Designing for cultural safety
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Community based care 17 March 2022

Designing for cultural safety

Melbourne Design Week - 17-27 March 2022 - continues to explore the theme of ‘Design the world you want’, asking designers to consider how they could collaborate to create a better and healthier future.

In this article we examine what cultural safety means and how it translates into the design of heath infrastructure.

Designing for cultural safety is about ensuring Aboriginal people’s voices are heard.

When we listen to Aboriginal voices, we’re able to design spaces that celebrate Culture, use appropriate imagery, and demonstrate acknowledgement of the Country on which we are building.

This applies to all health infrastructure and is especially important when we’re building dedicated services for Aboriginal people.

Understanding cultural safety

What is cultural safety?

Cultural safety is about shared respect, shared meaning and shared knowledge.

On a strategic level, cultural safety is about institutional reform. It means removing barriers to the optimal health, wellbeing and safety of Aboriginal people. This includes addressing unconscious bias, racism and discrimination, and supporting Aboriginal self-determination. By working with Aboriginal people to embed cultural safety in our designs, we can support improved health and wellbeing outcomes.

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Importance of identity

In designing health infrastructure, we use universal design principles.

Universal design is about inclusivity, and means designing something so that it’s accessible to as many people as possible. Whether that’s a building, product or service, an environment or a program, universal design thinks about the people who will be using something and puts their needs first.

Michael Walker is Principal Advisor, Universal Design at the Victorian Health Building Authority (VHBA).

He explains that supporting identity in universal design is about ‘support for the construction of a positive self-image... that could come in forms of how you create entry doors or breakout spaces, or smoking ceremony areas’.

‘Cultural compatibilities need to be considered because we must respect Aboriginal people’s connection to nature and provide spaces that calm the spirit.’

Michael Walker, Principal Advisor, Universal Design, Victorian Health Building Authority

He adds that it’s important to work with elders when thinking about cultural design, ‘because we've got so many different tribes. The Taungurung, where I come from, might have a completely different understanding of symbolism to the Yorta Yorta, for example’.

‘We need to design together and use only art and symbolism that is relevant to the local communities – so that they can connect with it. We are also currently working with Aboriginal people to develop guidelines for designing for cultural safety.’

‘It’s not about saying “you must do this or that”, it’s applying the Victorian Human Rights Charter and universal design principles.’

A landscaped fire pit area at the Ballarat and District Aboriginal Co-operative Medical and Regional Health Hub

Cultural safety in practice

Ballarat and District Aboriginal Co-operative Medical and Regional Health Hub

In 2019, we completed construction of the Ballarat and District Aboriginal Co-operative (BADAC) Medical and Regional Health Hub in Ballarat.

The purpose-built $8.5 million facility was designed in partnership with BADAC to create a culturally welcoming environment and provide a range of services for Aboriginal and non-Aboriginal people in Victoria’s greater western region.

Karen Heap (Yorta Yorta) is Chief Executive Officer of BADAC, and was involved in the design for the Medical and Regional Health Hub.

‘I was really trying to make sure that we incorporate Culture and the land into the building, and that we embrace appropriate Aboriginal colour schemes to reflect our cultural values, to ensure our community feel welcome and safe.’

Karen Heap, Chief Executive Officer, Ballarat and District Aboriginal Co-operative (BADAC)

The design includes the colours of the Aboriginal flag, images of a platypus and a fire pit area.

Jon Kanoa (Kerrupmara/Bunitj) is Chief Operating Officer at BADAC. Jon says the design creates a culturally safe environment, ‘making sure that whatever appointment they’re coming in for, that they're feeling comfortable in doing so’.

‘A respect for people, a respect for the environment and a respect for country. As architects we see that as very strong within our ethos as well, so the connection is really pretty seamless.’

Alan Morton, Director, Morton Dunn Architects

Learn more about the BADAC Medical and Regional Health Hub via our dedicated project page

Bendigo Hospital Aboriginal support services

The award-winning Bendigo Hospital, completed in 2018, has an Aboriginal support area with culturally significant features including a possum skin cloak and a smoking pit for traditional ceremonies.

The support area helps patients and their families feel culturally safe at the hospital, and signifies the importance the Aboriginal community has within the Bendigo and greater Loddon Mallee region.

Dave Kerr, Aboriginal Hospital Liaison Officer at Bendigo Health, said: 'The community involvement in the Aboriginal space has been via the Dja Dja Wurrung Aboriginal Corporation. They were heavily involved in the process, including the designing of the courtyard and the garden. We’ve also had involvement from our previous two Aboriginal hospital liaison officers, who were involved in meeting with community and discussing their needs for the space for now and into the future.'

'The Aboriginal space at Bendigo Health is really large and that’s important to be able to bring families. So, we quite often have large family groups who will come to the hospital when someone is unwell. Our culture is family and having everyone here when times are tough. Another great feature is the teleconference facilities that we have in there, which enables patients to contact family if they aren’t able to come down and visit them.'

'The new space has enabled us to raise the profile of Aboriginal Health in the region and also go towards our commitment to closing the gap.'

Dave Kerr, Aboriginal Hospital Liaison Officer, Bendigo Health

Consulting with communities

As new infrastructure projects take shape across the state, it’s important the communities they will serve have a say in their design and services.

Project teams often engage with local communities impacted by new health, transport or public housing developments through consultation. This could be via surveys, information sessions, letterbox drops, or consultative committees.

A community consultative committee is a group comprised of local residents, business owners, service providers and interest groups who can help a project team have meaningful and effective communications and discussions with the community affected by the project. Members of the committee are normally recruited via an ‘expression of interest’ application, which is advertised in outlets like the local newspaper and social media.

In essence, a consultative committee is a partnership between a project team and the local community impacted by the project.

The consultative committee plays a critical role in helping their project team get the information, views and feedback they need from the community to design an effective new infrastructure project. Aboriginal representation is a very important part of this.

We partnered with BADAC on the design of the Medical and Regional Health Hub, and CEO Karen Heap has also been involved with our Ballarat Base Hospital redevelopment community consultative committee.

Design guidelines

The design of our health facilities needs to address a range of cultural issues. There are poor statistics around Aboriginal and Torres Strait Islander health. The institutional presentation of many health facilities and the lack of welcoming spaces means that Aboriginal people may not take up much needed healthcare treatments.

Our Design Services team is currently using the International Indigenous Design Charter as a basis for new Aboriginal and Torres Strait Islander Infrastructure Design Guidelines, to address issues of cultural safety in the design of new health facilities.

The team is working closely with the Department of Health’s Aboriginal Health Division, aligned with the Department’s commitment to advance Aboriginal self-determination as outlined in the Victorian Aboriginal Affairs Framework and Victorian Government Self-Determination Reform Framework.

Design Services is also working to embed the cultural awareness requirements now outlined in the National Standard of Competency for Architects 2021 as a part of all requests for tender.

‘Work to date includes research into successful frameworks and guidelines in Victoria and interstate. We’ve also looked at case studies that illustrate projects completed by Aboriginal and Torres Strait Islander architects - or projects that have been successfully delivered through cultural engagement with local Aboriginal communities.’

Robert Deutscher, Principal Advisor, Victorian Health Building Authority

Cultural safety framework

The Department of Health’s Aboriginal and Torres Strait Islander Cultural Safety Framework has been developed to help Victorian health, human and community services and the department to create culturally safe environments, services and workplaces.

The framework provides a continuous quality improvement model to strengthen the cultural safety of individuals and organisations.

It aims to help the department and mainstream health, human and community services to strengthen their cultural safety by participating in an ongoing learning journey.

Celebrating Melbourne Design Week 2022 - Designing for good

Melbourne Design Week champions design across a broad range of disciplines and is a platform for people to come together and share ideas around how design can be used as a force for 'civic good' and 'making good'.

Learn how we're 'designing for good' here at the VHBA:

Learn more about Melbourne Design Week.

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Last updated: 17 March 2022