NACCHO Aboriginal & Torres Strait Islander Health News: This is not about money, profit or turf

The Pixabay image in the feature tile is from the ABC News article Pharmacist prescription trial proposed as possible solution to the GP shortage faces indefinite delays, 23 August 2022.

This is not about money, profit or turf

Dr Jillann Farmer, a Brisbane-based GP and former Medical Director of the United Nations has written an article for the Medical Journal of Australia’s InSight arguing that when something looks simple, it can deceptively create a sense that the work is simple. The ease with which health professionals exercise heuristic skills to rapidly synthesise patient demographic and social circumstances, comorbid conditions, pathology and epidemiology and arrive at a diagnosis and treatment choice make that expertise largely invisible and has likely contributed to an overall perception that most of what GPs do is simple and can be safely and appropriately done by alterative health professionals with significantly less training and experience. Some of the work GPs do absolutely can be done by others. But the health system needs those decisions to be informed by actual expert practitioners.

The North Queensland pharmacy trial, an election promise of the Palaszczuk government, followed on the urinary tract infection (UTI) treatment trial/pilot which allowed patients to present to a pharmacy and be dispensed antibiotics for a UTI. There have been significant concerns expressed about the diagnostic acumen of pharmacists in this space – prescribing based on symptoms alone. GPs do the same if we treat a UTI by telehealth, but for most, that is the exception, not the standard.

The UTI program seems to have emboldened the Queensland Government, and the North Queensland Pharmacy Trial was born. The proposal could cut doctors (not just GPs, but all doctors) out of decisions to diagnose and initiate prescription medicines of some pretty significant diseases. Hypertension and diabetes were on the original list where pharmacists would be able to diagnose and prescribe. The details of the proposals are not public domain, but within current funding frameworks, it seems almost impossible that pharmacists would be able to implement current guidelines for appropriate care to the same standard as doctors.

It is of particular concern that the trial was proposed for a region of Queensland where Aboriginal and Torres Strait Islander people are a significant proportion of the population. So we target an already disadvantaged population and substitute care that cuts them off from recommended diagnostic and management capabilities. It is no wonder that NACCHO expressed opposition to the trial.

To view the InSight+ article Give GPs problems to solve, not election promises in full click here.

Image source: RACGP newsGP webiste.

What a male midwife learnt in Arnhem Land

It was a dry Thursday afternoon in Arnhem Land, NT, when young mum Tanisha’s [name changed for privacy] waters broke at just 23 weeks of gestation. Approximately 417 kms from the nearest hospital, an aircraft and doctor chaperone were flown in to her remote Aboriginal community within a few hours of the call for medical evacuation. But Tanisha felt anything but relief when her medical retrieval arrived. The doctor disembarking the aircraft was a man, and in her Aboriginal culture it is taboo for men — including medical practitioners — to interact with women about ‘women’s business’.

In an interesting plot twist, however, Tanisha requested for her male midwife Christian Wright to come with her and be present for the birth. Aside from being one of just 448 men to be working in midwifery in Australia (1.6% of the total workforce) Christian is no ordinary practitioner. Recognising the sensitivities around men and women’s interactions in Aboriginal culture, Christian has always thought outside the box about how he can make his patients feel comfortable.

His trust building with Tanisha began early in the antenatal process, when he learnt the local language and used cultural linguistic cues to convey empathy and earn trust. “Speaking to people ‘in language’ is a great way to help them feel culturally safe. In some Aboriginal cultures though, there are other important linguistic considerations,” he said. “For example, when discussing taboo subjects, like women’s health, men should use alternative, almost euphemistic, variations to formal language, to minimise embarrassment.”

To view the Hospital and Healthcare article What I’ve learned as a male midwife in Arnhem Land in full click here.

Midwife Christian Wright. Image source: ABC Conversations Radio National Twitter.

Must be more than a day of checking in

In 2019 WA Coroner Ros Fogliani delivered the results of her inquest into the deaths of 13 children and young people in the Kimberley. The report is incredibly distressing to read and hollows you out with every page you turn. 13 Aboriginal children and young people who died as a result of hanging, with all bar one considered definite suicide (the other being an open finding). The Coroner explained in meticulous detail the cycle of violence, inter-generational trauma, complexities of distance and circumstances which saw the premature death of 13 people aged between 10 and 24 years of age.

What desolate desperation these children and young people must have faced, with hope so lost, that they thought the only solution was suicide. Case 12 was a young man, part of the Wungu community, born in 1994 and he died at age 20. Growing up his health was very poor, at 18 months of age he was presented to Katherine Hospital with anaemia, gastro and abscess so bad it required surgical intervention. At age six, he was referred to a child psychologist where he stated that he wanted to kill himself. Age six. In his mid-teens he witnessed multiple incidents of domestic violence between his parents.

Last Friday was R U OK? Day.If you asked an Indigenous person that question, the chances are that things are pretty tough. In truth we need to move beyond a single day of checking in (which is the real message of RUOK? Day) because if we’re ever going to start making positive change and turning the tide of suicide, it’ll only be a concerted and constant effort of talk the hard truths and face our struggles together.

To view the National Indigenous Times article Things can be tough for Indigenous people. RUOK Day needs to start a conversation for change in full click here.

Photo: Emily Jane Smith. Image source: ABC News.

Milestone contract to deliver GP training

The Royal Australian College of General Practitioners (RACGP) has signed a milestone contract with the federal Health Department to deliver GP training in Australia from 1 February 2023. It is the largest medical vocational training contract entered into in history by an Australian Government. The signing of the contract comes after the transition of GP training back to Australia’s specialist medical colleges, the RACGP and Australian College of Rural and Remote Medicine (ACRRM), was announced in October 2017 by then federal Health Minister Greg Hunt.

RACGP President Adj. Professor Karen Price welcomed the signing of the contract, “Just as general practice is integral to our health system, GP training is fundamentally important to provide our next generation of GPs, who will care for our communities into the future. We are working to make this a seamless transition, with as little disruption to the delivery of GP training as possible. We are also working closely with numerous stakeholders to make this happen, including the Department of Health, peak bodies representing GP supervisors and registrars, the National Aboriginal Community Controlled Health Organisation or NACCHO, rural workforce agencies and clinical schools, primary health networks, state health organisations, local hospitals and community health services, the list goes on.”

To view the medianet article RACGP welcomes milestone contract to deliver GP training in Australia in full click here.

Dr Tarun Patel trained as a GP in the NT and worked at Wurli Wurlinjan, an Aboriginal Medical Service in Katherine. Image source: ACRRM website.

‘Empathy’ key in dementia care

Nearly 500, 000 Australians are living with dementia. Its most common form, Alzheimer’s disease, is set to cost $26.6 billion over the next 20 years. Dementia, a degenerative brain disease, affects thinking, behaviour and the ability to perform everyday tasks, interfering with a person’s normal social or working life. First nations’ voices have rarely been heard on dementia care and health services have not always been developed with Indigenous people in mind.

Speaking at the two-day International Dementia Conference 2022 in Sydney last week former Olympian and federal senator Nova Peris – the first Aboriginal woman elected to federal parliament – said dementia care for Indigenous Australians needed to draw on best practice overseas and Indigenous consultation. “Don’t try and reinvent the wheel, look to world’s best practice … acknowledging and respecting the work that’s already been done in the first nations space,” Ms Peris said. She urged the aged care sector to have empath front and centre when caring for Indigenous people with dementia. “Empathy having that understanding of that person’s life and the care that you provide for them, makes them happy,” the former federal politician said.

To view the HealthTimes article ‘Empathy’ key in Indigenous dementia care in full click here. You can also read a related AgedCare News article IDC2022: our wrap-up of a conference promising a Brave New World ahead in full here.

Bidyadanga residents with dementia are supported by workers at the community care centre. From left: Angelina Nanudie, Zarena Richards, Rosie Spencer and Faye Dean. Photo: Erin Parke, ABC Kimberley.

Strengh-based approach to kids’ health needed

First Nations children represent the future of the world’s oldest continuing culture. Of the 66,000 Victorians who identified as Aboriginal and Torres Strait Islander in the 2021 Census, one-third were aged under 15 years. First Nations children in Victoria are doing well in several health outcomes, a recent Aboriginal Data and Action on Prevention Together (ADAPT) report, available here, has found. This report provides valuable insight into nutrition, physical activity and wellbeing among First Nations children living in regional Victoria.

The survey found more than 300 First Nations primary school children were meeting guidelines for physical activity, healthy eating and screen time. Those who met these guidelines also had higher health-related quality of life. However, the study is rare. Before the report, there was no information available about nutrition and physical activity among primary school-aged First Nations children in Victoria.

To examine First Nations childrens’ health, Aboriginal and non-Aboriginal researchers from Deakin University partnered with the Victorian Aboriginal Community Controlled Health Organisation (VACCHO), the peak body representing Victoria’s Aboriginal community-controlled health sector. VACCHO’s nutrition team works to improve food security and nutrition outcomes among Aboriginal communities across Victoria.

To view The Conversation article Rather than focusing on the negative, we need a strength-based way to approach First Nations childrens’ health in full click here.

Aboriginal childrens’ health data needs to steer away from negative focuses by balancing the findings with respective community’s progresses. Photo: Dan Peled, AAP. Image source: The Conversation.

Indigenous-led research positions

The University of Melbourne Indigenous Studies Unit, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences has two positions available:

Postdoctoral Research Fellow – Indigenous Studies

This is an exciting opportunity to become involved in leading Indigenous health research with a passionate and dedicated team. We are seeking a highly motivated Postdoctoral Research Fellow with a research background in qualitative and/or mixed methods research, particularly using action research approaches. As a member of the NHMRC funded ‘Improving understandings of and responses to alcohol-related family violence for Aboriginal people’ team, the successful applicant is expected to contribute to independent and team-based research aiming to develop the evidence base of alcohol misuse and family violence within Indigenous communities using innovative theoretical and methodological approaches, combining theories of medical anthropology, social network analysis (SNA) and Indigenous Studies.

The successful applicant will be expected to contribute to the development of high-quality research projects and play a key role in the production of outstanding quality outputs. The successful applicant will also contribute to the supervision of honours, Masters and/or PhD students. Indigenous Australians are strongly encouraged to apply for this position.

For more information about the position and details of how to apply click here.

Research Fellow – Indigenous Data Network

The Indigenous Data Network (IDN) is seeking a highly motivated Research Fellow with a background in quantitative and/or mixed methods research, with experience in data linkage. The IDN is a national consortium of organisations and individuals led by the University of Melbourne, within the Indigenous Studies Unit, Centre for Health Equity, Melbourne School of Population & Global Health. The Research Fellow will be expected to make significant contributions to existing projects and to the development or extension of new, innovative research.

The Research Fellow will work with the IDN leadership team to drive Indigenous data ecosystems transformation, and to develop and undertake ongoing community-led research and national and international engagement. The role will include significant engagement and governance activities with key stakeholders including universities, Federal, State and Local Governments, Aboriginal and Torres Strait Islander organisations and communities, and private and non-profit organisations.

For more information about the position and details of how to apply click here.

Students from the University of Melbourne Indigenous Knowledge Institute. Image source: University of Melbourne website.

Sector Jobs

Sector Jobs – you can see sector job listings on the NACCHO website here.

Advertising Jobs – to advertise a job vacancy click here to go to the NACCHO website Current job listings webpage. Scroll down to the bottom of the page to find a Post A Job form. You can complete this form with your job vacancy details – it will then be approved for posting and go live on the NACCHO website.

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