Review: Nurses’ views on the impact of mass media on the public perception of nursing and nurse–service user interactions

This is a review of paper published in the Journal of Research in Nursing about Nurses’ views on the impact of mass media on the public perception of nursing and nurse–service user interactions by Louise P Hoyle, Richard G Kyle and Catherine Mahoney. Cite as: De Souza, R. (2017). Review: Nurses’ views on the impact of mass media on the public perception of nursing and nurse–service user interactions . Journal of Research in Nursing, 0(0) 1–2. https://dx.doi.org/10.1177/1744987117736600

Mass media comprises the storytellers and portrayers of our social worlds (Nairn et al., 2014), and has a central role in reproducing the contradictory views held about nurses by the public. As the reviewed paper shows, media representations are far from harmless: they influence public understanding and confidence in the profession and impact on recruitment, policy and nurses’ self-image (Kalisch et al., 2007). Nurses are considered
highly trustworthy by the public due to their virtues of care and compassion. However, the dominant representations of nurses in the media are often inaccurate, erasing male nurses from the profession and downplaying the autonomous judgement of the nursing
professional. Nurses as feminised handmaidens play a subordinate support role to medical decision makers. The media nurse engages in bedside routines and repetitive tasks, and is sometimes a sex object, an angel of mercy or a battleaxe, sometimes all three. These stereotypical representations have changed over time, and sometimes nurses are depicted as strong and confident professionals (Kalisch et al., 1981; Stanley, 2008). Yet the significant professional, theoretical and scholarly innovations that have reshaped the role of nurses are largely invisible to the public (Ten Hoeve et al., 2014). In tandem with nursing’s processes of
professionalisation, austerity measures in the neoliberal health system have demanded efficiency and cost containment, while also reorienting services so they can be more clientcentred. This twin move to the proletarianisation of nursing care (through the growth of
various classes of healthcare assistants doing tasks previously performed by nurses) and democratisation of health within a technocratic, market-led and more participatory health system has profound implications for the future of nursing.

The reviewed paper is timely, given the growing focus on shared decision making and participation as an outcome of client-centredness in Western health systems. It raises questions about the customary role of nurses as gap fillers and problem solvers, who maintain the status quo on doctors’ orders. New media channels such as the Internet allow access to on-demand health information outside of authoritative channels, and new
technologies such as fitness trackers and wearables produce a wide range of personal health information. These technologies do some of the work of nursing in the sense that they put recipients at the centre of the health experience and allow health information to enhance the consumer’s knowledge of, control of and impact on their own healthcare. The role of the
nurse as a facilitator in these new flows of health information is yet to be effectively represented within the profession’s view of itself, let alone in the mass media, as this paper suggests.

The reviewed study’s findings on the aversion felt by nurse participants to informed consumers is an issue with significant ramifications. The question that remains is whether there is an opportunity for nurses to enter the public sphere in a meaningful alignment with consumer aspirations for healthcare? If healthcare is to become more participatory, equitable and consumer-driven, what transformative changes will we as nurses need to
make in our own self-identity and practice?

References
Kalisch BJ, Begeny S and Neumann S (2007) The image of the nurse on the internet. Nursing Outlook 55(4): 182–188.
Kalisch BJ, Kalisch PA and Scobey M (1981) Reflections on a television image: The nurses 1962–1965. Nursing & Health Care: Official Publication of the National League for Nursing 2(5): 248–255.
Nairn R, De Souza R, Barnes AM, et al. (2014) Nursing in media-saturated societies: Implications for cultural safety in nursing practice in Aotearoa New Zealand. Journal of Research in Nursing 19(6): 477–487.
Stanley DJ (2008) Celluloid angels: A research study of nurses in feature films 1900–2007. Journal of Advanced Nursing Available at: http://onlinelibrary.wiley.com/doi/10.1111/j. 1365-2648.2008.04793.x/full (accessed 30 September 2017).
Ten Hoeve Y, Jansen G and Roodbol P (2014) The nursing profession: Public image, self-concept and professional identity. A discussion paper. Journal of Advanced Nursing 70(2): 295–309.

Ruth De Souza on Wearable Technology

I am speaking at the WT | Wearable Technologies conference in Sydney next month. I spoke to Wearable Technologies Australia (WTA) about the future of the wearable tech industry and some of the challenges the industry is facing. Check out the  full program here.

Here’s a link to the interview we did and I’ve also reproduced it in full below.

WTA: Tell us a little bit about yourself and your journey within the wearable technology space

RDS: I am a nurse, educator and researcher by background and currently work in a unit called the Centre for Culture, Ethnicity and Health at North Richmond Community Health Centre in Melbourne. I came from Monash University to this role with an interest in translating research into practice. I was really interested in doing research in the community and being based there, so that there wasn’t such a big lag between research and knowledge implementation. Wearable tech seemed a good area to explore in a community setting where there is a high percentage of overseas-born residents (38%). Many speak a language other than English at home which has an impact on health literacy. I have been working with colleagues at the University of Melbourne and Paper Giant using “design probes” to engage women from culturally and linguistically diverse (CALD) backgrounds in discussions about health tracking and wearable health technologies in the context of pregnancy and parenting. We started with a stakeholder forum where we explored the research issues around wearable tech and cultural diversity to develop an agenda. More recently with the the University of Melbourne we have conducted a health self-tracking week where we provided daily community education sessions on a range of topics including diabetes and nutrition and self-tracking. Before the end of the year we will be following up with interviews with trackers and asking them about the barriers and enablers to self-tracking.

WTA: Wearable Tech is the next big thing now. Where do you see the industry heading in the next 5 years?

RDS:I am interested in what changes need to be made in health care systems to really maximise the benefits of Wearable Tech. What kinds of educational preparation will the future health workforce need? How will health workers need to modify their roles from being traditional gate-keepers of information in light of the democratisation of information access? What skills will they need to support patients who are activated, motivated and informed? How will health care systems need to change so they can really make the most of patient generated health data? How will workflows and practices change in order to accommodate the new models of care that are emerging with wearable tech?

WTA: According to your expertise in the wearables space which industry do you think will be impacted most by wearable technologies in the next few years

RDS: Technology is moving faster than the health care and education industries. In order to realise the benefits of advances in wearable tech, it’s going to be crucial for the health care workforce to be well prepared educationally and to develop digital literacies both at the undergraduate level and then in terms of continuing education and training. There’s going to have to be a huge shift not just in terms of knowledge and skills, but also in terms of understanding how to be more collaborative in health care.

WTA: Do you think personal IoT has a sustainable future? Will people need more than one platform to handle all their wearable devices?

RDS: I think interoperability is a big issue. Merely generating personal health data without the capacity to have it integrated into your health care means that the potential benefits may not be realised. For this our current models of care and institutional systems need to become more agile and nimble. Many health workers are sceptical about the benefits of wearable technology and concerned about who gets to benefit from the aggregation of health data. They need reassurance about the ethical treatment of data.

WTA: What do you think is the biggest challenge within the wearable technology industry?

RDS: I think the biggest challenge is how wearable technologies can work for people who are marginalised. Working in community health as a researcher I am interested in what wearable self tracking devices mean for people who don’t fit the wealthy, worried, well and white demographic, that typically wearables are marketed to. There is an urgent need to bring people and communities into processes of information handling that are more transparent and accountable. Health workers adhere to codes of conduct and have a duty of care, I’d like to see the developers of technologies engage in more careful scrutiny and have more transparency about the uses of data. I think also that if wearable tech is to be democratised and benefit everyone then communities who are wary of surveillance must have greater control of their data and personal health information.

I Smell You

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[et_pb_column type=”4_4″][et_pb_text admin_label=”Text”]De Souza, R. (2017). I Smell You, Life Matters, Radio National, Australia. Thursday 14 September 2017.

The wonderful Masako Fukui from Life Matters interviewed me for this story about olfactory assimilation.

I am a committed foodie, ‘somebody with a strong interest in learning about and eating good food who is not directly employed in the food industry’ (Johnston & Baumann, 2010, 61) who is also interested in the politics of food. In particular, the politics of food in public spaces like public transport and hospitals.

I am interested in the ways in which admission into western medical health services requires assimilation into a distinct patient subculture. This coercive incorporation and relinquishment of clothing and belongings is accompanied by the loss of autonomy over everyday activities and routines, which is ceded to health professionals and institutional processes. From being a socially integrated member of a community, the person within the dominant mode of biomedicine is reduced to being an individual, then a physical body or parts. The person becomes an object who receives care.

Food is more than sustenance and nutrition, it has social, cultural and symbolic meanings which structure not only our daily lives, but also life transitions such as maternity. Food represents an arena where powerful values and beliefs about being a human are evident. Food practices also demarcate cultural boundaries of belonging and not belonging. Forthcoming: De Souza, R. (in press). Going Without: Migrant Mothers, Food and the Postnatal Ward in New Zealand. In F. Guignard and T. Cassidy (Eds.), Moving Meals and Migrant Mothers. Toronto: University of Toronto Press.

Check out Masako Fukui’s great piece in ABC News: Is our dislike of ‘smelly’ food actually cultural intolerance?

Fish is OK, as long as it isn’t pungent. Curry is nice, as long as the spices don’t cling to the curtains. Kimchi is healthy, as long as the fermented garlic doesn’t linger on the train.

But for the migrant who feels displaced from their homeland, foods that olfactorily offend may play an important role in reinforcing identity, Dr De Souza says.

She says cooking and eating a beautiful curry is akin to “putting lotion on the part of me that feels dislocated, lonely, and isolated”. But that same curry can reek of spices that ultimately isolate her by making her smell different, even invoking disgust.

 

 

Okra and eggplant
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All I want for Christmas is… On International Day of Solidarity with Migrants 2015

December 18th marks the anniversary of the signing of the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families by the United Nations in 1990. Lobbying from Filipino and other Asian migrant organisations in 1997, led to December18th being promoted as an International Day of Solidarity with Migrants. The day recognises the contributions of migrants to both the economies of their receiving and home countries, and promotes respect for their human rights. However, as of 2015, the Convention has only been signed by a quarter of UN member states.

2015 has seen the unprecedented displacement of people globally with tragic consequences. UNHCR’s annual Global Trends report shows a massive increase in the number of people forced to flee their homes. 59.5 million people were forcibly displaced at the end of 2014 compared to 51.2 million a year earlier and 37.5 million a decade ago.

Politicians and media have a pivotal role in agenda setting and shaping public opinion around migrants, refugees and asylum seekers. A 100-page report, Moving Stories, released for International Migrants Day reviews media coverage of migration across the European Union and 14 countries across the world. The report acknowledges the vulnerability of refugees and migrants and the propensity for them to be politically scapegoated for society’s ills and has five key recommendations, briefly (p.8):

  1. Ethical context: that the following five core principles of journalism are adhered to:
    accuracy, independence, impartiality, humanity and accountability;
  2. Newsroom practice: have diversity in the newsroom, journalists with specialist knowledge, provide detailed information on the background of migrants and refugees and the consequences of migration;
  3. Engage with communities: Refugee groups, activists and NGOs can be briefed
    on how best to communicate with journalists;
  4. Challenge hate speech.
  5. Demand access to information: When access to information is restricted, media and civil society groups should press the national and international governments to be more transparent.

Much remains to be done, but it is heartening to see Canadian Prime Minister Justin Trudeau’s response to the arrival of thousands of Syrian refugees: 

You are home…Welcome home…

Tonight they step off the plane as refugees, but they walk out of this terminal as permanent residents of Canada. With social insurance numbers. With health cards and with an opportunity to become full Canadians

Trudeau’s response sharply contrasts with that of the United States, where many politicians have responded to Islamophobic constituencies with restrictions or bans on receiving refugees. The welcome from Indigenous Canadians to newly arrived refugees has also been generous and inclusive, considering that refugees and migrants are implicated in the ongoing colonial practices of the state. These practices can maintain Indigenous disadvantage while economic, social and political advantage accrue to settlers. It is encouraging that Trudeau’s welcome coincided with an acknowledgement of the multiple harms Canada has imposed on Indigenous people since colonisation. 

Alarmingly, the center-right Danish government’s bill currently before the Danish Parliament on asylum policy, allows for immigration authorities to seize jewellery and other valuables from refugees in order to recoup costs. The capacity to remove personal valuables from people seeking sanctuary is expected to be effective from February 2016 and has a chilling precedent in Europe, as Dylan Matthews notes in Vox:

Denmark was occupied by Nazi Germany for five years, from 1940 to 1945, during which time Germany confiscated assets from Jewish Danes, just as it did to Jews across Europe. Danish Jews saw less seized than most nations under Nazi occupation; the Danish government successfully prevented most confiscations until 1943, and Danes who survived the concentration camps generally returned to find their homes as they had left them, as their neighbors prevented Nazis from looting them too thoroughly. But Nazi confiscations still loom large in European historical memory more generally.

The UN, the Parliamentary Assembly of the Council of Europe (PACE) and the International Organization for Migration (IOM) have advocated for the development of regional and longer term responses. Statements echoed by Ban Ki-moon which proposed better cooperation and responsibility sharing between countries and the upholding of the human rights of migrants regardless of their status (Australia take note). He proposes that we:

must expand safe channels for regular migration, including for family reunification, labour mobility at all skill levels, greater resettlement opportunities, and education opportunities for children and adults.

On International Migrants Day, let us commit to coherent, comprehensive and human-rights-based responses guided by international law and standards and a shared resolve to leave no one behind.

What does this all mean for Australia and New Zealand? I’ve written elsewhere about the contradiction between the consumptive celebrations of multiculturalism and the increasing brutality and punitiveness of policies in both countries; the concerns of Australia’s key professional nursing and midwifery bodies about the secrecy provisions in the Australian Border Force Act 2015 and the ways in which New Zealand is emulating a punitive and dehumanising Australian asylum seeker policy.

It is appropriate then in this season of goodwill and peace to write an updated Christmas wish list, but with a migration focus. As a child growing up in Nairobi, one of my pleasures around Christmas time was drawing up such a list. I was so captivated with this activity that I used to drag our Hindu landlord’s children into it. This was kind of unfair as I don’t think they received any of the gifts on their list. For those who aren’t in the know, a wish list is a list of goods or services that are wanted and then distributed to family and friends, so that they know what to purchase for the would-be recipient. The idea of a list is somewhat manipulative as it is designed around the desires of the recipient rather than the financial and emotional capacity of the giver. Now that I’ve grown up a little, I’ve eschewed the consumptive, labour exploitative, commercial and land-filling aspects of Christmas in favour of spending time with family, as George Monbiot notes in his essay The Gift of Death:

They seem amusing on the first day of Christmas, daft on the second, embarrassing on the third. By the twelfth they’re in landfill. For thirty seconds of dubious entertainment, or a hedonic stimulus that lasts no longer than a nicotine hit, we commission the use of materials whose impacts will ramify for generations.

So, this list focuses on International Day of Solidarity with Migrants. All I want for Christmas is that ‘we’:

  1. End the Australian Government policy of turning back people seeking asylum by boat ie “unauthorised maritime arrivals”. 
  2. Stop punishing the courageous and legitimate right to seek asylum with the uniquely cruel policy of mandatory indefinite detention and offshore processing. Mandatory detention must end. It is highly distressing and has long-term consequences.
  3. Remove children and adolescents from mandatory detention. Children, make up half of all asylum seekers in the industrialized world. Australia, The United States, the United Kingdom, Germany and Italy directly contradict The Convention on the Rights of the Child (UNCRC).
  4. Engage in regional co-operation to effectively and efficiently process refugee claims and provide safe interim places. Ensure solutions that uphold people’s human rights and dignity, see this piece about the Calais “Jungle”.
  5. End the use of asylum-seeker, refugee and migrant bodies for political gain.
  6. Demand more ethical reporting by having news media: appoint specialist migration reporters; improve training of journalists on migration issues and problems of hate-speech; create better links with migrant and refugee groups; and employ journalists from ethnic minority communities, see Moving Stories.
  7. Follow the money. Is our money enabling corporate complicity in detention? Support divestment campaigns, see X Border Operational matters. Support pledges that challenge the outsourcing of misery for example No Business in Abuse (NBIA) who have partnered with GetUp.
  8. Support the many actions by Indigenous peoples to welcome refugees. Indigenous demands for sovereignty and migrant inclusion are both characterised as threats to social cohesion in settler-colonial societies.
  9. Challenge further racial injustice through social and economic exclusion and violence that often face people from migrantnd refugee backgrounds.
  10. Ask ourselves these questions:‘What are my borders?’ ‘Who do I/my community exile?’ ’How and where does my body act as a border?’ and ‘What kind of borders exist in my spaces?’ The questions are from a wonderful piece by Farzana Khan.
Seppo Leinonen, a cartoonist and illustrator from Finland
Seppo Leinonen, a cartoonist and illustrator from Finland

Learning to listen: Mental health and migration for CALD communities

In Victoria the goal of the Victorian Mental Health Reform Strategy 2009-2019 is to achieve better social and economic outcomes for people with mental illness, their families, carers and friends. Specifically Reform Area 6 outlines areas for reducing inequalities. The Cultural Diversity Plan for Victoria’s Specialist Mental Health Services, 2006-2010 suggests that achieving more culturally responsive services for culturally and linguistically diverse (CALD) and refugee communities is a clear priority given that:

  • Victoria has a diverse population with 24 per cent of Victorians being born overseas.
  • A third of this group come from non-English speaking countries.
  • Culturally and linguistically diverse (CALD) groups often have poorer mental health outcomes compared to Australian-born people, because they tend to present to services when their illness is more severe and therefore are also likely to experience higher rates of involuntary treatment.
  • There are sub-groups articularly refugees and older people who are at risk of developing a mental health problem.
  • Each year Victoria accepts over 3,500 humanitarian entrants (refugees and asylum seekers).
  • Victoria’s CALD population is increasingly being dispersed across the state. in regional and rural areas which requires primary health and mental health services provide culturally appropriate care.
  • Almost half of all CALD Victorians report having experienced some type of discrimination based on their ethnicity or nationality.
  • Experiences of discrimination are associated with depression, stress, anxiety and problematic substance use.

Better mental health outcomes for people of CALD backgrounds must include:

  • Strategies to promote social inclusion;
  • Acceptance of cultural diversity;
  • Workforce development ie develop work practices and cultures in mental health services that support high quality, effective, consumer-focused and carer-inclusive care;
  • Improving access to culturally competent mental health care at earlier stages of illness;
  • Enhancing the capacity of primary health services and workers in CALD community settings to identify, respond earlier to, and refer people with emerging mental health problems;
  • Enhancing mental health literacy and reduce stigma among refugee and asylum seeker groups;
  • Provide mental health literacy training to multicultural, ethno-specific and refugee agencies to improve their understanding of mental illness, so that workers in these agencies can better navigate the mental health service system on behalf of CALD consumers and;
  • Encourage practical partnerships between these agencies and specialist mental health services to facilitate culturally-specific input into clinical treatment and psychosocial rehabilitation plans;
  • Address language needs of CALD clients in specialist mental health services and address supply of interpreters  and promote client and carer awareness of language services;
  • Build on the work of Victorian Transcultural Mental Health and the Action on Disability within Ethnic Communities (ADEC) to improve training.

Migrating minds

In the last week of March 2015 I was honoured to be one of six panelists ranging from consumers, carers, filmmakers, and mental health practitioners to be part of a panel at an event called Migrating Minds: A forum on mental health within Culturally and Linguistically Diverse (CALD) migrant communities.The panel was organised by Colourfest in partnership with Victorian Transcultural Mental Health and held at the State Library of Victoria (SLV). Colourfest celebrates films about diaspora and migrant experiences and shares them with the broader community through free events, professional development/training, distributing films and producing resources.

What was especially wonderful about Colourfest was that consumers and carers were central to the event and got to tell their own stories in the films at the start and in the panel discussion at the end. The event began with seven short films which were stories told by people with a personal experience of mental health issues and perspectives of relatives/carers. Five of the short films were produced by Multicultural Mental Health Australia (MHiMA) and Victorian Transcultural Mental Health. There was also an international short film produced by a second-generation Vietnamese-American who shares their experiences with Depression and Post-Traumatic Stress Disorder.

These fabulous examples of cross-sectoral collaboration were evident in the partnership between Mental Health in Multicultural Australia (MHiMA) in conjunction with the Australian Centre for the Moving Image (ACMI) to produce Finding our way. This unique project focused on migrant and refugee stories where the personal stories of people living with emotional and mental health issues who were negotiating migrancy. Managed by Victorian Transcultural Mental Health (VTMH), St Vincent’s Hospital, Melbourne and the Global and Cultural Mental Health Unit at the University of Melbourne. Erminia Colucci & Susan McDonough coordinated the project for MHiMA. We watched The Visual Conductor by Maria. A story about family expectations, taking charge and staying well involving art, personal goals and play. We also viewed Dear Self by Akeemi, which was about childhood memories, moving to a new country, feelings of isolation and efforts to connect including original drawings and paintings. Both Maria Dimopoulos  and Akeemi from the Finding Our Way film project were also on the panel.

The Our Voices project told the stories of carers from refugee and migrant backgrounds through five short films, showing a poignant insight into the lives of carers from migrant and refugee backgrounds. At the Colourfest panel we were fortunate to view Kevser‘s story. Kevser arrived from Turkey in the late 60’s with her husband and is the primary carer for her daughter. What was extraordinary about this film and the other four (from Afghani, Egyptian, Somali and Vietnamese communities) were the common challenges they faced in finding culturally sensitive and culturally-responsive mental health care and support. The aim of the forum was to help healthcare practitioners, community workers and the general population to understand some of the needs of the CALD community and the films were a powerful mechanism for leading the audience to empathise with the experiences of families. Leyla Altinkaya spoke on behalf of her mother, Kevser on the panel. Our other panelists were Munira Yusuf , a young person speaking from a youth perspective on their lived experiences with mental health issues and David Belasic: A psychologist based at Drummond Street Services. He has a strong interest in community psychology and queer mental health.

Me answering a question from Pham Phu Thanh Hang Colourfest Melbourne Coordinator. Also in the shot from left to right, fellow panellists Akeemi, Maria Dimopoulos, Munira Yusuf and David Belasic.
Me answering a question from Pham Phu Thanh Hang Colourfest Melbourne Coordinator. Also in the shot from left to right, fellow panellists Akeemi, Maria Dimopoulos, Munira Yusuf and David Belasic.

One of the priorities of The Framework for Mental Health in Multicultural Australia: Towards culturally inclusive service delivery is that services evaluate their cultural responsiveness and develop action plans to enhance their delivery of services to CALD communities as part of core business. Central to this responsiveness is having processes where consumers, carers and family members can have a say in the planning, development, delivery and evaluation of services. Particularly important given that CALD consumer and carer participation lags behind mainstream participation. Hence, the importance of this event which placed the experiences of consumers and carers at the forefront.

Cultural competence in mental health emphasises the attributes of the service provider and outcomes of the cross-cultural encounter rather than the unfamiliar culture of the consumer/carer. I love the key elements of cultural competence identified in the Cultural diversity plan for Victoria’s specialist mental health services 2006-2010:

  • Respectful and non-judgemental curiosity about other cultures, and the ability to seek cultural knowledge in an appropriate way;
  • Tolerance of ambiguity and ability to handle the stress of ambiguous situations;
  • Readiness to adapt behaviours and communicative conventions for intercultural communication.

What’s lovely about this list is that it does not constitute a recipe or tick box that can be memorised and then deployed in every intercultural encounter. These qualities are about how we developing a capacity for being in relationship with other people when we cannot assume common ground (which is really kinda always).  I believe that watching the films provided a way to facilitate the beginnings of such a journey..

I am grateful to all those who made the films happen and for making visible the experiences of CALD consumers and carers. A grateful thanks to Gary Paramanathan and Pham Phu Thanh Hang Colourfest Melbourne Coordinator for the opportunity to be part of this wonderful panel.

Note that the Victorian Mental Health Reform Strategy 2009-2019 defines Cultural and linguistic diversity as:

the diversity of society in terms of cultural identity, nationality, ethnicity, language, and increasingly faith. Individuals from a CALD background are those who identify as having a specific cultural or linguistic affiliation by virtue of their place of birth, ancestry, ethnic origin, religion, preferred language, language(s) spoken at home, or because of their parents’ identification on a similar basis. CALD does not refer to an homogenous group of people, but rather to a range of cultural and language group communities.

To surveil and marginalise or to keep our hearts open? The aftermath of public violence.

Last week I visited the Tasman Peninsula in Tasmania, which was the country of the Pydairrerme band of the Oyster Bay tribe, before being invaded and settled by Europeans. As a a recent arrival in Australia (from New Zealand in 2013), I see it as my responsibility to develop a local nuanced understanding of settler-colonialism, the dispossession of indigenous Aboriginal people and the colonial carceral system. Port Arthur, a convict settlement for the former colony of Van Diemen’s Land on the Tasman Peninsula was on my itinerary. Maria M. Tumarkin points out that places like Port Arthur with their material remnants allow us to engage with events (like the trauma of convictism) and to experience the hardship and suffering endured by convicts without actually putting ourselves on the line. People that visit sites of trauma or traumascapes as Tumarkin calls them (also known as dark tourism (Philip Stone), thanatourism (A.V. Seaton), trauma tourism (Laurie Beth Clark) are not either “voyeuristic tourists” or “earnest pilgrims” but can also have mixed motives, some unknown to them. I wanted to better understand the colonial and convict history of my adopted homeland, especially because my partner is Australian born and has an ancestral convict history.

Port Arthur

Port Arthur has a history of prison tourism and its sandstone, pink brick and weatherboard buildings along a beautiful cove, belie it’s disciplinary role for convicts from 1830-1877. Prior to 1840, convicts were used as colonial labour for settlers, after 1840 convicts undertook a trial period of  labour in a government gang, and if this was satisfactory could then be hired out to the private sector. This partnership with the private sector transferred costs of rations, clothing and accommodation from the colonial government to private masters who did not pay wages (sound familiar?). Thus, Van Diemen’s Land was a panopticon without walls rather than a prison. More about panopticons later! For people that “abused” this “open” punishment or for whom a suitable assignment could not be found, a place of secondary punishment was needed. Hence the development of the penal station of Port Arthur to house those who could not be assigned and where labour could be extracted and the recalcitrant punished as Professor Hamish Maxwell-Stewart notes. After the closure of the penal station, decline and damage to the carceral buildings of Port Arthur ensued. Renewed interest in the late 1920s, saw restoration work begin so that the tourism potential of the site could be maximised. In the 1980s Port Arthur became Australia’s most famous open-air museum, and the 1996 killing of innocent people by an armed gunman did not diminish its role as a tourist site. A memorial garden now houses the Broad Arrow cafe where twenty of the thirty five victims were shot which represents a cathartic location -triggering powerful emotions.

Port Arthur2

The carceral buildings at Port Arthur including the Penitentiary and the Separate Prison in use nineteenth-century ideas about how adult deviants could be treated in order to transform them into skilled and docile members of society. Foucault used the metaphor of the panopticon designed by the philosopher Jeremy Bentham to talk about the change in society from a “culture of spectacle” (public displays of torture etc) to a “carceral culture.” where punishment and discipline became internalized. The panopticon was a prison designed so that a central observation tower could potentially view every cell and every prisoner. However, the prisoners could not view observers or guards, so prisoners could not tell if or when they were being observed. Consequently, they came to believe that they might be always being observed, and disciplined themselves into model prisoners. Port Arthur’s prison was shaped like a cross with exercise yards at each corner and prisoner wings connected to the surveillance core of the Prison from where each wing could be clearly seen, although individual cells could not (thus differing from the theory of the panopticon). Panopticism or the ever-present threat of potential or continual surveillance is a mechanism for translating technologies of disciplinary control into an individual’s everyday practices.

Reinforcing Islam and Muslims as ‘others’ 

This brings me to the key concern of this blog post, the events of December 15th when a single armed man took people hostage inside the Lindt Chocolate cafe in Sydney. His actions ultimately led to the death of two innocent people and overshadowed scrutiny of the mid-year budget update (which includes cuts to Foreign Aid and the Australian Human Rights Commission). The gunman had significant social and inter-personal problems but the media were quick to label the siege a terrorist attack (it was a Muslim person brandishing a flag after all) which also helped to justify future and recent past legislation limiting the movement of some groups of people. Only last week New Zealand politicians hastily passed anti-terror laws through Parliament. In the United Kingdom, PM David Cameron pointed out:

It demonstrates the challenge that we face of Islamist extremist violence all over the world. This is on the other side of the world (in Sydney) but it’s the sort of thing that could just as well happen here in the UK or in Europe.

Many media sources and other commentators were quick to jump to conclusions with The Daily Telegraph front page screaming “Death cult CBD attack” and anti Muslim scare mongering from shock jocks like Rad Hadley.

Tele-front-page

Interestingly the reportage focused on the religion of the gunman and brought out racist and inflammatory commentary from people on Twitter and Facebook. What was especially interesting was the way in which misinformation spread far and wide as Alex McKinnon carefully pointed out:

But the families of the people involved, and the broader public, have a right to information that is accurate and correct. Spreading rumours on something as potentially serious as this is not innocuous: it is actively harmful. Your best course of action is to refrain from commenting or spreading unchecked information, online or otherwise, until the facts are known, the situation is better understood and our collective emotions aren’t running so high.

 

 

In a critique of media coverage Bernard Keane of Crikey interrogated the language and phrases that proliferated in coverage:

The assumptions loaded into such “lost its innocence” statements merit entire theses; indeed, many have doubtless already been written. That Australia, established as a prison colony and forged in dispossession, genocide and gleeful participation in the long wars of imperialism throughout the 20th century, could be “innocent”; that it is such a fragile culture that a single moment of violence, however atypical, could comprehensively alter its very nature.

New Matilda predicted that there would be spike in violence against Muslims and mosques:

Just as Christian churches all over the nation were attacked in the immediate aftermath of the 1996 Port Arthur siege, Mosques around Australia will be vandalized. Because, naturally, if the siege is in fact being perpetrated by Muslim extremists, then all Muslims (and all symbols of Islam) are fair game.

Bernard Keane also predicted that media identities and journalists would:

 disgrace themselves and their profession by reporting wild speculation as fact.  When you’re reporting a big story on a 24 hours news cycle, and you have no idea what’s going on, you need to fill the gaps. Anything that moves is news, and if it doesn’t move, give it a push.

With the media finding:

some lone nut Muslim extremist somewhere to say something short of condemning the violence, and then portray that as the view of the broader Muslim population. Eventually, Australian media will start demanding that all Muslim leaders everywhere condemn the violence… even though Muslim leaders everywhere will have already condemned the violence.

This was an accurate prediction as in no time at all, the Australian Muslim community denounced the act:

Australiam

However, Randa Abdel-Fattah problematised this gesture in the context of broader insatiable community demands:

Muslim organisations – weary, under-resourced, under pressure – were ready to condemn, to distance, to reassure because after 13 years of condemning, distancing, and reassuring, the Australian public seems to still be in doubt about Islam’s position on terrorism.

Australian responses give me hope…

John Donegan ABC Sydney

As people gather to pay their respects in a very public way. I’d like to think that there’s an opportunity for healing rather than fomenting further hate and powerlessness. I agree with Tasmanian and Booker Prize winner Richard Flanagan’s observations of people:

I think evil, murder, hate… these things are as deeply buried within us as love, kindness, goodness and perhaps they are far more closely entwined than we would care to admit… And the face of evil is never the other, it’s always our face.

So with that in mind, I’d like to talk about the outpouring of grace, dignity, compassion and thoughtful analysis that I’ve also seen in abundance.

  • Clover Moore Lord Mayor of Sydney:

Clover Moore

 

  • Victoria Rollison challenged media representations of the gunman and the framing of the siege as a Muslim issue:

“I was a teenager when the Port Arthur massacre happened, and I don’t recall there being a backlash at the time against white people with blonde hair. I’m a white person with blonde hair, and no one has ever heaped me into the ‘possibly a mass murderer’ bucket along with Martin Bryant. Or more recently, Norwegian Anders Breivik, who apparently killed 69 young political activists because he didn’t like their party’s immigration stance which he saw as too open to Islamic immigrants. In fact, in neither case do I recall the word ‘terrorist’ even being used to describe the mass murders of innocent people.”

 

 

 

  • Clementine Ford similarly pointed out that Christianity has not come under the same scrutiny in other violent incidents, both in Australia and Norway, while also addressing the issue of violence against women:

Almost without fail, non-Muslim white men who behave as he did are given the benefit of individual autonomy. When Rodney Clavell staged a 13 hour siege at an Adelaide brothel in June of this year, his reported Christianity barely made any of the news reports. Where it did, it was in articles which spent a good proportion of time talking about how much of a good bloke he was. Norway’s Andres Breivik – a right wing Christian who murdered 77 people in 2011 – was frequently described as ‘a lone wolf’. His actions were certainly not treated as a defining characteristic of members of the Christian faith, nor did Christians have to fear backlash once his affiliation was revealed.

 

 

This expectation we place on Muslims, to be absolutely clear, is Islamophobic and bigoted. The denunciation is a form of apology: an apology for Islam and for Muslims. The implication is that every Muslim is under suspicion of being sympathetic to terrorism unless he or she explicitly says otherwise. The implication is also that any crime committed by a Muslim is the responsibility of all Muslims simply by virtue of their shared religion. This sort of thinking — blaming an entire group for the actions of a few individuals, assuming the worst about a person just because of their identity — is the very definition of bigotry.

 

  • The hashtag #illridewithyou (but also note Beyondblue’s national anti-discrimination campaign in 2014 which highlights the impact of discrimination on the social and emotional well-being of Aboriginal people which has not had the same flurry of support). Also some interesting critique from Eugenia Flynn  who asks What happens when the ride Is over?
  • Interfaith action from mosques, synagogues and churches inviting the public to gather for unity, and against violence, fear and hatred.
  • Social media sharing guidelines from Alex McKinnon: 

When in doubt, wait. When you are not in full possession of the facts, remain silent so that more informed voices can be heard

Breaking news comsumers handbook

  • Good to see some thought about the people who survived the siege and their recovery.
  • Lastly, it’s great to see some critique of mass media practice from John Birmingham in the Canberra Times and Bernard Keane in Crikey.

Ending with a reflection

Thinking with sadness of all the people traumatized by yesterday’s events, the innocent people that lost their lives and all their loved ones in Sydney. Thinking also of people who live with and are caught up in acts of power, control and violence which are not of their own making globally. Thinking of the ways in which ‘our’ institutions serve ‘us’ and how responsibly they exercise their power and influence (police, media, politicians), whether their role creates calm, understanding, light or heat, marginalising and stereotyping. Whether the creation of an ‘other’ is necessary and what future it holds open for ‘others’ who experience heightened vigilance, policing and surveillance. Thinking of those who work for peace, who work to address injustice. Thinking of the need to not conclude too quickly, to not judge too harshly before understanding. Mostly today sending love, prayers and hope into the world in this season of peace and goodwill.

Heartlight

Ethnic migrant media: Weaving ourselves a home

Exploring the role, benefits, challenges & potential of ethnic media in NZ .

Paper presented at the Ethnic Migrant Media Forum, Unitec Institute of Technology, Auckland, New Zealand. Also available as pdf from conference proceedings DeSouza keynote.

Tena koutou, tena koutou, tena koutou katoa, it’s an honour to be invited to speak at this forum where we are gathered to talk about ethnic media and the possibilities it offers for our communities. I wish to acknowledge this magnificent whare whakairo (carved meeting house) ‘Ngākau Māhaki’, built and designed by Dr Lyonel Grant which I think is the most beautiful building in the entire world. Kia ora to matua Hare Paniora for the whaikōrero, whaea Lynda Toki for the karanga and this pōwhiri. I acknowledge Ngāti Whātua as mana whenua of Unitec and Te Noho Kotahitanga marae. I acknowledge the organisers of this forum, Unitec’s Department of Communication Studies and Niche Media & Ethnic Media Information NZ, in particular Associate Professor Evangelia Papoutsaki, Dr Elena Kolesova, Lisa Engledew and Dr Jocelyn Williams and all the participants gathered here today.

As a migrant to Aotearoa and now Australia, there are a few places that I call home. Tamaki makau rau and Unitec specifically would be one of those places. This whenua has been central to my own growth and development. I love these grounds, I walked them when I was a student nurse at Oakley hospital in 1986 and then worked in Building 1 or as it was known then Ward 12 at Carrington Psychiatric Hospital in 1987. I also worked here at Unitec as a nursing lecturer from 1998-2004. I have this beautiful Whaariki (woven mat) made from Harakeke (NZ Flax) grown, dyed and woven at Unitec that has accompanied me for over three house moves since I left Unitec and more recently across the Tasman.

Whaariki from Unitec, gifted to Ruth DeSouza
Whaariki from Unitec, gifted to Ruth DeSouza

It is this being at home that interests me as a migrant. Home is the safe space where I can be myself and where there are other people like me. It’s a place where I can be nurtured and supported, where I can thrive in my similarities and in my differences. Where I can see my norms and values reflected around me. I believe that the media can have a special place in helping us to see ourselves as woven through like this exquisite mat as belonging to something larger than ourselves. I believe that it can contribute to helping us feel at home, through it we can feel embraced and included, we can be part of a conversation that can see us in all our glory. However, too often it is also a site where if we are already marginalised, we can be further marginalised.

Advert in the Australian 2013
Advert in the Australian 2013

Today, I am going to briefly talk about the limitations of mainstream media, review some key functions of ethnic media and conclude with some challenges and opportunities for ethnic media. As you’ll see from my bio, I co-founded the Aotearoa Ethnic Network, an email list and journal in 2006 to provide a communication channel for the growing number of people in the “ethnic” category. I’ve been passionately interested in the role of media practices in intercultural relations in health, and also on the relations between settlers, migrants and indigenous peoples in Aotearoa New Zealand. I have been actively involved in ethnic community issues, governance, research and education in New Zealand and Australia.

This hui is timely, given discussions about: biculturalism and multiculturalism; the Maori media renaissance, the growth of Pacific and Asian owned or run media including radio, newspapers, online media; television, web based news services; the underrepresentation of Maori, Pacific and Ethnic in media and journalism; the growth of blogs through early 2000s and the growth in social media (FB, Twitter) in the last decade. It’s also part of a longer conversation, I’m thinking about the forum we had in 2005 organised by the Auckland City Council and Human Rights Commission after the Danish cartoon fiasco, where I talked about the role of media in terms of “fixing” difference or supporting complexity; the role of media in making society more cohesive or divisive or exclusive and the relevance of New Zealand media relevant in the context of growing diasporic media. In that forum I suggested that there was a need for: ethnic media but also adequate representation in mainstream media; the showing of complex multicultural relationships not just ethnic enclaves and ways for people of ethnic backgrounds to be included in national and international conversations. Me and others have also taken mainstream media to task over representations of Asians (Asian Angst story by Debra Coddington);Paul Brennan’s Islamophobic comments on National Radio and Paul Henry’s comments about then Governor General Anand Satyanand. An editorial in the AEN Journal also examines the role of mainstream media in inter-cultural exchange and promoting inter-cultural awareness and understanding. I also challenged media representations of Maori and Pacific people as evidenced in cartoons by Al Nisbet, which were printed in New Zealand media. More recently, I’ve written with colleagues Nairn, Moewaka Barnes, Rankine,  Borell, and McCreanor about the role and implications of media news practices for those committed to social justice and health equity.

Let me start by introducing a fairly binary definition of ethnic media that I am going to use as referring to media created for/by immigrants, ethnic and language minority groups and indigenous groups (Matsaganis et al., 2011). In contrast, media that produces content about and for the mainstream is known as the mainstream media. However, as most of you will know there’s a lot of blurriness and consumers consume both. I also want to preface this talk  by introducing two key words which I am going to use as a lens for this keynote. I believe that these lenses are more important than ever in an era where critique is becoming censured for those in academia and in the context of corporate governance of media. Foucault’s notion of critique which is

“..a critique is not a matter of saying that things are not right as they are. It is a matter of pointing out on what kinds of assumptions, what kinds of familiar, unchallenged, unconsidered modes of thought the practices we accept rest” (Foucault, 1988, p.154).

and Stuart Hall’s definition of ideology:

Ideology: “The mental frameworks – the language, concepts, categories, imagery of thought and system of representation – which different classes and social groups deploy in order to make sense of, define, figure out and render intelligible the way society works” (Hall, 1996 p. 26).

 

It’s in the spirit of critique that I want to talk about the mainstream media’s role in co-option and converting audiences into seeing “like the media”. As Augie Fleras observes, media messages reflect and advance dominant discourses which are expertly concealed and normalised so as to appear without bias or perspective. The integrative role of  mainstream media reflects and amplifies the concerns of particular groupings of power so that attention is drawn to norms and values that are considered appropriate within society. In this way attitudes are created and reinforced, opinions and understandings are managed and cultures are constructed and reinvented. The headline below shows the ways in which language is used to create an “other”, the picture out of focus, the beard a stand in for evil and fear, a threat to national security.

Sponsor a jihad
Sponsor a jihad

Thus mainstream media’s main function becomes commercial, selling by pooling groups together for the purposes of advertising and marketing and in so doing must appeal to a large audience. It can’t be too controversial (unless it’s also supporting larger official agendas such as guarding against the insider Islamic threat or deterring the hordes of maritime arrivals through forcibly turning back the boats) and it cannot segment its audiences with any kind of nuance. I think this meme floating around Facebook captures this idea of communicating some kind of national identity and values well.

team australia

Consequently social media, the internet and ethnic media are seen as able to service more specific audiences. In the case of social media, there’s some great opportunities for connecting beyond the nation state:

As the internet surpasses the nation-state limitations and usually the legislative limitations that bind other media, it opens up new possibilities for sustaining diasporic community relations and even for reinventing diasporic relations and communication that were either weak or non- existent in the past (Georgiou 2002: 25).

 

Moving on to ethnic media, I see several functions or imperatives loosely using the typology by Viswanath & Arora (2000): Ethnic media as form of cultural transmission, community booster, sentinel, assimilator, information provider and one lesser mentioned in the literature, as having a professional development function.

The most obvious role of ethnic media is to provide information for the community, events both local and from the homeland are paid attention to. In the break I was talking to a journalist from Radio Torana who is flying to Brisbane for the G20 summit and to cover Modi’s visit to Australia. Through him I found out about the Modi express. For the first time ever, a train service is running under the name of an Indian Prime Minister from Melbourne to Sydney carrying some 200 passengers who are planning to attend Prime Minister Narendra Modi’s public address in Sydney during his visit to Australia, the first by an Indian premier in 28 years (Rajiv Gandhi was the last, he met with Bob Hawke in 1986). The organisers have arranged for music and dance troupes to entertain the passengers along with free Gujarati specialties like ‘Modi Dhokla’ and ‘Modi Fafda’ (Fafda is crunchy snack made from chick pea flour and served with hot fried chillis or chutney and Dhokla is snack item made from a fermented batter of chickpeas accompanied with green chutney and tamarind chutney).

Photo from India2Australia.com
Photo from India2Australia.com

In its role as cultural transmitter, it has a distributive function to publish or broadcast information that is important to the ethnic community, so information about events and celebrations comes to the fore. This in turn sustains and fosters a sense of belonging to an imagined community, that feels coherent, united and connected to a homeland. However, rarely in that role does it also act as a critic of community institutions or powerful groups within that community.

A second role of ethnic media is as a community booster. In this role the media presents the community as doing well, being successful and achieving. The communities served by the media expect that a positive image is reflected both to its own members and outside the community. Typically close links are fostered between local reporters and editors and the community elite. Stories consist of human interest features, profiles of successful members, particularly those that are volunteers or contribute. There many be a reluctance to feature more radical or critical voices or critical stories as these many adversely affect the community image and the commercial imperative.

A third role is the ethnic media as a sentinel or watch dog. There’s very little about this in the literature but in fulfilling this role, the ethnic media produce stories on issues that could affect the rights of communities, crime against immigrants and so on.

A more common function is that of assimilation, where ethnic media play a part in assisting their community members to be more successful; through learning the ropes of the system. Ethnic media coverage then focuses on the role of the community in local politics and fostering positive relations and feelings between that of the ethnic group’s homeland and adopted country.

Another crucial function which is rarely articulated in this literature, but has been pivotal to my development is that of the ethnic media as space for professional development. Through engagement in ethnic media, members of ethnic communities develop transferrable skills and the capacity to write, broadcast and present. This one is very personally relevant. Through writing for the Migrant News and Global Indian, I refined my writing skills. Through talking on ethnic radio stations like Samut Sari and Planet FM I developed and refined my own capacity to articulate thoughts and ideas. Being featured in stories on Asia Downunder I realised my own ability to speak on television. These opportunities led to developing the confidence to develop my own online journal, the Aotearoa Ethnic Network Journal and write peer reviewed publications and feature on commercial radio and television.  This would never have happened without the support of those ethnic media pioneers. I acknowledge them all.

However, ethnic media is on rapidly shifting terrain. Increasingly consumers are negotiating the availability of media from their place of origin via the internet. Ethnic media are having to consider their roles and business models in the context of neoliberalism and the withdrawal of the state from cultural funding.

The end of the charter. Picture via Against the Current
The end of the charter. Picture via Against the Current

Recently Television New Zealand the public service broadcaster announced that it intended to outsource production of Māori programmes (Marae, Waka Huia) and Pacific (Fresh and Tagata Pasifika) programmes. A depressing move given the unrelenting negative representations of people in these communities who are socially and culturally marginalised in New Zealand mainstream media (see my blog post on how blame for the disparities in health is attributed to individuals and communities rather than neoliberal and austerity policies). This very manoeuvre was used to outsource Asia Downunder a programme which ran from 1994-2011 for Asians in New Zealand and featured the activities of Asians in New Zealand and New Zealand Asians abroad gutted Asian institutional knowledge and capacity within TVNZ when it was replaced with Neighbourhood. Asia Downunder was a casualty of the loss of the Television New Zealand Charter which was introduced in 2003 by the Labour government and removed in 2011 by the National government on the basis that meeting its public service obligations were a barrier to its commercial obligations. The Charter encouraged TVNZ to show programmes that reflect New Zealand’s identity and provided funding. You can read more about its history and gestation and what has been lost in The End of an Error? The Death of the TVNZ Charter and its implications for broadcasting policy in New Zealand by Peter A. Thompson, Senior Lecturer, Media Studies Programme, Victoria University of Wellington.

In this context, I end with several questions. Given that ethnic media institutions help their audiences to reimage or sustain themselves and their place in the cultural and socio-political milieu of their new home (Gentles-Peart):

  • What is the relationship between ethnic media and the ‘mainstream ideological apparatus of power? (Shi, 2009: 599)
  • What is the relevance of ethnic media in terms of the next generation?
  • What is the relationship between ethnic media and indigenous media?
  • How do ethnic media import or reinforce or critique the power structures of immigrants’ homelands including gender, class and sexuality?
  • Are there opportunities for ethnic media to lobby and advocate for their communities?
  • What opportunities and possibilities are available for inter-ethnic media work?

I look forward to summing up the korero at the end of our forum, to report back to the roopu about the strands we’ve woven together and to enjoying the robust and dynamic discussions that I know are going to happen today. No reira me mihi nui kia koutou katoa ano, tena koutou tena koutou, tena ra koutou katoa.

Update: 12th March 2017: the curated conference proceedings of the Ethnic Migrant Media Forum are now available. Edited by Evangelia Papoutsaki & Elena Kolesova with Laura Stephenson.

 

 

 

 

 

Nursing in media-saturated societies: implications for cultural safety in nursing practice

Nairn, DeSouza, Moewaka Barnes, Rankine,  Borell, and McCreanor (2014). Nursing in media-saturated societies: implications for cultural safety in nursing practice in Aotearoa New Zealand. Journal of Research in Nursing September  19: 477-487,doi:10.1177/1744987114546724

Great to be published in the Journal of Research in Nursing September 2014 issue on ‘Race’, Ethnicity and Nursing, Edited by: Lorraine Culley. I had the pleasure of being included in a previous issue in 2007, so it’s great to be in this one.

Abstract

This educational piece seeks to apprise nurses and other health professionals of mass media news practices that distort social and health policy development. It focuses on two media discourses evident in White settler societies, primarily Australia, Canada, New Zealand and the United States, drawing out implications of these media practices for those committed to social justice and health equity. The first discourse masks the dominant culture, ensuring it is not readily recognised as a culture, naturalising the dominant values, practices and institutions, and rendering their cultural foundations invisible. The second discourse represents indigenous peoples and minority ethnic groups as ‘raced’ – portrayed in ways that marginalise their culture and disparage them as peoples. Grounded in media research from different societies, the paper focuses on the implications for New Zealand nurses and their ability to practise in a culturally safe manner as an exemplary case. It is imperative that these findings are elaborated for New Zealand and that nurses and other health professionals extend the work in relation to practice in their own society.

One of my favourite pieces of the article proposes some ways in which nurses can engage in critical assessment of mass media, by asking questions like:

  • From whose point of view is this story told?
  • Who is present?
  • How are they named and/or described?
  • Who, of those present, is allowed to give their interpretation of the matter?
  • Who is absent?
  • Whose interests are served by telling the story this way?

One of the things that I love about this journal is that they ask for commentaries from a reviewer. My former colleague Denise Wilson (Professor, Māori Health Taupua Waiora Centre for Māori Health Research/School of Public Health & Psychosocial Studies, National Institute of Public Health and Mental Health Research, Auckland University of Technology, New Zealand), has reviewed our paper and says:

I would urge nurses to read this paper and reflect on how the media influences their own practice and engagement with minority and marginalised groups. Media portrayals of minority groups often reflect negatively geared dominant cultural sentiments, becoming ‘accepted’ fact within our communities. Nurses need to be aware that their efforts to be culturally safe in their practice can be undermined by the normalisation and acceptance of what is portrayed in the media. Therefore, nurses are encouraged by the authors to come together and question the ‘taken-for-granted’ dominant cultural media portrayals to create a stronger platform for culturally safe practice.

Cartoons displace the blame for social consequences of neoliberal policy away from real culprits

Over the last few years I’ve been involved in various public health and health promotion programmes related to healthy eating and weight management (Clinical Guidelines for Weight Management in New Zealand Adults and the Clinical Guidelines for Weight Management in New Zealand Children and Young People) as well as a social marketing strategy called Feeding our Futures. I’ve also facilitated four Asian Nutrition and Physical Activity Fora for the Agencies for Nutrition Action (ANA) since they began in 2008. I’ve also been involved in research with colleagues at AUT University about problem gambling.

It was my involvement in community organisations and governance rather than my own background as a health practitioner with its attendant reductionist biomedical socialisation that prepared me for the sheer complexities of the determinants of health. I understand now more than ever that macro-level health determinants (that is factors that affect health) including socio-economic status, education, employment, physical and social environment affect health and reinforce the unequal distribution of health-related resources. In contrast, micro-level determinants (lifestyle, genes) have modest impacts on population health. However, more individualistic views dominate our understanding of obesity, smoking and problem gambling. Within that frame, food “choices” are linked with moral acceptability and people who eat “unhealthy” food (with “bad” nutritional elements are deemed as less moral. Equally people that smoke and people that gamble are less “good” than people who “take care” of themselves. Such views ignore the systemic, structural and historical origins of inequality.

Which brings me to two cartoons by Al Nisbet, which were printed in New Zealand media. In the first one published in the Marlborough Express yesterday an inter-generational group of people of “Polynesian appearance” wearing children’s school uniforms and joining a queue for a free school meal. The male adult wearing tattoos and a back-to-front baseball cap, says: “Psst! … If we can get away with this, the more cash left for booze, smokes and pokies!”

Marlborough

In the second cartoon published in the Press today, what appears to be a family group of seven large people are shown with Lotto tickets, beer cans, cigarette packets and flash electronics. The man with a back to front cap on his head says: “Free school food is great. Eases our poverty and puts something in you kids’ bellies.”

From the Press
From the Press

These despicable cartoons highlight the media’s role in perpetuating the myth that  responsibility for poor health (whether it’s about people who are obese, smokers or problem gamblers) is an individual and group one rather than linked with broader issues for example colonisation, economic restructuring or the devastating social consequences of state neoliberal policies. The editor of the Marlborough Express Steve Mason has “apologised for any offence”, a phrase that has always struck me as being bereft of any remorse at harm caused, let alone an understanding of the ramifications of the incident. More callously he commented that “he was delighted that it had sparked discussion on an important issue”. But at whose expense? I am so over the casual racism by white male media influencers that shape public opinion so profoundly, the abuse of their authoritative positions to portray and represent vulnerable groups in ways that further marginalise those groups.

Luckily the Mana party have also noticed how the cartoon takes aim at New Zealand’s most vulnerable children in particular Māori and Pacific children. John Minto, MANA party co-vice president contends in an interview with TVNZ, that the cartoon is insensitive to over 270,000 New Zealand children growing up in poverty who will benefit from the Breakfast at School programme and invites the public to further “scorn them as devious parasites.” Equally this cartoon hits out at Māori and Pacific Island people who are hardest hit by gambling related harms. About 50,000 New Zealanders or 1.2% of the population have a gambling problem (defined as patterns of gambling that disrupt personal, family, or vocational pursuits) and research shows that gambling and social inequality are linked. Māori experience high rates of problem gambling and are more likely than NZ Europeans to be worried about their gambling behaviour and more likely to want immediate help. Pacific peoples living in New Zealand experience socio-demographic risk factors that are associated with developing problem gambling, such as low socio-economic status, being young, living in urban areas and having low educational and low occupational status. In addition, Maori and Pacific women have been identified as an at risk group since “pokies”  (Electronic Gaming Machines) were introduced into Aotearoa New Zealand. Tobacco smoking is a leading cause of preventable death for Māori in New Zealand and responsible for 10 percent of the gap in health disparities between Māori and non-Māori. 45.4 percent of Māori adults identify themselves as smokers, –double that of non-Māori.  Māori contribute over $260 million in tobacco taxes each year. Cumulatively as Minto points out, the cartoon “plays to the lazy racism and deep bigotry of many well-off Pakeha”. It also neglects to consider the historical impacts of colonisation on the health status of Māori and punitive neoliberal social policy on both Māori and Pacific people.

Given that the wider community depend and receive their knowledge of raced and classed ‘others’ through the media, often in the absence of direct experience with those ‘others’, I am grateful for Media commentator Martyn Bradbury and the Daily Blog for alerting me to the cartoon and broadcasters like Marcus Lush, a thriving blogosphere and social media which enable the wide dissemination of alternative discourses. As I’ve said in other blogposts, the racist soup of Pakeha media culture not only excludes particular groups but it also reproduces pathological, deficient and destructive representations of groups that are already discriminated against and marginalised. Take the “common sense” racism of Paul Henry, Michael Laws and Paul Holmes who all compete for New Zealand’s top racist. And now Steve Mason who claims in the New Zealand Herald that “Cartoons are designed to stimulate discussion and obviously that has worked in this case. So that’s what it’s all about.” He obviously missed the hard work that former Race Relations Commissioner Joris de Bres and others did after the publication by the media of cartoons depicting the prophet Mohammed in 2006 (the New Zealand Herald took a leadership role and declined to publish them). At the time de Bres asked what media purpose was served by their publication and pointed out the tensions between “the principle of the freedom of the press and the responsibility of the press in exercising that freedom”. His leadership led to improvements in the relationships between media and communities, in Auckland I took part in a forum and in Wellington religious leaders from Muslim, Catholic and Jewish faiths met with the editors of The Dominion Post and The Press.

Let’s hope our new Race Relations Commissioner Dame Susan Devoy can similarly  take a leadership role in clearly articulating why publication of the cartoons is morally wrong and propose a way forward. But, she is only one person. We also need to address the other forces that reinforce casual racism and classism in our society. The media, the smug comfortable people reading the newspaper and feeling affirmed in their righteous anger by the cartoon, all of us I’d like to leave you with last words from another cartoonist and a cartoon representing another marginalised group. In an in interview in December 2012 in the Age about the role of the cartoonist as being “not to be balanced but to give balance”. Leunig said:

As a cartoonist I am not interested in defending the dominant, the powerful, the well-resourced and the well-armed because such groups are usually not in need of advocacy, moral support or sympathetic understanding; they have already organised sufficient publicity for themselves and prosecute their points of view with great efficiency.
The work of the artist is to express what is repressed or even to speak the unspoken grief of society. And the cartoonist’s task is not so much to be balanced as to give balance, particularly in situations of disproportionate power relationships such as we see in the Israeli-Palestinian conflict. It is a healthy tradition dating back to the court jester and beyond: to be the dissenting protesting voice that speaks when others cannot or will not.

 

Leunig in the Age Wednesday 15 August 2012
Leunig in the Age Wednesday 15 August 2012

Refugee women in New Zealand: Findings and recommendations

Today on International Women’s Day, it seems apt to share this article that I wrote on behalf of our research team for the Women’s Health Action Update, volume 16, Number 43, December 2012. Women’s Health Action is a charitable trust, that works to “provide women with high quality information and education services to enable them to maintain their health and make informed choices about their health care”. Their focus is on health promotion and disease prevention and they are particularly supportive of breastfeeding and screening. Their vision is ‘Well women empowered in a healthy world’.

More than 80 per cent of the world’s refugees are women and their dependent children. Often women of refugee backgrounds [1]are constructed within deficit frames as having high needs. This representation is problematic as it deflects attention from considering broader historical, social, systemic and political factors and the adequacy of resettlement support.

Little is known about the experiences of women who enter New Zealand through the Women at Risk category identified by The Office of the United Nations High Commissioner for Refugees (UNHCR). This category constitutes up to 75 places (10%) of New Zealand’s annual refugee quota of 750. Refugee Services worked with AUT University and the three Strengthening Refugee Voices Groups in Auckland, Wellington and Christchurch to undertake a project to examine the resettlement experiences of women who enter New Zealand through this category or become sole heads of households as a consequence of their resettlement experiences. This project was funded by the Lotteries Community Sector Research Fund.

The project was important not only for its findings but also for the research process, which focused on strengths, social justice, community development and transformative research. This transformative agenda aimed to enhance the wellbeing of refugee background women by focussing on the roots of inequality in the structures and processes of society rather than in personal or community pathology (Ledwith, 2011). Within this frame we were committed to constructing refugee women as an asset rather than deploying a deficit model of refugee women as a burden for the receiving society (Butler, 2005).

Focus groups were held in 2009 and 2010 with women who entered New Zealand as refugees under the formal category ‘Women at Risk’ or became women who were sole heads of households once they arrived in New Zealand. Women that took part had lived in New Zealand from between five months to sixteen years.  Lengthy consultations were held with the three Strengthening Refugee Voices groups in Auckland, Wellington and Christchurch prior to undertaking data collection, in order to scope and refine the research focus and process. These groups were subsequently contracted to provide services and support.

Key findings

Although support needs are similar to all refugees arriving in New Zealand, there were unique and exacerbated gender issues. Refugee background women experienced a double burden of stress with half the support, especially as they parented on their own. This is despite the tremendous unpaid and voluntary support provided by faith and ethnic community members. Women frequently postponed their own aspirations in order to assure the future of their children. When they were ready to take up further education (including English language classes) or employment, limited assistance was then available (given the focus on early resettlement) leading to women feel disadvantaged.

We have made several recommendations based around several specific themes. More broadly we recommended that:

  • More intensive and longer term instititutional support be made available from agencies such as Refugee Services.
  • Subsidised practical help be made available.
  • Assistance to broaden sources of support and networks is goven.
  • Subsidised English language lessons and childcare are available.
  • That a one stop shop/holistic support from culturally and linguistically skilled refugee community insiders be provided.

Parenting

Raising children in New Zealand brought new stresses. These included concern about the loss of culture, values and language and losing their children to less palatable values including the consumption of alcohol and drugs, gender mixing and loss of respect for elders. Women addressed these issues in a range of ways that included trying different less hierarchical styles of parenting, attempting to spend more time with their children, engaging them in broader supports eg mosque. However, a few women had the experience of losing their children through the intervention of CYFS and felt disempowered in their interactions with CYFS and with schools.

  • Programme for parenting for Refugee women, particularly around issues such as discipline, inter-generational gender issues
  • Programmes for young people.
  • Cultural competence training for CYFS.

Family reunification

Living in New Zealand is difficult for women who are conscious of their own comfort while other family members struggle. However, the cost of bringing family members over is prohibitive and the costs involved in providing support in the form of phone calls and remittances add a burden to already stretched lives of the women. The importance of extended family is highlighted for women on their own and the kinds of help that could be provided by family members. Additional stresses are the requirement that refugee women are able to support their families once they arrive in New Zealand. The process is also made difficult by the lack of transparency in the immigration process.

  • Prioritise the reunification with family for women who are here on their own.
  • Provide financial support to women.
  • Increase transparency of the processes and decisions that are made.

Health system

Women encountered a different health system that at times was difficult to navigate. Many women felt that their health concerns were not taken seriously and that the health system created new problems. In terms of some health beliefs and stigma there was value in having more culturally appropriate services available. The surfeit of refugee background health professionals was a potential resource that was not being used.

  • Train and employ a more ethnically, religiously, and linguistically diverse health workforce at all levels
  • Develop culturally responsive services.
  • Examine the affordability of services.
  • Develop cultural competence of staff working in health services.

Education

The cost and availability of day care for Refugee women on their own is prohibitive in some cases consuming the lion’s share of their income/benefit. Taking up loans in order to finance their own educations is also a problem. This prevents women from achieving their own goals such as learning English, driving or further education, which would assist them in the long term with employment and independence. Women generally considered their own advancement as secondary to their children. If women were resourced financially to gain an education this would assist them to also be a resource for their children. Having long-term support to enter the workforce would also be of benefit.

  • Subsidised day care for women on their own.
  • Mentoring.
  • Scholarships for further education.

Employment

Women were concerned that their children were not getting employed despite tertiary qualifications. Barriers to employment included: ‘lack’ of New Zealand experience, language barriers, their perceived difference (clothing, culture, skin colour) and paucity of appropriate childcare, poor public transport. The impacts of unemployment included losing their dignity, health impacts of taking inappropriate jobs, boredom

  • Subsidised driving lessons, support with transport
  • More work with employers to destigmatise refugee workers
  • Work mentoring/brokering services
  • Support for family members who come into New Zealand through the reunification category to obtain further education

Racism

Refugee women and their families experienced a range of racism related harms that were instititutional and interpersonal taking physical and verbal forms. Their clothes and accent marked them out, and verbal altercations saw stereotypes being invoked particularly around Islamophobia and discourses of war on terror. Women deployed a range of strategies to cope with racism including minimising the racism and helping their children to cope with it.

  • Social marketing campaigns
  • Community education
  • Addressing structural racism
  • National conversation on racism
  • National campaign against racism

The research team hope that this research provides a snapshot of the role and value of various sectors in enabling or constraining the resettlement of refugee background women. This could contribute to better informing theory, practice and policy in order that the self-determination and resilience of refugee background women and their communities is supported.

 


[1] Note that terms like ‘refugee background women’ and ‘communities’ refer to highly diverse groups of people (Butler, 2005). In capturing the experiences of refugee women as sole heads of households, we were mindful of the potential that using a category could imply a “single, essential, transhistorical refugee condition” (Malkki, 1995, p.511).