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Fellow in Focus: Working for a fair and equitable society

2 Dec 2021

Dr Scott Davis, a Fellow of CRANAplus, has worked in remote health for 30 years across the north of Australia and internationally, always with an eye on creating opportunities to support the training, education and supervision to grow the next generation of health professionals.

A few years ago Scott took the career deci­sion to move upstream, as he puts it, from ser­vice deliv­ery, pro­gramme design and pol­i­cy devel­op-ment in the pub­lic health and pri­ma­ry health care are­na, to work­ing direct­ly with rur­al and remote com­mu­ni­ties and tra­di­tion­al landown­ers to address the social deter­mi­nants of health.

He’s proud of the projects he’s been involved in and loves his work. At the same time, his ulti­mate objec­tive is to make him­self redun­dant so that com­mu­ni­ties and ser­vices are sus­tain­able and resilient. Here’s his story.

11 years ago, Scott returned to Cairns in Far North Queens­land to be clos­er to his age­ing parents. 

I have to say I have fall­en in love with the place all over again,” he says. I do think going away and com­ing back allows you to get per­spec­tive. Rur­al and coun­try towns work on rela­tion­ships and reciprocity. 

Build­ing long-term rela­tion­ships allows a com­mu­ni­ty to under­stand who you are and how you con­tribute to that com­mu­ni­ty, and the val­ues that under­pin what you do.”

One of the things I think is real­ly impor­tant for any­one who works in region­al, rur­al and remote com­mu­ni­ties is under­stand­ing and respect­ing the com­mu­ni­ties and the peo­ple you serve.

Invest­ing in build­ing this rela­tion­ship and under­stand­ing of the com­mu­ni­ty is a real­ly impor­tant part of my pro­fes­sion­al jour­ney.

It’s impor­tant to spend time in the com­mu­ni­ties you serve, good to be remind­ed of the rea­son why you do the work that you do.

Some­times it might seem that the task is enor­mous, but over time with sus­tained com­mit­ment you can see the dif­fer­ences in the lives of people.”

Scott has been a direc­tor for four years with My Path­way, a socio-eco­nom­ic devel­op­ment com­pa­ny that works in part­ner­ship with region­al, rur­al and remote communities.

One project I am par­tic­u­lar­ly proud of has been set­ting up an Indige­nous-led remote NDIS pro­gramme in a remote com­mu­ni­ty in Queens­land where all the staff, apart from two, are local peo­ple from the com­mu­ni­ty who are pro­vid­ing care and sup­port for peo­ple with dis­abil­i­ties in the community.

This pro­gramme has so many ben­e­fits. It gives local peo­ple employ­ment and the oppor­tu­ni­ty to gain new skills and career prospects. It is being devel­oped and co-designed in a way that is cul­tur­al­ly appro­pri­ate, safe and sus­tain­able and is done in part­ner­ship with local organ­i­sa­tions – reduc­ing the reliance on peo­ple fly­ing in and out to deliv­er care.

The excit­ing thing is you see peo­ple in the com­mu­ni­ty get­ting care for the first time, pro­vid­ed by mem­bers of their own com­mu­ni­ty. This is help­ing to rebuild and strength­en bonds and it’s all achieved with­in nation­al guidelines.”

Scott is also work­ing with tra­di­tion­al own­er groups to look at where there are oppor­tu­ni­ties to build local work­force and enable eco­nom­ic self deter­mi­na­tion in their communities.

There’s a range of social issues that we know are impor­tant for good health out­comes – a strong com­mu­ni­ty, sup­port­ive fam­i­lies, healthy envi­ron­ment, and access to edu­ca­tion and employ­ment oppor­tu­ni­ties: all are deter­mi­nants of good health in a com­mu­ni­ty.

The jour­ney to self deter­mi­na­tion is one I am com­mit­ted to,” Scott says. Every­body has a right and abil­i­ty to make deci­sions in their own inter­ests and those of their community.

I would argue many of our Indige­nous lead­ers today have come through that process. They have tri­umphed over adver­si­ty to excel. There are many more who maybe don’t yet have the same opportunities.

What I am talk­ing about is hav­ing a struc­tured, sys­tem­at­ic approach which allows indi­vid­u­als and com­mu­ni­ties to move for­ward more quick­ly than in the past.

My role in all of this is as the per­son behind the scenes, help­ing peo­ple to build skills and capac­i­ty and allow­ing them to go along their own jour­ney, so peo­ple have the best oppor­tu­ni­ty for employ­ment and to be lead­ers in their communities.

Peo­ple grow into their roles, and it is naïve to expect any­body to be an expert at the end of a train­ing programme.”

It’s always a learn­ing jour­ney. Mis­takes are not the end point in my mind. They are an oppor­tu­ni­ty to learn.”

Scott believes valu­ing knowl­edge in all its forms is a con­ver­sa­tion that is start­ing to emerge, and that sup­port­ing com­mu­ni­ties to build on that knowl­edge cre­ates a strengths-based approach to social and eco­nom­ic development.

In health there’s a move towards recog­nis­ing the impor­tant role of gen­er­al­ists with a well-round­ed skill base with per­haps advanced skills in a par­tic­u­lar con­text,” Scott says.

You cer­tain­ly don’t want peo­ple mak­ing clin­i­cal deci­sions out­side their range of scope. Safe­ty and qual­i­ty is cru­cial, but we have
to be care­ful of not ignor­ing the ben­e­fits of mul­ti­dis­ci­pli­nary roles.

It’s impor­tant to look at the assets in region­al, rur­al and Indige­nous com­mu­ni­ties, not the deficits. There is a dan­ger of see­ing these com­mu­ni­ties as lack­ing. I would argue that there are many assets with­in these communities.

It’s also impor­tant to pro­vide a sup­port­ive envi­ron­ment for peo­ple to return to do work in a tra­di­tion­al con­text and val­ue that work. It plays a strong role in build­ing a sense of iden­ti­ty and strength­en­ing culture.

In addi­tion, we need to recog­nise that cul­ture and com­mu­ni­ties are con­stant­ly chang­ing. There seems to be a view here in Aus­tralia that they are sta­t­ic. They’re not. With­in the com­mu­ni­ty there is always an ele­ment of flux.”

The resilience of peo­ple in rur­al and remote com­mu­ni­ties is impres­sive. They cope with all man­ner of obsta­cles, lack of resources and the dis­ad­van­tages of distance.”

At the same time, we must ensure we are not for­get­ting those who need sup­port, the most dis­ad­van­taged with­in any com­mu­ni­ty,” he says.

I’m talk­ing about all groups, not just Indige­nous peo­ple. Peo­ple with dis­abil­i­ties, the LGB­TIQ com­mu­ni­ty and so on. It is impor­tant we don’t leave peo­ple behind, that we facil­i­tate and sup­port self-deter­mi­na­tion and cre­ate an envi­ron­ment which sup­ports it to happen.

I believe that all of us, no mat­ter what role we play, should be think­ing about how we build and sup­port the capac­i­ty of others.

We have an oblig­a­tion to engage and sup­port the most dis­ad­van­taged. That’s the only way to have an equi­table and fair society.”

Hear from CRANAplus Fel­lows Toni Dowd, Sophie Heath­cote and Sharon Wey­mouth.