Physiotherapists are being urged to focus on their unique role in helping to close the aboriginal health gap, following the launch of the Australian Physiotherapists Association Reconciliation Action Plan late last year.

The plan - which will be activated throughout 2018 and 2019 - has two main goals. One is to provide a pathway for Aboriginal and Torres Strait Islander people to enter the physiotherapy profession.

The other is to actively and continuously teach physiotherapists about their important role in this area, through cultural awareness, needs training and improved relationships.

"Physiotherapists are highly qualified health professionals to help people get better and stay well," says Michael Reynolds, Chair of the Australian Physiotherapists Association Aboriginal and Torres Strait Islander Health Committee.

"The gap that exists for our first peoples is wide and multifaceted, with life expectancy around 69.1 years for men and 73.3 years for women," says Mr Reynolds.

"Physiotherapists are experts in keeping people moving well. It is well recognised that keeping active significantly improves health outcomes."

According to Mr Reynolds, the number of non-violent deaths of Aboriginal people could be halved in just three years, if physiotherapists work effectively with other health care providers and aboriginal communities.

But there is some work to go, with physiotherapists continuing to face numerous barriers when it comes to effectively providing these benefits to aboriginal and Torres Strait Islander people. 

"There is still a large lack of access to, and awareness of, physiotherapy services for aboriginal communities," says Mr Reynolds.

"When there is access to a physiotherapist, there is often a lack of funding and support to sustain the service. It is important that areas of need are serviced and funded appropriately."

Further, of the more than 30,000 physiotherapists registered in Australia, only 157 identify as Aboriginal or Torres Strait Islander, which is equal to just 0.5 per cent.

"Around 3 per cent of the Australian population identify as Aboriginal or Torres Strait Islander - closing this gap by improving opportunities and training for young Aboriginal people will help provide a better voice and better awareness of what moving well can do for you."

But perhaps one of the most significant issues facing physiotherapy and the health industry in general is a lack of real understanding of the importance of providing culturally appropriate health care.

"Health departments have introduced more cultural awareness training though I do think further culture shifts needs to take place," says Mr Reynolds. 

"Many Aboriginal people and communities still suffer from a lack of control and a voice in many facets of society despite being here for over 60,000 years. 

"As health professionals we are in a unique, privileged position of understanding how people are affected by this and we should lead the way in calling out racism wherever you encounter it."

Understanding the unique circumstances faced by Aboriginals in Australia, along with the importance of their cultural practices, is imperative to making the community feel welcome in alternative health care environments, such as physiotherapy.

"Aboriginal people still bear deep scars following European contact and are still wary of a nation that has not acted in their best interests in the past," Mr Reynolds says. 

"It is important that we all have an understanding for the people we care for, regardless of their background to enable sound clinical care.

"Given the special history that Aboriginal people have, it is important we try to understand their backgrounds and communicate in a fair and reasonable way to build a bridge for reconciliation. 

As part of the Reconciliation Action Plan, physiotherapists are encouraged to take active steps to understand cultural safety and apply it in their clinical practice.

Aboriginal and Torres Strait Islander peoples are more likely to feel safe and positively engaged within a healthcare setting that is culturally sensitive, which can lead to better health outcomes.

"If people aren’t treated with respect they won’t stay in that environment," says Mr Reynolds.

"Imagine you enter a café and are ignored or treated differently to other customers – you wouldn’t go back.

"Even if by chance one person showed you respect and service you really appreciated, but the next week it was back to the same old service – you still wouldn’t keep going back.

"This is the experience for many Aboriginal patients in the healthcare system.

"It is the responsibility of everyone in the health sector to help close the gap in their knowledge and understanding of Aboriginal culture.

"Without this, Aboriginal people and communities will not effectively engage in our health messages."

My Reynolds says physiotherapists can take active steps to develop a culturally safe environment in their practice by undertaking cultural awareness training, engaging with the APA’s Reconciliation Action Plan - or developing their own Reconciliation Action Plan - and providing an inviting environment for Aboriginal and Torres Strait Islander patients.

Simple steps that physiotherapists can follow to activate change might include:

• Providing opportunities for employment and training of Aboriginal people;
• Displaying Aboriginal artwork;
• Provide translation and articles in local languages;
• Learning more about their local Aboriginal communities and culture;
• Arranging in-services or meetings with Aboriginal health workers and local Aboriginal education officers to help identify areas of local need.