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“That heart sickness”: Young Aboriginal People’s Understanding of Rheumatic Fever (Research Review)

30 August 2018

An article published this month in Medical Anthropology - a peer-reviewed journal publishing cross-cultural studies in Health and Illness- reports on research that blended the disciplines of Public Health and Sociolinguistics around the topic of rheumatic fever (RF).
Published by PhD scholar Alice Mitchell, Associate Professor Anna Ralph and others, the article, –“That heart sickness”: Young Aboriginal People’s Understanding of Rheumatic Fever describes ethnographic research conducted in the Northern Territory (NT) of Australia among young Aboriginal people –a group where there is high prevalence of RF with poor outcomes. The ethnography explored young participants’ understandings of RF, experiences of health care for RF, and examined the languages used for expression and communication about RF.

The authors found that knowledge about causes of RF and ways to manage and prevent RF was sparse, despite a deep desire among families of children with RF for relevant information. This lack of knowledge was a result of communication difficulties experienced by clinicians and compounded by clinician’s transiency in their work placements. The operational language in all health services in the NT is English whereas, in many NT locations, such as the article’s study sites, Aboriginal languages are still in full use and English proficiency among clientele is highly variable. Clinicians preferencing of English in this setting was found to constrain dialogue and meaningful information-sharing. This had a disempowering effect on families that reduced their engagement with health services.

The authors described how Aboriginal languages are foundational to Aboriginal people’s identities. Non-valuing or disregarding of such languages was identified as a disrespectful stance, albeit an unintended one on the part of clinicians. Evidence presented by the authors concluded that separate disciplines need to work collaboratively to address RF in the NT– biomedicine did not have capacity in this instance to deliver important, and indeed life-saving information for Aboriginal families, thus contributing to poor outcomes. 
The authors framed clinicians’ communicative capacity in this setting as a social determinant of health. They recommended training for clinicians in cultural safety to improve healthcare approaches to Aboriginal clientele as well as improving service design by valuing local Aboriginal knowledge and local languages. 

For further information and to read the full article:
“That heart sickness”: Young Aboriginal People’s Understanding of Rheumatic Fever