Tuesday, February 28, 2017

Global medicine, local worlds: Medical anthropology & the study of health equity, 4th International Student Meet On Public Health (ISMOPH), University of Melbourne, 1 April 2017. Dr Kristen Smith


Medical anthropology is one of the newer subdisciplines of the field, drawing on social, biological, cultural and linguistic anthropology to address issues related to the experience, distribution and understanding of health and wellbeing. Medical anthropologists examine how the health of individuals and groups are affected by complex arrangements of policy, geography, history, justice and human rights in different social, cultural and biomedical contexts. In this presentation I will discuss how I, as a medical anthropologist, undertake research that focuses on health equity by drawing on examples of my research investigating medical tourism in India and alcohol management in Indigenous northern Australia.

About ISMOPH17

The 4th International Student Meet On Public Health (ISMOPH17) is a one-day student-organised and student-run satellite event of the 15th World Congress on Public Health that will bring together over 400 students from all around the world in order to:
- inspire them through academic talks and an academic panel
- engage them through a practical academic workshop.
- connect them with the future worldwide community of public health

For more information:

A regional approach to Alcohol Management in Northern Australia: Mobility, supply chains and community control, Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) National Indigenous Research Conference 2017: Impact, Engagement & Transformation, Canberra, Australian Capital Territory, 21 – 23 March 2017.
Professor Marcia Langton and Dr Kristen Smith

Day 3: Transformation 
Session: Community & regional health initiatives 

10:45 AM - 11:15 AM
Alcohol is one of the leading causes of social, legal and health problems for Indigenous Australians. This has led to significant legal, policy and administrative regulation of alcohol in communities where Australian Indigenous people live. Alcohol management plans (AMPs) have emerged as a central device in government policies for reducing alcohol-related harms among Indigenous Australians. This paper reports on the preliminary phases of an ARC-funded (DP160103192), multi-sited study of AMPs in northern Australia. The study includes a descriptive epidemiological analysis of the three case studies. The research focuses on the issues encountered when AMPs are developed in discrete, small-scale geographical locations, as each community (or town) has little ability to manage alcohol in the wider region in which it is embedded. This is a problem because open towns, such as Alice Springs and Kununurra, serve as sales and distribution hubs of alcohol into smaller townships, surrounding areas and remote regions; a highly localised AMP in a small community cannot limit the flow of alcohol from such centres into their own locales. The paper concludes with a discussion of how the research findings may be used to inform policy to develop more effective, inclusive AMPs, particularly in Indigenous community contexts.
Dr Kristen Smith is a Research Fellow in the Australian Indigenous Studies Unit, at the University of Melbourne and is in the Centre for Health Equity, School of Population and Global Health. She has developed the theory and practice of multi-sited ethnography and case study research, working on innovative research methodologies within interdisciplinary frameworks. She has contributed to research for the Australian Government in building capacity and the evidence base for the development of alcohol policy in northern Australia, with a particular focus on how this impacts Aboriginal communities. Smith works collaboratively with academic and non-academic bodies, using medical anthropological, rights-based and public health frameworks. Smith's research expertise is both local and global, ranging from macro-micro studies of international health systems to case study work in Australian Indigenous communities.

Professor Marcia Langton AM is a descendant of the Iman people of Queensland. She qualified as an anthropologist and geographer, and since 2000 has held the Foundation Chair of Australian Indigenous Studies at the University of Melbourne. Her current research concerns alcohol management in Aboriginal settings. She has produced a large body of knowledge in the areas of political and legal anthropology, and Aboriginal arts and culture. She has published and presented on Indigenous agreements and engagement with the minerals industry, Aboriginal land tenure, native title and Indigenous resource management. Her 2012 Boyer lectures titled ‘The Quiet Revolution: Indigenous People and the Resources Boom’) are examples of her contributions to public debate, and have added to her influence and reputation in government and private sector circles. In 2016 Professor Langton was honoured as a University of Melbourne Redmond Barry Distinguished Professor.

Other contributions to this session:

Evaluating fluid rules: Engaging Aboriginal Men in Codes for Life
 11:15 AM - 11:45 AM
Mr Michael Liddle & Ms Ruth Elvin
Intercultural Engagement Manager
Desert Knowledge Australia

Codes for Life is a program being piloted in Alice Springs by and with Aboriginal men. The program is initially focused on men who are in corrections and rehabilitation programs; it seeks to increase the men’s capacity to think about the choices they are making in the multiple worlds they inhabit. On the assumption that the majority of Central Australian Aboriginal men are admirers of Australian football (AFL), the program uses the AFL code of conduct as a medium through which the rules of Aboriginal and Western culture can be explored and understood as essential components of quality of life. The success of the program will determine how far the method can be used and in what range of situations, remote and urban.

Evaluating the impact of the program is a critical challenge, given regular turnover in staff, mobile participants, differing levels of multilingual capacity and literacy. Evaluators appropriate for the context appear scarce. Despite the focus on rules, the field is fluid; the immediate impact is clear, evident in immediate responses. Whether the longer term impact can actually be measured and attributed to the program is the question. 
Michael Liddle is a person who is very passionate about changing men’s behaviour. Being an Alyawarre man and having the understanding of the governance and authority of the Aboriginal world gives Michael a great advantage in assisting in developing change. Living on his family’s outstation at Hatches Creek in the NT for 3 years, at Utopia working for the Central Land Council for 7 years, and now being a member of the CLC for the past 6 years has given Michael invaluable experience on the importance of Aboriginal health and how important maintaining identity and the re-learning of identity is in assisting in changing his people’s behaviour for the better. Through his travels around Central Australia, Michael has developed relationships with people from all tribes in this area. He is currently Intercultural Engagement Manager with Desert Knowledge Australia.

Ruth Elvin is Senior Programs Manager with Desert Knowledge Australia, responsible for developing programs with a remote area focus, ranging from intercultural development and collective engagement to remote area power supplies. Previously Ruth has managed research programs with Batchelor Institute and the Centre for Appropriate Technology, as well as participating in research projects focused on the governance and engagement required in remote housing and infrastructure. Ruth holds graduate degrees in law and political science from the Australian National University, Brandeis University, and the University of NSW.

Caring for community – research collaboration between then: University of Wollongong and the Illawarra koori men’s support group
 11:45 AM - 12:15 PM

Professor Kathleen Clapham
Background: A multi-disciplinary coalition of Aboriginal and non-Aboriginal researchers from the University of Wollongong (UOW) worked collaboratively with Aboriginal community partners as part of the university’s Global Challenge initiative into ‘Transforming Lives and Regions’. Using community based participatory action processes the research focused on the importance of networks and partnerships and involved an in-depth case study of one organisation - the Illawarra Koori Men’s Support Group (IKMSG).
Methods: Mixed methods data was collected over 12 months through an online survey, stakeholder interviews and focus group discussions. Qualitative data was analysed using NVivo; a social network analysis of the survey data was undertaken.
Results: Twenty-two surveys, 21 interviews and three focus group discussions were completed. The study described and identified strong support for the IKMSG’s - health, justice, housing and educational and cultural services which address the health and wellbeing needs of Aboriginal people in the Illawarra region and link them to other services in the region.
Conclusions: The research highlights the vital role of Indigenous community organisations in the health and wellbeing of contemporary Indigenous Australians and make recommendations for ongoing support. The research collaboration requires institutional support to sustain collaboration and build capacity for Aboriginal community controlled research.
Kathleen Clapham is Professor of Indigenous Health at the Australian Health Services Research Institute, University of Wollongong.

Wednesday, February 8, 2017

15th World Congress on Public Health coming up in Melbourne soon...

I've been working on my presentation today that I'm giving at the 15th World Congress on Public Health in early April at the Melbourne Convention Centre. The title of my presentation is: The relationship between medical tourism and health inequity: Commercialisation, mobility and hospital(ity) in India and I'll be presenting on Tuesday 4th April in a Health Equity session running from 1.30pm to 3.30pm.

I'll be drawing on material from my PhD thesis (Medical tourism and hospital(ity) in Mumbai: Imprints of the global commodification of health). Here's my abstract:

The past two decades have seen the intensive privatisation and marketisation of health care globally. In India, the private health care sector has experienced virtually unfettered expansion alongside its struggling, underfunded public sector. Within this context, high expectations have been placed on the emergence of the medical tourism industry, or what many in the Indian sector have labelled ‘medical value travel’. Drawing on an ethnography of medical tourism conducted in Mumbai, India, this presentation explores how medical tourism’s embeddedness in structural and hierarchical networks of power and neoliberal ideologies serve to mask social and economic inequities in healthcare access both for destination countries and nations of origin. I describe how medical tourism is situated within shifting patterns of mobility, with the rise of national and international flows of mobility for some coinciding directly with the immobility and ill-health of others. Medical tourism can be disastrous for health equity in local populations, with the most destructive impacts apportioned to the most vulnerable. Although the phenomenon comprises only one of many ‘imprints’ emerging in the wake of rapid global healthcare commercialisation, the cost of the further expansion of the industry without serious consideration of its potential damage to local populations would be improvident. 

Monday, February 9, 2015

Pormpur Paanthu Aboriginal Corporation

Late last year I was very happy to accept an invitation to join the Board of a fantastic, community-controlled organisation in Pormpuraaw, the Pormpur Paanthu Aboriginal Corporation, as an Expert Director. As noted on their website:

"Pormpur Paanthu Aboriginal Corporation is a non-government, community controlled organisation, established in 1991 out of community need.
Its focus is to provide quality, evidence-based services for Aboriginal and Torres Strait Islander families in Pormpuraaw, providing child care, homeless and temporary accommodation, preventative education, intervention, crisis and responsive care; domestic and family violence therapies; and alcohol and other drug counselling and advocacy and support for families, young people and children.
Pormpur Paanthu Aboriginal Corporation is a proud employer of Aboriginal and Torres Strait Islander people and regards its human resources as a key component to the success of its services"

I look forward to working with PPAC on the multiple research projects we have going through the University of Melbourne and contributing to the organisation in any way I can.


The Foundation for Alcohol Research and Education are launching a new CAPR publication in Sydney, 24th Feb

Sunday, February 8, 2015

Photos from the field: Northern Australia 2014

The crocodile farm at Pormpuraaw. Disconcerting when driving around the perimeter to see the places where the crocs have tried to push through the fence!

This photo was taken down at the beach in Pormpuraaw, a beautiful little Aboriginal community in Western Cape York. So many shells, you could sit in amongst them for hours fossicking through all the variations. A bit prickly underfoot though!

Another one here of myself and a couple of friends in Pormpuraaw. 

A section of the corrugated road somewhere between Cairns and Pormpuraaw. Its a fantastic road trip, but really is a long way. And you really do need that 4WD.

A few photos of Marcia Langton and Liz Pearson walking down the gorgeous beach at Pormpuraaw just before sunset.

A bat colony flying over the crocodile farm in Pormpuraaw at dusk - beautiful and a little creepy!

This is just outside of Weipa in Cape York, overlooking some of Rio Tinto's mining apparatus. Ah, that red dirt gets into everything.

This one I took on a light plane flying back to Cairns from Cape York. Some of the winding networks of the rivers are amazing to see from above (even if the shot is a little over exposed).

 Simpson's Gap, a beautiful place just out of Alice Springs in the Northern Territory. I was up there working on a project investigating Alcohol Management Plans.

A glimpse through the trees of one of the quieter beaches in Darwin.

My first crocodile sighting in Cape York!

This one is at the opening of the Pormpurkuukyikngathar Culture, Knowledge and Learning Centre at the Cape York Youth Summit in Pormpuraaw.

More bats! These little critters were screeching up a storm when I was wandering through the rainforest getting bitten by swarms of mosquitoes. I wondered what the commotion was all about until I saw an eagle swoop into the trees and grab itself a tasty bat treat.

Mataranka thermal pools a little outside of Katherine in the Northern Territory. A beautiful part of Australia.

Another shot taken in Mataranka in the midst of the wet season.

Sunset from the 17th floor in Darwin...just minutes before a crazy monsoonal storm swept through like something out of a scene from a blockbuster movie.