Journal articles on the topic 'Aboriginal community-controlled health services (ACCHSs) movement'

Objective Aboriginal Community-Controlled Health Services (ACCHSs) deliver comprehensive, culturally appropriate primary health care to Aboriginal people and communities. The published literature acknowledging and supporting the roles of ACCHSs in improving Aboriginal health is limited. This paper seeks to collate and analyse the published evidence supporting the contribution of ACCHSs to improving the health of Aboriginal people. Methods A conceptual framework for exploring the contribution of ACCHSs was developed, drawing on the literature on the core functions of ACCHSs and the components of quality primary health care. This framework was used to structure the search strategy, inclusion criteria and analysis of the review. Results ACCHSs contribute to improving the health and well being of Aboriginal peoples through several pathways, including community controlled governance, providing employment and training, strengthening the broader health system and providing accessible, comprehensive primary health care. Conclusions ACCHSs make a range of important contributions to improving the health of Aboriginal peoples that are under-acknowledged. Consideration of the different ways ACCHSs contribute to improving Aboriginal health is of value in the design and evaluation of programs and policies that aim to improve the health of Aboriginal peoples. What is known about the topic? Aboriginal communities have long argued the vital role of ACCHSs in improving Aboriginal health. What does this paper add? This paper provides a comprehensive collation and analysis of the evidence supporting the contributions ACCHSs are making to improving Aboriginal health. What are the implications for practitioners? The conceptual framework and findings outlined in this paper illustrate that ACCHSs are making important contributions to improving Aboriginal health through several pathways. This information can be used to ensure actions to improve Aboriginal health are appropriate and effective. There are important gaps in the literature that researchers need to address.

This paper reviews the advocacy role of Aboriginal community controlled health services (ACCHSs) in the development of Aboriginal health policy over the past 30 years, with a specific focus on the recent changes in Commonwealth funding and administrative responsibility - the transfer of Aboriginal health service funding from the Aboriginal and Torres Strait Islander Commission (ATSIC) to the Office of Aboriginal and Torres Strait Islander Health Services (OATSIHS) within the Commonwealth Department of Health and Ageing (DoHA), and the development of policies aimed at Aboriginal health services accessing mainstream (Medical Benefits Scheme [MBS]) funds. The outcomes of this policy change include a significant increase in funding to Aboriginal primary health care (PHC), the inclusion of ACCHSs in collaborative strategic relationships, and the development of new arrangements involving regional planning and access to per capita funds based on MBS equivalents. However, the community sector remains significantly disadvantaged in participating in this collaborative effort, and imposed bureaucratic processes have resulted in serious delays in releasing funds for actual services in communities. Government agencies need to take greater heed of community advocacy, and provide appropriate resourcing to enable community organisations to better direct government effort, especially at the implementation phase. These remain major concerns and should be considered by non-health sectors in the development of new funding and program development mechanisms in the wake of the abolition of ATSIC.

Aboriginal community controlled PHC services have led the way in Australia in developing a model of PHC service that is able to address social issues and the underlying determinants of health alongside high quality medical care. This model is characterised by a comprehensive style rather than the selective PHC model that tends to be more common in mainstream services. Central to comprehensive PHC is community control, which is critical to the bottom up approach rather than the top down approach of selective PHC. The expansion of Aboriginal Community Controlled Health Services (ACCHSs) in Australia is a product of the colonial relationship that persists between Aboriginal and non-Aboriginal Australia. It is this relationship that explains why community control has been a feature of Aboriginal PHC services while similar attempts in the dominant society have tended to be incorporated into the mainstream. The mechanisms of control occur through community processes and should not be confused with day to day management processes, although the two are related. The Core Functions of PHC is a framework that reflects the experience of ACCHSs and allows for the development and assessment of comprehensive PHC. This framework is applied to a case study of the Central Australian Aboriginal Congress (Congress) which is the major Aboriginal health service in central Australia. The case study illustrates increasing utilisation of PHC services by Aboriginal people, and the capacity of community controlled organisations to respond to demographic and health pattern changes in their client populations.

IntroductionIndigenous peoples who have experienced colonisation or oppression can have a higher prevalence of alcohol-related harms. In Australia, Aboriginal Community Controlled Health Services (ACCHSs) offer culturally accessible care to Aboriginal and Torres Strait Islander (Indigenous) peoples. However there are many competing health, socioeconomic and cultural client needs.Methods and analysisA randomised cluster wait-control trial will test the effectiveness of a model of tailored and collaborative support for ACCHSs in increasing use of alcohol screening (with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)) and of treatment provision (brief intervention, counselling or relapse prevention medicines).SettingTwenty-two ACCHSs across Australia.RandomisationServices will be stratified by remoteness, then randomised into two groups. Half receive support soon after the trial starts (intervention or ‘early support’); half receive support 2 years later (wait-control or ‘late support’).The supportCore support elements will be tailored to local needs and include: support to nominate two staff as champions for increasing alcohol care; a national training workshop and bimonthly teleconferences for service champions to share knowledge; onsite training, and bimonthly feedback on routinely collected data on screening and treatment provision.Outcomes and analysisPrimary outcome is use of screening using AUDIT-C as routinely recorded on practice software. Secondary outcomes are recording of brief intervention, counselling, relapse prevention medicines; and blood pressure, gamma glutamyltransferase and HbA1c. Multi-level logistic regression will be used to test the effectiveness of support.Ethics and disseminationEthical approval has been obtained from eight ethics committees: the Aboriginal Health and Medical Research Council of New South Wales (1217/16); Central Australian Human Research Ethics Committee (CA-17-2842); Northern Territory Department of Health and Menzies School of Health Research (2017-2737); Central Queensland Hospital and Health Service (17/QCQ/9); Far North Queensland (17/QCH/45-1143); Aboriginal Health Research Ethics Committee, South Australia (04-16-694); St Vincent’s Hospital (Melbourne) Human Research Ethics Committee (LRR 036/17); and Western Australian Aboriginal Health Ethics Committee (779).Trial registration numberACTRN12618001892202; Pre-results.

IntroductionAccess to high-quality primary healthcare is limited for remote residents in Australia. Increasingly, remote health services are reliant on short-term or ‘fly-in, fly-out/drive-in, drive-out’ health workforce to deliver primary healthcare. A key strategy to achieving health service access equity, particularly evident in remote Australia, has been the development of Aboriginal Community Controlled Health Services (ACCHSs). This study aims to generate new knowledge about (1) the impact of short-term staffing in remote and rural ACCHSs on Aboriginal and Torres Strait Islander communities; (2) the potential mitigating effect of community control; and (3) effective, context-specific evidence-based retention strategies.Methods and analysisThis paper describes a 3-year, mixed methods study involving 12 ACCHSs across three states. The methods are situated within an evidence-based programme logic framework for rural and remote primary healthcare services. Quantitative data will be used to describe staffing stability and turnover, with multiple regression analyses to determine associations between independent variables (population size, geographical remoteness, resident staff turnover and socioeconomic status) and dependent variables related to patient care, service cost, quality and effectiveness. Qualitative assessment will include interviews and focus groups with clinical staff, clinic users, regionally-based retrieval staff and representatives of jurisdictional peak bodies for the ACCHS sector, to understand the impact of short-term staff on quality and continuity of patient care, as well as satisfaction and acceptability of services.Ethics and disseminationThe study has ethics approval from the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (project number DR03171), Central Australian Human Research Ethics Committee (CA-19-3493), Western Australian Aboriginal Health Ethics Committee (WAAHEC-938) and Far North Queensland Human Research Ethics Committee (HREC/2019/QCH/56393). Results will be disseminated through peer-reviewed journals, the project steering committee and community/stakeholder engagement activities to be determined by each ACCHS.

The aim of the present paper was to explore how social networks enable dissemination of health information within two Aboriginal communities in New South Wales. The study design was modelled on a social network analysis socio-centric model. Data collection was conducted primarily by Aboriginal community members who were trained as community researchers. Participants reported on their patterns of interaction and who they provided or received health information from, and awareness of the Aboriginal Enhancement of the Get Healthy Information and Coaching Service. In total, 122 participants across two sites participated in the study. Aboriginal Community Controlled Health Services (ACCHSs) and Aboriginal Community Controlled Health Organisations (ACCHOs) were cited as the main provider of health information in both sites. Between-ness, degree and closeness centrality showed that certain community members, ACCHS and ACCHO within the two communities in the present study were considerable enablers [actors] in enhancing the reach and flow of health information to their respective Aboriginal community. There is potential for future health-promotion activities to be increasingly targeted and effective in terms of reach and influence, if guided by local Aboriginal organisations and by key Aboriginal community members within and across family networks and communities.

This article assesses the accessibility of mainstream mental health services (MMHSs) in two regions of New South Wales (NSW), Australia, based on experiences and perspectives of Aboriginal young people aged 16–25. Semi-structured yarning interviews were conducted with thirteen Aboriginal young people in two regions of NSW. Thematic analysis was undertaken by all research team members to identify major themes from the data and conceptual connections between them. The identified themes from individual analysis and coding were triangulated during several analysis meetings to finalise the key themes and findings. Aboriginal young people had no experience of engaging with early-intervention MMHSs. MMHSs were identified as inaccessible, with most participants unaware that MMHSs existed in each region. Due to MMHSs being inaccessible, many Aboriginal young people presented to emergency departments (EDs) during a crisis. Aboriginal Community Controlled Health Services (ACCHSs) were identified as key providers of accessible, culturally meaningful, and effective social and emotional wellbeing (SEWB) service support for Aboriginal young people in NSW. If health and wellbeing outcomes are to improve for Aboriginal young people in NSW, MMHSs must increase accessibility for Aboriginal young people requiring SEWB support.

Objective The aim of the present study was to assess the accuracy of extracting national key performance indicator (nKPI) data for the Online Community Health Reporting Environment for Health Services (OCHREStreams) program using the Pen Computer Systems (Leichhardt, NSW, Australia) Clinical Audit Tool (CAT) from Communicare (Telstra Health Communicare Systems, Perth, WA, Australia), a commonly used patient information management system (PIMS) in Aboriginal primary care. Methods Two Aboriginal Community-Controlled Health Services (ACCHSs) were recruited to the present study. A sample of regular clients aged ≥55 years from each ACCHS was selected and a subset of 13 nKPIs was examined. A manual case note audit of the nKPI subset within Communicare was undertaken by a clinician at each participating ACCHS and acted as a ‘gold standard’ comparator for three query methods: (1) internal Communicare nKPI reports; (2) PenCS CAT nKPI manual filtering (a third-party data-extraction tool); and (3) nKPI data submitted to the Improvement Foundation qiConnect portal. Results No errors were found in nKPI data extraction from Communicare using the CAT and subsequent submission to the qiConnect portal. However, the Communicare internal nKPI report included deceased clients and past patients, and we can be very confident that deceased clients and past patients are also included in the qiConnect portal data. This resulted in inflation of client denominators and an underestimation of health service performance, particularly for nKPIs recording activity in the past 6 months. Several minor errors were also detected in Communicare internal nKPI reports. Conclusions CAT accurately extracts a subset of nKPI data from Communicare. However, given the widespread use of Communicare in ACCHSs, the inclusion of deceased clients and past patients in the OCHREStreams nKPI data program is likely to have resulted in systematic under-reporting of health service performance nationally. What is known about the topic? There has been limited validation of health data exported via data-extraction tools in Australia. More specifically, there are no current published data describing the accuracy of the CAT in mapping health data extracted from Communicare or the accuracy of internal nKPI reports generated by Communicare. Further, no systematic review has been undertaken to assess the accuracy of the nKPI data submission pathway from PIMSs at the health service level to the OCHREStreams qiConnect portal using the CAT. What does this paper add? The CAT accurately extracts a subset of nKPI data from Communicare and accurately submits this to the qiConnect portal. Minor errors exist in some Communicare internal nKPI reports. The inclusion of deceased clients and past patients in the nKPI reporting system for ACCHSs is likely to have resulted in systematic under-reporting of health service performance nationally through this program. What are the implications for practitioners? The inclusion of deceased clients and past patients in the OCHREStreams nKPI program limits the usefulness of these data for local quality improvement activities and national monitoring of health service performance for participating ACCHSs. The use of the CAT by ACCHSs independently from the OCHREStreams program can enable deceased clients and past patients to be excluded from reports that can provide more accurate nKPI data from Communicare for local quality improvement and planning purposes.

IntroductionOur study aimed to identify factors that influence access to eye care and eye health outcomes for remote Indigenous Australians living with diabetes.MethodsIn collaboration with Indigenous Community-Based Researchers (CBR) and Aboriginal Community Controlled Health Services (ACCHS), a qualitative, participatory action research approach was taken, drawing on Indigenist and decolonising methodologies. The study was undertaken in four remote communities, in the Katherine region, Northern Territory and north-western New South Wales, Australia. Interviews and focus groups were undertaken with Indigenous adults aged ≥40 years living with diabetes (n=110), and primary care clinicians working in ACCHSs (n=37). A series of interviews with CBRs (n=13) were undertaken before and after data collection to add cultural insights and validation to participant accounts. Data were analysed inductively using grounded theory, in-depth discussion and NVivo V.11.ResultsMore than one-third of all patients had little to no knowledge of how diabetes affects eye health. Limited access to health information and interpreters, language barriers, distrust of health providers and services, and limited cultural responsivity among non-Indigenous clinicians, were identified as determining factors in eye health and care.DiscussionWe outline a need to address gaps in trust and communication, through increased access to and resourcing of Indigenous language interpreters and cultural brokers, understandable and culturally sensitive diabetic eye health information and cultural responsivity training for non-Indigenous clinicians. Centring Indigenous cultures in healthcare practice will enable a shared understanding between clinicians and Indigenous patients, and subsequently more equitable eye health outcomes.

Background To inform a sexual health quality improvement program we examined chlamydia and gonorrhoea testing rates among 15–29 year olds attending Aboriginal Community Controlled Health Services (ACCHS) in New South Wales, Australia, and factors associated with chlamydia and gonorrhoea testing. Methods: From 2009 to 2011, consultation and testing data were extracted from four ACCHS. Over the study period, we calculated the median number of consultations per person and interquartile range (IQR), the proportion attending (overall and annually), the proportion tested for chlamydia and gonorrhoea, and those who tested positive. We examined factors associated with chlamydia and gonorrhoea testing using logistic regression. Results: Overall, 2896 15–29-year-olds attended the ACCHSs, 1223 were male and 1673 were female. The median number of consultations was five (IQR 2–12), four (IQR 1–8) for males and seven (IQR 3–14) for females (P < 0.001). Nineteen percent of males and 32% of females attended in each year of the study (P < 0.001). Overall, 17% were tested for chlamydia (10% of males and 22% of females, P < 0.001), and 7% were tested annually (3% of males and 11% of females, P < 0.001). Findings were similar for gonorrhoea testing. In the study period, 10% tested positive for chlamydia (14% of males and 9% of females, P < 0.001) and 0.6% for gonorrhoea. Factors independently associated with chlamydia testing were being female (adjusted odds ratio (AOR) 2.64, 95% confidence interval (CI) 2.07–3.36), being 20–24 years old (AOR: 1.58, 95% CI: 1.20–2.08), and having >3 consultations (AOR: 16.97, 95% CI: 10.32–27.92). Conclusions: More frequent attendance was strongly associated with being tested for chlamydia and gonorrhoea. To increase testing, ACCHS could develop testing strategies and encourage young people to attend more frequently.

IntroductionAboriginal Community-Controlled Health Services (ACCHSs) routinely collect sexually transmissible infection (STI) and blood-borne virus (BBV) clinical data from individuals through electronic medical records (EMRs). At a population level these data are an underutilised resource and can be used to help drive clinical and public health interventions. Accordingly, we have established a national STI and BBV sentinel surveillance network for ACCHSs —the ATLAS network. Objectives and ApproachIn establishing the ATLAS network, we standardised and automated extraction of deidentified clinical data from multiple EMRs using The University of Melbourne’s GRHANITE™ software. Regular reports are provided to each ACCHS, addressing 12 clinical indicators considered best practice in STI and BBV control and management. Data are used to drive Continuous Quality Improvement strategies, can be aggregated at regional and national levels, and have the ability to link to other surveillance networks also using GRHANITE™. ResultsThe ATLAS network currently includes more than 30 ACCHSs, including urban, regional and remote areas. To date, data have been analysed for >50,000 individuals aged ≥15 years attending medical consultations at ACCHS between January 2016 and December 2018. For clients in the key age-range for STI testing of 15–29 years, the mean annual rate of chlamydia/gonorrhoea testing was 25% (range: 1–59%). The mean annual rate of chlamydia positivity for clients 15–29 years was 3% (range: 0–19%) and the mean annual rate of gonorrhoea positivity was 2% (range: 0–18%). Conclusion / ImplicationsAn integrated network of STI and BBV testing and management data has been successfully established amongst ACCHSs nationally. The ATLAS network can be readily expanded and has the potential to link to other datasets using the GRHANITE™ tool. ATLAS provides a unique data infrastructure with capacity to support novel research programs as well as underpin quality improvement activities within participating sites.

Abstract Background Aboriginal Community Controlled Health Services (ACCHSs) play a critical role in providing culturally appropriate, accessible primary healthcare (PHC) for Aboriginal and Torres Strait Islander peoples in Australia. The success of many ACCHSs has led to increased policy support for their growth and development, including the transition of state government administered PHC services to Aboriginal community control in select communities. However, there is minimal published literature available which evaluates such transitions. This paper reports on an evaluation of one ACCHS (Gurriny Yealamucka Health Service)‘s experience of transitioning local PHC services to community control in Yarrabah, Queensland, with a focus on the processes and strategies which were implemented to achieve successful transition. Methods Data was collected from interviews with key personnel involved in the transition and organisational documents from the evaluation period. Face-to-face or telephone interviews were conducted with 14 key stakeholders, audio-recorded and transcribed with written consent. Historical organisational documents were provided by Gurriny. All interview transcripts and documents were imported into NVIVO, coded and analysed using grounded theory methods. Results Gurriny’s journey of achieving community control of PHC in Yarrabah entailed an almost 30 year process of building and demonstrating organisational capacity. The first stage (1986 to 2004) was focused on establishing and developing a community-controlled health service and the second stage (2005–14) on preparing for the transition. Formal handover occurred in June 2014. Stage one strategies included: addressing community social and emotional wellbeing; consulting the community; collaborating with researchers; and, strategically building services, organisation capacity and stakeholder trust. Stage two strategies were: communicating and engaging with stakeholders; ensuring strong governance; planning and developing the services and workforce; assuring quality; and, financial planning, management and modelling. Conclusion Achieving successful transition to community control of PHC for Gurriny entailed a lengthy process of substantial, ongoing organisational growth and development. Gurriny’s experience provides a framework for both governments and the ACCHS sector to inform future transitions of PHC services to Aboriginal community control.

Abstract Background Aboriginal and/or Torres Strait Islander people experience dementia at a rate three to five times higher than the general Australian population. Aboriginal Community Controlled Health Services (ACCHSs) have a critical role to play in recognising symptoms of cognitive impairment, facilitating timely diagnosis of dementia, and managing the impacts of dementia. Little is known about the barriers and enablers to Aboriginal people receiving a timely dementia diagnosis and appropriate care once diagnosed. This study aims to explore, from the perspective of healthcare providers in the ACCHS sector across urban, regional and remote communities, the barriers and enablers to the provision of dementia diagnosis and care. Methods A qualitative study involving semi-structured interviews with staff members working in the ACCHS sector. Aboriginal Health Workers, General Practitioners, nurses, practice or program managers, and Chief Executive Officers were eligible to participate. Consenting ACCHS staff completed a telephone interview administered by a trained interviewer. Interviews were audio-recorded, transcribed, and analysed using qualitative content analysis. Results Sixteen staff from 10 ACCHSs participated. Most participants perceived their communities had a limited understanding of dementia. Symptoms of dementia were usually noticed by the GP or another healthcare worker at the ACCHS who had an ongoing relationship with the person. Most participants reported that their service had established referral pathways with either hospital-based geriatricians, geriatricians located with aged care assessment teams, or specialists who visited communities periodically. Key enablers to high quality dementia care included the use of routine health assessments as a mechanism for diagnosis; relationships within communities to support diagnosis and care; community and family relationships; comprehensive and holistic care models; and the use of tailored visual resources to support care. Key barriers to high quality care included: denial and stigma; dementia being perceived as a low priority health condition; limited community awareness and understanding of dementia; lack of staff education and training about dementia; and numerous gaps in service delivery. Conclusions Substantially increased investments in supporting best-practice diagnosis and management of dementia in Aboriginal communities are required. ACCHSs have key strengths that should be drawn upon in developing solutions to identified barriers to care.

All history of this area and the general talk and all of that is that 1973 was a turning point and the Aquarius Festival is credited with having turned this region around in so many ways, but I think that is a myth ... and I have to honour the truth; and the truth is that old Dicke Donelly came and did a Welcome to Country the night before the festival. (Joseph in Joseph and Hanley)In 1973 the Australian Union of Students (AUS) held the Aquarius Arts and Lifestyle Festival in a small, rural New South Wales town called Nimbin. The festival was seen as the peak expression of Australian counterculture and is attributed to creating the “Rainbow Region”, an area with a concentration of alternative life stylers in Northern NSW (Derrett 28). While the Aquarius Festival is recognised as a founding historical and countercultural event, the unique and important relationships established with Indigenous people at this time are generally less well known. This article investigates claims that the 1973 Aquarius Festival was “the first event in Australian history that sought permission for the use of the land from the Traditional Owners” (Joseph and Hanley). The diverse international, national and local conditions that coalesced at the Aquarius Festival suggest a fertile environment was created for reconciliatory bonds to develop. Often dismissed as a “tree hugging, soap dodging movement,” the counterculture was radically politicised having sprung from the 1960s social revolutions when the world witnessed mass demonstrations that confronted war, racism, sexism and capitalism. Primarily a youth movement, it was characterised by flamboyant dress, music, drugs and mass gatherings with universities forming the epicentre and white, middle class youth leading the charge. As their ideals of changing the world were frustrated by lack of systematic change, many decided to disengage and a migration to rural settings occurred (Jacob; Munro-Clarke; Newton). In the search for alternatives, the counterculture assimilated many spiritual practices, such as Eastern traditions and mysticism, which were previously obscure to the Western world. This practice of spiritual syncretism can be represented as a direct resistance to the hegemony of the dominant Western culture (Stell). As the new counterculture developed, its progression from urban to rural settings was driven by philosophies imbued with a desire to reconnect with and protect the natural world while simultaneously rejecting the dominant conservative order. A recurring feature of this countercultural ‘back to the land’ migration was not only an empathetic awareness of the injustices of colonial past, but also a genuine desire to learn from the Indigenous people of the land. Indigenous people were generally perceived as genuine opposers of Westernisation, inherently spiritual, ecological, tribal and communal, thus encompassing the primary values to which the counterculture was aspiring (Smith). Cultures converged. One, a youth culture rebelling from its parent culture; the other, ancient cultures reeling from the historical conquest by the youths’ own ancestors. Such cultural intersections are rich with complex scenarios and politics. As a result, often naïve, but well-intended relations were established with Native Americans, various South American Indigenous peoples, New Zealand Maori and, as this article demonstrates, the Original People of Australia (Smith; Newton; Barr-Melej; Zolov). The 1960s protest era fostered the formation of groups aiming to address a variety of issues, and at times many supported each other. Jennifer Clarke says it was the Civil Rights movement that provided the first models of dissent by formulating a “method, ideology and language of protest” as African Americans stood up and shouted prior to other movements (2). The issue of racial empowerment was not lost on Australia’s Indigenous population. Clarke writes that during the 1960s, encouraged by events overseas and buoyed by national organisation, Aborigines “slowly embarked on a political awakening, demanded freedom from the trappings of colonialism and responded to the effects of oppression at worst and neglect at best” (4). Activism of the 1960s had the “profoundly productive effect of providing Aborigines with the confidence to assert their racial identity” (159). Many Indigenous youth were compelled by the zeitgeist to address their people’s issues, fulfilling Charlie Perkins’s intentions of inspiring in Indigenous peoples a will to resist (Perkins). Enjoying new freedoms of movement out of missions, due to the 1967 Constitutional change and the practical implementation of the assimilation policy, up to 32,000 Indigenous youth moved to Redfern, Sydney between 1967 and 1972 (Foley, “An Evening With”). Gary Foley reports that a dynamic new Black Power Movement emerged but the important difference between this new younger group and the older Indigenous leaders of the day was the diverse range of contemporary influences. Taking its mantra from the Black Panther movement in America, though having more in common with the equivalent Native American Red Power movement, the Black Power Movement acknowledged many other international struggles for independence as equally inspiring (Foley, “An Evening”). People joined together for grassroots resistance, formed anti-hierarchical collectives and established solidarities between varied groups who previously would have had little to do with each other. The 1973 Aquarius Festival was directly aligned with “back to the land” philosophies. The intention was to provide a place and a reason for gathering to “facilitate exchanges on survival techniques” and to experience “living in harmony with the natural environment.” without being destructive to the land (Dunstan, “A Survival Festival”). Early documents in the archives, however, reveal no apparent interest in Australia’s Indigenous people, referring more to “silken Arabian tents, mediaeval banners, circus, jugglers and clowns, peace pipes, maypole and magic circles” (Dunstan, “A Survival Festival”). Obliterated from the social landscape and minimally referred to in the Australian education system, Indigenous people were “off the radar” to the majority mindset, and the Australian counterculture similarly was slow to appreciate Indigenous culture. Like mainstream Australia, the local counterculture movement largely perceived the “race” issue as something occurring in other countries, igniting the phrase “in your own backyard” which became a catchcry of Indigenous activists (Foley, “Whiteness and Blackness”) With no mention of any Indigenous interest, it seems likely that the decision to engage grew from the emerging climate of Indigenous activism in Australia. Frustrated by student protestors who seemed oblivious to local racial issues, focusing instead on popular international injustices, Indigenous activists accused them of hypocrisy. Aquarius Festival directors, found themselves open to similar accusations when public announcements elicited a range of responses. Once committed to the location of Nimbin, directors Graeme Dunstan and Johnny Allen began a tour of Australian universities to promote the upcoming event. While at the annual conference of AUS in January 1973 at Monash University, Dunstan met Indigenous activist Gary Foley: Gary witnessed the presentation of Johnny Allen and myself at the Aquarius Foundation session and our jubilation that we had agreement from the village residents to not only allow, but also to collaborate in the production of the Festival. After our presentation which won unanimous support, it was Gary who confronted me with the question “have you asked permission from local Aboriginal folk?” This threw me into confusion because we had seen no Aboriginals in Nimbin. (Dunstan, e-mail) Such a challenge came at a time when the historical climate was etched with political activism, not only within the student movement, but more importantly with Indigenous activists’ recent demonstrations, such as the installation in 1972 of the Tent Embassy in Canberra. As representatives of the counterculture movement, which was characterised by its inclinations towards consciousness-raising, AUS organisers were ethically obliged to respond appropriately to the questions about Indigenous permission and involvement in the Aquarius Festival at Nimbin. In addition to this political pressure, organisers in Nimbin began hearing stories of the area being cursed or taboo for women. This most likely originated from the tradition of Nimbin Rocks, a rocky outcrop one kilometre from Nimbin, as a place where only certain men could go. Jennifer Hoff explains that many major rock formations were immensely sacred places and were treated with great caution and respect. Only a few Elders and custodians could visit these places and many such locations were also forbidden for women. Ceremonies were conducted at places like Nimbin Rocks to ensure the wellbeing of all tribespeople. Stories of the Nimbin curse began to spread and most likely captivated a counterculture interested in mysticism. As organisers had hoped that news of the festival would spread on the “lips of the counterculture,” they were alarmed to hear how “fast the bad news of this curse was travelling” (Dunstan, e-mail). A diplomatic issue escalated with further challenges from the Black Power community when organisers discovered that word had spread to Sydney’s Indigenous community in Redfern. Organisers faced a hostile reaction to their alleged cultural insensitivity and were plagued by negative publicity with accusations the AUS were “violating sacred ground” (Janice Newton 62). Faced with such bad press, Dunstan was determined to repair what was becoming a public relations disaster. It seemed once prompted to the path, a sense of moral responsibility prevailed amongst the organisers and they took the unprecedented step of reaching out to Australia’s Indigenous people. Dunstan claimed that an expedition was made to the local Woodenbong mission to consult with Elder, Uncle Lyle Roberts. To connect with local people required crossing the great social divide present in that era of Australia’s history. Amy Nethery described how from the nineteenth century to the 1960s, a “system of reserves, missions and other institutions isolated, confined and controlled Aboriginal people” (9). She explains that the people were incarcerated as a solution to perceived social problems. For Foley, “the widespread genocidal activity of early “settlement” gave way to a policy of containment” (Foley, “Australia and the Holocaust”). Conditions on missions were notoriously bad with alcoholism, extreme poverty, violence, serious health issues and depression common. Of particular concern to mission administrators was the perceived need to keep Indigenous people separate from the non-indigenous population. Dunstan described the mission he visited as having “bad vibes.” He found it difficult to communicate with the elderly man, and was not sure if he understood Dunstan’s quest, as his “responses came as disjointed raves about Jesus and saving grace” (Dunstan, e-mail). Uncle Lyle, he claimed, did not respond affirmatively or negatively to the suggestion that Nimbin was cursed, and so Dunstan left assuming it was not true. Other organisers began to believe the curse and worried that female festival goers might get sick or worse, die. This interpretation reflected, as Vanessa Bible argues, a general Eurocentric misunderstanding of the relationship of Indigenous peoples with the land. Paul Joseph admits they were naïve whites coming into a place with very little understanding, “we didn’t know if we needed a witch doctor or what we needed but we knew we needed something from the Aborigines to lift the spell!”(Joseph and Hanley). Joseph, one of the first “hippies” who moved to the area, had joined forces with AUS organisers. He said, “it just felt right” to get Indigenous involvement and recounted how organisers made another trip to Woodenbong Mission to find Dickee (Richard) Donnelly, a Song Man, who was very happy to be invited. Whether the curse was valid or not it proved to be productive in further instigating respectful action. Perhaps feeling out of their depth, the organisers initiated another strategy to engage with Australian Indigenous people. A call out was sent through the AUS network to diversify the cultural input and it was recommended they engage the services of South African artist, Bauxhau Stone. Timing aligned well as in 1972 Australia had voted in a new Prime Minister, Gough Whitlam. Whitlam brought about significant political changes, many in response to socialist protests that left a buoyancy in the air for the counterculturalist movement. He made prodigious political changes in support of Indigenous people, including creating the Aboriginal Arts Board as part of the Australian Council of the Arts (ACA). As the ACA were already funding activities for the Aquarius Festival, organisers were successful in gaining two additional grants specifically for Indigenous participation (Farnham). As a result We were able to hire […] representatives, a couple of Kalahari bushmen. ‘Cause we were so dumb, we didn’t think we could speak to the black people, you know what I mean, we thought we would be rejected, or whatever, so for us to really reach out, we needed somebody black to go and talk to them, or so we thought, and it was remarkable. This one Bau, a remarkable fellow really, great artist, great character, he went all over Australia. He went to Pitjantjatjara, Yirrkala and we arranged buses and tents when they got here. We had a very large contingent of Aboriginal people come to the Aquarius Festival, thanks to Whitlam. (Joseph in Joseph and Henley) It was under the aegis of these government grants that Bauxhau Stone conducted his work. Stone embodied a nexus of contemporary issues. Acutely aware of the international movement for racial equality and its relevance to Australia, where conditions were “really appalling”, Stone set out to transform Australian race relations by engaging with the alternative arts movement (Stone). While his white Australian contemporaries may have been unaccustomed to dealing with the Indigenous racial issue, Stone was actively engaged and thus well suited to act as a cultural envoy for the Aquarius Festival. He visited several local missions, inviting people to attend and notifying them of ceremonies being conducted by respected Elders. Nimbin was then the site of the Aquarius Lifestyle and Celebration Festival, a two week gathering of alternative cultures, technologies and youth. It innovatively demonstrated its diversity of influences, attracted people from all over the world and was the first time that the general public really witnessed Australia’s counterculture (Derrett 224). As markers of cultural life, counterculture festivals of the 1960s and 1970s were as iconic as the era itself and many around the world drew on the unique Indigenous heritage of their settings in some form or another (Partridge; Perone; Broadley and Jones; Zolov). The social phenomenon of coming together to experience, celebrate and foster a sense of unity was triggered by protests, music and a simple, yet deep desire to reconnect with each other. Festivals provided an environment where the negative social pressures of race, gender, class and mores (such as clothes) were suspended and held the potential “for personal and social transformation” (St John 167). With the expressed intent to “take matters into our own hands” and try to develop alternative, innovative ways of doing things with collective participation, the Aquarius Festival thus became an optimal space for reinvigorating ancient and Indigenous ways (Dunstan, “A Survival Festival”). With philosophies that venerated collectivism, tribalism, connecting with the earth, and the use of ritual, the Indigenous presence at the Aquarius Festival gave attendees the opportunity to experience these values. To connect authentically with Nimbin’s landscape, forming bonds with the Traditional Owners was essential. Participants were very fortunate to have the presence of the last known initiated men of the area, Uncle Lyle Roberts and Uncle Dickee Donnely. These Elders represented the last vestiges of an ancient culture and conducted innovative ceremonies, song, teachings and created a sacred fire for the new youth they encountered in their land. They welcomed the young people and were very happy for their presence, believing it represented a revolutionary shift (Wedd; King; John Roberts; Cecil Roberts). Images 1 and 2: Ceremony and talks conducted at the Aquarius Festival (people unknown). Photographs reproduced by permission of photographer and festival attendee Paul White. The festival thus provided an important platform for the regeneration of cultural and spiritual practices. John Roberts, nephew of Uncle Lyle, recalled being surprised by the reaction of festival participants to his uncle: “He was happy and then he started to sing. And my God … I couldn’t get near him! There was this big ring of hippies around him. They were about twenty deep!” Sharing to an enthusiastic, captive audience had a positive effect and gave the non-indigenous a direct Indigenous encounter (Cecil Roberts; King; Oshlak). Estimates of the number of Indigenous people in attendance vary, with the main organisers suggesting 800 to 1000 and participants suggesting 200 to 400 (Stone; Wedd; Oshlak: Joseph; King; Cecil Roberts). As the Festival lasted over a two week period, many came and left within that time and estimates are at best reliant on memory, engagement and perspectives. With an estimated total attendance at the Festival between 5000 and 10,000, either number of Indigenous attendees is symbolic and a significant symbolic statistic for Indigenous and non-indigenous to be together on mutual ground in Australia in 1973. Images 3-5: Performers from Yirrkala Dance Group, brought to the festival by Stone with funding from the Federal Government. Photographs reproduced by permission of photographer and festival attendee Dr Ian Cameron. For Indigenous people, the event provided an important occasion to reconnect with their own people, to share their culture with enthusiastic recipients, as well as the chance to experience diverse aspects of the counterculture. Though the northern NSW region has a history of diverse cultural migration of Italian and Indian families, the majority of non-indigenous and Indigenous people had limited interaction with cosmopolitan influences (Kijas 20). Thus Nimbin was a conservative region and many Christianised Indigenous people were also conservative in their outlook. The Aquarius Festival changed that as the Indigenous people experienced the wide-ranging cultural elements of the alternative movement. The festival epitomised countercultural tendencies towards flamboyant fashion and hairstyles, architectural design, fantastical art, circus performance, Asian clothes and religious products, vegetarian food and nudity. Exposure to this bohemian culture would have surely led to “mind expansion and consciousness raising,” explicit aims adhered to by the movement (Roszak). Performers and participants from Africa, America and India also gave attending Indigenous Australians the opportunity to interact with non-European cultures. Many people interviewed for this paper indicated that Indigenous people’s reception of this festival experience was joyous. For Australia’s early counterculture, interest in Indigenous Australia was limited and for organisers of the AUS Aquarius Festival, it was not originally on the agenda. The counterculture in the USA and New Zealand had already started to engage with their Indigenous people some years earlier. However due to the Aquarius Festival’s origins in the student movement and its solidarities with the international Indigenous activist movement, they were forced to shift their priorities. The coincidental selection of a significant spiritual location at Nimbin to hold the festival brought up additional challenges and countercultural intrigue with mystical powers and a desire to connect authentically to the land, further prompted action. Essentially, it was the voices of empowered Indigenous activists, like Gary Foley, which in fact triggered the reaching out to Indigenous involvement. While the counterculture organisers were ultimately receptive and did act with unprecedented respect, credit must be given to Indigenous activists. The activist’s role is to trigger action and challenge thinking and in this case, it was ultimately productive. Therefore the Indigenous people were not merely passive recipients of beneficiary goodwill, but active instigators of appropriate cultural exchange. After the 1973 festival many attendees decided to stay in Nimbin to purchase land collectively and a community was born. Relationships established with local Indigenous people developed further. Upon visiting Nimbin now, one will see a vibrant visual display of Indigenous and psychedelic themed art, a central park with an open fire tended by local custodians and other Indigenous community members, an Aboriginal Centre whose rent is paid for by local shopkeepers, and various expressions of a fusion of counterculture and Indigenous art, music and dance. While it appears that reconciliation became the aspiration for mainstream society in the 1990s, Nimbin’s early counterculture history had Indigenous reconciliation at its very foundation. The efforts made by organisers of the 1973 Aquarius Festival stand as one of very few examples in Australian history where non-indigenous Australians have respectfully sought to learn from Indigenous people and to assimilate their cultural practices. It also stands as an example for the world, of reconciliation, based on hippie ideals of peace and love. 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