Smoking Ceremony

We're moving out of a sagging, seven story tower in the heart of downtown Liverpool, where CHETRE has been based the last seven years, into a spanking new research compound adjacent to the local hospital. It's definitely an upgrade, but the move has got the office in a tizzy. Yesterday we inaugurated the new site with a traditional Aboriginal smoking ceremony. Around one hundred staff and faculty gathered in the building's lobby for the ceremony. 'Uncle Steve', the local elder, began by acknowledging Aboriginal and Torres Strait Islanders past and present as Australia’s first Peoples and the traditional owners and  custodians of the land on which the site was constructed. He then walked through the crowded lobby with an assemblage of smoking green leaves immersing us and the room in a cloud of smoke. Participants were invited to fan the smoke and take in the smoke. The ceremony is meant to cleanse the space, to leave behind troubles and initiate something new. The ceremony reminded me of when, during mass, the priest walks down the aisle swinging that metal box full of incense. The folks I work with were like get the American up there pronto. A lot of picture were taken. 

See the full gallery on Posterous

I know Uncle Steve from some work I've done at a local community health center and first met him after he led an invocation to inaugurate a statewide, mandated Aboriginal cultural competency course for frontline community health workers. There are many of these symbolic gestures made throughout Australian society that acknowledge and pay respect to the Aboriginal peoples that I can't imagine occuring in the United States. Before countless television programs I've watched (ermm...research) there are title card warnings to use caution viewing, as it may contain images or voices of dead persons, presumably out of respect for the cultural beliefs of indigenous Australians. It is in fact protocol at public events to first acknowledge that Aboriginal and Torres Strait Islanders are Australia’s first Peoples and the traditional owners and custodians of the land.  

Given the continued systemic marginilization, the blatantly racist policies of the Australian government (the Northern Territory Intervention being just one deplorable example) and the current status of Aboriginal health, I don't know how to feel about these symbolic gestures. Are they more important now that there doesn't seem to be any structural solutions on the horizon or do they stand-in for and act as a substitute for meaningful strategies addressing economic justice, social cohesion and health equity?

 

 

 

 

 

 

It's never too late to salute America

How I actually 'celebrated' the 4th of july: thai, tim tams and bubble gum. Once a month we have staff day at the CHETRE offices where the different research streams (community & primary health care services; disadvantaged communities; early childhood; aboriginal health; and HIA and healthy public policy) come together and discuss recent work, bounce ideas off each other, rehearse ppts. It's really informal, but it kind of drags on. We're moving to a new building at the Liverpool Hospital at the start of August so most of the 5 hr meeting was dominated by discussions about parking vouchers and seating arrangements at the new location.

Yesterday's meeting was more festive than usual, owing to the american flag printouts and red, white and blue streamers that decorated the conference room when I arrived. I love the folks I work with! I snapped a blurry photo.

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We snacked on tim tams (an Australian biscuit named after the winning horse at the 1958 Kentucky derby-so there's the American connection), oranges and bubble gum.  I got to choose lunch-we ordered Thai takeout. Before we broke for lunch the early childhood group, in preparation for an upcoming conference, presented the preliminary results of the Gudaga project - a five year federally funded project that is following a birth cohort of Aboriginal children from birth to 5 years in order to describe their health, development and service. The focus of the presentation was on developmental outcomes at 1 yr., 3 yr. and pre-school. They provided a very brief overview of the history of settler colonization/ resistance through the 20th century, most of which was familiar territory but nonetheless deeply disturbing. I did learn that it wasn't until 1972 that the Department of Education was no longer allowed to refuse Aboriginal students entry into public schools! The presentation stimulated a really interesting conversation about engaging history more critically in public health research, and representing marginalized voices. The day offered a parallax view of the history and current practices of the U.S. that I was meant to be commemorating. Like studying U.S. history in Northern Ireland.

Effectiveness of HIA in New Zealand, Australia

I've posted some of the slides from last week's conference.

Flaxmere_HIA_Presentation_for_Sydney.pptx Download this file

UNSW_HIA_Case_Study_SWSLHD.pptx Download this file

Morgan_CHETRE_June12.ppt Download this file

HIAinUS_EvalMtg_Sydney_15June2012_Dannenberg.pptx Download this file

HIA_in_Australia_120612.pptx Download this file

HIA_in_NZ_FINAL.pptx Download this file

HIA_effectiveness_project_presentation_fri_15.pptx Download this file

HIA_Housing.ppt Download this file

 

Happy Father's Day

To celebrate my dad and, more importantly, to shame yours, I'm including a recent email exchange concerning one Professor Coffey:

On 6/5/12 10:12 AM, "Mikael Johansson" 
wrote:

>Dear Professor Coffey,

>The patient you took care of on the flight was diagnosed with ST-T
>elevations and an acute myocardial infarction. She was immediately
>transferred to interventional thoracic radiology and had an emergency
>coronary angiography performed. It showed an occlusion and a dilation was
>performed. Her ST-T elevations restituted and she went home without
>symptoms after a few days. According to the senior cardiologist the
>decision to make an emergency landing in Umeå was correct and might have
>saved her life. In Kiruna there is no interventional radiology and in
>Sundsvall or Luleå (other landing options) the thoracic intensive care is
>less advanced.
>
>The cardiologists are very grateful for your early interventions and
>support in the decision to land in Umeå. They send their best regards!
>
>I hope your trip home to Nashville was nice and safe. I appreciated your
>contribution to the conference in Riksgränsen a lot and hop to meet next
>time for the third midnight sun (or polar night maybe) symposia when the
>field probably have advanced a little further.
>
>Best regards,
>
>Mikael Johansson
>
>Mikael Johansson, M.D., Ph.D.
>
>Dept of Oncology, Umeå University
>

 

>No sweat. You're welcome Sweden.

Regards, 

Dr. Coffey

 

southern Songlines

Songlines or dreaming tracks are paths across Australia which, according to traditional Aboriginal cosmology, mark the routes followed by the 'creator-beings' when the world was being made. These literal footpaths, which crisscross the continent and can span hundreds even thousands of miles, represent the footprints of the Ancestors.

Each path is said to have been sung into being by a dreamtime Ancestor. What is truly remarkable is that the paths continue to be preserved and memorialized through song. Songs, passed down from generation to generation, describe the topography of a trail and landmarks along the way. One need only sing the song to find one's way. 

Bruce Chatwin's The Songlines is ostensibly about these paths, but the book is swarming with ideas.

theory & practice

Yesterday morning I sat in on a design charrette for the Villawood East Affordable Housing Project, part of an ongoing planning process for a comprehensive community redevelopment project in Western Sydney. In the afternoon, I took the train back to Uni to participate in an investigators meeting looking at the findings of a multi-year study examining the effectiveness of health impact assessment (HIA). It was kind of dizzying jumping from the morning meeting where we spent considerable time discussing the relative merits of a surface versus raised pedestrian walkway at a specific intersection, to the investigators meeting where, to determine 'review groups', I was asked if I identified as a positivist or a constructivist. It was cheering to see how graciously I was afforded a seat at each. And surprising how effortless it has been the last three weeks navigating these kinds of situations. If the Clinton School teaches anything valuable it is something to do with facing ambiguity. I don't mean this in a trivial sense. As public policy practitioners or public servants (or in your daily life) you're faced with uncertainties and ambiguities. Questions of technical or scientific results are primarily issues of certainty and uncertainty. To answer these we look for evidence. Questions of purpose and intent, interpretation of meaning, and ethical and political choice are primarily issues of ambiguity. To deal with ambiguity we look for justification, precedent, tradition, other sources of legitimacy. Facing ambiguity requires the facility to work in a variety of politically and socially interactive processes, translating differing value systems. For me this has meant privileging the communicative process/ stressing how things are framed, always asking who is not in the room and becoming more comfortable with making shit up as I go along. Because people make shit up everyday.

The Villawood Project was not exactly what I expected. Our office was brought along a couple years ago to look at potential health impacts and make recommendations to enhance health benefits/mitigate health risks of the proposed project. The project has had many stops and starts due to funding issues and the politically sensitive nature of the work. Similar to the U.S., the post-war period saw a huge out-migration from Sydney's city center as the suburban bungalow became the new symbol of middle class virtues and values. The government facilitated this out-migration through the construction of huge housing developments, much of it in Western Sydney. Although these developments did form part of an integrated economic strategy where the estates were to be provided with regional shopping centres and work opportunities, this public housing-led form of development turned out to be extremely problematic. The growth expectations of the time were not realised, and industry was slow to develop. Meanwhile, the composition of public housing tenants was changing from working class families to largely welfare-dependant and often single parent families. Public transport and community services were poor or non-existent. As a result of these various developments, when coupled with the high number of new migrants being housed in Fairfield (a suburb in Western Sydney), the location of a major migrant hostel, the South Western and Western Sydney sectors quickly became more stigmatised. Social exclusion of these communities has been further reinforced by economic restructuring over the past 20 years. Half of Villawood's population is first-generation immigrant, with a large Vietnamese and Lebanese population. Villawood the suburb is also associated with the Villawood Immigration Detention Centre, a massive detention facility used in the processing of asylum seekers and illegal immigrants.

This particular meeting, facilitated by the urban planning and design firm overseeing the project, brought in developers, urban designers, representatives from various social services and social housing, and other stakeholders to discuss tentative scenarios the firm had drafted based on community consultations, prior meetings, etc. Our role was to provide a health perspective to conversation. However, much of the health considerations related to the built environment--walkability and active transport, food access, air quality--is already embedded in their plans. Pointing these things out was obvious or redundant. Where an HIA seems to be effective in this situation is to point out issues of equity, disproportional impacts, and the vulnerable communities that might be impacted. At first it seems of little consequence, but just having someone at the table who is raising these issues and helping to steer the conversation can impact the overall process in really meaningful ways. More about the HIA its theoretical underpinnings in the next post.  

 

VividSyd continued

The iconic Sydney Opera House deconstructed, dancefloor