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Unsettled in Australia: Reflections on my first Australia/Straya/Invasion day

koala bear

My first stuffed toy as a child in Nairobi was a koala bear and I’ve been besotted with them ever since. So you can imagine that I was captivated by this meme where the koala realises that she’s not a bear but a marsupial. To draw a very long bow, I think her puzzlement captures the experience of so many visibly different migrants in settler societies who believe they are part of a nation and then find that they aren’t, whether it’s because their qualifications aren’t recognised which leads them to be unemployed or under-employed or they begin to realise that their skin colour doesn’t lend them to being neatly absorbed into the imagined community on national days of celebration. So here I am in Australia, not as a nine year old (when my family were looking to migrate from Nairobi) but as an adult in mid-career, here to live and work. Joining a multitude of other New Zealanders (the most common country of birth of Australian residents outside of Australia is the United Kingdom followed by New Zealand, you’ll find other interesting nuggets on cultural diversity on Esther Hougenhout‘s blogpiece) who’ve also crossed the ditch. I’ve visited Australia for conferences and to visit my partner’s family, but it’s been over twenty years since I lived somewhere other than Aotearoa. In my work and community life I’ve carefully considered how migrants engage with settler institutions and their relationships with indigenous communities, but I am having a powerful opportunity to examine my own complicity in forms of oppression (in the context of another settler society) as Harsha Walia so powerfully puts it in a video on anti-oppression, decolonization, and being a responsible ally.

992894-australia-word-cloud

From news.com.au

australia-map-aboriginal-nations

Courtesy of Brisbane Murri Action Group

We’ve arrived in time for Australia day which commemorates the 225th anniversary of the arrival of the First Fleet in Sydney Cove, New South Wales in 1788, when British sovereignty was also proclaimed over the eastern seaboard of Australia. It’s a day of festivals, concerts, citizenship ceremonies and acknowledgements of the contributions Australians have made with the recipients of honours and Australian of the year announced. Entrepreneur and electrical retailer Dick Smith even got into the jingoistic spirit with his casually racist advertisement for Aussie foodstuffs, beautifully critiqued by Sunili. I’m not sure if the stones that hit both our heads as we were walking along the Nepean highway to look at housing options were an important Australia day cultural tradition for young blokes in fast cars (I’d like to know how their aim was so brilliantly accurate). Nevertheless fervent nationalism is everywhere, cars and houses are adorned with Australian flags and there is an exacerbation in bogan behaviour as comedians Aamer Rahman from Fear of a Brown Planet and Robert Foster/Kenneth Oathcarn observe.

S Peter Davis who made a YouTube video Straya Day, notes that

as January 26 rolls around, you begin to see cars on the road with little Australian flags poking out the windows like a diplomatic cavalcade. In what is usually a pretty tolerant and multicultural nation, this is one day of the year when folks start casting suspicious and slightly disapproving glances toward brown people. Anti-immigrant slogans like “We grew here, you flew here,” and the somewhat more direct “Fuck off we’re full” begin to make the rounds. Understand, it’s the minority of people, and Australia does not hold the patent on racism. But when you combine this with a cocktail of youth, alcohol and barbecue…parts of the country just explode in a shower of beer, singlets and thongs.

Or not as the pictures below reveal.

Beer baby

Via Chalk Hotel’s Facebook page

This day of barbecues and beer is also called Invasion or Survival day. It represents “an undercurrent of division and inequality that belies the happy, egalitarian culture that the day is meant to convey, “a day of mourning for the land that was taken and the ensuing two centuries of social alienation and discrimination” as Robin Tennant-Wood puts it. There are also Survival Day celebrations like the 2013 Share The Spirit Festival featuring Indigenous music, dance and culture. Numerous Invasion day marches have also taken place across Australia.

Grandtheft Australia

Via Idle No More Facebook page

Hip hop artists Reverse Polarities recent release “Invasion Day” acknowledges the historical and continuing injustices faced by Indigenous Australians and pushes for Australians to understand their history rather than being immobilised by guilt (white Australians) or innocence (visibly different new Australians):

Many Australians feel guilt for the actions their white predesessors and claim non- involvement due to being new Australians. We must be active in our understanding of history. The past is not ours to change, but the future can be shaped.

INM Invasion day

Via Idle No More Australia’s Facebook page

Peter Gebhardt a poet, retired County Court judge and former principal asks for accountability and reckoning with the history of genocide “What might an Aboriginal person say of Australia Day? Why should the Aborigines celebrate that day?” He adds:

It was the day that marked the theft of a land (terra nullius), the day that marked the theft and abduction of a people, of a culture, the day that initiated the pathways to the Stolen Children and, to our ultimate shame, the deaths in custody. It is a day that stands as a reminder of massacres. The wind-stench of bodies burned in bonfires hangs heavy upon the nation’s conscience and in the clouds…You can shuttle history, but you cannot shuttle facts. It would be a great Australia Day if it faced honesty, historical facts, abandonment, hypocrisy, shelved superiority and embarked upon an exercise of spiritual empathy rather than religious hubris.

A point supported by Tristan Ewins, who calls for celebration and critique of this national day:

There is a problem, here, in that there is still no formal resolution: comprehensively righting the injustices suffered by indigenous people. Without the closure provided by a just, representative and inclusive Treaty between the modern Australian nation and our indigenous peoples, it is hard to imagine a fully inclusive celebration of the Australian nation. Perhaps in the future – should such a resolution be achieved – then maybe this could become the focus of a new ‘national day’ for all Australians.

The desire for redress and accountability has a long way to go to being realised, but small steps toward reconciliation are evident. This year for the first time both the Aboriginal and Australian flags were simultaneously hoisted on the Sydney Harbour Bridge.

Aboriginal flag on bridge

Picture: Sam Ruttyn Source: News Limited via new.com.au

Apparently, more than 17,000 people from 145 countries took the citizenship pledge to become Australians on January 26th. Without any sense of irony whatsoever, Tony Abbott Leader of the Opposition told an Australia Day breakfast and citizenship ceremony in Adelaide that change should be welcomed “when it’s in accordance with the customs and traditions of our people” and he added that new citizens were “changing the country for the better”.

Being a new arrival in Australia myself has been interesting, there are many similarities with New Zealand. The neoliberal multicultural success stories of refugees and migrants loom large both in media and in private conversations. Take Akram Azimi, Young Australian of the Year 2013 who arrived  in Australia 13 years ago from Afghanistan and went from being ‘an ostracised refugee kid with no prospects’ to becoming his school’s head boy. Or diasporic Maori, Frank (name changed) who repeatedly called himself and other Maori “niggers”in front of his car salesman colleagues. He told me that his wife wanted to return home six months into their stint here and he insisted they “tough it out”, he quipped “things are fine if you just work hard”. He’s taught his children important aspects of Te Ao Maori and has disdain for the various groups that have formed stating that “if you want to learn about your culture you should go home to do it”. Rauf Soulio (chair of the Australian Multicultural Council and a judge of the District Court of South Australia) peppers an opinion piece with words and phrases like “enterprise”, “courage and commitment” and talks about people who “strove to build new and prosperous lives”.  Extolling a neoliberal narrative combined with a commitment to reconciliation:

It is one of the hallmarks of our multiculturalism that we work hard to ensure that those who come here have every opportunity to become fully participating members of Australian society, rather than remaining guests or temporary visitors. It doesn’t matter that you don’t have Australian lineage or ancestry when you arrive – as long as you contribute.

Aus-strayer

Illustration: Ben Sanders/The Jacky Winter Group in the Sydney Morning Herald

Yup, I’m here to work and become a “fully participating member” of Australian society, and to that end have also been consuming multiculturalism with relish and delight. I am blissfully happy at being able to access ingredients and cuisines that are difficult to find in Aotearoa. But consumption aside, I do want to find a way to engage ethically with this place. Shakira Hussein‘s incisive critique of Scott Morrison’s speech at the Menzies Centre for Australian Studies in London brilliantly skewers Morrison’s selective consumption of multiculturalism:

Morrison doesn’t spell out which aspects of “diversity” would be considered acceptable under a more balanced post-multicultural regime, but I’m guessing he subscribes to the consensus view that multiculturalism has had a beneficial effect on the Australian diet. (Sharia tribunals? No thanks. Homous and baklava? More, please.) Even those most ardent racists participate in the multiculturalism of consumption. But while enjoying our pizza and laksa, we need to “send a message” that such tolerance “is not a licence for cultural practices that are offensive to the cultural values and laws of Australia and that our respect for diversity does not licence: the primacy of the English language”.

His comments come just in time for Geert Wilder’s visit to Australia next month. See Deborah Kelly’s kit below.

Veiled woman

I was in Sydney almost seven months ago when I caught up with a friend of the family who asked me why I hate white people. I had to explain to him that my work is about critiquing white hegemony and that is a different thing. Critiquing hegemony and racism and advocating for indigenous rights is viewed decidedly un-Australian, as effectively parodied by Don Watson:

We’re pragmatists. It comes with being Australian that we don’t upset ourselves about things of no practical consequence. Of course, for some people the wine’s always corked. You’ll hear them from Ballarat to Bali, running the country down. Fair dinkum, you want to deck the bastards sometimes. But, as I said, we don’t upset ourselves. Poor things, they can’t think of the foundation of the country without thinking of the people it was taken from. They can’t think of dear old decent Arthur Phillip without thinking of the time he sent out men with bags to collect half a dozen Aboriginal heads. Nothing in the manifold benefits of British rule, British institutions, British customs and British capital cheers them up or excites a little gratitude.

Remind them of the nation’s progress, show them how human health and happiness have in general flourished here, and in return you’ll get the vale of tears it has been for the Aborigines, or the grave injustices to women, or the treatment of refugees arriving on boats: as if because some people got the rough end of the pineapple we are all supposed to be abraded by it.

Michel Foucault the French philosopher said that the point of “a critique is not a matter of saying that things are not right as they are. It is a matter of pointing out on what kinds of assumptions, what kinds of familiar, unchallenged, unconsidered modes of thought the practices we accept rest”. For me, as an academic with a commitment to social justice, blindly supporting the status quo is not an option. I know that I have a long journey of learning and unlearning ahead of me, without the reassurance of state sanctioned biculturalism or a biculturalism grounded in treasured processes and relationships in Aotearoa that have inflected my adult life. But this grounding from the place I’ve called home for most of my life will be fundamental to examining my complicity in the maintenance of oppression, my understanding of the multicultural project and to forging my own rather than received understandings of indigineity here in Australia. Luckily there are many who’ve already walked this path. Between their wisdom and those of my global intellectual and political community I think I am koalified to undertake this next adventure.

Via Colourfest film festival

Via Colourfest film festival

 

 

 

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Migrant support for Idle No More

When my parents were considering migrating from East Africa, their focus was on the white settler contexts of Australia, New Zealand, Canada and the United States. For a bunch of reasons I won’t go into here, they settled on Aotearoa New Zealand. A part of me always felt like my life would have been better if we’d moved to Canada or the United States, because there would have been a bigger Goan community and more support for my family. I reasoned I might have felt more culturally confident, more capable at speaking Konkani. My visit to Canada in October helped me accept the gift that my parents had given me in migrating to Aotearoa New Zealand. By not being wrapped in the comforting cocoon of an insular diasporic community, I had to figure out my own relationship with my personal and cultural history but also what Ghassan Hage terms, an ethical relationship with colonisation and living on colonised land. Visiting Canada and meeting terrific indigenous people and migrant scholars allowed me to see the contrast between Canada’s genocidal history and its self-representation as a benign, civilised and benevolent nation. The parallels between Aotearoa and Canada of a colonial history supplemented by exploited migrant labour to meet settler ends mirrored the clearly unfair outcomes in measures of health, well-being and prosperity for indigenous peoples that I see in Aotearoa New Zealand as a health professional. For the first time I began to see how the issues I’d been grappling with as a migrant were replicated across seemingly disparate white settler contexts.

Idle No More. Immigrants support Indigenous rights. Les immigrantes appuient les droits des peuples autochtones. Los inmigrantes apoyan los derechose de los pueblos indigenas. Via Harsha Walia
Image courtesy: Aaron Paquette

The Idle No More movement which began on Great Turtle Island on December 10, 2012 was initiated by four women Nina Wilson, Sylvia McAdam, Jessica Gordon & Sheelah McLean in response to legislation (Bill C-45) affecting First Nations people and gained momentum with the hunger strike by Attawapiskat First Nation Chief Theresa Spence. Impressively the United Church of Canada has acknowledged it’s complicity in colonization, inequality and abuse, through being one of the bodies that ran Indian Residential Schools. In 1986 they apologized to Aboriginal peoples for confusing “Western ways and culture with the depth and breadth and length and height of the gospel of Christ.” Apologizing to former residential schools students in 1998. Their response to the Idle No More movement has been to fully support Chief Spence’s statement that “Canada is violating the right of Aboriginal peoples to be self-determining and continues to ignore (their) constitutionally protected Aboriginal and treaty rights in their lands, waters, and resources.”

Other activists have also taken note of the commonalities of the struggle, noting how how what is particular, has universal relevance. Naomi Klein notes that

During this season of light and magic, something truly magical is spreading. There are round dances by the dollar stores. There are drums drowning out muzak in shopping malls. There are eagle feathers upstaging the fake Santas. The people whose land our founders stole and whose culture they tried to stamp out are rising up, hungry for justice. Canada’s roots are showing. And these roots will make us all stand stronger.

International support has come from the occupied lands of Palestine and indigenous communities around the globe. In Aotearoa New Zealand a Facebook page has been developed called Aotearoa in Support of Idle No More: Maori women’s group Te Wharepora Hou, a collective of wāhine based in Tāmaki Makaurau Auckland  with a commitment to ensure a stronger voice for wāhine have also pledged support. As a migrant occupying a disquieting position in a country working through issues of biculturalism and mutliculturalism in a monocultural context. Diasporic migrant communities and organisations have also backed the Idle No More movement, with South Asian activists and BAYAN-Canada, an alliance of progressive Filipino organizations noting the similarities between migrant experiences and indigenous struggles.

Immigrants in Support of Indigenous Rights via Harsha WaliaPhoto credit: Cameron Bode

Immigrants in Support of Indigenous Rights via Harsha Walia
Photo credit: Cameron Bode

How do we do engage with an indigenous struggle when we do and don’t belong at the same time? Himani Bannerji notes in a Canadian context (but one that readily resonates through various white settler contexts):

So if we problematize the notion of ‘Canada’ through the introjection of the idea of belonging, we are left with the paradox of belonging and non-belonging simultaneously. As a population, we non-whites and women (in particular, non-white women) are living in a specific territory. We are part of its economy, subject to its laws, and members of its civil society. Yet we are not part of its self-definition as ‘Canada’ because we are not ‘Canadians.’ We are pasted over with labels that give us identities that are extraneous to us. And these labels originate in the ideology of the nation, in the Canadian state apparatus, in the media, in the education system, and in the commonsense world of common parlance. We ourselves use them. They are familiar, naturalized names: minorities, immigrants, newcomers, refugees, aliens, illegals, people of color, multicultural communities, and so on. We are sexed into immigrant women, women of color, visible minority women, black/South Asian/Chinese women, ESL (English as a second language) speakers, and many more. The names keep proliferating, as though there were a seething reality, unmanageable and uncontainable in any one name. Concomitant with this mania for naming of ‘others’ is one for the naming of that which is ‘Canadian.’ This ‘Canadian’ core community is defined through the same process that others us. We, with our named and ascribed otherness, face an undifferentiated notion of the ‘Canadian’ as the unwavering beacon of our assimilation.

The experiences of marginalisation that Bannerji elucidates can guide our responses to the Idle No More movement. Gurpreet Singh from Vancouver, notes that South Asian seniors have always referred to the indigenous peoples as Taae Ke (family of elderly uncle). If we see a familiar connection between what we ourselves experience as migrants and extend that empathy to the struggles of indigenous people who have experienced an inter-generational slow genocide, we might be able to see beyond our own oppression and our view that we are too far outside the structures of power to claim a space. Privileged in some ways, disadvantaged in others, our futures are tightly imbricated in this indigenous struggle. Our presence has sometimes diffused indigenous claims and we must consider our complicity in the continuing colonisation of indigenous people. We must put pressure on governments to recognise the rights of indigenous people and their unique place as guardians of the lands we stand upon, our futures depend on it.

At the asset sales March in Auckland in April 2012. Banner by YAFA-Young Asian Feminists Aotearoa.

At the asset sales March in Auckland in April 2012. Banner by YAFA-Young Asian Feminists Aotearoa. Photo by Sharon Hawke.

 

 

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Xenoglossophobia: Speak English or die

So if you really want to hurt me, talk badly about my language. Ethnic identity is twin skin to linguistic identity—I am my language. Until I can take pride in my language, I cannot take pride in myself —Gloria Anzaldua.

Language maintenance and pluralism mean different things to different groups. Multilingualism is an act of survival for linguistic minorities, but read as a deviation, a threat, a sign of defiance and a rejection of fundamental nation-state values by the dominant culture in migrant receiving and white settler contexts. This interpretation of language pluralism is epitomised in the Stormtroopers of Death song Speak English Or Die (1985).

You come into this country
You can’t get real jobs
Boats and boats and boats of you
Go home you fuckin’ slobs
Selling hot dogs on the corner
Selling papers in the street
Pushing, pulling, digging, sweating
Where you come from must be beat[CHORUS]
You always make us wait
You’re the ones we hate
You can’t communicate
Speak English Or DieYou don’t know what I want
You don’t know what I need
Why must I repeat myself
Can’t you fuckin’ read?
Nice fuckin’ accents
Why can’t you speak like me
What’s that dot on you head,
Do you use it to see?

I was reminded of it with the news of a racist incident in Melbourne where a group of French-speaking women travelling on a bus were told by another woman to “speak English or die”. The verbal abuse captured on video shows a second man threatening to cut the woman with a knife. The knives remained in the kitchen in a New Zealand Herald report about the unfair dismissal of a chef who in addition to the sin of not knowing the difference between types of tofu “insisted on listening to Indian music and speaking Hindi” which  “affected” customers. This anxiety about the speaking of languages other than English extends to the policy sphere with many states in the US introducing legislative bills to make English the official state language, for example Minnesota in 2011. Even signs in languages in other languages provoke discomfort. Massey University researchers Robin Peace and Ian Goodwin found some New Zealanders responded with “annoyance” or “repugnance” when confronted with a space that did not make immediate, translatable sense.

What is with this monolingual sense of entitlement over public space and deep rage that is provoked by people speaking (or singing as the Frenchwomen were) in their own language?

I think it has a lot to do with how “we” might imagine “ourselves”. Language is a glue that coheres people, identities and values. Hearing a different language represents a threat to the power relations of the dominant group.

Immigrants are not supposed to be heard…. Immigrant culture and language—assumed to have little prestige or usefulness in comparison with the dominant American culture and the English language—are supposed to fade away quickly as assimilation runs its course—Castro, 1992.

The anxiety (Xenoglossophobia) generated in hearing a language that is out-of-place, reflects an anxiety about broader demographic changes that have resulted in the browning of our societies. Having a monoglot ideology though means that linguistic diversity is denied and prohibited. If English is the only language that can be heard, then this effectively silences other languages, cultures and ideas.

Assimilationist and genocidal approaches to linguistic plurality have been central to settler capitalist histories requiring the coercive adoption of majority languages in the interests of economic development. Monolingualism was fundamental to economic growth and supporting language minority rights was viewed as a threat to the nation-state because of having an unassimilated ‘other’ (Phillipson, Rannut, & Skutnabb-Kangas, 1994, p. 4). Colonisation and migration led many to abandon their own languages in order to access the social and political benefits of incorporation and assimilation or risk being stigmatised. My experience of trying to reclaim my own language is relevant here. The Portuguese colonisation of Goa led to the Konkani language being marginalised through the enforcement of Portuguese. This linguistic displacement made Konkani the lingua de criados (language of the servants) as Hindu and Catholic elites turned to Marathi and Portuguese respectively. Ironically Konkani is now the ‘cement’ that binds all Goans across caste, religion and class and in 1987 Konkani was made an official language of Goa. Ironically, contemporary iterations of [neo]colonial and [neo]liberal agendas require the appropriation of languages in the interests of global capital, as seen by the push for Chinese language learning in Australia, with monolinguists questioning the global relevance of indigenous languages. Setting up a familiar dynamic of competing indigenous and migrant others. Interestingly the National Statement on Language Policy published by The Human Rights Commission reflects these tensions:

Human Rights and Responsibilities

The right to learn and use one’s own language is an internationally recognised human right. Human rights treaties and declarations specifically refer to rights and responsibilities in relation to indigenous languages, minority languages, learning and using one’s mother tongue, the value of learning international languages, and access to interpretation and translation services. The New Zealand Bill of Rights Act provides that ‘a person who belongs to an ethnic, religious, or linguistic minority in New Zealand shall not be denied the right, in community with other members of that minority, to enjoy the culture, to profess and practise the religion, or to use the language of that minority’.

New Zealand has a particular responsibility under the Treaty of Waitangi and international law to protect and promote te reo Mäori as the indigenous language of New Zealand. It also has a special responsibility to protect and promote other languages that are indigenous to the New Zealand realm: Vagahau Niue, Gagana Tokelau, Cook Island Mäori, and New Zealand Sign Language. It has a regional responsibility as a Pacific nation to promote and protect other Pacific languages, particularly where significant proportions of their communities live in New Zealand.

Economic Development

A significant and growing proportion of New Zealand’s trade is with Asia and learning the languages of our key trading partners is an economic imperative.

Interestingly the New Zealand Settlement Strategy in its seven goals for successful settlement, aims for newcomers to New Zealand to:

  1. feel welcomed and connected
  2. get the right job and contribute to future prosperity
  3. speak and understand New Zealand English
  4. know how to access information and services
  5. feel proud and confident
  6. feel safe
  7. understand and contribute to New Zealand society.

But there is no emphasis on language maintenance.

Aotearoa New Zealand and linguistic pluralism

Aotearoa New Zealand has two official languages: Te Reo Māori and New Zealand Sign Language (NZSL). English is a de facto official language as it is widely used in Aotearoa, English is spoken by 95.9 percent of people, after which the most common language in which people are proficient in is Māori, spoken by 4.1 percent (157,110 people). 24,090 people report being able to use New Zealand Sign Language and 6,057 people can communicate in all three official languages. Between 2001 and 2006, the numbers of people in New Zealand who spoke Hindi almost doubled, from 22,749 to 44,589, the number of people able to speak Northern Chinese (Mandarin) increased from 26,514 to 41,391, the number of people able to speak Korean increased from 15,873 to 26,967, and the number of people able to speak Afrikaans increased from 12,783 to 21,123. The number of multilingual people increased by 19.5 percent between the 2001 and 2006 Censuses to reach 671,658 people, a 43.3 percent increase from 468,711 people in 1996. Where you were born has a big impact on whether you speak two or more languages, overseas-born residents are more likely than New Zealand-born usual residents to be able to speak two or more languages. 35 percent of overseas-born children (aged 0 to 14 years) speak two or more languages, compared with 11.5 percent of New Zealand-born children. As do working-age people aged between 15 to 64 years, of whom almost half 48.5 percent were multilingual, compared with 10.0 percent of New Zealand-born people. In 2006, 2.2 percent of people could not speak English. Of these, the majority were born overseas (80.3 percent).

The New Zealand Human Rights Commission views the promotion of language as a human right. Its 2005 vision for language was that “by the bicentenary of the signing of the Treaty of Waitangi in 2040 New Zealand is well established as a bilingual nation and communities are supported in the use of other languages”. It contributes to that vision in many ways including publishing a monthly e-newsletter, Te Waka Reo; a National Statement on Language Policy; supporting language weeks and other language promotion activities,and dealing with complaints about discrimination involving language (e.g. using languages other than English in the workplace).

Being fluent in three languages but not in Konkani when I arrived in New Zealand (and now not being able to speak at all in Maragoli and poorly in Swahili) has taught me that languages open up different ways of thinking and of understanding the world, but fluency isn’t passive. It must be nurtured in the context of a community. The last New Zealand Census identified that there were 588 Konkani speakers in Aotearoa, an increase from 210 in 2001. This rise gives me great heart and hope for the possibility that I might be able to reclaim my own language (amchi bas). Learning other languages has taught me to empathise and to advocate. Perhaps more than anything this is what learning another language or reclaiming our own language offers us, a chance to connect with ourselves and others in ways that are truly meaningful, but that too must be fostered.

If you talk to a [wo]man in a language [s]he understands, that goes to [her]/his head. If you talk to [her]/him in [her]/his language, that goes to [her]/his heart—Nelson Mandela

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A smile and more: Improving Asian health in Auckland

Many years ago I remember talking to an older Chinese woman in Wellington about a presentation I was going to give about cultural safety. When I gave her a slightly academic and jargon laden explanation, she said to me: “Ruth, it’s really simple, you just have to smile at people”. I’ve never forgotten her words and I agree with her. A smile communicates several things, it says “I am going to look after you and care for you, you will be safe with me”. I’ve been teaching students to remember to smile ever since. I’ve also been interested in what makes a good experience for patients/service users/tangata whai ora and three words come to mind. These are competence (we need to know that nurses have the skills and resources to provide care), communication (we need to feel informed about what is happening to us, so that we can make informed decisions) and caring (we need to feel cared for and important).

A new discussion paper launched by The Human Rights Commission last month  examines how structural discrimination or institutional racism perpetuates inequalities and outlines government initiatives with potential to achieve systemic change. Four areas receive attention: health, justice, education, the economic system and the public service. In the section on health, the discussion paper cites the 2006/07 New Zealand Health Survey which found that the experience of feeling treated with respect and dignity by their primary health care provider varied by ethnicity, Asian, Pacific and Māori adults:

were significantly less likely than adults in the total population … to report that their health care professional treated them with respect and dignity ‘all of the time’.

Cultural competence has been enshrined in the Health Practitioners Competence Assurance Act (2003), but focuses on the ‘differences’ between the giver and recipient of care rather than broader macro-processes. Māori and Pacific experience the greatest health disparities in New Zealand. Consequently their dissatisfaction with mainstream services that don’t meet their needs has been chanelled into developing innovative, effective and responsive parallel services which have invigorated the health landscape and called mainstream services to account for better outcomes for racialised groups. However, the numbers of Māori and Pacific health workers are small which means that invariably Māori and Pacific people will be nursed by someone from a different ethnic background. Given the globaI recession, it is unlikely that parallel services will become available for Asians and the growing population group of MELAA so it is incumbent for all health professionals to develop skills for working inter-culturally. Hence, I am grateful for the development by nurses in New Zealand of the concept of cultural safety, requiring that nurses pay attention to their own social location and to account for their own role as a culture bearer and having an awareness of the colonising impacts of the culture of health care. Rather than other approaches where learning a laundry list of cultural preferences is the thing.

I’ve been a nurse since 1984 (including being a nursing student, dropping out and coming back). There was a time when I was the ‘go to’ person for anything related to culture and health, thankfully there are now lots of great people around. Our expertise is growing as is our evidence base about the health needs and experiences of Asians and other groups in Aotearoa. Hence my delight at the launch of a new Asian health needs assessment . It comes on the back of several other reports: Health needs assessment of Middle Eastern, Latin American and African (MELAA) people living in the Auckland region (pdf 2.84 MB); A health profile of young Asian New Zealanders who attend secondary school (pdf, 2.71 MB); Asian Public Health Project Report (pdf, 819 KB); Asian Health Chart Book; Health Needs Assessment for Asian People in Counties Manukau (pdf, 2.2 MB); Health Needs Assessment for Asian People in Waitemata (pdf, 1.2 MB); Asian Health in Aotearoa in 2006–2007: trends since 2002–2003 (pdf, 2.23 MB) and Talking Therapies for Asian People, Building Evidence for Better Practice in Support of Asian Mental Wellbeing, Asian Mental Health and Addiction Research Agenda for New Zealand 2008-2012, Service Responsiveness to Asian, Refugee and Migrant Populations: Factsheet series, Spotlight on: Asian, refugee and migrant mental health and addiction support, Te Pou Research Update – May 2011 – Issue 2 – Asian Mental Health Service Responsiveness Mental Health Issues for Asians in New Zealand: A Literature Review.

Health needs assessments (HNA) involve collecting and analysing data about a population’s demand and need for health services (rather than individuals) in order to help prioritise health needs and services and determine strategic priorities for the medium and long term. Collecting information also involves talking to people about their priorities and gaps in services. The New Zealand Public Health and Disability Act 2000 requires that District Health Boards (DHBs) regularly assess the health and disability service needs of local populations.

The health needs assessment is aimed at “identifying the health needs, including inequalities in health status, of the main Asian ethnic groups living in the Auckland region”. Commissioned by the Northern DHB Support Agency on behalf of the Auckland Regional Settlement Strategy Migrant Health Action Plan it’s an acknowledgement of the size of the Auckland Asian population which represents 22% of the total population in the Auckland region: 310,000 Asian people live in the Auckland region, made up of 127,000 Chinese, 100,000 Indians, and 84,000 Other Asian people according to 2010 figures. These numbers are expected to increase, so that Asians make up more 60% of the total population in the Auckland region by 2026. Asian people comprise 9.2% of the total New Zealand population and are seen to have similar or better health than European New Zealanders. Many complain that the term Asian is confusing and problematic homogenising a diverse group of people with a range of migration and social histories whose needs can be disguised and subsumed. This needs assessment addresses concerns about the need to disentangle the category while maintaining the strategic importance of the umbrella term in advocating for health services.

Ahem, we already know from the from the New Zealand Health Survey and Youth ’07 that Chinese, Indian and Other Asian adults and youth eat fewer fruit and vegetables and do less physical activity (we’re studying actually) and we have a higher prevalence of adult obesity compared to other ethnic groups (cough!) This week we found out we had even more problems. I’ve tried to summarise them here, but you should really check out the full report.

Health concerns among Asian populations in Auckland include:

Chinese: diabetes prevalence among older men and middle-aged and older women, diabetes in pregnancy, child oral health, cervical screening coverage, cataract extractions and terminations of pregnancy.

Indians: CVD, diabetes (including during pregnancy), child oral health, child asthma, low birth weight deliveries, terminations of pregnancy, cervical screening coverage, family violence, hysterectomies, cataract extractions and total knee joint replacements.

Other Asian populations: stroke and overall CVD hospitalisations, diabetes (including during pregnancy), child oral health, child asthma, cervical screening coverage, terminations of pregnancy and cataract extractions.

Access issues:

Asians generally do pretty well, except in primary care (Chinese have low rates of PHO enrolment rates among Chinese across Auckland), but Asian women have lower cervical screening coverage across Auckland compared with European/Other rates. Asian people have lower rates of access to mental health services, disability support services and aged residential care compared to other ethnic groups.

Recommendations for the Three Auckland DHB’s to:

There’s no point trying to summarise all the key findings as you can go to the Executive summary for that. But the following recommendations are important and timely:

1) Notice Asians are here:

  • Advocacy for the health needs of Asian people in health-related policy, planning, monitoring and reporting at a regional and national level.
  • There should be better ethnicity data collection for the ‘Asian’ group and for Asian ethnic sub-groups, particularly with regard to CVD and diabetes and consistent use of ethnic coding for Asian ethnic groups at all levels.
  • Review whether the ‘Indian’ ethnic group should be replaced by ‘South Asian’.

2) Get Asians to be more healthy

  • Promoting healthy eating, adequate physical exercise, being smoke-free and cervical screening
  • Targeting CVD, diabetes, oral health (particularly among children), child asthma, family planning and contraception. Especially the ones that carry stigma such as disability, mental illness, and family violence.
  • Enabling health literacy by providing culturally-appropriate written information and providing this through community sessions and utilising local community media.
  • Educating health professionals about the key health needs for Asian communities.

3) Offer targeted health services for Asian people (within mainstream services):

  • Asian-focussed CVD and diabetes nurse practitioners (and how are they going to do this?)
  • Expanding and further developing existing Asian mental health service models .
  • Early intervention for family violence.
  • Family planning and contraception advice, including for Asian international students
  • More culturally-appropriate disability respite services.
  • More culturally-appropriate residential care facilities for older Asian people
  • Culturally-appropriate community oral health services, particularly for Asian children.

4) Improve PHO enrolment data and access to primary care services for Asian people

  • Better coding of ethnicity data
  • Increasing PHO enrolment rates for Chinese people across Auckland, and Indian and Other Asian people in WDHB.

5) Reduce cultural and language barriers to care

  • Training up the health and disability workforce across the Auckland region using culturally and linguistically diverse (CALD) cultural competence training and providing freely available resources.
  • Expanding cultural support services for Asian people in the Auckland region.
  • Providing additional resources for development of the Asian health workforce reflecting the ethnic composition of the populations served including: scholarships for further training of Asian health professionals; more bridging courses in nursing and allied health, for overseas-qualified Asian health professionals to register and work. Having language-matched carer-support workers for non-English speaking families in the home-based support sector.
  • Encouraging health service providers, particularly GPs to use qualified interpreters.
  • Additional funding for English as a Second Language (ESOL) courses, to increase the number of Asian people attending these courses.I don’t understand this)

6) More collaboration between health service providers in the Auckland region

  • •Better awareness among health service providers of the Auckland Asian, migrant and refugee services, programmes and initiatives currently available.
  • Sharing service delivery models of evaluation and research for Asian population health outcomes between the three DHBs in order to plan services.

7) Improving social capital among Auckland Asian communities

  • Funding to initiate and maintain community support groups for Asian people affected by disability, mental illness, family violence and other key health issues should be considered by Auckland DHBs.
  • Better awareness of charitable organisations that provide support services to Asian people, including Shanti Niwas (for older Asian people) and Umma Trust (for women and children), is required.
  • Better publicity about the community centres, libraries, public transport and other public facilities available to Asian communities in Auckland to reduce social isolation among migrants.
  • Consultation with Asian community leaders and community groups should be sought when evaluating existing health services or planning additional health services.

8) Future research

Another health needs assessment of Asian people across the Auckland region in 4-5 years; consultation with Auckland Asian communities regarding health needs and barriers to accessing appropriate health care; further examination of the effects of acculturation on the health of Asian migrants and subsequent generations in Auckland; a comparison of the health profiles of Fijian Indians as compared to other ‘Indians’ to determine if there are important differences; further analyses around the health of older Asian people as data for Asian ethnic sub-groups becomes available; the prevalence of disability in Auckland Asian communities; and ethnic-specific analyses of falls and pressure sores occurring in residential care, as well as osteoporosis and sun exposure.

Things I like about the report:
  • It confirms in writing what many of us who are passionate about health already know, it gives legitimacy to this knowledge, provides a benchmark and starting point for action.
  • The needs assessment considers Asian health within the context of broader determinants of health, I like the attention to improving social capital among Asian peoples and health literacy.
  • The report implies that the three Auckland DHB’s need to make a better effort at seamlessness and integration, collaboration and so on which are good things. The report also asks the DHB’s to take more action at Regional and National levels.
  • The recommendation to consult Asian communities when re-evaluating or starting new services.
  • The identification of health priorities eg mental health, reproductive health, services for older people etc.
  • The emphasis on developing a culturally responsive workforce.
  • Ensuring that future health professionals reflect the workforce and supporting the transition of the exisiting workforce who have struggled to get their qualifications recognised.
  • Better ethnicity data collection.
  • The desire to sharpen up terms (eg South Asian versus Indian) and to disentangle and fine tune the analysis of the largest groups of Asians that is Chinese and Indians.
  • The HNA consulted with “insiders” for their perspectives.
I’d be interested in how some of the recommendations are realised given the current financial climate of health service prudence and how pivotal upskilling our workforce is to making services engaging, safe and acceptable for Asian communities. I am not sure how prepared our workforce is for working with the kind of superdiversity we have in New Zealand and for me this is an enormous gap that I’ve worked hard to address in my research, teaching, presentations and publications.
One of my favourite definitions of health is from the Ottawa Charter which defines health as the “full personal development and participation in balanced and independent social, economic and cultural life”. I like the way it allows health to be considered in the context of health structures and systems as well as wider social, cultural, economic and political environments. Considering the social determinants of health, that is the conditions in which people are born, grow, live, work and age, including the health system is important, because these conditions are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries. It is my hope that this needs assessment and the report on structural discrimination contributes to an agenda that allows everyone to flourish and to enjoy “full personal development and participation in balanced and independent social, economic and cultural life” in Aotearoa, New Zealand.
References

Mehta S, Health needs assessment of Asian people living in the Auckland region. Auckland: Northern DHB Support Agency, 2012.

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A fair go? Using liberal principles to support Islamophobia and racism.

I am interested in the issue of fairness. Anyone with siblings might be I would think. Whether it’s about making sure everyone gets an equally sized piece of cake or equal chances to speak, fairness has been a driving force in my life that I might have inherited.  As one of three daughters it was very important to our parents that we were treated fairly. So every birthday and Christmas we got the same kinds of presents, matching housecoats, matching crockery and so on. I kinda like the way I can go to both my sisters’ houses and enjoy drinking from the same cups. But over the years I’ve realised that treating people the same (is universalism) isn’t always all it’s cracked up to be and sometimes we need to treat people differently (particularism) to support them to get their needs met. For example, my parents have a prolific avocado tree and out of all my sisters I like avocados the most (hint hint), therefore is it fair that we all get the same number of them? This issue has resonance in health too, treating everyone the same can result in differential outcomes and sometimes you need to treat people differently to get the same outcome-for example for different population groups to have a long life different strategies might be needed. Which brings me to the issue that’s driving this blog post. How can we ensure that what we do is fair? and how do we define what fairness is? How might discourses invoking equality reinforce inequity and oppression?

The backlash against KONY 2012 did something useful. It made people think twice before re-posting items on their newsfeed and drew attention to the ways in which activism through social media can go horribly wrong. Joshua Foust says KONY 2012 accentuated the challenges “of enthusiastic support for someone who seems to be doing the right thing without really investigating whether their methods are the best, and privileging the easy and fun over the constructive”. In the case of the social media whirl around Russian punk band Pussy Riot, Foust’s criticism is that a serious concern about the erosion of political freedoms and civil liberties has been converted into a celebration of feminist punk music and art, detracting from the brutality and mistreatment being meted by Putin’s government to Russian activists or political prisoners.

It’s been a lousy few weeks for women in the west. The Julian Assange saga, Republican Todd Akin’s stupidity and comments that women can’t get pregnant from rape and more. But even more grump inducing has been the appearance on my Facebook feed of more white saviour complex campaigns, this time run by white feminists. Feminism is supposedly about building a fairer and more just society for women, but these campaigns only reinforce the limitations of western feminisms for engaging with axes of oppression such as ethnicity, racialisation and social class. This isn’t my only beef with western feminisms, the others are that they have a decidedly liberal tone with a focus on individual rights and also the frequency with which feminist discourses are co-opted for neoliberal ends. For example, the way in which western feminisms have legitimated expansionist neoliberalism, think Muslim women needing to be rescued from the Taleban by the Enlightened West in Afghanistan.

This hero/martyr narrative in this annoying image from Feminists United is illustrative of a hierarchy that pits western women against non-Western women.

The advert represents a white woman as a hero, both educated and modern and able to freely exercise choice and control over her own body. In contrast, the ‘non Western woman’ is represented as oppressed by her culture, other women and tradition, all of which impinge on her sexuality. The comments on this image included:”Indeed, a horrific practice that comes from satan’s kingdom of darkness and needs to end; ” and “In Africa 3000 girls every day!!!”. Thankfully commentators also pointed out the racist and imperial assumptions of this advert. The comments recentre Western feminisms rather than expose the limitations of Western epistemological frameworks for making sense of women’s experiences outside the West. Given my own health background, I’m conscious of the ways in which FGM/C is constructed as a health issue. The image implicitly reifies the superiority of Western medicine for having the values most emblematic of Western civilisation such as enlightenment, benevolence and humanitarianism. We’ll just ignore the collusion of Christian missionary medicine and biomedicine in the advancement of colonialism and imperialism.

One of my intellectual and political concerns is with the ways in which certain practices and subjectivities are privileged through liberal feminist discourses that actually replicate the colonising impacts of heteropatriarchy (even though feminism was developed to critique it). These liberal feminist discourses construct femininity within particular norms such as being liberated that are within normative modes of middle class white behaviour. Racialised “oppressed” women are constituted as a threat to the liberal and neoliberal projects of self regulation and improvement which in turn reinforce the centrality of a white world view

The comments on the second set of images that popped up on my feed were also disturbing, viewing Muslim women as victims of their male partners. The comments framed the woman as unagentic and Muslim males as dominating and unable to control their sexual drives. The inability to recognise sexism and misogyny closer to home in the context of Todd Akin talking about “legitimate rape” were interestingly absent. This ‘fighting sexism with racism’as Sherene Razack (1995) calls it fills me with dismay, especially when differences are framed as a civilisational clash between western liberal values of equality and individualism versus the patriarchal, hierarchical and communal values of the ‘other’.

As Arundhati Roy articulates in a pointed essay:

Western-liberal feminism (by virtue of its being the most funded brand) [has become], the standard-bearer of what constitutes feminism. The battles as usual, have been played out on women’s bodies, extruding Botox at one end and Burkhas at the other. (And then there are those who suffer the double-whammy, Botox and the Burkha.) When, as happened recently in France, an attempt is made to coerce women out of the burkha rather than creating a situation in which a woman can choose what she wishes to do, it’s not about liberating her, but about unclothing her. It becomes an act of humiliation and cultural imperialism. Coercing a woman out of her burkha is as bad as coercing her into one. It’s not about the burkha. It’s about the coercion. Viewing gender in this way, shorn of social, political and economic context, makes it an issue of identity, a battle of props and costumes. It’s what allowed the US Government to use western feminist liberal groups as moral cover when it invaded Afghanistan in 2001. Afghan women were (and are) in terrible trouble under the Taliban. But dropping daisy-cutters on them was not going to solve the problem.

These coercive aspects reeking of cultural imperialism and humiliation have been close to home this week in Aotearoa with the furore over the decision by Lower Hutt’s Dowse Art Museum to ban men from seeing a video work by Qatari-American Sophia Al-Maria. The video Cinderazahd: For your eyes only was filmed in a woman only section of her grandmother’s home in Doha and shows Muslim women preparing for a relative’s wedding without their veils. Al-Maria requested that it only be shown to women and children in keeping with the belief that male strangers should not see their faces. However, this ban on mail viewers has resulted in complaints of gender discrimination to the Human Rights Commission.

The Dominion Post argues:

The real issue is that the Dowse is a ratepayer-funded organisation. As such, it should not be using the public purse to stage exhibits from which some ratepayers are excluded. The sum involved in this case – $6000 for the complete exhibition of 17 artists – is small, but the principle is important.

Clearly, the conflict between Al-Maria offering a work that can be seen only by women and the gallery’s duty to ensure equal access to all those who contribute towards funding it cannot be reconciled. That being the case, the Dowse should withdraw the video from the exhibition and Al-Maria should find a private gallery in which to show it.

Luckily there’s been some great responses from the blogosphere. Especially from QOT who says:

There’s a lot of argument going down around the fact that the Dowse is publicly-funded, is this discrimination, do we owe it to the poor oppressed brown women to tear away their autonomy because they’re too stupid to know they’re oppressed … yeah, guess where I fall on that one.

QOT checks our Human Rights legislation and notes that it is not unlawful to discriminate on the ground of religious belief (within particular circumstances). QOT acidly remarks that this legislation is what enables Catholics to ban women from the priesthood, but who’s complaining? If the primary complainant was a male student taking a third-year compulsory Art History paper where half the final exam marks were based on the film this would then disadvantage the males in the class. But is not being able to see that exhibit going to disadvantage the complainant really? Wise words also from Gaayathri, pointing out how important it is for those who are marginalised to be able to create and have access to safe spaces. Gaayathri cynically notes how the incident smacks of using Islamic women’s rights as a political football and if we indeed gave a damn then listening to their wishes would be a great start, and even better respecting the boundaries that have been set for the viewing of the work.

Contemporary racism is covert and subtle, a response to the social taboo against the open expression of racist sentiments. It is also more likely to be denied by majority group members.What I find most interesting about the Dowse drama is how the parameters of cultural consumption can only be set by the dominant culture. Whether it’s invoking the white saviour discourse or railing against so-called Islamic oppression, it’s the dominant white settler culture who decides how much culture is palatable and in what form. Setting boundaries results in the range of devastating comments that you can see on the interweb and it shows me that the veneer of civility is wafer thin. Kiwis can indeed hold negative views of particular groups in tandem with liberal principles of equality, tolerance, fairness and justice and just as quickly invoke these liberal values of fairness and equity in the service of  Islamophobia and racism. Our attitudes and beliefs in New Zealand haven’t been tested in the same way Australians have. They are forever in the spotlight about asylum seekers, but what it does make me think is that we should not be too complacent in New Zealand about the moral high ground. In all of this, what I am most grateful for is that like KONY 2012, these frustrating and painful incidents provide an opportunity to consider more deeply questions of freedom and liberation and more importantly to find out who our allies are.

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Refugee women on their own in New Zealand: Uncommon courage

Recently the report  “Doing it for ourselves and our children: Refugee women on their own in New Zealand” was launched in Auckland, New Zealand. The project was jointly undertaken by AUT University and Refugee Services New Zealand with the support, guidance and practical assistance of the three Strengthening Refugee Voices groups in Auckland, Wellington and Christchurch. It was an honour for me to write the report.

The purpose of this project was to examine the resettlement experiences of women who entered New Zealand through the category of Women at Risk (identified by the Office of the United Nations High Commissioner for Refugees (UNHCR). This category constitutes up to 75 places (10%) of New Zealand’s annual refugee quota of 750 applicants) or who became sole heads of households as a consequence of their resettlement experiences. The terms ‘refugee women’ and ‘communities’ refer to highly diverse groups of people  and in this report we don’t assume a “single, essential, transhistorical refugee condition” (Malkki, 1995, p.511).

A focus on strengths and principles of social justice, community development and capacity building were central to this investigation. Specifically, we had a transformative agenda, which was to enhance the wellbeing of refugee women by focussing on the roots of inequality in the structures and processes of society rather than in personal or community pathology. Within this frame, we were committed to constructing refugee women as assets rather than deploying as replicating deficit models where refugee women are represented as burdens for the receiving society.

You can read the whole report on the Refugee Services website 

 

 

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Sisters, friends or whānau?

This is a lengthier version of an editorial published in this month’s Kai Tiaki New Zealand Nursing Journal. It is based on an invited address I gave at the 10th Annual Conference of the Women’s Health Section:’Divine Secrets of the Sisterhood’ on April 26th  2012.

I recently spoke at the NZNO Women’s health conference about sisterhood. Not that I don’t care about men (I do deeply), but as one of three sisters and as a woman who has spent most of my adult life working in the female dominated profession of nursing, relationships between women are of great personal and professional interest. The call to action in the women’s movement almost thirty years ago emphasised sisterhood and demanded the end of oppression and the commitment to women as a social group (Klein & Hawthorne, 1994). However, the movement also raised questions of difference. Many suggested that in order to understand what women had in common they also needed to pay attention to what they didn’t have in common such as race, gender and sexuality. Focusing on similarity erased and overlooked important differences, but only focusing on difference led to the “othering” of others, stereotyping and pushing people away.

I believe these questions remain important for nursing, because I think our differences can make nursing stronger. An understanding of our differences can help us to better understand our similarities. As Audre Lorde points out “it is within our differences that we are both most powerful and most vulnerable, and some of the most difficult tasks of our lives are the claiming of differences and learning to use those differences for bridges rather than as barriers between us”. So I believe an important question for nurses is how can we capitalise on the energy and movement in difference and resist the coercive force of sameness?

One of the challenges is that differences raise critical issues of power, because differences are often institutionalised (Crenshaw,1994, p.411). Take the idea of the implicit ideal nurse-typically the ideal nurse is female, white, middle class, heterosexual, able bodied, nice, obedient and nurturing (Giddings, 2005; Reverby, 2001). Those nurses that fit the norm experience privilege and those that don’t are marginalised. Internationally, women of colour are present in practice settings with less prestige, lower wages, less security, and less professional autonomy (Gustafson, 2007). While, a disproportionate number of white men and women are ensconced in nursing management, academia and research, whose world view is supported by the dominance of white, Western, biomedical interpretations of health and illness. Grada Kilomba defines whiteness as “a political definition, which represents historical, political and social privileges of a certain group that has access to dominant structures and institutions of society”.  As Ang-Lygate (1997, p,2) points out “political sisterhood is suspect unless those sisters who enjoy privileges denied to other sisters are seen to share the responsibility of dismantling the differences”.

This dominance of whiteness in our workforce and our ideas about health and illness are present in nursing in New Zealand too. We are undergoing a period of unprecedented diversity. Transitioning from largely New Zealand-born European to being increasingly ethnically diverse, our dependence on overseas-born migrant nurses is evident in their composition of 29% of the workforce- one of the highest proportions in the OECD. At the same time Māori and Pacific Islands nurses are under-represented in our workforce while these communities experience the greatest health need. This inequity is challenging and as Margaret Southwick notes provides “justification (if one be needed) for the claim that nursing needs to take seriously the challenge of working with diverse and marginalised groups within society is to be found in the health status of these very same groups of people.” (Southwick, 2001).

So given the diversities in nursing and the health inequities that confront our communities, new strategies are necessary. I’m proposing moving away from sisterhood which implies the shared experience of being a woman and experiencing gender oppression to consider a new metaphor that allows greater consideration of our differences so that we can better articulate our similarities (Simmonds, 1997). There’s friendship for a start, a relationship based on equals who have affection, and interest in each other (Friedman, 1993, p.189). Its etymology is in the word free. It means to love, to love our own freedom, and to love and encourage the freedom of the other (Mary Daly, 1987). Friendship allows us to work in each other’s interests because part of what is compelling is our differences.

The notion of friendship as an alliance within the context of difference can be seen in this brilliant blog post entitled Queer Sisters Keep Saving Me: The Brilliantly Selfish Act of Being an Ally by Black Artemis

Heterosexual people especially women owe a tremendous debt to the LGBTQ struggle for some of the sexual freedoms we enjoy…the boundaries queer people bend and bust at the risk of their own lives in many ways expand our heteronormative privilege. Their radical decision to be simply who they are makes it much safer for the rest of us to redefine who we may want to be. We have a broader range of acceptable sexual expression because of the queer liberation movement for every time they push the envelope, they set a new “normal,” and it’s not even they who benefit the most for their courage. Rather it is those of us whose sexual identity is already validated.

If we are going to use the metaphor of sisterhood we consider the idea of a “chosen family” used by LGBTQ communities or the Māori concept of whānau. It too is based on love rather than biology and includes people as who are a source of love and support outside the heteronormative idea of family.

I’d like us to strengthen nursing by strengthening ourselves, for creating space for all nurses to be able to come together with our diverse traditions and values, to be united based on solidarity not sameness. I’d like us to be able to articulate our shared beliefs and practices while acknowledging how we differ.

I’m proud to be a nurse in New Zealand, I value the shared commitment to caring and to social justice in the shape of cultural safety. I’d like to build on our legacy and see nurses critically examine the values, goals, and intents shaping our profession. I’d like us to have some challenging conversations about power and privilege, to deconstruct our own classism, racism, and homophobia and to think about recognition and reparation. I leave my final words to Audre Lorde:

So this is a call for each of you to remember herself and himself, to reach for new definitions of that self, and to live intensely. To not settle for the safety of pretended sameness and the false security that sameness seems to offer. To feel the consequences of who you wish to be, lest you bring nothing of lasting worth because you have withheld some piece of the essential, which is you.

References

ANG-LYGATE, M., CORRIN, C. & HENRY, M. S. 1997. Desperately seeking sisterhood: Still challenging and building, London, Taylor and Francis.

CRENSHAW, K. 1994. Mapping the margins: Intersectionality, identity politics, and violence against women of color. In: FINEMAN, M. A. & MYKITIUK, R. (eds.) The public nature of private violence. New York: Routledge.

DALY, M. (1978) Gyn/Ecology: The Metaethics of Radical Feminism, Boston: Beacon.

FRIEDMAN, M. 1993. What are friends for?: feminist perspectives on personal relationships and moral theory, New York: Cornell University Press.

GIDDINGS, L. S. 2005. Health disparities, social injustice, and the culture of nursing. Nursing Research, 54, 304.

GUSTAFSON, D. L. 2007. White on whiteness: Becoming radicalized about race. Nursing Inquiry, 14, 153-161.

HAWTHORNE, S. & KLEIN, R. 1994. Australia for Women: travel and culture, New York, Spinifex Press.

LORDE, A. 2009. Difference and Survival: An Address to Hunter College” Rudolph, New York:, Oxford University Press.

REVERBY, S. 2001. A caring dilemma: Womanhood and nursing in historical perspective. In: HEIN, E. C. (ed.) Nursing issues in the twenty-first century: Perspectives from the literature. Philadelphia: Lippincott, Williams and Wilkins.

SIMMONDS, F. N. 1997. Who Are the Sisters? Difference, Feminism, and Friendship. 19-30. In ANG-LYGATE, M., CORRIN, C. & HENRY, M. S. 1997. Desperately seeking sisterhood: Still challenging and building, London, Taylor and Francis.

SIMMONDS, F. N. 1997. Who Are the Sisters? Difference, Feminism, and Friendship. Desperately Seeking Sisterhood: Still challenging and building, 19-30.

SOUTHWICK, M. R. 2001. Pacific women’s stories of becoming a nurse in New Zealand: A radical hermeneutic reconstruction of marginality. Unpublished Doctoral thesis, Wellington: Victoria University of Wellington.

 

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Questions haunt nursing student

In 2007 a student nurse called Lisa Kenyon wrote to the Kai Tiaki asking questions about nursing. I’ve reprinted her letter here and then my response. It seems relevant at the moment

I am a year-one nursing student from Waiariki Institute of Technology, doing my bachelor of nursing at Windermere in Tauranga. I have recently been out on my first practicum for three weeks and have come away with a multitude of questions. I am a 34-year-old married woman with a child, and consider myself experienced in the traumas and joys that life can bring. After finishing my practicum, which I thoroughly enjoyed, I was left reflecting on my personal experience with the elderly.

I cared for a dear man who unfortunately died in my second week of being his student nurse; I was so privileged to have spent that time with him and his family. But I was left with a list of questions and thoughts to which I have no answers. Maybe there are no answers and maybe, with more nursing experience, these questions will make sense, but for now I want to share my thoughts and wonder how other experienced nurses or student nurses have overcome these difficulties.

The questions that bother me are: Can a nurse “care” too much? Don’t patients deserve everything I can give them? How do I protect myself and still engage on a deeper level with the patient? How do I avoid burnout? Why can’t I push practice boundaries, when I see there could be room for adjustment or improvement? Isn’t it okay to feet emotionally connected to the patient? Don’t I need to continually ask questions, if nursing is to change, or will that just get me fired?! Finally, am I just being a laughable year-one student, with hopes and dreams and in need of a reality check?

I would really appreciate feedback from other student nurses who have felt the same or from experienced nurses with some insight into these questions, as I am left doubting what kind of nurse I am going to be.

Lisa Kenyon, nursing student, Waiariki Institute of Technology, Tauranga.

My response below:

I was pleased to see Lisa Kenyon’s letter, Questions haunt nursing student, in the December/ January 2006/2007 issue of Kai Tioki Nursing New Zealand (p4). The questions she has reflected on indicate she is going to be an amazing nurse.

I believe nursing is both an art and a science, and our biggest tools are our heart and who we are as human beings. I was moved by her letter and thought I’d share my thoughts. The questions she posed were important because the minute we stop asking them, we risk losing what makes us compassionate and caring human beings.

Let me try to give my responses to some of the questions Lisa raised–I’ve been reflecting on them my whole career and continue to do so.

1) Can a nurse “care” too much?

Yes, when we use caring for others as a way of ignoring our own “issues”. No, when we are fully present in the moment when we are with a client.

2) Don’t patients deserve everything I can give them?

They deserve the best of your skills, compassion and knowledge. Sometimes we can’t give everything because of what is happening in our own lives, but we can do our best and remember we are part of a team, and collaborate and develop synergy with others, so we are resourced and can give our best.

3) How do I protect myself and still engage on a deeper level with the patient?

I think we have to look after our energy and maintain a balance in our personal lives, so we can do our work weft. We also need healthy boundaries so we can have therapeutic communication.

4) How do I avoid burnout?

Pace yourself, get your needs met outside work, have good colleagues and friends, find mentors who have walked the same road to support you. I’ve had breaks from nursing so I could replenish myself.

5) Why can’t I push practice boundaries, when I see there could be room for adjustment or improvement?

I think you can and should, but always find allies and justification for doing something. Sometimes you have to be a squeaky wheel

6) Isn’t it okay to feet emotionally connected to the patient?

Yes, it is okay to feel emotionally connected to the patient, but we also have to remember that this is a job and our feelings need transmutation into the ones we live with daily.

7) Don’t I need to continually ask questions, if nursing is to change, or will that just get me fired?

Yes, you do have to ask questions but it is a risky business. Things don’t change if we don’t have pioneers and change makers.

8) Finally, am I just being a laughable year-one student with hopes and dreams, and in need of a reality check?

No, your wisdom and promise are shining through already and we want more people like you. Kia Kaha!

Ruth DeSouza RN, GradDipAdv, MA, Centre co-ordinator/Senior Research Fellow, Centre for Asian and Migrant Health Research, National Institute for Public Health and Mental Health Research Auckland University of Technology

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A nice post

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