Knowing and Being Known. Approaching Australian Indigenous Tourism Through Aboriginal and Non-Aboriginal Politics of Knowing

Based on ethnographic research conducted with Bardi and Jawi people, two Indigenous groups from the Northwestern Kimberley region of Western Australia, the aim of this paper is to approach the complexities related to Indigenous tourism in Australia through the politics of knowing and not-knowing as embodied by Indigenous tour guides and non-Indigenous tourists. It examines the notion of knowing (or not-knowing) and its usages by Indigenous and non-Indigenous people in the context of their tourist encounter. ‘Knowing’ represents an important aspect through which Aboriginal people and their non-Indigenous guests negotiate their interactions. In particular, the paper shows how Indigenous and non-Indigenous expectations from tourism lead actors to adopt divergent positions and to assert renewed claims in relation to knowledge or knowing, casting new light on issues of self-representation and empowerment in the domain of Indigenous tourism.     

Health ethics and Indigenous ethnocide

In colonial societies such as Canada the implications of colonialism and ethnocide (or cultural genocide) for ethical decision‐making are ill‐understood yet have profound implications in health ethics and other spheres. They combine to shape racism in health care in ways, sometimes obvious, more often subtle, that are inadequately understood and often wholly unnoticed. Along with overt experiences of interpersonal racism, Indigenous people with health care needs are confronted by systemic racism in the shaping of institutional structures, hospital policies and in resource allocation decisions. Above all, racism is a function of state law – of the unilateral imposition of the settler society law on Indigenous communities. Indeed, the laws, including health laws, are social determinants of the ill‐health of Indigenous peoples. This article describes the problem of Indigenous ethnocide and explores its ethical implications. It thereby problematizes the role of law in health ethics.     

Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia,Prospective Population Based Data Linkage Study

BackgroundIndigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants.MethodsOur primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation.FindingsThere were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77–2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98–2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88–2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96–1.13, p = 0.356).InterpretationWA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live.     

Living on Climate-Changed Country: Indigenous Health,Well-Being and Climate Change in Remote Australian Communities

Closing the gap between the health and well-being status of Indigenous people living in remote areas of northern Australia and non-Indigenous Australians has long been a major target of federal health policy. With climate projections suggesting large increases in hot spells in desert regions and more extremes in rainfall in other areas of the north, direct and indirect impacts resulting from these changes are likely to further entrench this health and well-being disparity. This paper argues that it is time to explicitly draw on Indigenous definitions of health, which directly address the need to connect individual and community health to the health of their country, in order to develop effective climate adaptation and health strategies. We detail how current health policies overlook this ‘missing’ dimension of Indigenous connection to country, and why that is likely to be detrimental to the health and well-being of people living in remote communities in a climate-changed future.     

Ethnic Differences in the Quality of the Interview Process and Implications for Survey Analysis: The Case of Indigenous Australians

Comparable survey data on Indigenous and non-Indigenous Australians are highly sought after by policymakers to inform policies aimed at closing ethnic socio-economic gaps. However, collection of such data is compromised by group differences in socio-economic status and cultural norms. We use data from the Household, Income and Labour Dynamics in Australia Survey and multiple-membership multilevel regression models that allow for individual and interviewer effects to examine differences between Indigenous and non-Indigenous Australians in approximate measures of the quality of the interview process. We find that there are both direct and indirect ethnic effects on different dimensions of interview process quality, with Indigenous Australians faring worse than non-Indigenous Australians in all outcomes ceteris paribus . This indicates that nationwide surveys must feature interview protocols that are sensitive to the needs and culture of Indigenous respondents to improve the quality of the survey information gathered from this subpopulation.     

The Contribution of Geography to Disparities in Preventable Hospitalisations between Indigenous and Non-Indigenous Australians

Objectives

To quantify the independent roles of geography and Indigenous status in explaining disparities in Potentially Preventable Hospital (PPH) admissions between Indigenous and non-Indigenous Australians.

Design, setting and participants

Analysis of linked hospital admission data for New South Wales (NSW), Australia, for the period July 1 2003 to June 30 2008.

Main outcome measures

Age-standardised admission rates, and rate ratios adjusted for age, sex and Statistical Local Area (SLA) of residence using multilevel models.

Results

PPH diagnoses accounted for 987,604 admissions in NSW over the study period, of which 3.7% were for Indigenous people. The age-standardised PPH admission rate was 76.5 and 27.3 per 1,000 for Indigenous and non-Indigenous people respectively. PPH admission rates in Indigenous people were 2.16 times higher than in non-Indigenous people of the same age group and sex who lived in the same SLA. The largest disparities in PPH admission rates were seen for diabetes complications, chronic obstructive pulmonary disease and rheumatic heart disease. Both rates of PPH admission in Indigenous people, and the disparity in rates between Indigenous than non-Indigenous people, varied significantly by SLA, with greater disparities seen in regional and remote areas than in major cities.

Conclusions

Higher rates of PPH admission among Indigenous people are not simply a function of their greater likelihood of living in rural and remote areas. The very considerable geographic variation in the disparity in rates of PPH admission between Indigenous and non-Indigenous people indicates that there is potential to reduce unwarranted variation by characterising outlying areas which contribute the most to this disparity.     

Collaborative research partnerships inform monitoring and management of aquatic ecosystems by Indigenous rangers

Aquatic ecosystems are critical to the long-term viability and vibrancy of communities and economies across northern Australia. In a region that supports significant cultural and ecological water values, partnerships between Indigenous and non-Indigenous stakeholders can benefit aquatic ecosystem management. We present, as a case study from the Kimberley region of Western Australia, a collaborative research program that successfully documented Indigenous and Western Scientific knowledge of remote wetlands, using a variety of field-based activities, questionnaires, interviews and workshops. The sharing of knowledge between Indigenous and non-Indigenous research partners facilitated a comprehensive understanding of ecosystem values, threats, processes, management priorities and aspirations. These formed the basis of a management plan and monitoring tools, designed to build the capacity of an Indigenous ranger group to engage in research, monitoring and management of wetlands. The project provides a useful example of the benefits of collaborations in the context of remote-area management where local communities are responsible for environmental management and monitoring, such as is the case in northern Australia and presumably other areas of the world.     

Building International Indigenous People’s Partnerships for Community-Driven Health Initiatives

In this article we present an international Indigenous people’s partnership project co-led by two Indigenous communities, Musqueam (Coast Salish, Canada) and Totoras (Quichua, Ecuador), as a community-driven health initiative. The Musqueam-Totoras partnership includes Indigenous organizations, universities, international agencies, government, and nongovernmental organizations to address Indigenous health concerns in both communities. Our collaborative approach provides a framework to (a) increase the development expertise of Indigenous people internationally, (b) increase skills among all participants, and (c) facilitate Indigenous knowledge mobilization and translation to promote cultural continuity. This international Indigenous people’s partnership between north and south reflects the diversity and commonalities of Indigenous knowledge, contributes to cultural revitalization, and minimizes the impact of assimilation, technology, and globalization. Indigenous people’s partnerships contribute to self-determination, which is a prerequisite to the building and maintenance of healthy communities and the promotion of social justice. The exchange of Indigenous knowledge upholds Indigenous values of respect, reciprocity, relevance, and responsibility. Given the history of colonization and the negligence of governments in the exercising of these values with respect to Indigenous communities, this contemporary exchange among Indigenous people in the Americas serves to reclaim these values and practices. International cooperation empowering Indigenous people and other marginalized groups has become fundamental for their advancement and participation in globalized economies. An international Indigenous people’s partnership provides opportunities for sharing cultural, historical, social, environmental, and economic factors impacting Indigenous health. These partnerships also create beneficial learning experiences in community-based participatory research and community-driven health initiatives, provide culturally sensitive research ethics frameworks, increase capacity building, and address basic human needs identified by participating communities.     

Indigenous Cultural and Natural Resources Management and Mobility in Arnhem Land,Northern Australia

Many programmes formally engage Australian Indigenous people in land and sea management to provide environmental services. There are also many Indigenous people who ‘look after country’ without rewards or payment because of cultural obligations. We investigated how Indigenous peoples’ mobility in and around two communities (Maningrida and Ngukurr) is affected by their formal or informal engagement in cultural and natural resource management (CNRM). Understanding factors that influence peoples’ mobility is important if essential services are to be provided to communities efficiently. We found that those providing formal CNRM were significantly less likely to stay away from settlements than those ‘looking after their country’ without payment or reward. Paying Indigenous people to engage with markets for CNRM through carbon farming or payments for environmental services (PES) schemes may alter traditional activities and reduce mobility, particularly movements away from communities that extend the time spent overnight on country. This could have both environmental and social consequences that could be managed through greater opportunities for people to engage in formal CNRM while living away from communities and greater recognition of the centrality of culture to all Indigenous CNRM, formal or otherwise.     

Quantifying the changes in survival inequality for Indigenous people diagnosed with cancer in Queensland,Australia

The survival inequality faced by Indigenous Australians after a cancer diagnosis is well documented; what is less understood is whether this inequality has changed over time and what this means in terms of the impact a cancer diagnosis has on Indigenous people. Survival information for all patients identified as either Indigenous (n = 3168) or non-Indigenous (n = 211,615) and diagnosed in Queensland between 1997 and 2012 were obtained from the Queensland Cancer Registry, with mortality followed up to 31st December, 2013. Flexible parametric survival models were used to quantify changes in the cause-specific survival inequalities and the number of lives that might be saved if these inequalities were removed. Among Indigenous cancer patients, the 5-year cause-specific survival (adjusted by age, sex and broad cancer type) increased from 52.9% in 1997–2006 to 58.6% in 2007–2012, while it improved from 61.0% to 64.9% among non-Indigenous patients. This meant that the adjusted 5-year comparative survival ratio (Indigenous: non-Indigenous) increased from 0.87 [0.83–0.88] to 0.89 [0.87–0.93], with similar improvements in the 1-year comparative survival. Using a simulated cohort corresponding to the number and age-distribution of Indigenous people diagnosed with cancer in Queensland each year (n = 300), based on the 1997–2006 cohort mortality rates, 35 of the 170 deaths due to cancer (21%) expected within five years of diagnosis were due to the Indigenous: non-Indigenous survival inequality. This percentage was similar when applying 2007–2012 cohort mortality rates (19%; 27 out of 140 deaths). Indigenous people diagnosed with cancer still face a poorer survival outlook than their non-Indigenous counterparts, particularly in the first year after diagnosis. The improving survival outcomes among both Indigenous and non-Indigenous cancer patients, and the decreasing absolute impact of the Indigenous survival disadvantage, should provide increased motivation to continue and enhance current strategies to further reduce the impact of the survival inequalities faced by Indigenous people diagnosed with cancer.     

Early Life Predictors of Increased Body Mass Index among Indigenous Australian Children

Aboriginal and Torres Strait Islander Australians are more likely than non-Indigenous Australians to be obese and experience chronic disease in adulthood—conditions linked to being overweight in childhood. Birthweight and prenatal exposures are associated with increased Body Mass Index (BMI) in other populations, but the relationship is unclear for Indigenous children. The Longitudinal Study of Indigenous Children is an ongoing cohort study of up to 1,759 children across Australia. We used a multilevel model to examine the association between children’s birthweight and BMI z-score in 2011, at age 3-9 years, adjusted for sociodemographic and maternal factors. Complete data were available for 682 of the 1,264 children participating in the 2011 survey; we repeated the analyses in the full sample with BMI recorded (n=1,152) after multilevel multiple imputation. One in ten children were born large for gestational age, and 17% were born small for gestational age. Increasing birthweight predicted increasing BMI; a 1-unit increase in birthweight z-score was associated with a 0.22-unit (95% CI:0.13, 0.31) increase in childhood BMI z-score. Maternal smoking during pregnancy was associated with a significant increase (0.25; 95% CI:0.05, 0.45) in BMI z-score. The multiple imputation analysis indicated that our findings were not distorted by biases in the missing data. High birthweight may be a risk indicator for overweight and obesity among Indigenous children. National targets to reduce the incidence of low birthweight which measure progress by an increase in the population’s average birthweight may be ignoring a significant health risk; both ends of the spectrum must be considered. Interventions to improve maternal health during pregnancy are the first step to decreasing the prevalence of high BMI among the next generation of Indigenous children.     

Long-distance travel for birthing among Indigenous and non-Indigenous pregnant people in Canada

BACKGROUND:For Indigenous Peoples in Canada, birthing on or near traditional territories in the presence of family and community is of foundational cultural and social importance. We aimed to evaluate the association between Indigenous identity and distance travelled for birth in Canada.METHODS:We obtained data from the Maternity Experiences Survey, a national population-based sample of new Canadian people aged 15 years or older who gave birth (defined as mothers) and were interviewed in 2006–2007. We compared Indigenous with non-Indigenous Canadian-born mothers and adjusted for geographic and sociodemographic factors and medical complications of pregnancy using multivariable logistic regression. We categorized the primary outcome, distance travelled for birth, as 0 to 49, 50 to 199 or 200 km or more.RESULTS:We included 3100 mothers living in rural or small urban areas, weighted to represent 31 100 (1800 Indigenous and 29 300 non-Indigenous Canadian-born mothers). We found that travelling 200 km or more for birth was more common among Indigenous compared with non-Indigenous mothers (9.8% v. 2.0%, odds ratio [OR] 5.45, 95% confidence interval [CI] 3.52–8.48). In adjusted analyses, the association between Indigenous identity and travelling more than 200 km for birth was even stronger (adjusted OR 16.44, 95% CI 8.07–33.50) in rural regions; however, this was not observed in small urban regions (adjusted OR 1.04, 95% CI 0.37–2.91).INTERPRETATION:Indigenous people in Canada experience striking inequities in access to birth close to home compared with non-Indigenous people, primarily in rural areas and independently of medical complications of pregnancy. This suggests inequities are rooted in the geographic distribution of and proximal access to birthing facilities and providers for Indigenous people.

Access to birth close to home, surrounded by loved ones, is taken for granted by most Canadians. The societal importance of family support during birthing has been highlighted during the severe acute respiratory syndrome and COVID-19 pandemics, despite the known and potentially fatal risks to hospital visitors, because people in labour have been one of the few patient groups exempt from visitor restrictions.^1,2 For residents living in rural areas of Canada, long-distance travel for birth is a reality that is becoming increasingly common in some regions because of closures of obstetrical services in smaller community hospitals.³ This is only partially mitigated by the revitalization of rural midwifery practice.^4,5Emerging evidence shows that the frequency of adverse medical events during labour and delivery for rural populations is similar for births that take place close to home and births for which people travel because of an absence of services close to home.^3,4,6 Less is known about the impacts of travel for birth on breastfeeding rates, maternal mental health and family functioning. Several studies have documented the negative impacts of birthing away from home with respect to maternal satisfaction and birth experience.^7–10 This evidence is particularly compelling for Indigenous populations for whom birthing on or near traditional territories in the presence of family and community is a long-standing practice of foundational cultural and social importance that contributes to well-being, cultural continuity and kinship.^7–12The striking isolation, family disruption and racism experienced by Indigenous people who are forced to travel alone for birth as a result of externally imposed federal “evacuation for birth” policies¹¹ has been met with a series of policy initiatives to support return of birth to rural and remote Indigenous communities. ^13–15 In April 2017, then federal Minister of Health Dr. Jane Philpott, committed to “a path to be able to return the cries of birth” to Indigenous communities and funding to support travel for a companion when Indigenous people living in rural and remote areas needed to travel away from home for birth.¹⁶ Before 2017, Indigenous pregnant people often travelled and birthed away from home alone without family or community support, because escorts were not deemed medically necessary. Although these initiatives have improved access to Indigenous perinatal programming and Indigenous birth attendant support in some local areas, over the past decade there has not been any substantial expansion of Indigenous birthing facilities outside of urban centres in Canada and at least 1 remote Indigenous birthing facility has closed.¹⁷Given this dynamic policy context, the national scope and Indigenous identifiers in the Canadian Maternity Experiences Survey (MES) provides a unique opportunity to quantify how often Indigenous and non-Indigenous people are travelling away from home for birth and to evaluate the association between Indigenous and non-Indigenous identity and distance travelled for birth in Canada.     

Anti-chikungunya virus seroprevalence in Indigenous groups in the São Francisco Valley,Brazil

BackgroundChikungunya fever (CHIKF) is a serious public health problem with a high rate of infection and chronic disabling manifestations that has affected more than 2 million people worldwide since 2005. In spite of this, epidemiological data on vulnerable groups such as Indigenous people are scarce, making it difficult to implement public policies in order to prevent this disease and assist these populations.ObjectiveTo describe the serological and epidemiological profile of chikungunya virus (CHIKV) in two Indigenous populations in Northeast Brazil, as well as in an urbanized control community, and to explore associations between CHIKV and anthropometric variables in these populations.Methodology/Principal findingsThis is a cross-sectional ancillary study of the Project of Atherosclerosis among Indigenous Populations (PAI) that included people 30 to 70 years old, recruited from two Indigenous tribes (the less urbanized Fulni-ô and the more urbanized Truká people) and an urbanized non-Indigenous control group from the same area. Subjects underwent clinical evaluation and were tested for anti-CHIKV IgG by enzyme-linked immunosorbent assay. Serological profile was described according to ethnicity, sex, and age. The study population included 433 individuals distributed as follows: 109 (25·2%) Truká, 272 (62·8%) Fulni-ô, and 52 (12%) from the non-Indigenous urbanized control group. Overall prevalence of CHIKV IgG in the study sample was 49.9% (216; 95% CI: 45·1–54·7). When the sample was stratified, positive CHIKV IgG was distributed as follows: no individuals in the Truká group, 78·3% (213/272; 95% CI: 72·9–83·1) in the Fulni-ô group, and 5.8% (3/52; 95% CI: 1.21–16) in the control group.Conclusions/SignificancePositive tests for CHIKV showed a very high prevalence in a traditional Indigenous population, in contrast to the absence of anti-CHIKV serology in the Truká people, who are more urbanized with respect to physical landscape, socio-cultural, and historical aspects, as well as a low prevalence in the non-Indigenous control group, although all groups are located in the same area.     

Reconciliation and Australian Indigenous Health in the 1990s: A Failure of Public Policy

In 1991, the Australian Commonwealth Parliament unanimously passed the Council for Aboriginal Reconciliation Act 1991. This Act implemented a 10-year process that aimed to reconcile Indigenous and non-Indigenous people by the end of 2000. One of the highest priorities of the reconciliation process was to address Indigenous socio-economic disadvantage, including health, education and housing. However, despite this prioritising, both the Keating Government (1991–1996) and the Howard Government (1996–2000) failed to substantially improve socio-economic outcomes for Indigenous people over the reconciliation decade. In this paper, I examine one of the most prominent socio-economic areas, that of Indigenous health. First, I discuss the appalling levels of Indigenous health throughout the reconciliation decade by analysing a number of health indicators, including life expectancy, infant mortality rate, standard mortality ratios, hospital rates and health Infrastructure. This analysis reveals significant and often worsening disadvantage in these health indicators. Second, I analyse a number of policies and programs concerning Indigenous socio-economic disadvantage that were developed by Commonwealth Governments in the 1990s. I argue that these policies and programs largely failed to address Indigenous socio-economic disadvantage. I also discuss alternative policies and programs that could reduce the significant levels of socio-economic disadvantage suffered by Indigenous people.     

Indigenous Research: A Commitment to Walking the Talk. The Gudaga Study—an Australian Case Study

Increasingly, the role of health research in improving the discrepancies in health outcomes between Indigenous and non-Indigenous populations in developed countries is being recognised. Along with this comes the recognition that health research must be conducted in a manner that is culturally appropriate and ethically sound. Two key documents have been produced in Australia, known as The Road Map and The Guidelines, to provide theoretical and philosophical direction to the ethics of Indigenous health research. These documents identify research themes considered critical to improving the health of the nation’s Indigenous peoples. They also provide values that, from an Indigenous perspective, are foundational to an ethical research process. This paper examines these research themes and values within the context of a current longitudinal birth cohort study of Indigenous infants and children in south-west Sydney: the Gudaga Study. Considerable time and effort have been invested in being true to the values stated in these documents: reciprocity; respect; equality; responsibility; survival and protection; and spirit and integrity. We have learnt that it is vital to be true to these values when conducting Indigenous health research—to quite literally “walk the talk”.     

The use of mortality data in setting priorities for disease prevention

The examination of specific disease mortality by five-year age groups helps identify health problems as problems of people and how they live. Traditional methods of examining data in broad classifications tend to obscure etiological factors and the importance of behaviour. Violence, a major cause of death in young adults, gives way to so-called diseases of indulgence in middle age, especially among men who have a much higher death rate than women. Male life expectancy at age 40 has increased only marginally in the past 40 years. Health-related human behaviour must be considered within an ecological framework since social, cultural and physical environmental differences as well as personal factors influence life-style. The responsibility for prevention rests more with the individual and society at large than with health workers. Probability tables, Health Hazard Appraisal (a system of personal risk assessment) and personal counselling can reinforce healthful life-styles and help correct hazardous ones.     

Understanding the conservation challenges and needs of culturally significant plant species through Indigenous Knowledge and species distribution models

Indigenous People in the Klamath River Basin have cared for and utilized ecosystems and component resources since time immemorial, proactively conserving species through continuous use and stewardship. Though many culturally significant plants are still tended and used by Indigenous people, many species are also experiencing prolonged stress from colonial forest management practices and environmental change. By integrating western and Indigenous ways of knowing, as part of a participatory and collaborative research and extension project, we present an approach to informing the conservation of four culturally significant plants (tanoak, evergreen huckleberry, beargrass, and iris) and understanding the influence of bioclimatic factors and stress on Indigenous people’s relationships with plants and the broader forest ecosystem. Mixed methods and ways of knowing generate a detailed assessment of each case study species that presence only species distribution models cannot supply alone. In this study we use MAXENT to model species distributions of our four study species and the flexible coding method in NVivo for qualitative interview and focus group data. Using species distribution models and 127 interviews and focus groups with cultural practitioners, we found significant shifts in huckleberry harvesting times, beargrass and iris cultural use quality, and tanoak acorn availability that must be addressed for the long-term vitality of these species and interconnected cultures and people. Tribes have generations of knowledge, experience, and connection to land that can help inform how to combat stressors and enhance productivity of forest foods and fibers and the health of forest ecosystems.     

What’s at stake? Determining indigeneity in the era of DIY DNA

Social scientists have found that direct-to-consumer genetic ancestry testing can increase the influence of genetic notions of identity, but has a varying effect on test takers depending on the individual, social and political context. This paper considers the potential effects of genetic ancestry testing on the Indigenous peoples of Australia. We first review the effects of genetic ancestry testing in different populations, particularly Native Americans. We then draw on a comparative analysis of indigenous political structures in the United States and Australia in order to assess the likely impact of genetic ancestry testing in Australia in the coming years. The most salient point of difference is Australia’s relatively broader definition of Indigenous status. Due to this difference, genetic ancestry testing is likely to have minimal social impact among those who already identify as Indigenous, but may significantly impact those who discover genetic ancestry and do not yet identify as Indigenous.     

Cervical Abnormalities Are More Common among Indigenous than Other Australian Women: A Retrospective Record-Linkage Study, 2000–2011

Indigenous Australian women have much higher incidence of cervical cancer compared to non-Indigenous women. Despite an organised cervical screening program introduced 25 years ago, a paucity of Indigenous-identified data in Pap Smear Registers remains. Prevalence of cervical abnormalities detected among the screened Indigenous population has not previously been reported. We conducted a retrospective cohort study of population-based linked health records for 1,334,795 female Queensland residents aged 20–69 years who had one or more Pap smears during 2000–2011; from linked hospital records 23,483 were identified as Indigenous. Prevalence was calculated separately for Indigenous and non-Indigenous women, for cytology-detected low-grade (cLGA) and high-grade abnormalities (cHGA), and histologically confirmed high-grade abnormalities (hHGA). Odds ratios (OR) were estimated from logistic regression analysis. In 2010–2011 the prevalence of hHGA among Indigenous women (16.6 per 1000 women screened, 95% confidence interval [CI] 14.6–18.9) was twice that of non-Indigenous women (7.5 per 1000 women screened, CI 7.3–7.7). Adjusted for age, area-level disadvantage and place of residence, Indigenous women had higher prevalence of cLGA (OR 1.4, CI 1.3–1.4), cHGA (OR 2.2, CI 2.1–2.3) and hHGA (OR 2.0, CI 1.9–2.1). Our findings show that Indigenous women recorded on the Pap Smear Register have much higher prevalence for cLGA, cHGA and hHGA compared to non-Indigenous women. The renewed cervical screening program, to be implemented in 2017, offers opportunities to reduce the burden of abnormalities and invasive cancer among Indigenous women and address long-standing data deficiencies.     

Mepimbat tedul proujek: Indigenous knowledge of culturally significant freshwater turtles addresses species knowledge gaps in Northern Australia

Indigenous biocultural knowledge offers valuable insights for species conservation; however, like biological diversity, associated cultural knowledge is also often threatened. This paper demonstrates how Indigenous biocultural knowledge of species can contribute to addressing gaps in species occurrence data and conservation knowledge using a case study from the South East Arnhem Land Indigenous Protected Area (SEAL IPA), northern Australia. Using a series of mapping workshops and interviews this collaborative project recorded Indigenous biocultural knowledge of the distribution, ecology, cultural significance and threats to freshwater turtles (freshwoda teduls in the local Indigenous language, Roper River Kriol). Based on past freshwoda tedul hunting experiences, 74 Indigenous knowledge holders identified 753 past freshwoda tedul occurrences, significantly adding to the 12 occurrences previously listed for the SEAL IPA in Australia's online species database, the Atlas of Living Australia. Importantly, these were the first ‘memory’ records of past species sightings by Indigenous people to be recognized and added to Australia's national species database. In addition, a blog summarizing this research was promoted through the Atlas of Living Australia, raising awareness of the Indigenous biocultural knowledge associated with these species. The Mepimbat tedul proujek revealed the cultural significance of freshwoda teduls and reported declines in abundance since the turn of the century, implicating invasive hard-hooved ungulates (buffalo, pig) and reduced rainfall. The addition of non-sacred Indigenous knowledge to free online species databases may offer innovative solutions for storage, interaction and sharing of indigenous knowledge, with opportunities for intergenerational and cross-cultural learning and broader application in conservation management and decision-making.