Do no harm: decolonising Aboriginal health research

Abstract

This thesis addresses the question: Why has health research not improved Aboriginal health? Exploring this question from an Indigenous perspective required the development of a methodological approach that I personally undertook as a journey, as both a participant and researcher. This methodology was informed by a decolonisation framework, used Indigenous critical theory and required the balancing of two ways of knowing, to grow a new approach to Indigenous health research. It was initiated and guided by Aboriginal Elders. The thesis critiques the historical, political, social and current context of Indigenous health and well-being in relation to the Western dominance of knowledge production and ongoing colonisation in Aboriginal health research. Positivistic methods used in health research are interrogated in relation to their lack of contextualisation of the objects (Aboriginal persons) studied. A major focus of this study is the problematic constructions of Aboriginal people as a colonial strategy linked to the Invasion doctrine of terra nullius. The replication of this colonial strategy within the Aboriginal health research discourse since the 1870s through to the present and the impact these representations have had and continue to have on Indigenous Australians is examined. The building and maintenance of the institution of the Western Aboriginal health ‗expert‘ is deconstructed in the light of Edward Said‘s Orientalism and Michel Foucault‘s discourses on the power of Western knowledge production. Fieldwork was undertaken in Alice Springs, Northern Territory, where I interviewed participants involved in Indigenous health research. Their stories and my own story in relation to research practices exemplify the maintenance of Western knowledge production problematising Indigenous peoples and treating them as the ‗Other‘. The consequences of such practice are injury; unethical practice; silencing of Indigenous voices and views; subjugating of Indigenous knowledges and solutions; and production of invalid data that lead to further injury and poor health status. The findings show a way forward, modelled through Indigenous research methods, with ethics and respect at the core of these approaches. The thesis builds an evidence-based argument that decolonisation is critical to improving the health outcomes of Indigenous people through Indigenous informed health research.