A disjuncture of world views: manifestation in burns care for Aboriginal and Torres Strait Islander children in Australia

Ms Sarah Fraser1, Associate Professor Julian Grant1, Dr Tamara Mackean1, Dr Kate Hunter2, Associate Professor Warwick Teague3, Professor Rebecca Ivers4

1Flinders University, Adelaide, Australia, 2The George Institute for Global Health, Sydney, Australia, 3University of Melbourne, Melbourne, Australia, 4UNSW, Sydney, Australia


Aboriginal and Torres Strait Islander children are over-represented in burn injuries and experience longer lengths of stays in hospital than other Australian children. Despite these inequities, it is unclear whether the burn care Aboriginal and Torres Strait Islander children receive is structured and delivered according to their culturally-specific needs.

Existing models of burn care were critiqued for quality and cultural safety. Interviews with burn team individuals were conducted and analysed using an inductive thematic method overlayed by ecological modelling and a decolonising lens. A patient journey mapping tool was developed and tested to assess quality and safety.

A disconnect between Western and Indigenous knowledges was observed in both Australia’s healthcare system and in the documents that inform burn care. Imbalances of power and the perpetuation of colonisation, through hierarchal teams and dominant use of the biomedical model, indicated that equity in healthcare was limited, and that capacity for delivery of care based on needs beyond those aligned with the biomedical model was restricted. We identified mixed understanding of the need to provide different care for Aboriginal and Torres Strait Islander children and families, and little or no critical reflexivity in practice. Patient journey mapping successfully identified gaps in care quality.

The full potential of burn care in Australia is not realised for Aboriginal and Torres Strait Islander children accessing care. There is however, an opening for Western biomedical and Aboriginal and Torres Strait Islander knowledges to come together in the development of a new, culturally-competent model of care for burns.


Sarah has a background in nursing, child development and Aboriginal health. Sarah currently works in an clinical systems co-ordinator role at the Aboriginal Health Council of South Australia. This role has a focus on implementation of best practice care and quality improvement in the community controlled health care sector.


ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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