Kristen Smith | University of Melbourne (original) (raw)

Papers by Kristen Smith

Audiovisual materials have been produced and stored by remote Indigenous media and cultural organ... more Audiovisual materials have been produced and stored by remote Indigenous media and cultural organisations in Australia for over thirty years, representing a distributed national collection of high cultural, linguistic and national significance. However, technical obsolescence of analogue materials, harsh environmental conditions and limited access to technological and financial resources in many remote communities present serious risk of information and knowledge being lost forever. This report outlines a collaborative project undertaken by the Melbourne Networked Society Institute and researchers from the University of Melbourne’s Australian Indigenous Studies Unit, Research Unit for Indigenous Languages and the Grimwade Centre for Cultural Materials Conservation. In partnership with the Kanamkek-Yile Ngala Museum, Wadeye, NT, and the Australian Institute for Aboriginal and Torres Strait Islander Studies, the researchers investigated how culturally significant and endangered Indige...

Aboriginal communities in north-western Australia are likely to be disproportionately affected by... more Aboriginal communities in north-western Australia are likely to be disproportionately affected by climate change. Direct environmental impacts from predicted outcomes will exacerbate present difficulties in many Indigenous communities beset by social and economic disadvantages. In 2012 Indigenous people held land interests in about 80 per cent of northern Australia. Their land management responsibilities for this substantial portion of the Australian land mass include normal obligations, as well as distinct Indigenous forms of stewardship over areas of special Aboriginal and Torres Strait Islander freehold and native title. The effective management of this land and its ecologies requires adaptation planning and strategies for capacity building involving Indigenous people and their traditional ecological knowledge. Insufficient research exists into potential climate change impacts on Aboriginal and Torres Strait Islander communities at a local level, and even less on how Indigenous p...

The overall aim of the Victorian Aboriginal Child Mortality Study (VACMS) is to measure the patte... more The overall aim of the Victorian Aboriginal Child Mortality Study (VACMS) is to measure the patterns and trends of Aboriginal infant and child mortality and the disparities between Aboriginal and non-Aboriginal populations for births occurring in Victoria spanning (birth) years 1988-2008, inclusive. In order to calculate mortality rates, a more accurate count of Aboriginal births was an essential first step. The VACMS is a total population, data linkage, child mortality study being undertaken at Onemda VicHealth Koori Health Unit at The University of Melbourne in conjunction with the Victorian Aboriginal Community Controlled Health Organisation. It is funded by the Australian Research Council, Department of Health Victoria, the Australian Government Department of Prime Minister and Cabinet (formerly Families, Housing, Community Services and Indigenous Affairs), the Lowitja Institute and the R E Ross Trust. The study has four distinct phases: Phase 1. Matching of vital statistics datasets containing birth information to obtain a more accurate and complete Indigenous identification for Aboriginal births. Phase 2. Calculation of an 'ever-never Aboriginal' identifier. Appending of the perinatal information describing all births in Victoria from 1988-2008, inclusive to the matched dataset. Analysis of matched birth dataset and reporting of the patterns and trends of births in Victoria to Aboriginal and/or Torres Strait Islander mothers and/or fathers from 1999-2008, inclusive. Phase 3. Review of all death information (reported to the Consultative Council on Obstetric & Paediatric Mortality and Morbidity), coding and classification of the death information using a specific cause of death code and validation of the coding and classifications. Development of a comprehensive death dataset (infant and child deaths in Victoria, 1988-2009). Phase 4. Linking the matched birth dataset with the death dataset. Analysis and preparation of a report that describes the patterns and trends of deaths for Aboriginal and/or Torres Strait Islander compared with non-Aboriginal and/or Torres Strait Islander infants and children (0-11 years), for births from 1999-2008, inclusive. The six-year study commenced in 2009 and is now complete with the publication of this report.

Research Report, 26/2020, 2020

Improving access to and suitability of legal and support services for Aboriginal and Torres Strai... more Improving access to and suitability of legal and support
services for Aboriginal and Torres Strait Islander perpetrators
of violence against women is an urgent priority to reduce the
unacceptably high rates of Aboriginal and Torres Strait Islander
family violence. This report outlines our research investigating
the pathways of Aboriginal and Torres Strait Islander men
through the family violence legal and support service system,
seeking better understanding of the opportunities for
rehabilitation that are respectful and culturally responsive,
and to see if these pathways enable positive shifts in the lives
of women, children and communities affected by family
violence.
As reported in the associated study of Aboriginal women who
are victims of family violence (Langton et al., 2020), these
matters are of national importance in Australia. Aboriginal
and Torres Strait Islander people are increasingly overrepresented
in the criminal justice system and Aboriginal and Torres Strait Islander perpetrators of violence constitute the most significant group of offenders (Australian Law Reform Commission [ALRC], 2017), driving alarming rates of incarceration and other contacts with the criminal justice system in every jurisdiction.

Research report, Issue 25/2020, 2020

This report identifies priorities for reducing and preventing violence against, and improving ser... more This report identifies priorities for reducing and preventing violence against, and improving services for, Aboriginal women in the Victorian and New South Wales towns of Mildura, Albury and Wodonga. The study contributes to the evidence base on best quality practices to strengthen
Aboriginal and Torres Strait Islander communities and services in meeting the needs of women and their children experiencing family violence. This report also describes aspects of the frontline family violence workforce and services, both Aboriginal and non-Indigenous, in order to obtain an understanding of their capability to improve the safety of women and children experiencing violence.

The Alcohol Management Plan at Pormpuraaw. An ethnographic community-based study, 2019

Alcohol is one of the leading causes of social, legal and health problems for Indigenous Australi... more Alcohol is one of the leading causes of social, legal and health problems for Indigenous Australians. Since 2002, Alcohol Management Plans (AMPs) have been used in many Indigenous communities as a framework to reduce alcohol-related harms. (Smith et al., 2013)
This report outlines the findings of an ethnographic research project which gathered and analysed the AMP in the remote Indigenous community of Pormpuraaw on the western coast of Cape York Peninsula in far north Queensland.
The qualitative and quantitative evidence examined in this project shows a significant reduction in alcohol-related harms following the introduction of the AMP.
We obtained data on hospital admissions which support the views of the majority of the Pormpuraaw community members who observed that violence and community disharmony reduced with the reductions in alcohol supply.

This report outlines the findings of an ethnographic research project which gathered and analysed... more This report outlines the findings of an ethnographic research project which gathered and analysed the Alcohol Management Plan (AMP) in the remote Indigenous community of Pormpuraaw on the western coast of Cape York Peninsula in far north Queensland.

This report contributes to the developing body of knowledge and evidence about AMPs in Indigenous Australian contexts. It offers nuanced understandings of how AMPs are understood, investigates their effectiveness in responding to alcohol-related harms and examines community engagement in their design, implementation and evaluation. ISBN:978-0-6484267-7-6

Aboriginal and Torres Strait Islander Australians are under-serviced by digital technologies, wit... more Aboriginal and Torres Strait Islander Australians are under-serviced by digital technologies, with indigenous Australians being 69% less likely than non-indigenous people to have any Internet connection and are about half as likely to have broadband access. This 'digital divide' contributes to and reinforces educational, income, employment and geographical disadvantage. While uneven access remains a particular problem for rural and remote Aboriginal communities, digital technology also provides a way of overcoming Indigenous social disadvantage.

This project examines how to foster provision of culturally relevant information to Indigenous communities enabled by broadband connectivity. The research focuses upon the network of 70 touch screen kiosks installed at key community locations in remote, regional and urban communities operated by HITnet. The HITnet network is designed to address 'information disadvantage' by using IT to improve and maintain community connectedness, digital development and digital social inclusion.

Content for the information kiosks focuses on a range of critical Indigenous health issues including sexual health, cancer, mental health and nutrition. The kiosks provide a gateway to tailor-made interactive content for low literacy and inexperienced technology users with the program attracting over 100,000 users in 2012.

Currently, the kiosks face bandwidth constraints. Higher bandwidth made available via broadband creates the potential to increase community participation in content creation, including the local upload of rich media content such as video.

This research project aims to assess current user practice around the kiosks to consider what features contribute to a successful interaction, such as physical placement, digital literacy and the relevance of the content. Linked to this is how the kiosks can be adapted to meet the evolving and diverse needs of Indigenous people, particularly, the potential for a transition from kiosk as information delivery system to digital community hub enabling new possibilities for local community co-creation/co-management of content.

Audiovisual materials have been produced and stored by remote Indigenous media and cultural organ... more Audiovisual materials have been produced and stored by remote Indigenous media and cultural organisations in Australia for over thirty years, representing a distributed national collection of high cultural, linguistic and national significance. However, technical obsolescence of analogue materials, harsh environmental conditions and limited access to technological and financial resources in many remote communities present serious risk of information and knowledge being lost forever.
This report outlines a collaborative project undertaken by the Melbourne Networked Society Institute and researchers from the University of Melbourne’s Australian Indigenous Studies Unit, Research Unit for Indigenous Languages and the Grimwade Centre for Cultural Materials Conservation. In partnership with the Kanamkek-Yile Ngala Museum, Wadeye, NT, and the Australian Institute for Aboriginal and Torres
Strait Islander Studies, the researchers investigated how culturally significant and endangered Indigenous audiovisual archives could be effectively preserved and transmitted to current and future generations using innovative digital technologies.

The Victorian Aboriginal Child Mortality Study (VACMS) provides an analysis of mortality and disp... more The Victorian Aboriginal Child Mortality Study (VACMS) provides an analysis of mortality and disparities for Aboriginal compared to non-Aboriginal infants, children and young people dying between 2008 and 2009 addressed, for the first time, the inaccurate recording of Aboriginal and Torres Strait Islander births in Victoria. The project brought together birth and death information from a number of Victorian vital statistics data sources to give an accurate report of the number of Aboriginal and Torres Strait Islander babies born between 1988 and 2008, and the number and causes of any deaths.

This study built on past and continuing efforts by State and Federal governments to further reform the quality of data in health information systems and to report on progress towards improving the health of Aboriginal and Torres Strait Islander children in Victoria.

Indigenous Law Bulletin, 2017

This article outlines the background and rationale of the Cashless Debit Card (CDC) trial, illust... more This article outlines the background and rationale of the Cashless Debit Card (CDC) trial, illustrating its public health, rights-based approach, with a focus on alcohol issues.It further addresses outcomes of early evaluations and related evidence. Although initial evaluations of the trial have reported largely positive results, there are also mixed and negative findings. It is accurately pointed out by the evaluators and understood by experts and practitioners, that one year is insufficient time to decisively understand the long-term outcomes of any new and complex social or public health program. However, given all factors, this article argues the recently granted extension of the trial was warranted, allowing the incorporation of potential improvements and better understandings of its long-term outcomes.

This brief provides an analysis of Alcohol Management Plans (AMPs); a relatively new instrument j... more This brief provides an analysis of Alcohol Management Plans (AMPs); a relatively new instrument joining the extensive range of regulations relating to alcohol supply and consumption. AMPs vary in design and implementation across Australia, and include strategies designed to reduce harms resulting from alcohol misuse. The authors chart the background and development of these instruments in Australia, as well as providing a comparison to international alcohol supply and control reforms. The authors find that evaluations in the public domain are limited. These evaluations appear to indicate that where AMPs are locally driven and owned, there are stronger and more sustainable outcomes. There is a good evidence base for the individual components that make up an AMP. Success has been achieved through alcohol restrictions, and both harm and demand reduction strategies have an evidence base as targeted interventions. The authors conclude that as more AMPs are implemented across Australia, there is a greater need for further research to better understand the process of implementation and how communities can work together with governments to design, implement and evaluate AMPs.

Developing world bioethics, Jan 1, 2012

ABSTRACT The past two decades have seen the extensive privatisation and marketisation of health ... more ABSTRACT

The past two decades have seen the extensive privatisation and marketisation of health care in an ever reaching number of developing countries. Within this milieu, medical tourism is being promoted as a rational economic development strategy for some developing nations, and a makeshift solution to the escalating waiting lists and exorbitant costs of health care in developed nations. This paper explores the need to problematize medical tourism in order to move beyond one dimensional neoliberal discourses that have, to date, dominated the arena. In this problematization, the paper discusses a range of understandings and uses of the term ‘medical tourism’ and situates it within the context of the neoliberal economic development of health care internationally. Drawing on theory from critical medical anthropology and health and human rights perspectives, the paper critically analyzes the assumed independence between the medical tourism industry and local populations facing critical health issues, where social, cultural and economic inequities are widening in terms of access, cost and quality of health care. Finally, medical tourism is examined in the local context of India, critiquing the increasingly indistinct roles played by government and private sectors, whilst linking these shifts to global market forces.

Dissertation/Thesis by Kristen Smith

In India, neoliberal ideology have progressively displaced traditional socialist principles, infi... more In India, neoliberal ideology have progressively displaced traditional socialist principles, infiltrating many areas previously perceived within the realm of social “goods”, including the domain of health. Evidence of liberalisation within the health system has emerged over the last thirty years, however with the advent of structural adjustment programs implemented in the late 1980s and early 1990s by the World Bank, and the ongoing influence of a number of other international organisations, the role of the market has been amplified in health services.
This study investigates the relationships between: economic adjustment; liberalisation; commercialisation; and the influence of international organisations on the health care system of India. Within this frame, the research analyses these relationships in order to uncover their
contribution to inequalities in health status, access and cost of curative health care services for different sectors of the population within India. Within the context of globalisation, international organisations, particularly international financial institutions, have increasingly influenced the formulation of government policy, encouraging the commercialisation of
sectors formerly the responsibility of government. This has impacted greatly upon the health care system in India, where ongoing liberalisation reforms have led to further disadvantages for those in lower socio-economic groups, as well as those in rural areas in India in terms of
access to, and the cost of health care with the increasing commercialisation of health. Although these sectors of the population have been at a disadvantage in the past, the gap in equity is increasing as a result of these influences.

Internationally, healthcare has been intensively privatised and commercialised over the past thre... more Internationally, healthcare has been intensively privatised and commercialised over the past three decades. Medical tourism has emerged in this context as an economic development strategy for many developing nations, and provisional remedy for patients in developed countries facing rising costs and long waiting periods to access healthcare at home. This study is based in India and is predominantly ethnographic. As such, it is grounded in local realities, with a close eye to how everyday interactions and actions are shaped by significant global interconnections. The research findings have been directly shaped by the daily interactions of living and studying the footprint of medical tourism in five private hospitals in Mumbai, the city itself and, the wider nation of India.The study offers a microcosmic view of broader economic patterns occurring within and between nations with healthcare services swiftly transitioning to another global commodity like any other product for commercialisation, consumption and exploitation.

Conference Papers by Kristen Smith

Knowledge and Value in a Globalising World, Joint International Conference of the International ... more Knowledge and Value in a Globalising World, Joint International Conference of the International Union of Anthropological and Ethnological Sciences (IUAES), Australian Anthropological Society (AAS) and Association of Social Anthropologists of Aotearoa / New Zealand (ASAANZ), University of Western Australia, Perth, Australia, 6 October 2011

Research Report, 26/2020, 2020

Research report, Issue 25/2020, 2020

The Alcohol Management Plan at Pormpuraaw. An ethnographic community-based study, 2019

Audiovisual materials have been produced and stored by remote Indigenous media and cultural organ... more Audiovisual materials have been produced and stored by remote Indigenous media and cultural organisations in Australia for over thirty years, representing a distributed national collection of high cultural, linguistic and national significance. However, technical obsolescence of analogue materials, harsh environmental conditions and limited access to technological and financial resources in many remote communities present serious risk of information and knowledge being lost forever.
This report outlines a collaborative project undertaken by the Melbourne Networked Society Institute and researchers from the University of Melbourne’s Australian Indigenous Studies Unit, Research Unit for Indigenous Languages and the Grimwade Centre for Cultural Materials Conservation. In partnership with the Kanamkek-Yile Ngala Museum, Wadeye, NT, and the Australian Institute for Aboriginal and Torres
Strait Islander Studies, the researchers investigated how culturally significant and endangered Indigenous audiovisual archives could be effectively preserved and transmitted to current and future generations using innovative digital technologies.

Indigenous Law Bulletin, 2017

Developing world bioethics, Jan 1, 2012

ABSTRACT The past two decades have seen the extensive privatisation and marketisation of health ... more ABSTRACT

Internationally, healthcare has been intensively privatised and commercialised over the past 20 y... more Internationally, healthcare has been intensively privatised and commercialised over the past 20 years. Medical tourism has emerged in this context as an economic development strategy for many developing nations, and provisional remedy to the rising costs and waiting lists for healthcare in developed nations. Drawing on an ethnographic study of medical tourism in Mumbai, this paper outlines how the processes of healthcare commodification, hospital corporatisation and increased transnational mobility have influenced the local medical workforce. With the shortage of medical personnel in India, education and credentialling characteristics of the medical workforce of India loom large as issues that affect the quality of service and the standing and morale of the workforce. These factors are in turn influenced by the Indian diaspora, the value placed on the significance of overseas education, and the implications of different forms of mobility on healthcare workers, the interchanges and flows of people, power and knowledge systems. The economic drivers of the diverse forms of development and territorial logics of power deeply impact on the everyday roles of healthcare professionals. In this paper I present my findings on the local engagement of healthcare professionals with these economic phenomena. I pay particular attention to the changing status and hierarchy of doctors, nurses and hospital administrators in the context of a market-led model and the relative rise of the hospital administrator within the social dynamics and market power structures of the nation.

Medical tourism, or the transnational travel of patients for the consumption of health services, ... more Medical tourism, or the transnational travel of patients for the consumption of health services, is a rapidly expanding industry across the globe, with a satellite “medicity” being built in Dubai, entire states in India promoted as “medi-hubs” and cruise ships transformed into seaborn hospitals docking in international waters to service patients. Somewhat disturbing advertising slogans such as “First World Treatment at Third World Prices” or “Sun and Surgery” are utilised by corporations and governments alike, driving an industry estimated to be already worth as much as US$60 billion and growing at a rate of 20 percent per annum. However, beyond the luxurious corporate hospitals used by foreign patients in countries such as India, are populations facing critical health issues, unable to access treatment at all. Consequently, this presentation will examine both the practice and industry of medical tourism through the lens of Critical Medical Anthropology in order to examine systemic structures of power manifest in the dominant discourses produced by social actors and institutions across the globe, looking to the impacts of medical tourism upon international health equity.

Alcohol management plans are used as a central device in government policies for reducing alcohol... more Alcohol management plans are used as a central device in government policies
for reducing alcohol-related harms among Indigenous Australians, particularly in remote
locations. AMPs have been viewed as a viable way of creating a new and effective means to
combat a range of alcohol problems through the use of local community control over alcohol
availability and management of alcohol-related problems. However, there are many
challenges in developing and implementing AMPs in Australia. This paper discusses some of
the more critical factors impacting on AMP effectiveness through addressing the complex
contextual environments of AMPs, exploring their weaknesses and strengths in specific
settings. Some of the key themes explored include issues associated with complex and
intersecting, multi-tiered government policy and legislation, and the local implications of the
contested interests of industry, public health, communities and government. The paper
concludes with an exploration of how these findings can inform local, State, Territory and
Federal policy in developing more effective, inclusive AMPs, particularly within Indigenous
community contexts.

Alcohol Management Plans (AMPs) have become an important Australian government policy response to... more Alcohol Management Plans (AMPs) have become an important Australian government policy response to the harms from alcohol in Australian communities. Indigenous communities have been central to the development of AMPs in many communities, particularly throughout northern Australia. This paper explores the role and understandings of Alcohol Management Plans (AMPs) and related alcohol interventions in Indigenous communities in Australia. The paper discusses the preliminary findings from an ethnographic study of AMPs conducted in the Northern Territory, based on qualitative, semi-structured, in-depth interviews and focus groups conducted with a range of key stakeholders in Alice Springs, Darwin, Katherine and the community of Jilkminggan. Some of the key themes explored include: the problems associated with complex and intersecting, multi-tiered government policy and legislation; local issues related to the contested interests of industry, public health, communities and government; the absence of integrated, regional responses; and, some of the factors that have led to success within this increasingly volatile context. The paper concludes with an exploration of how these findings can inform State, Territory and Federal policy in developing 'best practice' pathways for communities to develop, implement and monitor AMPs.

Audiovisual materials have been produced and stored by remote Indigenous media and cultural organ... more Audiovisual materials have been produced and stored by remote Indigenous media and cultural organisations in Australia for over thirty years, representing a distributed national collection of high cultural, linguistic and national significance. However, technical obsolescence of analogue materials, harsh environmental conditions and limited access to technological and financial resources in many remote communities present serious risk of information and knowledge being lost forever. This report outlines a collaborative project undertaken by the Melbourne Networked Society Institute and researchers from the University of Melbourne’s Australian Indigenous Studies
Unit, Research Unit for Indigenous Languages and the Grimwade Centre for Cultural Materials Conservation. In partnership with the Kanamkek-Yile Ngala Museum, Wadeye, NT, and the Australian Institute for Aboriginal and Torres Strait Islander Studies, the researchers investigated how culturally significant and endangered Indigenous audiovisual archives could be effectively preserved and transmitted to current and future generations using
innovative digital technologies.

Chapter 18: Alcohol Management Plans. Smith, K, Langton, M, d'Abbs, P, Room, R, Chenhall, R, Brown, A,

Stemming the tide of alcohol: Liquor licensing and the public interest, , 2014