Newsletter – Winter 2024

Article by Croakey. Image credit Isaac Brown. Aboriginal and Torres Strait Islander readers are advised this article includes names and images of people who have passed, published with permission of families.

Members of the Aboriginal Kidney Care Together – Improving outcomes Now (AKCTION) program at the University of Adelaide generously share their stories below, about the importance of spirituality and the cultural determinants of health, and the benefits of decolonising healthcare and research.

This story is dedicated to our AKction2 kidney warriors Inawinytji Williamson and Nari Sinclair who joined their Ancestors in 2023, on whose shoulders we stand to disrupt systems of racism. AKction2 has permission and encouragement from families to use their images and names to continue building legacies for equity and access in kidney care and keeping our people off the machines in the first place.

The Aboriginal Kidney Care Together – Improving Outcomes Now (AKction2) Reference Team (A2RT) are Australian First Nations Peoples who have lived experience of chronic kidney disease, dialysis treatments, are awaiting kidney transplants, or have received a kidney transplant. Interwoven around the A2RT, are 4 sub-studies that make up the AKction2 research project: Indigenous Governance, Peer Support, Health Journey Mapping, and Cultural Safety in kidney care.

These four studies are managed by the AKction Project Team (APT), staff employed by the University of Adelaide to carry out and coordinate the project, and postgraduate/undergraduate students undertaking A2RT-directed research. We work together as a team of Indigenous researchers with our non-Indigenous allies, on the shared aim of decolonising kidney care and increasing culturally safe practice.

We share our skills and knowledge in our quest to prioritise principles of culturally and clinically safer treatment and care for Aboriginal kidney patients and family members and their communities.

Aboriginal and Torres Strait Islander Nations are a deeply spiritual and relational peoples, with a knowledge database stretching beyond 60,000 years. We acknowledge the wisdom and contributions of Elders and Ancestors, including A2RT members who have passed away. When unplanned situations create successful outcomes, we say “It is the Ancestors,” as we believe in this universal energy drawing us together to make a difference.

Spirit is described differently by Australian First Nations Peoples across this vast landscape and throughout this article we share our stories and knowledge around the cultural practices we use to grow and nurture our spiritual strength on our health journeys.

In AKction2, we work together with the aim to decolonise the spaces we live and work in by using our own Australian First Nations languages. We describe our decolonising process as our “Aboriginal ways of knowing, being and doing”.  We use our own first languages in this article, to help us articulate our First Nations concepts and perspectives, in contrast to the dominant Australian Eurocentric worldviews.

The spiritual essence of a person or the Wannapi, as Adnyamathanha People describe, is the term used for spirit. Ngarrindjeri People describe the human spirit as Miwi – the sense of oneself. The Miwi is located behind the stomach and is closely translated to ‘soul substance,’ as the source of emotions, as an eternal part of humans where all important feelings, experiences and thoughts are expressed. The Kaurna word for spirit is Tuwila. These concepts are linked back to the spiritual, emotional, physical, and mental aspects of oneself.

Nurturing and teaching our spirit to be strong and healthy helps to support our emotional, physical, and mental health, enabling us to be resilient and courageous on our health and wellbeing journeys as we live, work, and walk together on Yarta (Adnyamathanha and Kaurna) or Ruwi (Ngarrindjeri). Our connections to culture, family, and Yarta/Ruwi, are a priority for our overall health and wellbeing, and are central to solidifying our sense of identity of who we are and how we carry ourselves through life using a holistic approach.

The health of our Spirit impacts every aspect of our lives, including our mind/mental (brain), feelings/emotions (heart) and physical/senses (body).

Australian First Nations Peoples who use cultural knowledge and practices in health, research, and medical spaces gain strength and protection from the Ancestors and our Creator, which helps to centre the Kidney Warriors Wannapi/Miwi/Tuwila as they manage their kidney disease and navigate the health system.

Connection to Country

A key factor in keeping one’s Wannapi/Miwi/Tuwila strong is by staying connected to Yarta/Ruwi, the Adnyamathanha, Kaurna, and Ngarrindjeri words for Country.

This quote by Mick Dodson beautifully explains:

For us, country is a word for all the values, places, resources, stories and cultural obligations associated with that area and its features. It describes the entirety of our ancestral domains.

All of it is important – we have no wilderness, nor the opposite of wilderness, nor anything in between.

Country is country – the whole cosmos.

Country underpins and gives meaning to our creation beliefs – the stories of creation form the basis of our laws and explain the origins of the natural world to us – all things natural can be explained.”