Aharon Friedland: a fighter for First Nations health

What sparked your interest in Aboriginal health?

I have felt very strongly about Aboriginal health for a long time. It has always been an area that I have been passionate about.

Growing up in South Africa was a formative experience for me. The values instilled within me and the exposure of South Africa – the desperation and devastation, the discrimination and huge amount of disadvantaged people and communities – taught me a responsibility to give myself to others who have been wronged or who are vulnerable.

Moving to Australia when I was 12 years old and benefitting from all the advantage of being a white person, while knowing that First Nations communities are among the most disadvantaged in this country, created an obligation to contribute to and serve Aboriginal people.

In my biomedical science degree, I undertook a couple of elective units in Broome on Aboriginal history, culture and spirituality. It was the highlight of my undergraduate degree – possibly even my entire university experience. Hearing from Yawuru and Karrajari elders, rangers and community members; going out on Country; learning so much about the way Aboriginal people connect to each other and to the land was a very motivating and inspiring experience. It solidified my commitment to and interest in Aboriginal health.

Tell me about your practice in this field.

During my medical degree, I spent a clinical year up north in Karratha, which is a small town in the Pilbara. That brought me experience in rural medicine, and there I was exposed to remote Aboriginal communities and their health issues.

I had a placement in Roebourne where I worked in a medical service with GPs. I also volunteered with a mobile clinic that screens Aboriginal children's ears for middle ear infection – a huge health issue that disproportionately impacts Indigenous kids and can cause long-term hearing loss as well as a range of other health concerns.

Coming back to the city, I wanted to better understand Aboriginal health within a metropolitan context and applied to the Royal Perth Hospital, an inner-city tertiary hospital with a high proportion of Indigenous patients, as well as those from low socioeconomic backgrounds who may be struggling with homelessness or drug and alcohol issues, for example. I started my internship at Royal Perth Hospital last year and I am now doing my second year of practice there.

How do you reflect on being a white person practicing Indigenous medicine?

For me, it is always a question of how I can contribute as a ‘wadjela’ or ‘whitefella’ in Australia without being paternalistic, or doing things for Aboriginal people, or thinking only through a Western model of medicine.

It is something that I am trying to understand and grapple with, but having humility and learning how to practice medicine in a way that is most beneficial, useful and appropriate for Aboriginal people is an important guide. It is about looking at Aboriginal health from a strengths-based perspective, and learning from Indigenous communities themselves and their incredible resources.

I have also had excellent mentors, Indigenous and non-Indigenous, who have provided me with so much advice in such a warm and welcoming way.

Are we getting it right when it comes to Indigenous health care?

Being involved in the care and healing of patients that are in their most vulnerable moments has been a real privilege, but on the other hand, you get exposed to the disheartening moments where people are not treated appropriately.

I have heard of and seen several examples of racism within healthcare. There is a lot of despair – from disparaging comments and attitudes to actual borderline negligent treatments, just because a person is Aboriginal, homeless or drug affected.

I met with an executive who is at the top of the hospital chain, and even they told me that, as an Aboriginal person, they were not taken seriously when they went to the emergency department, or doctors have assumed their family members were drunk when they were coming in with real problems. There are lots of examples of that kind of behaviour.

It is not all the time and everyone, but being exposed to some of that racism reinforces the belief that more needs to happen, that the culture needs to change and that there is still a long way to go.

Do you think part of the problem is how Aboriginal culture is taught at school?

It is a big shame generally in Australian education that people do not get exposed to Aboriginal culture and teachings. It is very limited, and even more so when it comes to taking a positive, strength-based lens.

Until I got to university, all I learned about was the Rabbit-Proof Fence story. I think most people going through school, tertiary education and even work, do not keep learning about Indigenous education. I have been very lucky to have that focus throughout my life.

How do Aboriginal and Jewish cultures intersect?

There are some very profound similarities between Aboriginal culture and Judaism, but there are also quite a lot of differences.

The Aboriginal concept of kinship and interrelatedness is something I find quite bewildering. That everything is connected and one – from the land and sea to the spirits and each other – there is a value of reciprocity and community where everyone looks after each other. It is something that we feel in the Jewish community too.

I have always thought about the comparison that people make between the Jewish connection to Israel and Aboriginal people’s connection to land. It is not a perfect comparison but there is a shared understanding that both of our peoples have a history of persecution, struggle and discrimination. That puts Jews in a very important place in Australia to advocate for Indigenous rights and freedoms.

During the campaign for the Voice to Parliament, I wrote something brief to appeal to the Jewish community, expressing what I believed was one of the reasons why we should really appreciate and value Aboriginal recognition – that is the concept of Jewish memory. It is such a central value in Judaism, which is not very well understood but is about always remembering where we come from, who we are, and what our values are. History in Australia is often forgotten or actively disremembered, and as Jews, we can understand that even better given our own history.

Jewish-Indigenous collaboration has spanned throughout time. From the early Freedom Ride with Jim Spigelman, Mabo and native title with Ron Castan and today with the Voice Referendum and Mark Leibler. There has always been a Jewish sensibility to contribute to Aboriginal rights and advancements in Australia, which is important to reflect on.

One concept that motivates me constantly is a dictum from Pirkei Avot: "It is not up to you to complete the work, but neither are you free to desist from it". 

My commitment to Indigenous health and justice is born directly out of my Jewish beliefs and values. It is one in the same. I feel as if pursuing a career in Indigenous health is the realisation and culmination of my religious Jewish upbringing, values and ideals.

What's in store for your future medical practice?

I am still trying to figure out what I want to specialise in. One interest I currently have is paediatrics.

There is such a huge way to go with Aboriginal children and young people’s health. Especially ear disease, rheumatic heart disease and infectious diseases that do not occur in any other Western country. When it comes to the increased rates of diseases in Indigenous children compared to non-Indigenous kids, there is a whole list, and it is never ending. Added to that is the fact that one of the leading causes of death in young Aboriginal people is suicide, which is just incomprehensible and appalling to consider. It is something that should not even be acceptable.

I hope to get involved in the local Aboriginal medical service with their child health program and at the Perth Children’s Hospital. Committing to the health and wellbeing of young Indigenous people is something I am very passionate about.