Injury in Indigenous Communities: A Call for Enlightened Action

Abstract

What can surgeons do to address the suffering caused by injury in Australian Aboriginal communities? The answer lies in two areas in which surgeons excel -patient care and community and workplace leadership. In their article regarding the epidemic of stab injuries seen at Alice Springs Hospital, Jacob, Boseto and Ollapillil emphasize the importance of these dual roles. 1 As surgeons, first and foremost, we are tasked with the victims' resuscitation and haemorrhage control, visceral repair and we operate to restore structure and function. We break bad news and we comfort our patients and their families. We coordinate other clinicians and we foster recovery and rehabilitation.Caring for victims of interpersonal violence can be confronting and complex, especially in a cross-cultural setting where there are communication difficulties. Consider, for example, Mary (not her real name), a quiet and withdrawn Aboriginal woman whom I recall limping into a remote community clinic bent over, clutching her abdomen and cradling an injured forearm. She had often presented with beatings after closing time at the club and had previously undergone surgery for burns, fractures, lacerations and an intracranial bleeding. However, her nights spent at a women's refuge centre had always seen her return home to her abusive husband. Her courage in doing so was only matched by her mistrust of

Unexpected hidden knife blade in the chest wall: A rare case report

“…Detailed history from paramedics or witnesses can be helpful in determining whether the knife was intact after stabbing [1] . Commonest cause of stab injuries requiring admission are in increasing order: the chest, abdomen and neck, however cardiac injuries are rare and incidence is highest in middle age males [2,3,4] . The thorax has also been the site for most of the retained knife injuries [5] .…”

Changing trends in the pattern and outcome of stab injuries at a North London hospital

“…In most studies for penetrating injuries, the typical patient was a young middle-aged man accounting for 90% of affected victims. [511] It is widely accepted the majority of stabbing occurs in public places like streets and pubs. Hutchison et al .…”

“…This belief is further supported by several studies done in other countries such as Israel,[2] Jamaica,[3] Zambia[4] and Australia. [56] It is reported that around 1200 knife crimes took place in London in 2005. [7] Despite these alarming statistics, recent hospital admission with stab injuries since 2005 is lacking in the literature.…”

Addressing surgical inequity for Aboriginal and Torres Strait Islander people in Australia's universal health care system: a call to action

“…Practical approaches include encouraging clinicians to learn about the impact of culture on health and health care and to recognize that clinician biases may contribute to inequities in health care 22,74 . While providing care, clinicians should take the time to develop relationships with patients to learn about their individual sociocultural context, needs, knowledge, values and goals and engage in effective communication to do so 75 .…”