NACCHO Aboriginal Health News : National Award in Indigenous Health Ethics goes to SA

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Research into health and wellbeing needs to be driven by and involve Aboriginal and Torres Strait Islander people, and provide a tangible benefit back to community and to develop an understanding of Aboriginal and Torres Strait Islander resilience, diversity and community needs.”

Dr Rosie King from the Aboriginal Health Council of South Australia

A project from South Australia has recently been recognised for forging ties between Indigenous and medical research communities for better health outcomes in Aboriginal Australians.

A National Award in Indigenous Health Ethics was presented to the joint project between the Aboriginal Health Council of South Australia and the Wardliparingga Aboriginal Research Unit within the South Australian Health and Medical Research Institute (SAHMRI).

The winning project is entitled “Next Steps for Aboriginal Health Research: How research can improve the health and wellbeing of Aboriginal people in South Australia.”

The tarrn doon nonin award – meaning ‘trust’ in the Woiwurrung language of central Victoria – comes from the Lowitja Institute, Australia’s National Institute for Aboriginal and Torres Straight Islander Health Research. The award recognizes excellence in Aboriginal and Torres Strait Islander health research ethics, and provides $10 000 towards project research funds.

“Research into health and wellbeing needs to be driven by and involve Aboriginal and Torres Strait Islander people.”

Dr Rosie King from the Aboriginal Health Council of South Australia said the philosophy underpinning the project was founded quite simply on asking the South Australian Aboriginal community what they thought research should focus on.

“People told us they want research to focus on their everyday health and wellbeing needs, but importantly they also want approaches that respect and engage with a view of life that is holistic and interconnected with cultural, spiritual, social and physical needs across the lifespan,” she said.

“Research into health and wellbeing needs to be driven by and involve Aboriginal and Torres Strait Islander people, and provide a tangible benefit back to community and to develop an understanding of Aboriginal and Torres Strait Islander resilience, diversity and community needs.”

The winning project was informed by an historic accord for negotiated health outcomes between Indigenous South Australians and medical health researchers, launched at SAHMRI in 2014.

SAHMRI also recently published details of its exemplar Closing the Gap health project ESSENCE to address cardiovascular health in Indigenous Australians based on a foundation of evidence and standards for equitable care.

Kim Morey, the manager for Knowledge Transition and Exchange in SAHMRI’s Aboriginal Research Unit, said that SAHMRI was thrilled to be recognised for the project.

“SAHMRI was most excited about this first partnership with ACHSA on the Next Steps project because it developed Aboriginal Community driven research priorities. SAHMRI welcomes recognition for Next Steps project, which refocuses the research agenda so that those issues most important to South Australian Aboriginal Communities begin to receive the attention that they deserve. Moreover, the majority of the researchers on the Next Steps team are Aboriginal.”

The online resource EthicsHub was also launched at the Indigenous Health Ethics award ceremony. This initiative will support individuals and organisations working or participating in Aboriginal and Torres Strait Islander health research.

NACCHO Health News : Indigenous children now able to access free flu vaccine in Australia.

 

WADEYE ABORIGINAL CLINIC NT

“For the first time, Indigenous children are able to access free flu vaccine in Australia

This is important because Aboriginal and Torres Strait Islander children are five times more likely to be hospitalised with flu and pneumonia than non-Indigenous children. Indigenous children are also 17 times more likely to die from flu or pneumonia than non-Indigenous children.”

Letter From Dept of Health Re Aboriginal Flu Vaccine_Page_1

DOWNLOAD important letter from Dept. of Health free flu vaccine in Australia ;Letter From Dept of Health Re Aboriginal Flu Vaccine

It’s that time of year again when scientists and doctors make predictions about the impending influenza (flu) season and we must decide whether to go out and get the flu vaccine.

The government-funded flu vaccine will be available from 20 April, a month later than most years, as the vaccine has been reformulated to cover a new strain. But some GPs may offer the vaccine privately before then.

So, who should consider getting the vaccine and who gets it for free? And are we really in for a bad flu season in Australia?

Aeron Hurt, WHO Collaborating Centre for Reference and Research on Influenza

How does the vaccine work?

The flu vaccine helps prevent us from getting the flu each season. It contains dead, broken-up bits of flu viruses that are expected to circulate during the upcoming season.

Once injected into our arms, the pieces of dead virus stimulate our body’s immune response to produce antibodies, which act as a defence that can rapidly swing into action when a live flu virus infects our nose and throat.

Because the viruses in the vaccine are dead, they can’t give us flu.

What’s new about flu vaccines in 2015?

For the first time, Indigenous children are able to access free flu vaccine in Australia.

For the first time, Indigenous children are able to access free flu vaccine in Australia.

This is important because Aboriginal and Torres Strait Islander children are five times more likely to be hospitalised with flu and pneumonia than non-Indigenous children. Indigenous children are also 17 times more likely to die from flu or pneumonia than non-Indigenous children.

This year a new flu vaccine, known as “quadrivalent”, will be available. This type of vaccine contains four flu viruses compared with three in the normal trivalent vaccine. The additional flu strain provides extra insurance that may be useful if unexpected viruses begin to circulate.

However, it’s likely that the standard trivalent vaccine will cover the great majority of the flu A and B strains expected to circulate in Australia this winter.

The quadrivalent vaccine won’t be available via the government’s free flu vaccine program and will be more expensive than the standard trivalent vaccine if purchasing it privately.

Who should get the flu vaccine?

For certain members of the community, catching flu can lead to severe illness or death. It is these “high-risk” groups (listed below) that should actively avoid catching it. Getting the flu vaccine is a major step towards achieving protection from flu.

Certain groups of individuals at high risk of developing severe illness or complications if infected with flu are eligible for free flu vaccine via the federal government. These are:

  • Anyone aged 65 years or over
  • Aboriginal and Torres Strait Islander people aged 15 years or over
  • Aboriginal and Torres Strait Islander children aged between six months and five years
  • Pregnant women

Anyone with with medical conditions that can lead to severe influenza, including people with heart disease, severe asthma and diabetes. A full list of eligible medical conditions can be found here.

Within the over-65 age group, a high proportion of people are vaccinated (more than 70%).

But although the flu vaccine is provided free of charge to vulnerable people, many still don’t get it. Less than 30% of pregnant women and Indigenous people receive the flu vaccine. Only half of those with medical conditions that can lead to severe influenza get vaccinated.

Although not included in the government’s free flu vaccine program, children under the age of two years are also highly susceptible to flu.

Once infected with flu, young kids are more likely to be hospitalised with severe illness than those in the over 65 age group. About half of young children who die from the flu are otherwise healthy with no underlying medical conditions or known risk factors.

Most children who die from flu are not vaccinated. Therefore the idea that fit, healthy infants can simply “fight off” a flu infection without any problem is not always true.

Another benefit of preventing flu in children is that it reduces the spread of infections to other vulnerable family members such as grandparents.

What’s in store for us this winter?

The one predictable thing about flu, is that it is unpredictable! However, we often look to the northern hemipshere’s winter flu season to give some insights into what might be expected here.

The recent flu season in the United States and most of Europe was dominated by the A(H3N2) strain of flu. This virus has historically been associated with increased severity in the elderly.

There has been a lot of media coverage about bad vaccine match in the northern hemisphere. This is because most of the serious influenza was caused by the A(H3N2) viruses which had changed over the five to six months when the vaccine producers were manufacturing the vaccine. But the other components of the vaccine were well matched.

Our vaccine has been updated to protect Australians against the new A(H3N2) viruses.

So, if you or a loved one fall within the high-risk groups described above, getting the vaccine remains the most effective way to avoid the inconvenience and potentially severe health risks of the flu – and passing it on.

Aeron Hurt is a Senior Scientist at the WHO Collaborating Centre for Reference and Research on Influenza, VIDRL based at the Peter Doherty Institute, Parkville, Melbourne. Aeron is also an honorary Principal Fellow at the University of Melbourne within the Melbourne School of Population and Global Healths The Melbourne WHO Collaborating Centre for Reference and Research on Influenza is supported by the Australian Government Department of Health and also receives funding from the IFPMA (International Federation of Pharmaceutical Manufacturers & Associations) and Novartis Vaccines under cooperative research agreements. AH holds shares in CSL Limited, a manufacturer of influenza vaccines.

Article by The Conversation

NACCHO Health News: AMA speech “Social Determinants and Aboriginal Health”

Brian

Investment in local health services is a must. Delivery of appropriate health services, particularly through Aboriginal community controlled health services, must be culturally safe, and delivered in the right locations by the right people. Spending on health is an investment. Investing in health must underpin our future policies to Close the Gap, and to address what is, for Australia, a prominent blight on our nation.

Governments and other groups that influence policy cannot do this work themselves. It must be a partnership with Indigenous Australians.

The AMA is committed to working, in partnership with our first peoples to Close the Gap in Indigenous health and disadvantage.”

AMA PRESIDENT A/PROF BRIAN OWLER (pictured above with Matthew Cooke NACCHO chair at recent Parliamentary event )

SPEECH TO BMA SYMPOSIUM The Role of Physicians and National Medical Associations in Addressing the Social Determinants of Health and Increasing Health Equity LONDON 24 MARCH 2015

The Social Determinants of Health: the Australian Perspective

The Australian connotation of the words ‘social determinants’ in relation to health immediately conjure images of the issues faced by Australia’s first people, our Australian Aborigines and Torres Strait Islanders.

And this is rightly so. The social determinants of health are major issues for Australia as a nation in its attempts to ‘close the gap’ for disadvantage of Indigenous people in relation to a range of outcomes, including health.

The implications of the social determinants are not bound by race, although race might be thought of as a social determinant in itself. Social determinants are important to health outcomes for all Australians.

The issues are much more complex than whether someone has a roof over the head, whether they have access to clean water and nutritious food. What I want to talk about, from the Australian perspective, are two issues.

First, there are deeper issues that underlay the social determinants of health. This comes from a sense of physical, social, and emotional wellbeing, the origins of which have deep spiritual roots for Australia’s Indigenous people.

The second is that the term ‘social determinants of health’ is somewhat misleading. While I know many here understand this, we must not forget that health is a determinant of social and other outcomes.

Australian Indigenous peoples represent about 3 per cent of the Australian population. Indigenous Australians experience poor health outcomes. We have a gap between Indigenous and non-Indigenous Australians in terms of health, but also in many other aspects of life. Indeed, the health outcomes are poorer compared to the Indigenous populations of other nations.

Life expectancy of Indigenous Australians is 10.6 years less for men, and 9.5 years for women. This gap in life expectancy is a serious blight on our nation, and remains unacceptable.

The AMA sees that addressing this issue is a core responsibility of the AMA and the medical profession.

While the gap in life expectancy remains unacceptable, there have been gains in Indigenous health. Life expectancy has increased by 1.6 years and 0.6 years for men and women respectively over the past five years. Mortality rates for Indigenous Australians declined by 9 per cent between 2001 and 2012.

So, what are the main contributors to the gap in life expectancy?  Chronic diseases are the main contributors to the mortality ‘gap’ between Indigenous and non-Indigenous Australians.

Four groups of chronic conditions account for about two-thirds of the gap in mortality: circulatory disease, endocrine, metabolic and nutritional disorders, cancer, and respiratory diseases.

Another major contributor to the gap in life expectancy is the Indigenous infant and child mortality rate. These rates remain well above that of the non-Indigenous population.

The infant mortality rate remains high at around five deaths per 1000 live births, compared to 3.3 per 1000 for non-Indigenous children.

External causes, such as injury and poisoning, account for around half of all deaths of children aged 1–4 years. External causes, mainly injury, are also the most common cause of death among Indigenous children aged 5–14, and account for half of the deaths in that age group.

The trend data for most States show a 57 per cent decline in the Indigenous infant mortality rate between 2001 and 2012, and a 26 per cent decline in the non-Indigenous rate.

There has been progress here, but clearly there is much more to do.

Suicide was the third leading cause of death among Indigenous males, at six per cent.

The rate of suicide is about two times higher for males and 1.9 for females, compared to non-Indigenous Australians. Suicide also occurs at a younger age. This is not consistent with Aboriginal culture, in which suicide was thought to be rare.

These sorts of reports highlight several important issues.

First, as is already known, non-communicable diseases, in particular circulatory disease and diabetes, remain very significant issues for the Australian Indigenous people.

Investment in local health services is a must. Delivery of appropriate health services, particularly through Aboriginal community controlled health services, must be culturally safe, and delivered in the right locations by the right people.

Second, the rate of suicide, particularly among young Indigenous males, is unacceptably high. This speaks to something much more difficult to address.

It is an issue of how we address mental health, the need to focus on drug and alcohol problems, but it also raises questions about why so many Indigenous people take their own lives.

Third, our child and infant mortality rates are too high, but are improving. What is disturbing is that many of the deaths remain preventable. That is, they are caused by trauma or injury. Some of these injuries will be non-accidental.

While those with chronic disease need to be cared for, prevention, particularly in the early part of life, is the key if we are going to see a generational change in health outcomes.

As a nation, Australia is conscious of the need to improve the health of Indigenous Australians – to Close the Gap.

Each year, the Prime Minister, in the first week that Federal Parliament sits, delivers a report on Closing the Gap.

In 2008, the Council of Australian Governments, or COAG, set six targets aimed at reducing Indigenous disadvantage in relation to health and education.

The Closing the Gap targets are to:

  • close the life expectancy gap within a generation (by 2031);
  • halve the gap in mortality rates for Indigenous children under five within a decade (by 2018);
  • ensure access to early childhood education for all Indigenous four year olds in remote communities within five years (by 2013);
  • halve the gap in reading, writing and numeracy achievements for children within a decade (by 2018);
  • halve the gap for Indigenous students in year 12 attainment rates (by 2020); and
  • halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade (by 2018).

Despite good intention and considerable investment by successive Governments, the disparity in outcomes remains.

As expressed in this year’s Closing the Gap statement by the Prime Minister: ‘It is profoundly disappointing that most Closing the Gap targets are not on track to be met’.

Closing the Gap is an incredibly difficult task, and it is fair to say that Australia and Australians have learnt much about how to Close the Gap over a number of decades.

There were many mistakes, not only in Closing the Gap, but also in how modern Australia has treated Indigenous Australians. These issues have had to be confronted in order to advance efforts to Close the Gap.

For example, from 1910 to 1970, it is estimated that 100,000 Indigenous children were taken from their families and raised in institutions or fostered to non-Indigenous families.

The ‘Stolen Generation’, as they are termed, was disastrous in its outcome, however well-intentioned it may have been – separating families, but also alienating individuals from their own culture and families.

There have been many examples of Governments trying to address the social determinants of health – but often they have failed. For example, the Australian Government attempted to improve the living conditions of Indigenous people by building houses.

The houses were often inappropriate for the location. The plumbing would block because of the hardness of the water. They would fall into disrepair, and they did not serve the needs of the communities. These initiatives were well meaning, but improvements in health outcomes were somewhat marginal.

We have learnt, unfortunately by mistake, but also through partnership with Indigenous Australians. When it comes to health, there is much more to improving Indigenous health than building houses and sending people to school.

The concept of health for Indigenous Australians is very different from that of Western culture. There is no word for health in many Aboriginal languages. Rather, health is more of a concept of social and emotional wellbeing than of physical health.

Even that statement is a generalisation.

Before the arrival of Europeans, Australia was inhabited not by a uniform nation of Aboriginal people, but rather hundreds of ‘Indigenous nations’, whose language varied tremendously, along with their culture and beliefs.

Despite this variation, a unifying theme in terms of that ‘social and emotional wellbeing’ is the connection of Indigenous people with their land.

Australia’s first peoples have been continuously sustained, both physically and spiritually, by their land for 50,000 years of more. They have a deep connection with the land, and it is an important component of maintaining their spiritual wellbeing.

The close connection with the land also means that Indigenous people often live in remote regions. These remote communities present challenges in delivering health care as well as infrastructure and services that improve the social determinants of health.

For Indigenous Australians, their very existence, let alone their lifestyle, was threatened by European settlement as late as 1788. For Indigenous Australians, the arrival of Captain Cook in 1770, and subsequently the First Fleet in 1788, is not seen as European settlement, but rather as a modern invasion.

It signified displacement, imprisonment, forced adoption and much worse. It has left both emotional and spiritual wounds open and unable to heal. Modern economic solutions will continue to fail until these much more deeply seated issues are confronted.

There have been important steps in our young nation’s history that have attempted to approach these issues.

As I mentioned, the attachment to land is an important part of Indigenous culture. For each Indigenous ‘nation’, certain places hold spiritual importance.

From the land stemmed the basis of Aboriginal ‘dreamtime’, the spiritual conceptualisation of the universe and the basis of human existence for Aboriginal peoples. One might say that their landscape was their religion.

Recognition of the longstanding connection to the land came through a series of legislative changes that largely started under the Whitlam Government in 1972. Whitlam established the Aboriginal Land Rights (or Woodward) Commission to examine the possibility of establishing land rights in the Northern Territory.

In 1975, the Whitlam Government purchased traditional land and handed it back to the Gurindji people. In a now famous gesture, Whitlam poured sand into the hands of Vincent Lingiari, an Elder of the Gurindji people.

The Aboriginal Land Rights Act was passed by the Fraser Government in 1976, and established land rights for traditional Aboriginal landowners in the Northern Territory.

In 1992, the doctrine of terra nullius was overruled by the High Court of Australia in Mabo v Queensland, which recognised the Meriam People of Murray Island in the Torres Strait as native title holders over part of their traditional lands.

The Native Title Act was legislated the following year, 1993, by the Keating Government.

Not only did this provide the legal acknowledgement that Indigenous Australians sought, it also provided a source of revenue. The use of land for mining purposes, for example, provided significant funding to Aboriginal people through regional land councils.

More has been done since, but these are important issues to address that underlay social and emotional wellbeing and, therefore, the health of Indigenous people.

In 2008, Prime Minister Kevin Rudd issued a formal apology to Indigenous people for the stolen generation. It had enormous symbolism for Indigenous Australians.

The next likely step is to recognise Australia’s first people in our Constitution.

Constitutional recognition is a vital step towards making Aboriginal and Torres Strait Islander people feel historically and integrally part of the modern Australian nation.

Recognising Indigenous people in the Constitution will improve their self-esteem, their wellbeing, and their physical and mental health.

The AMA is a proud supporter of the Recognise campaign, and is a Foundation Signatory of the campaign.

In 2013, the Abbott Government was elected. Prime Minister Abbott had spent significant amounts of time with Indigenous people, often living for a week at a time in Indigenous communities.

In Government, he ‘ran the country’ for a week from a remote Indigenous community in Arnhem Land of the Northern Territory.

Prime Minister Abbott also took over the responsibilities for many Indigenous policy areas. The coalescence of these responsibilities into the Department of Prime Minister and Cabinet coincided with the reduction of the number of Indigenous programs into five main areas.

The Indigenous Advancement Strategy, or IAS, that began on 1 July 2014 now embodies these aims. The IAS outlines a number of priority areas – getting children to school, adults to work, and making communities safer.

The IAS replaced more than 150 individual programs with five broad programs – Jobs, Land and Economy; Children and Schooling; Safety and Wellbeing; Culture and Capability; and Remote Australia Strategies.

These are all worthy aims. They remain important.

But what is missing from the core of the IAS is a focus on health.

Health, in a modern sense, underpins many of these outcomes. We need to get the balance right and we, the AMA, need to ensure that health is seen as a foundation to these outcomes.

So, what is our role as a national medical association? Our role is to guide politicians and their policies; to shape the national narrative and debate.

The AMA’s Indigenous Health Taskforce, which I chair, draws experts in Indigenous Health together. It highlights the AMA’s commitment to working, in partnership with Indigenous Australians, to improve the health of Indigenous Australians.

Not only do we highlight the problems, but the AMA works on solutions and to highlight the successes as well.

The AMA regularly publishes the AMA Indigenous Report Card.

Last year, we highlighted the importance of a healthy early start to life.

My predecessor, Dr Steve Hambleton stated that: “Robust and properly targeted and sustained investment in healthy early childhood development is one of the keys to breaking the cycle of ill health and premature death among Aboriginal peoples and Torres Strait Islanders.”

Gains can be made by focusing on antenatal care.

In the Pitinjarra lands of north western South Australia there have been major gains in antenatal care, with 75 per cent of all pregnant women seen in the first trimester.

The proportion of children under three years of age with significant growth failure has fallen from 25 per cent in the 1990s to less than 3 per cent today. Immunisation rates approach 100 per cent.

This year, the AMA Report Card will focus on the bigger picture of the importance of health in underpinning the outcomes of education, training, and employment.

We will also focus on the issues of Indigenous incarceration rates, which have continued to escalate.

Law and order policies and health policies are often interlinked. Incarceration leads to a multitude of poorer physical and emotional health outcomes.

Poor health, and a poor start to life, is likely to increase the chances of incarceration. The AMA will be working with the Law Council of Australia on this issue.

To change the health of an entire population is an enormously difficult task. It is too easy for Governments to ignore health, to focus on the economics. Education and economics alone are not sufficient. Health is the cornerstone on which education and economics are built.

If you can’t go to school because you or your family are sick, truancy officers won’t work. If you can’t hear because of otitis media, you won’t learn. If you miss training opportunities because of depression or ill health, you won’t progress to employment. You can’t hold down a job if you keep having sick days.

Spending on health is an investment. Investing in health must underpin our future policies to Close the Gap, and to address what is, for Australia, a prominent blight on our nation.

Governments and other groups that influence policy cannot do this work themselves. It must be a partnership with Indigenous Australians.

The AMA is committed to working, in partnership with our first peoples to Close the Gap in Indigenous health and disadvantage.

DOWNLOAD THE NACCHO HEALTHY FUTURES REPORT CARD HERE

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NACCHO $ Funding updates : Indigenous-controlled sector the clear loser of Indigenous Reform Agenda

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“The IAS has offered us nothing in terms of new imaginings of and engagement with Aboriginal people, communities and capabilities

One would think, given the inability of mainstream services to close the gap in indigenous disadvantage to date, that all funding for indigenous advancement outcomes would require “high standards of governance and accountability.Yet in reading between the lines, it is primarily the indigenous community-controlled sector that requires additional scrutiny and surveillance.These special measures of surveillance and exemption in indigenous affairs are all too familiar to indigenous Australians who have lived under the protectionist and assimilationist policies of the last century and beyond.”

Dr Chelsea Bond, a senior lecturer in the Oodgeroo Unit at Queensland University of Technology.

“Maningrida has not had a youth suicide in the past 3 years, has seen a decrease in youth crime, teen pregnancies and STI rates which can be attributed to the support given by the youth centre to the young people of the community. In addition, the youth centre through its weekly Mooditj program offers disengaged and referred youth the opportunity to learn about sexual health, safe sex, life skills and much more”

Story 2 Below:  Malabam Health Board Aboriginal Corporation (Maningrida NT ) oversees the “GREATS” Youth Services (GYS) which has been hit hard with an 80% cut to its annual $400k budget under the IAS cuts!

Picture above :The Inala Wangarra Sport and Recreation Program aims to provide sporting and recreational opportunities for local Aboriginal and Torres Strait Islander people. (see story Below)

According to the federal government, the Indigenous Advancement Strategy represents a“new relationship of engagement” with indigenous Australia. Yet it was just under a decade ago that we were inflicted with a “new paternalism” by our Prime Minister, then the federal health minister, in justifying a raft of indigenous social policy measures including the Northern Territory Emergency Response (the Intervention), the introduction of alcohol management plans in Aboriginal communities in Queensland and the mainstreaming of indigenous services in urban and regional centres, which was continued under successive Labor governments.

Perhaps the only new thing about this strategy is the $534 million funding cut from the Indigenous Affairs portfolio. This is despite what the PM deems the “profoundly disappointing” results outlined in the government’s own Closing the Gap report last month. The PM’s chief indigenous adviser, Warren Mundine, did warn us that the reform agenda would produce “winners” and “losers”, and certainly from the coverage over the past few weeks, many indigenous communities are feeling as though they are on the losing side. While a full list of the winners and losers has yet to be released, we can see that the indigenous community-controlled sector has been hit particularly hard — be they peak bodies or local grassroots organisations, from Tennant Creek to Inala (the community in which I live), a wide range of front-line services will no longer exist as a result of the IAS announcement.

The other less reported “new reform“ under the IAS introduced last year has been the requirement for indigenous organisations receiving “grants of $500,000 or more in a single financial year from funding administered by the Indigenous Affairs portfolio to incorporate under Commonwealth legislation under the Corporations (Aboriginal and Torres Strait Islander) Act 2006”.

Organisations may be exempt from this requirement if they don’t primarily service indigenous people, or alternatively indigenous organisations may be exempt if they “can demonstrate that they are well-governed and high-performing”. This strategy we are told is to “ensure organisations receiving Australian Government funding to deliver Indigenous programmes have high standards of governance and accountability”.

One would think, given the inability of mainstream services to close the gap in indigenous disadvantage to date, that all funding for indigenous advancement outcomes would require “high standards of governance and accountability”. Yet in reading between the lines, it is primarily the indigenous community-controlled sector that requires additional scrutiny and surveillance. These special measures of surveillance and exemption in indigenous affairs are all too familiar to indigenous Australians who have lived under the protectionist and assimilationist policies of the last century and beyond.

Ironically, the indigenous community-controlled sector already meets high standards of accountability —  accountability for outcomes within our own communities. These organisations are governed and largely staffed by local indigenous community members who are held accountable to our communities for delivering on outcomes, often well beyond what we are funded to deliver and beyond the usual hours of business. This is not in lieu of financial accountability requirements to funding providers, but rather in addition to — an additional burden not often faced by large NGOs staffed by people from outside of our community.

Take, for instance, the community organisation I’m a board member of: InalaWangarra, which was one of the losers under the IAS.

Recently our organisation was funded around $50,000 to deliver an outcome of 20 indigenous people into careers as security guards, which was well shy of the actual costs of the program. Just this week 20 local indigenous people in Inala graduated from the program with a certificate II in security, certificate III in hospitality, and received their blue cards, police checks and security licences and now are all embarking on careers with a security company in our region. For that small investment, the CEO is dealing with three different state and federal funding providers and writing grant applications and acquittals for each one, on top of regular visits and phone calls from funding providers just to check on how we are doing, with another requiring written monthly reports. Part of the funds for this program was provided after completion to ensure we delivered on the outcomes, thus requiring the organisation to resource program implementation from other funds.

This isn’t good governance surely? And this is despite our previous achievement under a federal government pilot program that placed 88 local indigenous community members into jobs, most of whom were long-term unemployed, and retained employment beyond 13 weeks. Despite demonstrating competency, indigenous community-controlled organisations are still deemed “too risky” to funding providers, and it is this “relationship of engagement” that demands reform.

The “new reforms” in indigenous social policy must include equal, if not greater scrutiny over the inability of mainstream services to deliver the outcomes they are funded to deliver in our communities. Their governance structure doesn’t enable local communities to hold them accountable, and every year we are surprised at the new NGO that has rolled into our suburb or received funding to service our community, despite having demonstrated little engagement with our community.

One such example is the federal funding in 2012 for indigenous men’s sheds across the country as a men’s health initiative. Within our local community, the Inala Police Citizens Youth Centre was funded to establish a men’s shed. Yet, one year later The Satellite newspaper reported: “The one-year-old building at the back of the Inala Police Citizens Youth Centre (PCYC) has every tool imaginable on its shelves, walls and benches and a pile of wood just waiting to be crafted.” There is, however, one problem. The shed is predominately empty due to a lack of members. Yet Inala Wangarra’s indigenous men’s group has never struggled with engaging local men in its activities — it has simply struggled to engage financial investment from state or federal funding providers. This is not an isolated case, and examples of poor engagement and poor service delivery can be found across critical areas of health, education, housing, employment and training, which explains much of the gap of inequality that our people suffer. It is often left to the under-resourced local indigenous community controlled organisation to fill the gaps of mainstream service delivery models.

This is the site where genuinely “new reform” could be demonstrated — ensuring that all funding (both indigenous-specific and mainstream) advances the interests of the indigenous community it services, both in terms of process and outcomes.

Indigenous people are more than consumers of social services; we have the skills and capabilities to drive the services within our community. Our model of service delivery requires us to employ local indigenous people and build the capacity of the workforce within our community and this is what makes the indigenous community controlled sector so critical to achieving the Closing the Gap targets.

Our model of service delivery doesn’t trade off old imaginings of indigenous incompetence, dysfunction or despair.

New reform” in indigenous social policy will only be realised through new imaginings of and engagement with Aboriginal people, communities and capabilities. Unfortunately the IAS has offered us nothing new in this regard.

Malabam Health Board Aboriginal Corporation (Maningrida) oversees the “GREATS” Youth Services (GYS) which has been hit hard with an 80% cut to its annual $400k budget under the IAS cuts!

Maningrida has not had a youth suicide in the past 3 years, has seen a decrease in youth crime, teen pregnancies and STI rates which can be attributed to the support given by the youth centre to the young people of the community. In addition, the youth centre through its weekly Mooditj program offers disengaged and referred youth the opportunity to learn about sexual health, safe sex, life skills and much more

Media Release Malabam Health Board Aboriginal Corporation

“GREATS” Youth Services

Greats

Another frontline community driven organisation has been hit hard by the recent release of the funding cuts made to Aboriginal community controlled organisations under the Federal Governments Indigenous Advancement Strategy.Malabam Health Board Aboriginal Corporation (Maningrida) oversees the “GREATS” Youth Services (GYS) which has been hit hard with an 80% cut to its annual $400k budget under the IAS cuts!

The Federal government has offered the youth services in Maningrida an annual budget of $80,000 to be involved in a children and schooling program which has little relevance to the extensive suite of services that it has been providing to the community over the past five years ; it currently services a youth population of 1500! Half of the population in Maningrida is under the age of 25 years and it is the biggest community in Arnhem Land with a population of 3500 people and 38 outstations.

GYS is the youth service that operates in Maningrida and offers a suite of activities, workshops, projects and community events and has done so since 2005. GYS currently employs 7 local indigenous staff and has a nightly head count of 75 youth at its drop-ins. GYS hosts a weekly community movie night and attracts an audience of 150 community families to enjoy social connections.

The monthly Friday night discos attract an audience of approx. 250 people and offer an alternative to boredom that can lead to crime, suicide and assaults.

Maningrida has not had a youth suicide in the past 3 years, has seen a decrease in youth crime, teen pregnancies and STI rates which can be attributed to the support given by the youth centre to the young people of the community. In addition, the youth centre through its weekly Mooditj program offers disengaged and referred youth the opportunity to learn about sexual health, safe sex, life skills and much more. GYS offers a weekly back to country bush trip with elders to re-engage the youth with culture! GYS also coordinates the NT police youth diversion program and focuses on restorative justice to keep youth out of jail!

The cuts through the IAS will force the seven local staff out of work and the youth centre to shut its doors 30th June, 2015. The youth centre will not be in a position to contiue its worthwhile service delivery primarily because the $80k on offer from the federal government has no connection with the services that have been on offer for the past nine years.

This will see the 1500 youth in the community without a service and a safe place to be at night. The community of Maningrida is in disbelief at the governments decision to cut its only youth service and are concerned with the impact of not having a reliable youth service beyond June

Youth Manager Noeletta McKenzie said “If GYS is to close I am concerned about the impact on the community and the probable rise in youth suicides and crime rates”, “We as a team at GYS have worked extremely hard to overcome the youth gang mentality and extended our hands out to the youth to ensure that suicide is not a thought”!. “I feel that youth services across the board through the IAS have been overlooked”!. “We are creating strong young leaders and all youth services play a vital role in the early lives of youth, especially in our communities”!

GYS was a community driven project when Mr. Millren (Dec) wrote a letter to the government 10 years ago seeking support as the youth were out of control and had no future! GYS is Mr. Millren’s legacy and it is now under threat, the decision by the government in relation to IAS funding for Maningrida is regrettable and has disheartened the many people who have travelled the journey since the innception of youth services in 2005 and observed the positive change that the service has had on the youth of

 

Having trouble with your IAS application ?

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The Minister Nigel Scullion advises that hotline has been setup to deal with funding inquiries 1 800 088 323 

 

NACCHO Health News: Free flu vaccines for Aboriginal children thru Aboriginal Medical Services

 

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Indigenous children will benefit from the Federal Government’s free flu vaccine program for the first time this year as authorities brace for a virulent strain of flu heading for Australia.

The Government announced at the NACCHO parliamentary breakfast in Canberra yesterday that  it would extend its free flu program to the children to help reduce flu deaths among the vulnerable group.

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Health Minister Sussan Ley speaking at the NACCHO event said five Indigenous children died from the flu each year.

PHOTO ABOVE 1.Federal Health Minister Sussan Ley with Indigenous children receiving free flu vaccinations in Broken Hill, NSW last weekend 2.Making announcement with NACCHO Chair Matthew Cooke and CEO Lisa Briggs

Under the National Immunisation Program (NIP), essential vaccines – including seasonal influenza vaccinations – are provided free of charge to at-risk groups within the community.

When the 2015 influenza vaccine is available in April, parents of Aboriginal and Torres Strait Islander children aged between six months and five years will be able to get their children vaccinated for free through general practitioners, community controlled Aboriginal Medical Services and immunisation clinics.

Free influenza vaccines are also available to Aboriginal and Torres Strait Islander people aged 15 years and over, people aged 65 years and over, pregnant women and people over six months who have specific medical conditions that increase their susceptibility to influenza.

The NIP is a joint initiative between the Australian Government and state and territory governments.

For more information,

Contact the Immunise Australia information line on 1800 671 811

Extra information below by ABC NEWS medical reporter Sophie Scott and Alison Branley

“The key objective I believe of every Federal Health Minister when it comes to Indigenous health must be closing the gap in life expectancy and that starts in childhood,” Ms Ley said.

“It’s vital we include children under five in as many health initiatives as possible and flu vaccination is one of them.”

Indigenous children will be able to get a flu vaccine through their GP, Aboriginal Medical Services and immunisation clinics.

Health experts said Aboriginal and Torres Strait Islander children were twice as likely to be hospitalised from the flu as non-Indigenous children.

Free flu vaccines are already provided for vulnerable groups such as people aged over 65, pregnant women and people with a range of chronic conditions who are at increased risk from flu complications.

The announcement comes as Australian doctors predict a killer flu season.      

In the northern hemisphere, flu rates were high and a deadly strain called H3N2 saw thousands of elderly people hospitalised.

More than 100 children have died in the United States.

“The objective is to be prepared,” Ms Ley said.

“You must take the flu seriously. As a nation, we’ll wait and see what happens with this year’s flu and hope it isn’t as bad as it was in the northern hemisphere.”

Flu vaccination program delayed to improve formula

This year’s Australian public flu immunisation program has been delayed so the flu vaccine can be reformulated from 2014 to replace two strains.

Australian Technical Advisory Group on Immunisation chairman Dr Ross Andrews said the flu vaccine would include the same strain that caused the pandemic in 2009 and two new strains from the northern hemisphere.

“It’s been delayed because of new strains that have been added to the vaccine,” he said.

“There’s been a delay to make sure we’ve got sufficient supplies, so two suppliers providing the vaccine to make sure we’re covered.

“It was a bad year in the northern hemisphere, it was a reasonably bad year last year for us as a flu season.

“It was the worst year … since 2009 and it’s possible we might be heading again to another severe flu season.”

The vaccine will be available from GPs from April 20, he said.

The US Centres for Disease Control and Prevention reported flu hospitalisation rates for people aged over 65 were the highest in 2014 since flu tracking began in 2005.

Doctors have urged vulnerable patients to be vaccinated as soon as the new vaccine is available.

Data from the Influenza Specialist Group shows almost 2,500 Australians have already had the flu this year, with the majority of cases in Queensland.

NACCHO Media Release: Aboriginal health must remain the priority to close the gap

The peak Aboriginal health organisation today said Aboriginal health, commitment to programs that work, Aboriginal control and long-term funding were all necessary to close the ongoing gap between Aboriginal and other Australians.

The National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson Matthew Cooke said closing the gap was achievable.

“Closing the gap is about generational change and there are no quick fixes,” Mr Cooke said.

“Real gains, although small, are already being made in life expectancy and other key areas like maternal and child health.

“We need to see continued, long-term commitments from all levels of government in the programs that work. In health, it’s Aboriginal Community Controlled Health Services that are making the biggest inroads against the targets to close the gap.

“They are also contributing to other targets, such as in employment, as the largest employers of Aboriginal people.”

Mr Cooke said the Federal government’s focus on getting kids into school, adults into work and community safety, is welcomed, but cannot be achieved without a similar prioritisation of health issues.

“Put simply, sick kids can’t go to school, sick workers can’t work.

“Yet our health services continue to live with great uncertainty. The last funding allocation was for only twelve months and expires at the end of June this year. Without better funding certainty, we can’t provide certainty to our staff or to our patients.”

Mr Cooke said Aboriginal Community Controlled Health Services are the primary health care sector that delivers the best results for Aboriginal and Torres Strait Islander People but are the least funded.

“What we would like to see is a clever re-allocation of the Aboriginal health budget from mainstream services into community controlled health.

For example the government currently allocates Aboriginal health funding to Medicare Locals. We would like to see this redirected to our sector to ensure Aboriginal and Torres Strait Islander people continue to receive quality care during the transition to Primary Healthcare Networks.

“The Abbott Government supported establishment of the Closing the Gap targets while in opposition and must continue to honour these commitments in government if we are to meet the targets for overcoming Indigenous disadvantage by 2031.”

NACCHO welcomes new service to North West Queensland

Matt and Lizzie at Gidgee Normanton cropped

Pictured L to R: Matthew Cooke (Chair NACCHO), Elizabeth Adams (Chair QAIHC), Shaun Soloman (Chair Gidgee Healing) and Dallas Leon (CEO Gidgee Healing)

The peak Aboriginal health organisation today welcomed the opening of a new Aboriginal community controlled health centre in the community of Normanton in Queensland’s north west.

The National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson Matthew Cooke attended the opening and said the new Recovery and Community Wellbeing Centre was key to providing improved health services to Aboriginal people in the lower Gulf.

The new centre is a federally funded initiative which is operated by Gidgee Healing, an Aboriginal Medical Service, and The Salvation Army.

“Getting appropriate health and wellbeing services into remote parts of Australia is a huge challenge,” Mr Cooke said.

“It’s difficult for remote communities to get the quality health care they need.

“This centre will go a long way to helping many Aboriginal people get on the road to good health.”

Recovery and Wellbeing Centre Normanton cropped

Mr Cooke said the new Normanton Recovery and Community Wellbeing Service would be run by Aboriginal people for Aboriginal people.

“The population of Normanton and surrounding areas is overwhelmingly Aboriginal and they need access to culturally-appropriate health care.

“Having local people involved in this centre will be key to it’s success in attracting clients and improving the health of the community. It also has the potential to boost employment and training opportunities for local residents.

“This is a significant addition to the Gulf and we congratulate all involved in making it a reality.”

NACCHO Health Summit 2015: Call for Abstracts

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The 2015 NACCHO Health Summit will be held in the Gold Coast from the 16th to the 18th of June 2015. 

NACCHO invites abstracts submission from its members the Aboriginal Community Controlled Health Organisations, Affiliates and key stakeholder organisations to showcase policy frameworks, best practice and investment in Aboriginal Health. The delegates will be a representation from all over Australia in clinical practice, policy and research.

Learn more at: http://www.naccho.org.au/events/2015-naccho-summit/#sthash.hOruDVPa.dpuf

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Important Dates

  • Call for Abstracts Open – 2nd February
  • All Abstracts Due – 6th March 2015
  • Abstract Notifications – 6th April 2015
  • Early Bird Registration Open – 20th February 2015
  • Early Bird Registration Closes – 17th April 2015
  • Program Released – 6th April 2015
  • Summit Commences – 16th June 2015

NACCHO Media Release: Aboriginal community controlled health services are the key to reducing Hep C rates

22 January 2015

Aboriginal community controlled health services are the key to reducing Hep C rates

The peak Aboriginal health organisation will today tell a Senate inquiry today that more must be done to reduce the high rate of Hepatitis C infection among Aboriginal people.

National Aboriginal Community Controlled Health Organisation (NACCHO) CEO Lisa Briggs said the rate of new Hepatitis C infection continues to rise in Aboriginal populations even though it is falling for other Australians, and that Aboriginal Community Controlled Health Services are the are key to reducing infection rates.

“Mainstream services are clearly failing Aboriginal people, who are three times as likely to become infected with Hepatitis C as other Australians,” said Ms Briggs.

“It is clear that more prevention and treatment programs are needed that meet the needs of Aboriginal people,” said Ms Briggs.

She said the main contributors to the increased rate of infection for Aboriginal people are higher rates of unsafe injecting drug use and higher rates of incarceration, with the prevalence of the disease in prisoners who inject drugs above 50%.

“Aboriginal Community Controlled Health Services should play a bigger role in Hepatitis C prevention and treatment programs because they have proven to be the most effective providers of primary health care to Aboriginal people.

“These services need the funds and resources so they can provide prevention programs including needle exchange programs and opiate replacement therapy.

“A commitment to more outreach programs by Aboriginal Community Controlled Health Services into prisons will also help with infection rates in these populations.

“Hepatitis C rarely occurs in isolation.  Many patients are likely to have multiple health issues including mental illness, drug and alcohol addiction and type two diabetes. Aboriginal Community Controlled Health Services have proven time and time again to be the best model to provide comprehensive primary health care for these complex needs.

“Hepatitis C infections are decreasing among other Australians and we want to see them decreasing among Aboriginal people, too.

“We look forward to working with the Government to ensure our Aboriginal medical services have the funds and resources to make this happen.”

Aboriginal health services concerned about lack of transparency in GP co-payment discussions

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Aboriginal health services today called on the Federal Government to consult more widely on the impact of the GP co-payment before it is put to the Senate.

The National Aboriginal Community Controlled Health Organisation (NACCHO) Deputy Chairperson Matthew Cooke said the dealing apparently going on behind closed doors without input from the Aboriginal health sector was cause for concern.

“The fact is, the introduction of a GP co-payment is poor health policy for all Australians,” Mr Cooke said.

“Abolishing free universal health care will introduce a dangerous disincentive for people to seek the medical attention they need until their health conditions are advanced and need more invasive and costly attention.

“When applied to Aboriginal health its impact is likely to be magnified.

“We have made some gains in improving the health of Aboriginal people but we still have a long way to go to close the appalling health gap between Aboriginal and other Australians.

“We need our pregnant women to attend check ups, we need our children to be immunized, we need our young men to have access to mental health services.

“We simply can’t put any barriers in the way of Aboriginal people seeking health care or we risk the gains we are making in Aboriginal health. The GP co-payment is a significant barrier.”

Mr Cooke said speculation about exemptions from the GP co-payment for particular groups would only go part of the way to addressing the issues.

“Although we applaud the AMA’s efforts to work with the Federal Government to resolve the impact of a GP co-payment on vulnerable Australians, an exemption for Aboriginal Medical Services is not the silver bullet.

“The majority of our Services would have waived the co-payment for their patients, which would effectively have meant a cut in their funding, so in this regard it would be of benefit for our Services.”

“However, many Aboriginal people do not have access to Aboriginal Community Controlled Health Services because of where they live.

“There are 150 Aboriginal Community Controlled Health Services across Australia, providing primary health care to over half Australia’s Aboriginal population.

“But we don’t have national coverage so that would leave a lot of Aboriginal people using mainstream services still subject to the GP co-payment.”

Mr Cooke said he was also concerned about the additional pressures on Aboriginal Community Controlled Health Services if the exemption only applied to these Services.

“Demand for our Services is growing at a rate of about six per cent a year. Aboriginal people are already travelling large distances to seek out our Services as they prefer to be treated by someone who understands their culture and community.

“The co-payment exemption is likely to increase demand even further and would be a challenge for our Services to manage within their existing budgets and resources.”