The Biomedical Approach

An issue with responding to Aboriginal health, solely via a biomedical model, is that as the name suggests, a biomedical approach positions causation for illness within biological contexts and doesn’t consider broader culturally founded conceptualisations of that particular illness or disease (Dungeon, Garvey & Pickett 2000). Workable definitions related to traditional Aboriginal healing practices tend to conceptualise a more holistic approach to illness treatment too, where in contrast, most western biomedical models treat illness by seeking to either human biology and or cognitions (Smith 2003).

Resultantly, the biomedical approach targets individual psychopathology or

symptomatology as the sites for ill health and the multiplicity of the human

experience, is often overlooked (Dungeon, Garvey & Pickett 2000). Perhaps a

clearer understanding of the Aborigin cultural appropriation of a presenting

illness, may occasion biomedical treatment modalities to encompass a more

spirit based and emotionally focussed approach, that would be more conducive

to Aboriginal cultural expressions (Dungeon, Garvey & Pickett 2000).

Aboriginal Determinants of Social and Emotional Wellbeing

Biomedical Model

Article 24: “Indigenous peoples have the right to their traditional medicines

and to maintain their health practices, including the conservation of their vital

medicinal plants, animals and minerals. Indigenous individuals also have the

right to access, without any discrimination, all social and health services”.

(The United Nations Educational, Scientific and Cultural Organization [UNESCO] 2015).

The obvious dualism which exists between traditional Aboriginal healing methods and clinical medicine, is also the result of a conflict between the social organisation of Indigenous and non-Indigenous people and this is played out across the globe (Panzironi 2013). Here Aboriginal people have been forced to forego their “distinctive spiritual relationship with their traditionally owned or otherwise occupied and used lands” (UNESCO 2015, p. 5), in favour of participating in the social and cultural life of the state (Panzironi 2013).

Article 8: “Indigenous peoples and individuals have the right not to be

subjected to forced assimilation or destruction of their culture”.

(UNESCO 2015, p. 3).

This also includes the adoption of western biomedical perspectives over Ngangkari. Quite obvious too is this difference between Aboriginal and biomedical diagnostic practices, that where a Ngangkari seeks to achieve a visual confirmation of the absence of or misalignment of the spirit within the body (NPY 2013), a biomedical approach seeks to measure the disordered physiological processes within the body (Carson et al. 2007). This conflict makes the provision of westernised health promotion initiatives for Aboriginal people, both urban and remote a challenge, as it isolates the causation of illness again, to a western determined variable (Panzironi 2013).

Where biomedical models consider counsellors as separate constituents to

doctors in the promotion of patient health, underlying traditional Aboriginal

healing, is an abridging of the elements which are believed to elicit a curative

effect (NPY 2013; Panzironi 2013; Smith 2003). While notwithstanding the

community regard for Ngangkari wisdom, there is a lack of hierarchy between

healer and patient and a mutuality of respect situates the individual as a

healing agent (Calabrese 2013). Given the perceived lack of choice in health

care, the provision of Aboriginal health and wellbeing initiatives has been

further complicated by its continual infringement on a succession of articles

upheld by the United Nations Declaration of the Rights of Indigenous Peoples

(UNESCO 2015). The dominance of colonial medicine has become so

indoctrinated within the public health system (Panzironi 2013), that Aboriginal

people are being involuntarily re-educated to seek mainstream treatments

over more traditional methods (NPY 2013). However, this has also been made

possible by the imposition of debilitating ‘lifestyle diseases’ which the

community know Ngangkari have no ability to heal (NPY 2013). The western

health beliefs and values that allow the biomedical model to remain

unquestioned, have been propagandised (Calabrese 2013) and resultantly, it is

questionable as to whether there may ever be a place for Ngangkari alongside Aboriginal Pathway to Wellbeing

mainstream health provision (NPY 2013).

Furthermore, in response to the noted gap in health outcomes between Indigenous and non-Indigenous Australian’s, the Aboriginal and Torres Strait Islander Women’s Taskforce (2000, pp. xvi) made the recommendation that more “localised healing programs that are specifically developed and subject to community accountability” may be a more efficacious antidote to the ills caused by colonisation, than the continued imposition of foreign healing systems.

Article 24.2 “Indigenous individuals have an equal right to the enjoyment

of the highest attainable standard of physical and mental health. States

shall take the necessary steps with a view to achieving progressively the

full realisation of this right”. (UNESCO 2015, p. 5).

In the context of Aboriginal healing, wellbeing is the embodiment of harmony that exists between the spiritual, social and physical selves (Panzironi 2013). Here, spiritual and emotional dis-ease is also considered by Ngangkari as causation for biomedical classifications of mental illness in Aboriginal people (Panzironi 2013). From the perspective of an Aboriginal worldview, Ngangkari may well be an efficacious restorative modality, either in isolation to, or in cooperation with pharmacology and the biomedical patient/practitioner dynamic (NPY 2013). What constitutes illness from a western perspective, may not necessarily constitute illness from an Aboriginal perspective (Smith 2003) and given the huge disparity between the health outcomes of Aboriginal and non-Indigenous people, Ngangkari believe that the differences in conceptualisation must be reconciled, as standard care is not complete (NPY 2013; Panzironi 2013).