of the dire situation of Aboriginal mental health.

Aboriginal Languages

Australia’s Aboriginal linguistic mosaic is incredibly diverse. In an interview with The Borgen Project, Yale University’s Dr. Claire Bowern explained, “In 1788, there were probably around 400 Aboriginal languages spoken… These days, there are about 80 languages that have sizable numbers of speakers.”

There is no presiding dominant language or dialect for Aboriginal groups. Aboriginals across the country speak dozens of different languages, demonstrating the diverse cultures and histories of the continent.

However, given the variety of languages and the relatively small Aboriginal population, many of Australia’s native languages are experiencing a critical endangerment. “About 15 to 20 languages are being learned by children, so there is still community-wide language acquisition. Out of the roughly 80 languages, 60 of them do not have kids learning the language as a first language or as their own language,” said Bowern.

Although several of these languages are experiencing an existential reckoning, many Aboriginal people across the country still use native languages as their primary or sole form of communication.

In fact, in the Northern Territory, which hosts Australia’s largest Aboriginal population, 60% of all Indigenous Australians primarily speak an Aboriginal language.

Linguistic Barriers to Healthcare

With all the linguistic differences, challenges arise for thousands of Aboriginal people who are in desperate need of healthcare. With doctors and health facilities almost always exclusively in English, many Aboriginals face trouble in such settings.

According to the Australian Broadcasting Corporation, Aboriginals have complained for years about the unfamiliar environment and communication barriers present in hospitals and health facilities. Additionally, there are frequent instances of Aboriginal people discharging themselves early from hospitals, approximately 12% of all admittances, presumably due to discomfort or communication issues.

Dr. Claire Bowern offered a particular instance where language presented a particular barrier for Aboriginal healthcare. During the Northern Territory Intervention of 2007, which came about following the release of concerning health and child sexual abuse reports in Aboriginal communities, the Australian government sent the national military and doctors into Indigenous Northern Territory communities.

“Many of these doctors had not worked with Aboriginals before. The communication barriers really came up. Someone from Southeast Australia who has never heard Kriol before may assume that a person they’re talking to is speaking English, but some of the words mean different things. They didn’t provide interpreters,” explained Bowern.

Working to Resolve Linguistic Barriers

Closing the Gap, was established in 2008 and serves as a health campaign seeking to reduce the health disparity that exists between Indigenous and non-Indigenous communities. One central tenet of Closing the Gap is “Celebrating Indigenous Cultures,” which includes the fostering and promotion of Aboriginal languages, such as in healthcare contexts. Although Closing the Gap has had limited success and has not completed several goals it set out to do, a degree of progress has nonetheless been achieved since its inception.

According to Malcolm Trumbull, former Prime Minister of Australia, “Today, Aboriginal and Torres Strait Islander people, on average, are living longer than ever before and factors contributing to the gap such as death from circulatory diseases are going down.”

Additionally, a system of interpreters has been proposed for Aboriginal people in hospitals, in the hopes that the linguistic challenges of these settings may be averted.

One study, published in the Medical Journal of Australia, described a pilot program that incorporated interpreters and translators into Royal Darwin Hospital. The program found that by providing Aboriginal patients with interpreters when they needed one, the number of patients that discharged themselves early decreased significantly.

The program was able to demonstrate the exciting promise and potential of providing interpreters to combat linguistic barriers in Australia’s healthcare. However, the program’s limited capacity resulted in only approximately 12% of patients needing interpreters receiving one.

The Road Ahead

Australia’s issues with neglect and disengagement of Aboriginal communities in terms of health and language is one that harms thousands of Australia’s First Peoples and continues to weigh on the nation. However, even though slow, positive progress is evident and constructive dialogue is growing.

As people and organizations continue to address the linguistic barriers in healthcare that Aboriginal Australians face, the hope is that the shocking disparity between the health of Indigenous and non-Indigenous communities in Australia will drastically decline.

Shayaan Subzwari
Photo: Flickr

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