We are one, but we are many
With the diversity of cultures that call Australia home, medical care must often be tailored accordingly. Dr Joe Kosterich explores which approaches seem to work - and which need more work.
When the human genome project was completed it came as a surprise to many to learn that all humans share over 99% of the same genetics. After all, we are all different. However in another respect this makes perfect sense. Whilst our cosmetic appearance may vary we all have one heart, two lungs, one liver, a skeletal structure - and so it goes.
We know that certain groups are more susceptible to certain medical conditions. Some of this is genetic but more often it is cultural, particularly with lifestyle-related conditions. Rates of diseases in migrants soon reflect the country they are in, rather than the one they are from.
There are also cultural differences in how people see the role of the doctor and their expectations. In some cultures if some form of medication is not provided the doctor is viewed a not a good doctor. In other cultures there is a belief that almost every complaint warrants tests to be done.
With the great diversity of people who now live in Australia, GPs (and all health practitioners) need to work with a wide variety of belief systems and cultural norms. This is not to say that people should be treated differently on a medical basis. For example, a laceration that needs suturing must be sutured, regardless of the person’s background.
But certainly with chronic illness and especially mental health issues, management plans need to take cultural beliefs into account. This can be as basic as dietary advice: it is no use recommending foods that people will not eat.
A laceration that needs suturing must be sutured, regardless of the person’s background.
On the very big plus side Australians enjoy a high standard of health, and our life expectancy is continuing to increase. It stands to reason that those who migrate here will in due course benefit form this directly and indirectly.
That said, there remains one group where health outcomes lag significantly, which is in Aboriginal and Torres Straight Islanders. It is clearly beyond the scope of this piece to solve this problem. However, this does bring to mind a famous quote by Albery Einstein: “No problem can be solved from the same level of consciousness that created it”.
Despite billions of dollars and a myriad or government programs, far less has been achieved than was hoped for. Yet often the call is essentially to do more of the same. Unfortunately, what hasn’t worked thus far is unlikely to work in the future.
Perhaps rather than impose programs on Indigenous people we need to listen to what is going on in their communities, which are generally hundreds of miles from those making decisions. In November three brave Indigenous women addressed the National Press Club and claimed that high rates of domestic violence were being excused as a “matter of culture”. The three said this was devastating families, and women and children in particular. Other Indigenous leaders such as Noel Pearson have also called for a new approach.
To reach the point where all Australians regardless of background or culture have the same opportunity to enjoy good health, it will take a willingness to discuss ideas openly, to challenge conventional thinking and to be prepared to act differently.
We all need to be up to this task.
Dr Joe Kosterich MBBS
Doctor, speaker, author of three books, media presenter and health industry consultant, Dr Joe Kosterich wants you to be healthy and get the most out of life.
He is a regular on Channel 9 and radio, writes for various medical and mainstream publications, as well as maintaining a website and blog providing health information. He is the health ambassador for locally grown fresh potatoes. Dr Joe also gives practical motivational health talks for the general public and organizations.