Maridulu Budyari Gumal: bridging the health-care gap for indigenous Australians

Maridulu Budyari Gumal, otherwise known as the Sydney Partnership for Health, Education, Research and Enterprise, or SPHERE, draws its ranks from 14 thought-leading organisations across the Sydney basin – universities, hospitals, research institutes, community and primary care centres. It utilises their combined resources, including 50,000-odd staff, 100,000-plus students and more than $5 billion in annual revenue, to ‘start new conversations, explore new avenues and … [create] a new kind of healthcare’.

The name Maridulu Budyari Gumal, gifted to the SPHERE partnership by the Dharug people, means ‘working together for good health and wellbeing’. According to Aunty Kerrie Doyle, Professor of Indigenous Health at Western Sydney University, and co-chair/research lead of the SPHERE’s Aboriginal Health and Wellbeing Clinical Academic Group, it’s an apt description of the partnership’s mission.

“I think that it speaks to the core values of our whole program,” Prof. Doyle says. “It demonstrates respect and it’s a vehicle for community inclusion, so that people can feel as though they own this.

“Having ownership of something means that you have say, and buy-in to what occurs, and that’s really important.”

Bridging the health-care gap

The SPHERE’s footprint covers the Greater Western Sydney region, one of the fastest growing, most diverse populations in Australia. The region is home to people from 140 nationalities, ‘some of which are the most disadvantaged in the country’, and to the nation’s largest urban population of Aboriginal and Torres Strait Islander people.

Health outcomes for Australia’s indigenous people lag significantly behind those of their non-indigenous fellow citizens, Prof. Doyle notes. This unacceptable situation has persisted since the early days of white settlement.

To add insult to injury, the western medical system that dominates our national healthcare landscape neither acknowledges nor incorporates more than 40,000 years of accumulated knowledge regarding Australia’s indigenous medicine and health.

Bridging this gap involves working actively and collaboratively to improve health outcomes for indigenous peoples, Prof. Doyle contends. Importantly, for such an effort to succeed, it must include indigenous voices and know-how.

And the process of developing a health-care model inclusive of indigenous perspectives needs to be fast-tracked. ‘Waiting two decades for medical discoveries to become regular practice is unacceptable,’ states the SPHERE. ‘Every person, in every community, should have access to world-class healthcare … that combines research, innovation, education and knowledge translation’. 

One of the primary goals of Maridulu Budyari Gumal is working collaboratively to achieve better health outcomes for Australia’s first peoples.

Unlike the Western biomedical model, which is singular, Aboriginal health research must speak to the physical, social, emotional, spiritual and cultural wellbeing of the entire community,’ notes the partnership’s website.

One way to help bridge the gap between health outcomes for Australia’s non-indigenous (predominantly western European and Asian) and indigenous peoples is to include the intended recipients when devising health-care strategy. This means finding out from the members of indigenous communities – in the Greater Western Sydney region and further afield:

  • what health problems need to be solved in these communities;
  • what treatments are likely to work best for, and be most acceptable to members of these communities; and
  • how we can best deliver healthcare to these communities.

Part of this means encouraging and empowering more indigenous individuals to train for – and advance in –health-care sector careers.

Part of it means looking to incorporate the prodigious medical knowledge of traditional Aboriginal healers in health-care models – involving these healers in educating others and in developing and administering health-related programs, especially those directed towards indigenous communities.

Bridging the communication gap

It takes time and trust, collaboration and cultural humility to ensure Aboriginal communities get their voices heard in healthcare. Part of the battle involves giving non-indigenous people the communication skills they need to work effectively with indigenous people – not just across Australia but worldwide.

“There is a lack of familiarity with the mob,” Prof. Doyle explains. “If you can garner trust with an indigenous community, you’re doing really well.” She cautions, though, against putting the onus on ‘the community’ to provide solutions: “We don’t know the questions, much less the answers”.

Collaboration, and strengthening relationships between the academic, clinical and Aboriginal communities, are key to working constructively together to deliver effective, appropriate health care to indigenous communities, Prof. Doyle says.

To develop a health-care system benefiting everyone, she contends, what’s needed is cultural humility – a stance that permeates Maridulu Budyari Gumal. It’s when neither side expects their culture, their way to be the only way. “It’s more than respect,” she says. “It’s applied respect. It’s clinical humility.”

Changing health outcomes for Australia’s indigenous peoples

Maridulu Budyari Gumal partners are committed to working humbly and collaboratively ‘to accelerate life-changing research’ in the area of indigenous health, with the multiple goals of:

  • reducing indigenous health-care costs while increasing health-care value across Greater Western Sydney area and surrounding regions;
  • inspiring and training the next generation of indigenous health professionals in and beyond the region;
  • improving economic prosperity for disadvantaged people in the region;
  • creating real-world benefits for local patients and their communities; and
  • forging effective, inclusive partnerships to break down the barriers to high-quality health care for all. 

The collective is keen ‘to forge new, collaborative ways of working’, empowering health professionals to become ‘world leaders in health care’, and inspiring and training the next generation to do similarly.

In its research, the SPHERE supports ‘likeminded future-makers, who can see better ways to deliver innovative discoveries… that will have a profound impact on the health of our communities’. In the wider, enterprise sense, the group is ‘listening to and learning from industries outside health … connecting with these industries to innovate … to see what new opportunities, jobs, technologies and models of care we can create together.’

The Aboriginal Health and Wellbeing group: community-endorsed health-care solutions

The SPHERE’s Clinical Academic Groups (CAGs) are ‘at the front line of medical innovation’, seeking answers to complex health challenges impacting Australians, such as: ‘How has mental health become less taboo, yet suicide is the leading cause of death among Australian men aged 15-44?’ and ‘Why do Aboriginal and Torres Strait Islander infants die at three times the rate of non-indigenous infants?’.

One of the most active CAGs in the SPHERE is the Aboriginal Health and Wellbeing (AHW) group, the vision of which is ‘to reinforce Aboriginal research leadership, build on the strengths and success of positive health and wellbeing outcomes, and develop innovative models of care and service delivery’.

The AWH group works with indigenous leaders to ensure its perspectives and research projects meet indigenous communities’ needs and follow Aboriginal protocols: focusing on ‘sense of place, leadership and culture’ and seeking solutions within the community.

The multi-skilled trans-disciplinary team comprises Aboriginal and Torres Strait Islander Elders, community organisations, Aboriginal community health advocates, health and wellbeing researchers, educators, practitioners and service professionals, and includes representation from 11 of the SPHERE’S 14 partner organisations.

Fittingly, it is led by Prof. Doyle, who cites her greatest skill as “bringing people together”.

A Winninninni woman raised on Darkinjung country in New South Wales, ‘Aunty Kerrie’ Doyle knows how crucial it is to have indigenous health professionals if you want to improve the health outcomes of Aboriginal and Torres Strait Islander peoples.

Doyle became the first Aboriginal woman to graduate from Oxford University and has worked in the health sector ever since. After a career spanning more than four decades in which she’s specialised in indigenous health, mental health and cultural proficiency, she’s excited to head up the AHW CAG.

Currently, the group is engaged in the following activities:

  • Community engagement: including members of the Aboriginal and Torres Strait Islander communities in health planning and translation activities to foster meaningful, ongoing engagement.
  • Program evaluation: the group is developing a suite of products to evaluate research, education and healthcare programs more accurately and efficiently.
  • Education: ensuring every non-indigenous clinician, researcher, service provider and organisation understands how to engage constructively with Aboriginal people;
  • Prisoner health: the group is examining research, education and practice in this space, building on existing projects to ensure care is continued, with the aim of establishing ‘translation models’ that can be used to align prison and mainstream health services.

The AWH group’s overarching goal is ‘to understand the concerns of everyone involved – patients, carers, service providers, policymakers and the public’ – then use this knowledge to translate research quickly and ‘bring lasting improvement and economic benefit to the Aboriginal people of the Sydney basin’.

Further reading

Engaging Aboriginal communities in healthcare: In conversation with Aunty Kerrie Doyle

Aunty Kerry Doyle’s blog.

More information

For further information on the SPHERE and its valuable work, visit the partnership’s official website.

Contact Prof. Doyle at