Bulletproofing Indigenous health students and staff against racism

Objectives: The aim of this project was to describe how Indigenous health students and staff have experienced and responded to racism, in order to identify strategies that promote resilience and to explore how this knowledge can be translated into an organisational response in health service and tertiary education settings. It was thought that an exploration of bulletproofing might provide useful additional strategies to the main aim of reducing racism itself. Design and setting: This was a two-phase exploratory qualitative study involving interviews and a literature review conducted between 2004 and 2005. The twenty-six participants were Indigenous health service and academic staff and health students. Results: Each participant was able to recount many experiences of racism in classroom and health service settings, some of the most disturbing being that directed at patients. Participants described a small number of different racist events that were highly predictable and repeated over and again. Staff described the long-term stresses associated with racism, including the considerable stress associated with deciding whether and how to respond and the sense of success or failure associated with how this went. A strong sense of guilt was associated with not responding or responding in a way that was self-appraised as being ineffective. Long term staff described factors that promoted their personal resilience, which included having a number of ‘successes’ dealing with racist events, having support of other Indigenous staff and family and working in a supportive institutional environment. There have been a range of training programs, though few directly about racism, that have useful lessons for Indigenous resilience building. Conclusion: Racism was reported as a major stresser and was commonly experienced by Indigenous health students and staff. Resilience training is the under-explored flip-side of current cross-cultural training and along with improved institutional responses has the potential to increase the sense of well-being of Indigenous staff and students and their participation in the health professions. Bulletproofing Indigenous health students and staff, offers benefits while racism persists