Acupuncture Outreach to Aboriginal Women
Lisa Holden describes her experience providing an acupuncture service to Aboriginal women in a community health centre in South West Sydney.
It is well known in Australia that Aboriginal and Torres Strait Islander Australians have worse health outcomes than non-first nation Australians. They are overrepresented in all measures of chronic disease. This article describes my experience treating Aboriginal women at a monthly clinic in South Western Sydney and includes my own clinical impressions.
Liverpool Women’s Health Centre (LWHC) is a non-government organisation that receives funding from NSW Health. It operates from a feminist perspective, with an understanding of a gendered approach to health. Acupuncture has been offered to disadvantaged women at LWHC for many years. It was observed that acupuncture at LWHC was becoming increasingly popular amongst Aboriginal women.
On the initiative of LWHCs Aboriginal health promotion, education and access worker, a monthly acupuncture outreach service began at a local Aboriginal community health centre in 2019. This acupuncture clinic is offered free of charge to the Aboriginal women who attend.
It is essential that health services be affordable and accessible to Aboriginal people. Demand for acupuncture at the community health centre has been consistently high. It is fully booked well in advance each month and boasts high attendance rates; every available appointment has been taken since inception of the clinic. The Liverpool women’s health centre Aboriginal health promotion, education and access worker takes personal responsibility for the appointment bookings to ensure access and equity. She also attends each appointment to assist with cultural aspects of the care provided.
While women attend with a range of issues including but not limited to kidney disease, chronic pain, diabetic neuropathy, substance use issues, grief and loss and high stress levels, a common and usually undisclosed issue affects all of them, Intergenerational Trauma.
From a clinical perspective acupuncture can assist people who are affected by trauma including intergenerational trauma. Clinical observation has determined that auriculotherapy has an integral part to play in the treatment of people experiencing trauma and its effects. Nogier’s auriculotherapy and use of the Vascular Autonomic Signal (VAS) doesn’t require the in depth history taking of Traditional Chinese Medicine but can simply and easily be incorporated into a TCM treatment. Use of the VAS determines which ear points and the exact location to be needled. Only points on the ear that correlate to a site of disharmony will be ‘VAS active’ and benefit from needling. Consistencies in the ‘active’ points amongst Aboriginal women at the community health centre indicate past trauma even when it is not reported by the patient. This trauma is intergenerational and often compounded by trauma experienced by the woman herself.
Intergenerational trauma is well recognised. It is a cycle of trauma that affects families and communities and its impact is passed from one generation to the next. It must be addressed in any strategy that aims to improve health outcomes for Aboriginal people.
My clinical experience indicates intergenerational trauma differs from the type of trauma that appears to cause Post Traumatic Stress Disorder (PTSD) in that it is passed from parents in the Jing. It is perhaps less recognised than PTSD by those experiencing it though they certainly experience and recognise the effects of it. Anecdotally, acupuncture, particularly Nogier’s auriculotherapy appears to assist Aboriginal women well beyond the usual improvements in their presenting complaints; it supports them managing the effects of intergenerational trauma.
All patients respond to acupuncture differently and this response can be seen to be on a continuum. Some patients respond to acupuncture, as with all health interventions better than others respond to the same (or similar) intervention. My experience is that Aboriginal people respond to acupuncture on the upper end of that continuum. It is rare that an Aboriginal person comments that the effect of an acupuncture treatment is less than excellent. While I recognise this could be coincidence, it appears consistent over time and range of people of different ages and presentations. In terminology generally used and understood by Aboriginal people, I have developed the opinion that Aboriginal people are closer to ‘spirit’ than some of their non-Aboriginal counterparts therefore, perhaps more responsive to the energetic and non-tangible aspects of an acupuncture treatment.
I believe acupuncture has part to play in a targeted, needs based health care that is responsive to the needs of Aboriginal people. It should be accessible and freely available to Aboriginal people should they wish to access it. The intangible, difficult to measure aspects of acupuncture have the potential to assist Aboriginal people manage the trauma that pervades their communities.
At the time of writing Lisa Holden had been the acupuncturist at Liverpool Women’s Health Centre for 10 years, was supervising undergraduate students at the uniclinic of Western Sydney University, contracting to the Cancer Wellness Centre at Liverpool Hospital and had her own busy practice at Bella Vista and Winmalee.