Diabetes Care from an Australian First Nation Perspective – by Chris Lee

Much of this is based on my own journey and in observations and conversations with family, friends, and First Nations people I’ve encountered in my professional, personal and cultural lives. I was diagnosed with type 2 diabetes back in 2014, and it’s been a difficult journey to discover what my condition was, what it was doing to my body, and how I can manage it better.

I was brought up in a family of 14 living in a 4-bedroom housing commission house in Darwin on the outskirts of the Aboriginal camp in Bagot. I grew up amidst the struggle of feeding, clothing and schooling such a tribe, and I started my career as a storyteller soon after leaving high school when I took up a traineeship at the Central Australian Aboriginal Media Association (CAAMA) in Alice Springs. I was immersed in a world of Centralian First Nations languages, people, cultural protocols, and LORE. 

Chris on the road to Pupanya in Central Australia

I was fortunate to live and work on the Pitajantjatjarra homelands in the community of Ernabella (Pukatja) working at Ernabella Video and Television (EVTV) in a language only workplace where the Aunties ruled, and everyone did what they told us to do. This was a period of intense cultural immersion and learning cultural lessons: After stints of teaching remote media students at Batchelor College and setting up the national body, I entered the criminal justice system as a youth worker at the Brisbane Youth Detention Centre. So many young, lost, mainly First Nations souls. I moved to the adult system first as a Custodial Correctional Officer and then returned as a Cultural Liaison Officer. Much of my time working the adult system was explaining documents, rules and encouraging the First Nations boys to get educated to break the cycle of offending. 

Many experienced trauma, were illiterate, and suffered from substance abuse (inhalants were the biggie at that time) and from abusive and broken homes. Life on the streets felt safe, and it was where they found a sense of family and camaraderie through other street kids. Crime seemed like almost a natural progression after dealing with food and housing insecurities and dulling childhood trauma through a substance habit, so these adolescents rotated through the juvenile justice system until they graduated to the adult system to join other incarcerated family.

I worked with a trauma-informed legal, therapeutic, and cultural support service on the Royal Commission into Institutional Responses to Child Sexual Abuse as the Queensland and Northern Territory First Nations engagement manager. I led First Nations community engagement and established a culturally safe space for First Nations survivors to give evidence to the Royal Commission. It was an absolutely traumatizing time for all involved. Throughout these positions, my main role was to digest then translate difficult and sensitive information and raise it in consultation with survivors, offenders, and suspicious clients in a way that engages them in the conversations. 

This was such an important foundation to where I’m at today.

My lived experience is the basis of my role at Diabetes Australia, where, as I said in a 2020 interview with the Melbourne School of Population and Global Health, I work to “provide an Aboriginal and Torres Strait Islander cultural lens on our range of projects, resources and policies which seek to reduce the terrible burden and impact of diabetes in Aboriginal and Torres Strait Islander people and communities.” There are many well-articulated reports and directives out there which outline many ways to provide culturally competent care by making small changes to accommodate cultural differences and be more culturally responsive. The Indigenous Allied Health Association (www.iaha.com.au) has published a fantastic report titled ‘Cultural Responsiveness in Action; An IAHA Framework’ which is incredibly informative. 

I believe it’s critical to provide the non-First Nations reader, clinician, or health professional with some understanding of the First Nations patient perspectives, in addition to offering some small changes to clinical practice which may improve the clinical experience for First Nations people and encourage greater participation in the journey. A wide range of obstacles get in the way of effective First Nations participation in the clinical experience, and it’s my goal to use my own journey to educate and empower Aboriginal and Torres Strait Islander people as well as clinicians to build stronger connections around diabetes management.