NACCHO Aboriginal & Torres Strait Islander Health News: Breaking down eye health inequities

The image in the feature tile is of Dr Angus Turner assessing an ultra widefield retinal scan at the new Northwest Hub, the first permanent eye clinic in the Kimberley region based in Broome. Image source: Insight feature report Bringing telehealth and artificial intelligence into real-world ophthalmology practice published on Wednesday 7 December 2022.

Breaking down eye health inequities

Telehealth and artificial intelligence hold the key to breaking down some of the biggest eye health inequities in Australian ophthalmology, according to Dr Angus Taylor, but the sector needs to find ways for real-world implementation.

The tyranny of distance in Australia – and the subsequent eye health disparities for rural and remote communities – was the focus of Dr Angus Turner’s presentation at Specsavers Clinical Conference 2022 that offered new solutions by way of technology. In his discussion entitled ‘Integrating telemedicine and artificial intelligence into eyecare services’, Dr Turner outlined the real-world efficiencies brought about by telehealth consultations in eyecare. This technology is applied in regional and rural WA where he founded the Lions Outback Vision outreach program.

In addition to convenience for the patient, telehealth has been shown in peer-review papers to drive better eye health outcomes, including a halving the wait time for cataract surgery, a 10 times increase in access for Aboriginal people when an on-call service was introduced and high patient satisfaction. A systematic review also showed outcomes were equal or better with telehealth compared to regular specialist care, it improves surgeon efficiency and eliminates duplication, and reduces and eliminates pre- and post-op visits. 

Another major technological puzzle piece to overcome distance barriers to care is AI. Turner’s presentation focused on applying the technology to diabetic eye disease, which his team’s recent study found affected Aboriginal people more than non-Aboriginal. Turner said many patients were not getting recommended screening checks, with data showing 28% haven’t been checked in the Kimberley region. This added impetus for new ways to make it easier for patients to receive a screening grade on the spot. 

To view the Insight feature report Bringing telehealth and artificial intelligence into real-world ophthalmology practice in full click here.

Lions Eye Institute managing director Prof Bill Morgan (from left), A/Prof Angus Turner, Patrick Dodson and Divina D’Anna at the Kimberley Eye Hub opening in October. Photo: Sarah Landro. Image source: Insight.

How Pat Turner helped launch NITV

In 2006, after decades of service in government and elsewhere, working towards the self-determination of Indigenous people, Pat Turner moved home to Alice Springs for a well-deserved retirement. “I had no intention of working again,” the Gudanji Arrernte woman told NITV. Then she received a call from filmmaker Rachel Perkins. The acclaimed director was one of a group of Aboriginal professionals working in media who had met in Redfern with the intention of realising a dream that had been floated for years: a dedicated Aboriginal and Torres Strait Islander television station. With years of sound and transparent administration to her name, Turner was an obvious choice to steer the ship.

“Rachel rang me first and said ‘Come down, can you do this for a couple of months until we get a CEO?’ “I had gone home to retire! And so, it was all just chance, really.” By the end of that year, she was on a plane to Sydney, for a three-week stay to look over the history and the aspirations of the board. What she saw lit a fire. “I could see the potential, and I became really enthusiastic about it. Having our own Aboriginal and Torres Strait Islander television service run by us, for us. It was just a light bulb moment.”

Rome wasn’t built in a day, and creating a TV station from scratch isn’t much easier. It was a mammoth effort, much of it falling to Turner, who was appointed CEO in January 2007. “It was just sheer hard work. I mean, all hands on deck,” she said. “When I started, I did it on the back patio of my house in Alice Springs, with a laptop and a mobile phone that I bought. “I financed the whole operation until the money came through. From December [2006] until February or March [2007] I didn’t get any wages. It cost thousands of dollars.”

To view the SBS NITV story From her back deck, Pat Turner helped launch NITV with just a laptop and a phone. This is how she did it in full click here.

Strep A – what is it, who’s at risk?

The bacteria that causes group A streptococcus (strep A) is incredibly common. The bacterium is found in the throat and on the skin. It is carried without symptoms by many people, but often causes high fever or throat infections. Professor Michael Good from Griffith University in Queensland has explained “strep A is known to everybody because everyone has kids or themselves have had a strep throat (tonsillitis) or they get school sores – those conditions are very prevalent.” For most, a strep A infection will be minor, but for 1,000s it triggers very serious or in some cases deadly diseases such as Meningitis, Toxic Shock Syndrome, Rheumatic Heart Disease (RHD) and Sepsis.

The best way to avoid infection, according to the Department of Health, is to maintain good hygiene. While anyone can develop an infection, there are some groups who are at much higher risk of disease than others:

  • children under five years of age, especially infants
  • older people over 65 years of age
  • people with poor access to hygiene facilities
  • people who live or spend time in crowded conditions
  • people with weak immune systems or chronic illnesses

NSW Health and researchers also say Aboriginal and Torres Strait Islander peoples are at high risk from strep A. There is currently no vaccine for strep A although Griffith University researchers have recently developed a vaccine candidate to treat the bacteria. The first human trials of the vaccine began in Canada last month. If all goes well the vaccine will be widely available in five years time.

To read the 9 News article What is strep A, the disease that has killed six children and has UK authorities on high alert? in full click here.

Researchers Professor Michael Good and Dr Manisha Pandey from Griffith University, QLD. Image source: 9 News.

Oral microbiomes may add to chronic disease load

Indigenous Australians have unique microbes in their mouths, which may contribute to a higher burden of chronic diseases, such as diabetes and cardiovascular disease, according to new research led by Pennsylvania State University (Penn State) and the University of Adelaide. The results suggest that understanding this “oral microbiome” could be a useful target to help Indigenous Australians improve their health.

Like the gut microbiome is the community of microbes living in the gut, the oral microbiome is the community of microbes living in the mouth. Some of these oral microbes are crucial to human health; for example, they can defend against invading pathogens. Others, however, may be harmful and contribute to oral diseases, such as periodontal — or gum — disease.

“Indigenous Australians disproportionately experience poor oral health, which is linked to other negative health outcomes,” said Laura Weyrich, Associate Professor of Anthropology, Penn State. “For example, periodontal disease increases the risk and severity of diabetes, chronic kidney disease and cardiovascular disease. Exploring oral microbiome may reveal new pathways to improve both oral and systemic health outcomes for Indigenous Australians.”

To view the Penn State research article Indigenous Australians’ unique oral microbiomes may add to chronic disease load in full click here.

Some of the potentially harmful organisms making their home in the human oral cavity. Image: Rasi / Image source: Dental Products Report.

Weigelli gets infrastructure boost

The Western NSW Local Health District will receive $250,000 for important works to be carried out at Weigelli Centre Aboriginal Corporation as part of the NSW Government’s Aboriginal Health Minor Capital Works Program. Member for Cootamundra Steph Cooke said this funding will go a long way to ensuring the important work carried out by Weigelli Centre continues not only now but into the future.

“This amazing facility has been operating since 1996, offering an all-important drug and alcohol rehabilitation service,” Ms Cooke said. “I know this investment will allow Weigelli to provide open and welcoming spaces to those in the community who need their support. It is important that we continue to support these services as they provide the assistance needed for those on their journey to recovery.”

Minister for Aboriginal Affairs Ben Franklin said this funding will provide Aboriginal Community Controlled Health Services the funding they need to better support their local communities with optimal services and infrastructure. “This important funding will deliver safe and effective primary health care services to Aboriginal communities across the State which are delivered by Aboriginal people, services and specialists,” Mr Franklin said.

To view The Cowra Phoenix article Weigelli gets infrastructure boost in full click here.

Member For Cooatmundra Steph Cooke with Weigelli’s Kerri-Anne Cutmore, Norm Henderson and CEO Daniel Jeffries. Image source: The Cowra Phoenix.

Support for going sober in the bush

It took a long time for Shanna Whan to realise there was a problem. Eight years ago, she awoke in hospital after a drunken fall and realised her choice was to change or die. “I was a suicidal, sick, desperately-close-to-death human. It was horrific,” Ms Whan said. She later founded the not-for-profit, Sober In The Country, which has now blossomed into a social impact enterprise and peer support network called the Bush Tribe.

“It takes on average 18 years for someone to seek help. So there’s like nearly two decades that people are falling and we don’t even see it,” Ms Whan said. “Alcohol is one of the most dangerous drugs to detox from,” said Chris Davis, a GP who specialises in drug and alcohol services. “Going cold turkey, if you’re alcohol dependent, can lead to seizures and death.” Dr Davis is one of the operators of an in-home detox service called Clean Slate Clinic. Now, the virtual format program is being trialled in country NSW and outback Queensland to see if it can be adapted to the needs of remote patients.

Sandy Gillies is the CEO of the Western Queensland Primary Health Network (PHN) which commissioned one the Clean Slate trials. She said the region had one of the highest rates of risky alcohol consumption in the state but lacked services, and could not afford to build a facility or recruit the workers needed to run it.  A lot of her work focuses on First Nations health which is also an area in which Clean Slate is looking to provide culturally safe services. “We want to explore the cultural responsiveness and safety of a service such as this, especially in our rural and remote Aboriginal and Torres Strait Islander communities,” Ms Gillies said.

To view the ABC News article Support for going sober in the bush as new program helps break the stigma of giving up alcohol in full click here.

Ms Gillies is the first Indigenous person to head up one of the 31 PHNs. Photo: Stephen Cavenagh, ABC News.

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.

One comment on “NACCHO Aboriginal & Torres Strait Islander Health News: Breaking down eye health inequities

  1. G’day,
    I was surprised by the soft tone of this piece on Strep A (and by implication acute rheumatic fever and chronic rheumatic heart disease).
    Historically this was a fairly common condition in mainstream Australia.
    I trained in the UK in the mid 1970s and there were a few elderly patients with loud heart murmurs from rheumatic heart disease who were brought in to be examined for the medical exams. Otherwise I never saw a case of acute rheumatic fever or rheumatic heart disease in my training. On returning to Australia to work I never came across a case until I moved to Central Australia in 1983, and became only too familiar with the problem.
    Why did the condition disappear in the UK and mainstream Australia?
    Principally because of a reduction in poverty, an improved standard of living, and especially the building of enough public housing to end overcrowding in slum housing.
    I find it ironic that we find the money to spend on medical interventions after the fact, but as a rich nation we cannot find the wherewithal to prevent and eradicate this condition by the “Old Public Health” measures which did the job for the rest of the country.

Leave a Reply

Your email address will not be published. Required fields are marked *