National Rural Health Alliance

SEARCHHELPHOME CATALOGUE NRHA National Rural Health Alliance PRINT THIS DOCUMENT RETURN TO JOURNAL INDIGENOUS MEN TAKING THEIR RIGHTFUL PLACE IN SOCIETY? A PRELIMINARY ANALYSIS OF A PARTICIPATORY ACTION RESEARCH PROCESS WITH YARRABAH MEN'S HEALTH GROUP Komla Tsey, David Patterson, Mary Whit eside, Leslie Baird and Bradley Baird The Australian Journal of Rural Health Volume 10 Number 6 December 2002 Copyright © 2002 Aust. J. \bural \fealth (2002) 10, 27\b – 2\b4 Blackw\bll Sci\bnc\b\f Ltd\L Oxford\f UKAJRTh\b Australian Jour\Lnal of Rural H\balth\L 1038-52822002 Blackw\bll Sci\bnc\b A\Lsia Pty Ltd D\bc\bmb\br 2002 10 6O\figinal A\fticle Australian Journal \Lof Rural H\balth K. TSEY ET AL. INDIGENOUS MEN TAKING THEIR RIGHTFUL PLACE IN SOCIETY? A PRELIMINARY ANALYSIS OF A PARTICIPATORY ACTION RESEARCH PROCESS WITH YARRABAH MEN’S HEALTH GROUP Komla Tsey, 1 David Patte\fson, 2 Ma\fy Whiteside, 1 Leslie Bai\fd 2 and B\fadley Bai\fd 2 1School of \bopula\fion Heal\fh, Universi\fy of Queensland, Cairns and 2Gurriny Yealamucka Heal\fh Service, Yarrabah, Queensland, Aus\fralia ABS\bRAC\b: Men’s groups are increasingly being accepted as an important strategy in improving health and well- being, especially in Indigenous communities. \fowever, it is hard to find systematic documentation and evaluation of such initiatives in the literature. This paper analyses the formative stages of a participatory action research (PA\b) process which aims to engage and support the members of the Yarrabah Men’s \fealth Group plan, implement and evaluate their activities. Data for the paper are based on a combination of a review of relevant literature, analysis of project documentation, participant observation and discussion and reflection with the participants of the men’s group. The paper highlights the importance of (a) using a reflective approach, such as PA\b, to engage men’s support groups to clearly define the principles and values which both define them and to which they aspire and (b) personal development, education and employment, as a prerequisite for Indigenous men taking greater control and responsibility for their lives. These types of micro-level studies have important implications for the way community development is perceived and approached in Indigenous settings. There are also implications for the roles that academic researchers can play in supporting and adding value to community-driven initiatives to the mutual benefit of both parties. \fEY WORDS: community development, control factor, Indigenous men’s groups, participatory action research INTRODUCTION It is wid\bly acknowl\bdg\bd that m\bn \bxp\bri\bnc\b high\br l\bv\bls of illn\bss and di\b young\br than wom\bn. On av\brag\b Australian m\bn di\b six y\bars \barli\br than wom\bn\f th\by ar\b mor\b lik\bly to hav\b h\bart dis\bas\b and canc\br\f to di\b from accid\bnts and injury\f alcohol and cigar\btt\b abus\b\f and th\by ar\b mor\b lik\bly to commit suicid\b. 1 How\bv\br\f th\b situation for Indig\bnous p\bopl\b\f and Indig\bnous m\bn in particular\f is \bv\bn wors\b. For Indig\bnous p\bopl\b\f lif\b \bxp\bctancy is b\btw\b\bn 15 and 20 y\bars l\bss than non- Indig\bnous Australians. 2 Within th\b Indig\bnous popula- tion\f m\bn ar\b faring wors\b than wom\bn as ag\b-sp\bcific d\bath rat\bs for m\bn ar\b high\br than for wom\bn in \bv\bry Correspondence: Dr Komla Ts\by\f School of Population H\balth\f Univ\brsity of Qu\b\bnsland\f PO Box 1103\f Cairns\f QLD\f 4870.\f Email: komla_ts\[email protected]\balth.qld.gov.a\Lu Accepted for publication June 2002. YARRABAH MEN’S HEALTH GROUP: K. TSEY ET AL. 279 ag\b group and b\btw\b\bn th\b ag\bs of 15 and 24\f th\b rat\bs ar\b four tim\bs high\br. 3 For Indig\bnous m\bn living in rural and r\bmot\b s\bttings\f th\b situation is \bv\bn mor\b alarming du\b to a combination of factors including inad\bquat\b s\brvic\bs\f isolation\f lack of \bmploym\bnt opportuniti\bs\f \bnd\bmic alcohol and oth\br drug abus\b and viol\bnc\b. Th\b past thr\b\b d\bcad\bs has s\b\bn\f int\brnationally\f th\b \bm\brg\bnc\b of a m\bn’s mov\bm\bnt which s\b\bks to off\br analys\bs of what has gon\b wrong for m\bn and \bxplor\bd how this can b\b addr\bss\bd. 4 This mov\bm\bnt has s\b\bn th\b \bm\brg\bnc\b of a rang\b of ‘s\blf-h\blp’ and ‘s\blf-improv\bm\bnt’ initiativ\bs\f m\bn’s conf\br\bnc\bs and th\b growth of m\bn’s groups. In Australia\f th\br\b ar\b ov\br 300 m\bn’s groups cr\bat\bd through n\bighbo\Lurhood n\btworks\f co\Lmmunity groups\f at work plac\bs or through church\bs. 4 Indig\bnous m\bn hav\b b\b\bn forming groups to addr\bss th\bir own issu\bs too. Th\bs\b groups \bmphasis\b th\b n\b\bd for m\bn to hav\b a culturally saf\b spac\b for h\baling and to \bncourag\b and \bmpow\br th\bm to r\bass\bss\f r\bvi\bw and r\b-\bstablish th\bir rol\bs in th\b family and in th\bir community. 5 D\bspit\b th\b growing acc\bptanc\b of m\bn’s support groups as important strat\bgi\bs in improving h\balth and w\bll-b\bing in Indig\bnous communiti\bs\f \bxc\bpt for a f\bw \bxc\bptions\f it is hard to find syst\bmatic docum\bntation and \bvaluation of such initiativ\bs in th\b lit\bratur\b. 5 Th\br\b is much an\bcdotal r\bporting of th\b valu\b of m\bn’s groups but th\br\b has b\b\bn littl\b r\bfl\bctiv\b information to dat\b. This pap\br analys\bs th\b formativ\b stag\bs of a participatory action r\bs\barch (PAR) proc\bss which aims to \bngag\b and support th\b m\bmb\brs of Yarrabah M\bn’s H\balth Group to plan\f impl\bm\bnt and \bvaluat\b th\bir activiti\bs. As co-authors\f w\b would lik\b to \bmphasis\b from th\b outs\bt that this proj\bct is not an acad\bmic inv\bstigator driv\bn r\bs\barch. Rath\br\f it forms part of a whol\b of community Gurriny Yealamucka \fealth Strategy and r\bpr\bs\bnts a v\bry good \bxampl\b of acad\bmic r\bs\barch\brs r\bsponding dir\bctly to id\bntifi\bd Indig\bnous community r\bs\barch n\b\bds and prioriti\bs. Th\b rol\b of th\b acad\bmic r\bs\barch\brs (KT\f MW) in th\b r\bs\barch t\bam is to train local m\bn’s h\balth group l\bad\brs and proj\bct coordinators (DP\f LB and BB) in facilitation\f \bvaluation and docu- m\bntation of th\b action r\bs\barch proc\bss. This pap\br is th\br\bfor\b a joint initiativ\b b\btw\b\bn \bxt\brnal facilitators/ \bvaluators from th\b Univ\brsity of Qu\b\bnsland and k\by m\bn’s group l\bad\brs. It is th\b first in a s\bri\bs of r\bgular f\b\bdback pap\brs to th\b wid\br m\bmb\brships of th\b m\bn’s group\f Gurriny Y\balamucka H\balth S\brvic\b Gov\brning Committ\b\b and th\b National Suicid\b Strat\bgy which funds th\b proj\bct. Ethics approval was grant\bd by Cairns Bas\b Hospital Ethics Committ\b\b (251) whil\b Gurriny Y\balamucka H\balth S\brvic\b Gov\brning Committ\b\b gav\b p\brmission to publish th\b pap\br. YARRABAH MEN’S GROUP IN CONTEXT Yarrabah is a north \LQu\b\bnsland rural Abor\Liginal community of som\b 3000 r\bsid\bnts. It is locat\bd on th\b coast 54 km south of Cairns by road. Els\bwh\br\b w\b hav\b docum\bnt\bd th\b history and \bvolution of Yarrabah as a community; k\by social probl\bms associat\bd with this history and community r\bspons\bs to th\b probl\bms and th\br\bfor\b n\b\bd not r\bp\bat th\b d\btails h\br\b. 6 Th\b following is a bri\bf summary of th\b r\bl\bvant points. Th\b Kunghanhi p\bopl\b liv\bd in th\b ar\ba long b\bfor\b Yarrabah was s\bt up as an Anglican mission in 1892. Th\b church administ\br\bd th\b s\bttl\bm\bnt for th\b n\bxt 70 y\bars. Th\b church administ\br\bd th\b plac\b with h\bavy hand\bdn\bss and during this tim\b diff\br\bnt Aboriginal groups\f including childr\bn of mix\bd d\bsc\bnt had b\b\bn r\bmov\bd from th\bir famili\bs \bls\bwh\br\b in Qu\b\bnsland and s\bttl\bd at Yarrabah. Th\b polici\bs cr\bat\bd a lot of probl\bms such as conflicts ov\br land own\brship which ar\b som\b of th\b issu\bs that th\b m\bn’s group has b\b\bn trying to addr\bss. In 1960\f th\b Qu\b\bnsland \LD\bpartm\bnt of Nativ\b Aff\Lairs assum\bd dir\bct control of th\b community. This was follow\bd by a gradual d\bv\blopm\bnt of th\b infrastructur\b and s\brvic\bs that had b\b\bn\L availabl\b to n\barby no\Ln-Indig\bnous communiti\bs. In 1972\f a pav\bd road conn\bcting Yarrabah to Cairns was op\bn\bd\f furth\br \broding d\bpartm\bntal con- trols ov\br r\bsid\bnts’ mov\bm\bnts. Ov\br th\b n\bxt f\bw y\bars\f th\b d\bpartm\bntal administrators and staff gradually l\bft\f and in 1986 community manag\bm\bnt was incr\bas\bd with all Stat\b r\bs\brv\bs (including Yarrabah) b\bing gaz\btt\bd as ‘d\b\bd of grant in trust’ communiti\bs. 6 As in most parts of Australia\f th\b history of colonial disposs\bssion and th\b r\bsultant social\f cultural\f \bconomic and political dislocations continu\b to impact on th\b p\bopl\b of Yarrabah\f \bsp\bcially m\bn. How\bv\br\f as P\barson argu\bs\f th\bs\b factors alon\b cannot \bxplain th\b full \bxt\bnt of th\b h\balth and o\Lth\br r\blat\bd chall\bn\Lg\bs facing Yarrabah p\bopl\b. 7 Th\b availability of w\blfar\b paym\bnts from th\b 1970s\f originally d\bsign\bd to b\b a saf\bty n\bt for only small minoriti\bs of th\b Australian mainstr\bam population\f has in th\b cont\bxt of Yarrabah b\bcom\b th\b main sourc\b of sust\bnanc\b for th\b larg\b majority of p\bopl\b. Thus\f th\b availability of w\blfar\b paym\bnts through CDEP (a work for th\b dol\b syst\bm r\bquiring participants to work two days p\br w\b\bk for th\bir social s\bcurity paym\bnts)\f unlimit\bd amounts of l\bisur\b tim\b\f availability of alcohol and oth\br drugs and a g\bn\brally p\brmissiv\b alcohol and drug cultur\b in mainstr\bam Australian soci\bty hav\b all combin\bd in varying d\bgr\b\bs to cr\bat\b what P\barson calls an ‘alcohol \bpid\bmic’ with d\bvastating \bff\bcts for th\b community. 7 280 AUSTRALIAN JOURNAL OF RURAL HEALTH Writing about Yarrabah in th\b 1970s\f Craig obs\brv\bd that m\bn w\br\b turning incr\basingly to alcohol\f ‘and wiv\bs oft\bn hav\b to driv\b th\bir in\bbriat\bd husbands from th\bir hom\bs’ and that th\b r\bsultant ‘d\bstabilisation of th\b family is impairing its function as an ag\bnt of social control’. 8 Cons\bqu\bntly\f h\b continu\bd\f th\b ‘young\br g\bn\brations on Yarrabah ar\b growing up to acc\bpt curr\bnt patt\brns of alcohol abus\b as normal …’. 8 By mid 1980s\f th\b commun- ity was convuls\bd with a s\bri\bs of viol\bnt suicid\bs among young m\bn\f s\bv\bral of th\bm in custody. This trag\bdy was to b\b r\bp\bat\bd across Australia l\bading to th\b Royal Commission into Aboriginal D\baths in Custody. In Yarrabah\f a s\bri\bs of locally driv\bn initiativ\bs w\br\b d\bv\blop\bd \bith\br dir\bctly or indir\bctly in r\bspons\b to th\b trag\bdi\bs. Among th\bm w\br\b th\b formation of a h\balth council in 1988\f som\b improv\bm\bnts in acc\bss to mainstr\bam s\brvic\bs\f a d\bcision to clos\b th\b alcohol cant\b\bn in 1997\f th\b d\bv\bl- opm\bnt of a compr\bh\bnsiv\b h\balth strat\bgy and th\b \bstablishm\bnt of a m\bn’s support group to provid\b a saf\b \bnvironm\bnt for m\bn to talk about th\bir probl\bms and \bxamin\b possibl\b solutions. 6 Th\b Yarrabah M\bn’s Group start\bd in 1998 as a voluntary support group. Th\b main activiti\bs includ\bd w\b\bkly h\balth \bducation s\bssions on topics of int\br\bst to th\b group\f couns\blling\f m\bn’s h\balth clinics provid\bd by a visiting Aboriginal doctor\f activiti\bs to promot\b social skills and bonding such as going to r\bstaurants for m\bals and visiting th\b cin\bma\f hunting\f fishing and camping. M\bmb\brs paid for th\b costs of th\bs\b activiti\bs th\bms\blv\bs. Gurriny Y\balamucka H\balth S\brvic\b\f th\b incorporat\bd community h\balth council\f provid\bd in-kind support through a v\bnu\b for m\b\btings\f coordination of activiti\bs and us\b of comput\br and oth\br faciliti\bs for th\b production of promotional mat\brial including a vid\bo\f brochur\bs and post\brs. By 2000\f th\b community had acknowl\bdg\bd th\b b\bn\bfits of th\b m\bn’s h\balth group and call\bd for th\bir activiti\bs to b\b \bxt\bnd\bd to m\bn that w\br\b most in n\b\bd. Thos\b at particular risk of suicid\b includ\b m\bn who ar\b h\bavy drink\brs\f who hav\b a history of viol\bnc\b and m\bn in th\b corr\bctions syst\bms. Out of a total population of 3000\f th\br\b w\br\b n\barly 70 mal\bs on int\bnsiv\b corr\bctional ord\brs and probation or parol\b in 2000. Most of th\bs\b ord\brs r\blat\b to viol\bnc\b. Thus\f th\br\b was a f\b\bling that a much mor\b syst\bmatic and coordinat\bd approach was r\bquir\bd to acc\bss th\L\bs\b m\bn and hav\b th\bm p\Larticipat\b in th\b group activiti\bs. Following a succ\bssful application\f th\b M\bn’s Group s\bcur\bd 2-y\bar National Suicid\b Strat\bgy funding from August 2001 to support its activiti\bs. This allow\bd two local m\bn to b\b \bmploy\bd (1 full-tim\b and 1 part-tim\b) to coordinat\b and support th\b activiti\bs of th\b M\bn’s Group. A small van was also purchas\bd to facilitat\b th\bir activ- iti\bs. As part of th\b funding agr\b\bm\bnt th\b Univ\brsity of Qu\b\bnsland was contract\bd to \bvaluat\b th\b M\bn’s Group proj\bct. Th\b r\bst of this pap\br d\bscrib\bs th\b formativ\b stag\bs of th\b us\b of a participatory action r\bs\barch (PAR) proc\bss to support m\bmb\brs of th\b m\bn’s group plan\f impl\bm\bnt and \bvaluat\b th\bir activiti\bs. PARTICIPATORY ACTION RESEARCH Participatory action r\bs\barch is a proc\bss that allows ordinary p\bopl\b acting as r\bs\barch\brs to \bxplor\b priority issu\bs aff\bcting th\bir day to day liv\bs\f r\bcognis\b th\bir own r\bsourc\bs\f produc\b knowl\bdg\b and tak\b action to improv\b th\bir situation\f oft\b\Ln in solidarity with \L\bxt\brnal support\brs. Grundy and K\bmmis d\bfin\bd th\b proc\bss as ‘th\b id\bnti- fication of strat\bgi\bs of plann\bd action which ar\b impl\b- m\bnt\bd\f and th\bn syst\bmatically submitt\bd to obs\brvation\f r\bfl\bction and chang\b’ and ‘participants in th\b action b\bing consid\br\bd as int\bgrally involv\bd in all th\bs\b activiti\bs’. 9 Th\b proc\bss its\blf is spiraling. Knowl\bdg\b and und\br- standing informs strat\bgy d\bv\blopm\bnt in th\b first instanc\b. This is th\bn follow\bd by action\f which aft\br b\bing monitor\bd and r\bfl\bct\bd upon informs n\bw und\brstanding\f strat\bgy and action\f with ongoing chang\b b\bing th\b goal. Bas\bd on this mod\bl\f a thr\b\b-ti\br PAR proc\bss \bvolv\bd as follows: • Th\b \bxt\brnal \bvaluator facilitat\bs planning and \bvalu- ation training s\bssions for th\b M\bn’s Group \bmploy\b\bs and oth\br l\bad\brs of th\b group\f fortnightly initially and lat\br monthly; • Thos\b train\bd by th\b \bxt\brnal \bvaluator in turn facil- itat\b planning and \bvaluation s\bssions for th\b wid\br m\bmb\brship of th\b m\bn’s group; • Th\b two \bmploy\b\bs and th\bir workplac\b sup\brvisor att\bnd w\b\bkly m\b\btings to r\bvi\bw and follow-up issu\bs arising from th\b planning and \bvaluation s\bssions. THE FORMATIVE PROCESS From th\b outs\bt th\b m\bn d\bv\blop\bd a s\bt of conc\bptual valu\bs and principl\bs to und\brpin th\b group. Whil\b it is important for m\bn\f \bsp\bcially Indig\bnous m\bn to und\br- stand how th\by hav\b b\b\bn hurt by soci\bty’s tr\batm\bnt of th\bm\f it is also vital for m\bn to appr\bciat\b how th\by in turn hurt wom\bn: ‘An awar\bn\bss of th\b importanc\b of chall\bnging s\bxism is in fact c\bntral to m\bn’s “r\bconstruc- tion” of th\bir mal\bn\bss sinc\b our r\bpudiation of “th\b f\bminin\b” holds our masculinity in plac\b.’ 10 B\bcaus\b m\bn fr\bqu\bntly minimis\b\f d\bny\f or blam\b oth\brs for th\bir viol\bnc\b\f it is oft\bn v\bry chall\bnging for facilitators of m\bn’s groups YARRABAH MEN’S HEALTH GROUP: K. TSEY ET AL. 281 to maintain a position of not colluding with such attitud\bs\f \bv\bn subconsciously. Th\b d\bv\blopm\bnt of a cl\bar vision ground\bd in th\b principl\bs of \bmpow\brm\bnt right from th\b outs\bt has b\b\bn h\blpful in g\btting th\b m\bn to r\bgularly r\bfl\bct on th\bir own b\bli\bfs\f attitud\bs and practic\bs. 11 An initial task which th\b m\bn \bngag\bd in was th\b d\bv\blopm\bnt of a common languag\b that d\bscrib\bd th\bir vision or goal. Th\b original vision stat\bm\bnt of th\b group as docum\bnt\bd in th\b grant application was: to r\bstor\b m\bn’s rightful rol\b in th\b community using a holistic h\baling approach \bncompassing in th\b program th\b spiritual\f m\bntal\f physical\f \bmotional and social asp\bcts of lif\b. Th\b m\bn w\br\b ask\bd in small groups to r\bfl\bct on th\b m\baning of ‘m\bn’s rightful rol\b in community’ and to indicat\b how a man who plays his rightful rol\b can b\b r\bcognis\bd. Aft\br a proc\bss of d\bbat\b and r\bfl\bction\f participants d\bv\blop\bd cons\bnsus around a s\bt of basic b\bli\bfs\f attitud\bs and b\bhaviours that th\by b\bli\bv\b by which a Yarrabah man who plays his rightful rol\b in soci\bty could b\b judg\bd. Th\bs\b w\br\b cat\bgoris\bd into Do’s and Don’ts as follows: Some of the Do’s • B\b loving\f kind\f compassionat\b\f forgiving\f r\bsp\bctful\f hon\bst and truthful; • Support family by working and paying bills; • Having a job\f \bmploym\bnt; • Rol\b mod\bl for wif\b and kids; • Don’t say on\b thing and do som\bthing \bls\b practic\b what you pr\bach; • Shar\b hous\bhold r\bsponsibility in family; • B\b an \bxampl\b\f rol\b mod\bl; • Hav\b goals; • Communicat\b with kids and wif\b r\bgularly; • Sp\bnd tim\b r\bading to your kids; • Look at spiritual n\b\bds and valu\bs; • R\bsolv\b conflict by talking rath\br than fighting; • B\b activ\bly involv\bd in finding positiv\b solutions to community conflicts\f for \bxampl\b land issu\bs; • Show mor\b positiv\b l\bad\brship in family and community; • T\bach your kids to r\bad; • Instil CONFIDENCE in your family; • L\barn to b\b a m\bdiator; • R\bsp\bct yours\blf and oth\brs; • Admit wh\bn h\b is Wrong; • Mak\b sur\b th\br\b is food in th\b cupboard. Some of the Don’ts • Argu\b and fight in front of kids; • Abus\b wif\b or kids; • Gambl\b mon\by away; • B\b slav\bs to alcohol\f drugs\f gambling and pl\basur\bs of th\b s\blf; • Hat\b\f r\bj\bct and put down p\bopl\b; • B\bcom\b ‘Mr Moms’ (Sol\bly r\bsponsibl\b for hous\bhold chor\bs)\f shar\b r\bsponsibility; • Tak\b sid\b with oth\brs in community disput\bs; • B\b lazy and \bxp\bct \bv\brything lik\b a king; • B\b macho about c\brtain jobs; • B\b asham\bd of who you ar\b; • B\b viol\bnt to oth\brs and famili\bs; • Don’t b\b s\blfish\f think of oth\brs. Th\bs\b principl\bs hav\b giv\bn th\b group a cl\bar id\bntity about who th\by ar\b an\Ld th\b valu\bs to which\L th\by aspir\b as w\bll as provid\b a s\bt of crit\bria against which th\b activiti\bs of th\b group will continu\b to b\b monitor\bd and \bvaluat\bd. Th\b m\bn th\bn \bxplor\bd th\bir ass\bts or str\bngths\f both as individuals and as a group in ord\br to d\bv\blop und\br- standing about barri\brs or things that may b\b stopping th\bm from taking th\bir rightful plac\b in soci\bty\f and what m\bn n\b\bd to do to ov\brcom\b such barri\brs. To assist th\b group mak\b inform\bd d\bcisions\f information on a wid\b rang\b of r\bl\bvant topics was pr\bs\bnt\bd and critically r\bfl\bct\bd upon. Th\bs\b includ\b background history of Yarrabah and th\b M\bn’s Group\f a bri\bf r\bvi\bw of th\b lit\bratur\b on m\bn’s support groups\f th\b d\bt\brminants of h\balth and \bvid\bnc\bd-bas\bd int\brv\bntions to r\bduc\b h\balth in\bqualiti\bs 12 and P\barson’s analysis of th\b rol\b of alcohol in Indig\bnous communiti\bs. 7 As a r\bsult of this proc\bss\f th\b group id\bntifi\bd four major s\bts of initiativ\bs that th\by b\bli\bv\b can support and \bnhanc\b th\bir capacity to tak\b th\bir rightful plac\b in th\b community. Pe\fsonal Development, Leade\fship and Pa\fenting Th\bs\b r\blat\b to a s\bt of basic lif\b skills. Th\by includ\b gr\bat\br und\brstanding and skills in par\bnting\f conflict r\bsolution\f m\bdiation\f drug and alcohol\f gambling\f p\br- sonal incom\b manag\bm\bnt\f r\blationships and community l\bad\brship. Th\by also includ\b m\bn d\bv\bloping gr\bat\br ability to r\bfl\bct on th\bir b\bli\bfs\f attitud\bs and actions and how th\bs\b may b\b aff\bcting th\bm or oth\brs. Th\br\b was strong f\b\bling that \bach man n\b\bds to tak\b\f in th\b words of on\b participant\f ‘a hard and hon\bst look’ at hims\blf. Opportuniti\bs for l\barning n\bw ways and skills of und\br- standing and d\baling with lif\b w\br\b s\b\bn as important st\bps towards m\bn taking th\bir rightful plac\b. Th\b \bmphasis on p\brsonal d\bv\blopm\bnt and r\bspons- ibility as \bss\bntial st\bps in Indig\bnous m\bn taking th\bir rightful plac\b in soci\bty r\bsonat\bs with th\b conc\bpt of th\b ‘control factor’ in h\balth. According to Sym\b\f 282 AUSTRALIAN JOURNAL OF RURAL HEALTH ‘th\b high\br social class\bs hav\b\f from th\bir \barli\bst y\bars\f b\b\bn giv\bn mor\b training\f opportunity\f r\bsourc\bs and skills to d\bal with lif\b probl\bms; th\b low\br a p\brson’s position in th\b social hi\brarchy\f th\b l\bss lik\bly h\b or sh\b is to hav\b r\bc\biv\bd th\bs\b b\bn\bfits.’ An important factor in improving h\balth and w\bll-b\bing is som\bthing Sym\b calls mastery: b\bing abl\b to trav\brs\b lif\b’s difficulti\bs and solv\b \bv\bryday probl\bms so that th\by do not ov\brwh\blm us. 13 As Sym\b puts it\f th\b chal- l\bng\b is ‘how to giv\b p\bopl\b s\bcr\bts for how th\by can n\bgotiat\b th\bir lif\b .’ 13 Mor\b work cl\barly n\b\bds to b\b don\b to improv\b our und\brstanding about th\b natur\b and rol\b of individual control and r\bsponsibility and how on\b might go about promoting this \bsp\bcially in Indig\bnous s\bttings. This should hav\b important implications for th\b way community d\bv\blopm\bnt can b\b p\brc\biv\bd and approach\bd. Employment Th\b issu\b of \bmploym\bnt was a dominant th\bm\b. Th\b m\bn w\br\b \bmphatic that for th\bm to tak\b th\bir rightful plac\b in th\b community th\by n\b\bd to hav\b r\bal jobs and not just th\b Community D\bv\blopm\bnt Employm\bnt Program (CDEP). Th\br\b was a f\b\bling that th\b community was b\bing divid\bd b\btw\b\bn th\b f\bw who hav\b r\bal jobs and thos\b on CDEP\f ‘th\b hav\bs and hav\b nots’ as on\b p\brson d\bscrib\bd it. Thos\b with r\bal jobs ar\b th\b on\bs whos\b famili\bs ar\b functioning r\blativ\bly w\bll whil\b thos\b without jobs t\bnd to b\b mor\b aff\bct\bd by alcohol and oth\br drug probl\bms. As in most rural ar\bas\f th\b m\bn acknowl\bdg\bd th\b limit\bd opportuniti\bs in Yarrabah for m\baningful \bmploym\bnt. N\bv\brth\bl\bss\f th\by also acknowl\bdg\bd that \bv\bn wh\bn jobs b\bcom\b availabl\b from tim\b to tim\b in th\b so-call\bd ‘w\blfar\b’ or s\brvic\b s\bctors it is oft\bn hard to find p\bopl\b\f \bsp\bcially m\bn to apply for th\b positions. Th\b main r\bason is that most m\bn simply lack skills and /or confid\bnc\b to apply for jobs. As a r\bsult\f such jobs ar\b \bith\br r\bcycl\bd among th\b f\bw alr\bady \bmploy\bd or tak\bn up by outsid\brs. For rural communiti\bs such as Yarrabah\f th\b group agr\b\bd that gr\bat\br att\bntion n\b\bds to b\b paid to mor\b cr\bativ\b ways of achi\bving \bmploym\bnt though th\by also b\bli\bv\b that this would r\bquir\b m\bn to chang\b th\bir attitud\bs towards c\brtain typ\bs of \bmploym\bnt. For \bxampl\b\f mor\b m\bn should b\b \bncourag\bd to train and b\bcom\b prof\bssional car\brs for m\bn with physical or m\bntal disabiliti\bs for which th\br\b has always b\b\bn a signi- ficant d\bmand in th\b community. Th\b importanc\b of basic lif\b skills as w\bll as mor\b formal \bducation and training programs as first st\bps in tackling th\b issu\b \bmploym\bnt was \bmphasis\bd. Education and T\faining For som\b m\bn\f it was f\blt that all that th\by n\b\bd\bd was r\bgular information on job opportuniti\bs\f basic skills and confid\bnc\b to apply and go through th\b int\brvi\bw proc\bss. M\bmb\brs will m\bntor and support som\b of th\bs\b p\bopl\b to id\bntify and apply for jobs both in Yarrabah and in Cairns. For oth\brs\f it was f\blt that mor\b formal training and \bducation would b\b r\bquir\bd. In adopting th\bir prior- ity \bducation and training initiativ\bs\f particular att\bntion was giv\bn to th\b \bxp\bri\bnc\b and int\br\bsts of individual m\bmb\brs of th\b group. Th\b following priority \bducation and training initiativ\bs w\br\b adopt\bd: • Driving and boat lic\bnc\b cours\bs; • Small busin\bss d\bv\blopm\bnt; • D\bv\blopm\bnt of f\basibility plans in th\b ar\bas of art and craft\f traditional danc\b and music; • N\bwsag\bncy including printing and publicity; • Computing; • How to apply for jobs\f d\bv\blop a CV and int\brvi\bwing; • Basic r\bading and writing; • S\bcurity guard training; • Family w\bll-b\bing p\brsonal d\bv\blopm\bnt program; • Drug and alcohol couns\blling. T\fadition, Cultu\fe and Yubba Bimbie Men’s Place Th\b fourth major cat\L\bgory of strat\bgic init\Liativ\bs r\blat\bs to m\bn l\barning mor\b about th\bir Aboriginal id\bntity and cultur\b\f th\b incorporation of th\b M\bn’s Group as a community controll\bd Aboriginal organisation\f and th\b \bstablishm\bnt of Yubba Bimbi\b M\bn’s Plac\b. Yubba Bimbi\b\f m\baning fath\br and son\f is \bxp\bct\bd to provid\b a saf\b spac\b for m\bn of all ag\bs to int\bract\f for young p\bopl\b to l\barn from th\b \bld\brs\f for m\bn to r\bc\biv\b couns\blling and oth\br support. Yubba Bimbi\b will also b\b a plac\b to coordinat\b and support th\b rang\b of id\bntifi\bd p\brsonal d\bv\blopm\bnt\f \bmploym\bnt and busin\bss d\bv\blopm\bnt training initiativ\bs. Oth\br important initiativ\bs und\br tradition and cultur\b includ\b sharing \bxp\bri\bnc\b and information with oth\br Indig\bnous m\bn’s groups and working towards r\bconciliation with whit\b m\bn through n\btworking with r\bl\bvant non-Indig\bnous m\bn’s groups. Th\b four broad ar\bas id\bntifi\bd d\bs\brv\b an additional comm\bntary. W\b hav\b alr\bady \bmphasis\bd th\b r\bl\bvanc\b of p\brsonal d\bv\blopm\bnt to th\b control factor in h\balth. What th\b ov\brall strat\bgy planning proc\bss also shows is that any syst\bmatic and community driv\bn approach to addr\bssing h\balth will n\bc\bssarily n\b\bd to involv\b multi l\bv\bl strat\bgi\bs that addr\bss both upstr\bam and downstr\bam factors. 14 YARRABAH MEN’S HEALTH GROUP: K. TSEY ET AL. 28\b A 2-y\bar d\btail\bd op\brational plan incorporating short and long-t\brm activiti\bs in \bach of th\b four broad strat\bgic ar\bas was compl\bt\bd in D\bc\bmb\br 2001. Th\b Group has sinc\b b\b\bn impl\bm\bnting th\b plan. Som\b of th\b k\by achi\bv\b- m\bnts so far includ\b th\b comm\bnc\bm\bnt of an 18 month family w\bll-b\bing p\brsonal d\bv\blopm\bnt and l\bad\brship program (through funding from both Qu\b\bnsland H\balth and th\b D\bpartm\bnt of Family and Community S\brvic\bs Strong\br Famili\bs and Communiti\bs Strat\bgy)\f pr\bliminary inv\bstigations r\bgarding a rang\b of id\bntifi\bd training and small busin\bss d\bv\blopm\bnt initiativ\bs\f and th\b \bstablish- m\bnt of s\bv\bral working parti\bs to support impl\bm\bntation of various compon\bnts of th\b plan. Som\b int\br\bsting r\bsults ar\b b\bginning to \bm\brg\b and som\b chall\bnging dichotomi\bs ar\b arising for th\b m\bn to addr\bss. For \bxampl\b\f th\b m\bn’s group is b\bcoming r\bcog- nis\bd by local magistrat\bs as a plac\b of r\bf\brral. Whil\b this r\bcognition is \bncouraging\f th\br\b is also a s\bns\b that som\b m\bn ar\b using th\b group as a m\bans for minimising l\bgal sanctions. Also\f whil\b m\bn’s outings hav\b b\b\bn s\b\bn as succ\bssful\f and \Lth\br\b has b\b\bn f\b\bdback\L that som\b m\bn ar\b now also having outings with th\bir famili\bs\f th\br\b hav\b also b\b\bn r\bports that conflict has aris\bn b\btw\b\bn coupl\bs ov\br th\b us\b of mon\by. This has \bmphasis\bd th\b n\b\bd for gr\bat\br skills in p\brsonal financial planning. CONCLUSION This pap\br has sp\bcifically focus\bd on th\b formativ\b stag\bs of \bstablishing a fram\bwork for \bnabling th\b int\bgration of an \bvaluation proc\bss into strat\bgic planning to addr\bss th\b issu\bs confronting m\bn in th\b Yarrabah community. This has occurr\bd through th\b utilisation of a PAR approach. As appli\bd social r\bs\barch\f PAR s\b\bks \bxplicitly to addr\bss and transform social in\bqualiti\bs. Th\b approach\f which int\bgrat\bs sci\bntific inv\bstigation with skill d\bv\bl- opm\bnt and political action\f is wid\bly acknowl\bdg\bd as an appropriat\b m\bthodology in th\b cont\bxt of Indig\bnous r\bs\barch\f not l\bast b\bcaus\b of its pot\bntial to \bmpow\br thos\b participating in th\b r\bs\barch. As on\b Indig\bnous \bducator r\bc\bntly r\bfl\bct\bd\f ‘W\b (Indig\bnous p\bopl\b) can us\b r\bs\barch ours\blv\bs to gain accurat\b knowl\bdg\b of our own r\baliti\bs\f so that w\b ar\b \bmpow\br\bd to find our own solutions … Participatory action r\bs\barch cr\bat\bs opportuniti\bs for th\bs\b aspira- tions to b\b m\bt.’ 15 Participants in th\b m\bn’s group proc\bss hav\b so far found th\b proc\bss to b\b \bmpow\bring: This proc\bss has \bmpow\br\bd participants to r\bally d\bv\blop th\b futur\b of Yarrabah M\bn’s Group\f n\bv\br b\bfor\b th\by had such opportunity to hav\b input into th\b program and I find th\b proc\bss to b\b \bxc\bll\bnt\f b\bcaus\b what w\b discuss ar\b about ours\blv\bs and th\b first st\bp in man finding his rightful rol\b w\b n\b\bd to fac\b our probl\bms hon\bstly and admit th\bm and mov\b forward to find solutions and th\bs\b st\bps r\bv\bal l\bad\brship that li\bs in \bach of th\b m\bn. Ind\b\bd\f our co-author David Patt\brson\f founding m\bmb\br and m\bn’s group proj\bct coordinator captur\bd th\b s\bntim\bnts of th\b m\bn’s group l\bad\brship in a promotional po\bm\f titl\bd True Friends Indeed \f which w\b r\bproduc\b in full: My Yabba in your tim\bs of n\b\bd W\b th\b M\bn’s Group\f ar\b your tru\b fri\bnds ind\b\bd. Our aim is to h\bal th\b Inn\br Man\f For th\b sak\b of our family and our community W\b n\b\bd to mak\b a positiv\b stand. In our mind\f w\b can r\bv\brs\b th\b rippl\b \bff\bct of d\bspair\f I pl\ba to thos\b who ar\b in n\b\bd\f to att\bnd th\b M\bn’s Group for r\bpair. It’s und\brstandabl\b if you’r\b in doubt\f but giv\b th\b M\bn’s Group consid\bration\f Caus\b h\baling is by word of mouth. W\b onc\b w\br\b p\bac\bful warriors roaming happy and fr\b\b\f w\b mu Gurriny Y\balamucka H\balth Strat\bgy Plan to r\bv\brt back to this way\f For th\b whol\b damn world to s\b\b. At pr\bs\bnt th\b group is consist\bnc\b but stabl\b\f With no l\bss than 10 m\bn surrounding Th\b discussion tabl\b. Th\b succ\bss of th\b group is t\bstam\bnt to th\b pow\br of th\b will\f To b\b part of this group is a privil\bg\b and honor\f But d\b\bp down in my h\bart it’s a thrill. W\b \bmphasis\b b\bing a Rol\b Mod\bl to our family and community\f Ess\bnc\b of our daily liv\bs is th\br\bfor\b\f W\b as on\b must truly liv\b in unity. Int\br\bsting r\bsults ar\b b\bginning to \bm\brg\b from this ongoing proc\bss and ar\b forming th\b basis for furth\br analysis. ACKNOWLEDGEMENTS Th\b authors would lik\b to thank m\bmb\brs of Yarrabah M\bn’s H\balth Group and Gurriny Y\balamucka H\balth S\brvic\b Gov\brning Committ\b\b for th\bir support and p\brmission to publish th\b pap\br. Funding for th\b proj\bct cam\b from National Suicid\b Strat\bgy. 284 AUSTRALIAN JOURNAL OF RURAL HEALTH Univ\brsity of Qu\b\bnsland provid\bd in-kind contribu- tion through funding from Qu\b\bnsland H\balth Public H\balth S\brvic\bs. REFERENCES 1 Wilson A. Why Are Men Less \fealthy Than Women? NSW: H\balth D\bpartm\bnt\f 1998. 2 Adams M. Establishing a National Fram\bwork for Improv- ing th\b H\balth and W\bll-B\bing of Aboriginal and Torr\bs Strait Island\br Mal\bs. Aboriginal and Islander \fealth Worker Journal 2002; 26: 11–12. 3 McL\bnnan W\f Madd\bn R. The \fealth and Welfare of Australia’s Aboriginal and Torres Strait Islander People 1999\f 1999. Australian Bur\bau of Statistics\f Commonw\balth of Australia\f Catalogu\b no.\f 4704.0. 4 Biddulph S. Manhood. Sydn\by: Finch Publishing\f 1995. 5 Franks A. M\bn Exploring N\bw Dir\bctions. Aboriginal and Islander \fealth Worker Journal 2000; 24: 12–20. 6 Hunt\br E\f Ts\by K\f Baird M\f Baird L. Indig\bnous m\bntal h\balth promotion. 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