Conference Poster presentation for the topic Cultural Competence in Nursing and Midwifery.
Answer :
DIABETES IN INDIGENOUS POPULATIONCULTURAL COMPETENCE AND NURSING CARE
SOCIAL DETERMINANTS OF HEALTH THAT RELATE TO DIABETES IN INDIGENOUS POPULATION
Improvement in the state of health in indigenous population has been a challenge in the countries like Australia.  It has been observed that social determinants play an important role in population health and health inequity.
The important social determinants of health inequality in indigenous population are lack of accessibility to primary health care, poor housing and sanitation, lack of healthy food and safe water.
According to ‘Summary of Australian Indigenous health, 2014’, diabetes is the second leading cause of mortality in the indigenous population.
The mortality rate was found to be six times higher in indigenous population than in non-indigenous people. (Hanley 2006)
Obesity and physical inactivity have been found to be the major risk factors for diabetes in indigenous population. (ASSO1995)
The study conducted on indigenous population have shown a relation of these risk factors to traditional diet and sedentary lifestyle.
The major social barriers for health especially in diabetics of indigenous population are lack of awareness among the people, lack of healthy food habits which has been a consequence of unemployment and low income and poor access to the primary health care settings.
LINK BETWEEN CULTURE AND HEALTH IN INDIGENOUS POPULATION
The traditional health beliefs of the indigenous population are related and based mainly upon their land and religion. (Maher 1999)
The definition of health in indigenous population was ‘social, emotional and cultural well-being which includes land, human body, environment, relationships and community’.
The illness was categorized into
natural
environmental
direct supernatural
indirect supernatural
emergent
The critical or severe illness was thought to be caused due to some supernatural reasons and sorcery.  It was believed that the sorcery arises from some dangerous sites and may lead to the death of the person affected. This eventually affects the family members of that person and may cause severe illness.
Hence, traditional healers were consulted to determine the cause and solution to the illness. These healers should not interfere if the illness was due to a punishment.
Sorcery was used as a means of punishment by the law providers.
Hence, if the patient suffers from illness they are in a state of confusion whether it was a punishment. Thus they do not follow the instructions given by the health personnel and do not take responsibility for their illness.
There is a great gender disparity in this group of people. Hence, same gender healthcare providers are preferred by these people.
The treatment included mainly of preventive care and traditional healing.
Good health is assumed as a result of following approved behaviours and avoiding dangerous places and food.
The traditional healing included bush medicine, traditional healers, chanting and some external remedies
NURSING PRACTICES FOR INDIGENOUS POPULATION WITH DIABETES
The nursing care should focus on the following areas (ICN summary)
focus on social determinants of health in diabetics
providing access to health care facilities
creating awareness on diabetes prevention methods
recognizing the traditional healing techniques for diabetes
providing knowledge to the indigenous healers
set up of more number of primary care centers
encouraging the participation of indigenous population in the preventive programs of diabetes such as exercises, healthy nutrition, etc.
There are several effective strategies to deliver care to the indigenous diabetic population. (Reimer et al., 2001)
One of such strategies is involving the community leader of this population in the knowledge process. This includes delivering the care and knowledge regarding diabetes to the indigenous population through these community persons. They can also be additionally supported by the nurses to deliver the care.
Use of social media also plays an important role in prevention and treatment of diabetes in this population. The information can be disseminated through the local channels.
Another strategy is to communicate in the same language as that of the indigenous people for encouraging them to access the primary care facilities and follow the instructions of the healthcare providers.
