You work in education at a needle and syringe program in the inner city. Marie, a young Indigenous girl is visiting from a rural town and is looking for her sister. She is anxious to find her as she has some speed already mixed up in a syringe to share with her. You offer to supply her with a pack of clean syringes. She refuses saying ‘no, it’s all right we always share everything’. One of your fellow workers says to you ‘don’t bother following that one up, it’s a cultural thing’. What do you do?
Issues for discussion
- Discuss what kinds of cultural factors influence Marie?
- Remind participants that Indigenous people may identify with and practice ‘traditional’ protocols or cultural expressions regardless of their regional area, appearance or diversity of experiences.
Client issues
- Discuss options of Marie working with an Indigenous health worker in the area and/or establishing a community link with these services
- How can you address hep C education (understanding sharing is a positive cultural value) while being respectful to the way in which Marie expresses her relationship with her sister?
- Language can be a useful tool. Instead of forming negative associations around ‘sharing’, talk about looking after each other utilising positive cultural values, while emphasising not ‘mixing’ items with blood products
- Confidentiality issues within Indigenous communities can concern some IDUs, always gain informed consent to network with agencies.
Organisational issues
- Discuss the fellow worker’s response of ‘not following up’ a health issue due to the person being Indigenous and its implications
- Perhaps in-house training from an Indigenous organisation in the area would be suited to the organisation to make workers feel more confident in understanding and addressing cultural issues
- Can the organisation facilitate a peer education program?
- Discuss strategies for employing an Indigenous worker in the organisation if an Indigenous worker(s) are not already in place.