NACCHO Aboriginal & Torres Strait Islander Health News: Voice can deliver tangible health benefits

image CAAC CEO Donna Ah Chee holding hand of Sabella Turner as she receives COVID-19 vaccine; text 'Proponents confident the Voice can deliver tangible health benefits'

The image in the feature tile is of Central Australian Aboriginal Congress Aboriginal Corporation (Congress) CEO Donna Ah Chee (R) and Congress’ Cultural Lead, Sabella Turner (L). Image source: Congress Twitter post 31 March 2021.

The NACCHO Aboriginal and Torres Strait Islander Health News is platform we use to showcase the important work being done in Aboriginal and Torres Strait Islander health, focusing on the work of NACCHO, NACCHO members and NACCHO affiliates.

We also share a curated selection of news stories that are of likely interest to the Aboriginal and Torres Strait Islander health sector, broadly.

Voice can deliver tangible health beneftis

Dr Norman Swan last week’s ABC Radio National Health Report episode, on Monday 7 August 2023, was the program’s first foray into the debate about the Voice referendum, the referendum on the Voice to Parliament. Dr Swan said that the debate on the Voice had become fraught, with some arguing that what’s been lost in the whole debate is that the Voice is actually a health issue, with evidence that we can confidently expect tangible benefits.

Dr Swan spoke to two people who are well qualified to speak about how the Voice can deliver positive health outcomes to Aboriginal and Torres Strait Islander people: Professor Fiona Stanley, a past Australian of the Year, founding director of the Telethon Institute for Child Health Research in WA, and a researcher into Aboriginal health for last 50 years, and Donna Ah Chee who heads one of Australia’s oldest and largest ACCHOs, Central Australian Aboriginal Congress Aboriginal Corporation (CAAC), and is a proud Bundjalung woman.

Ms Ah Chee said the NT is a case study that shows a Voice-like mechanism can be successful and show results. She said there was “a key turning point in the 1990s with the establishment of a strong Aboriginal leadership body in the NT. And we’d long advocated for a forum that would give us a voice, not just at the local community level through our Aboriginal community-controlled health services, but also at the table where big decisions on health were made. And we finally won this argument, and the NT Aboriginal Health Forum was established in 1998. And it’s a place where the Aboriginal health sector and governments meet together and plan how to improve the health of our communities. It really laid the groundwork for many of our health improvements in the NT that we’ve seen since. It’s not perfect, we don’t always agree, but it does demonstrate what we had always said; when you have structures that are based on genuine Aboriginal involvement and leadership, you get better outcomes.”

You can listen to the ABC RN Health Report episode Importance of The Voice for Aboriginal health in full and/or read the transcript in full here.

collage CAAC CEO Donna Ah Chee & Professor Fiona Stanley - both outdoor portrait shots against trees

CAAC CEO Donna Ah Chee, Image source: Off the Leash. Professor Fiona Stanley. Image source: ABC News.

ACCHRTOs attend resource mapping workshop

On Wednesday 9 and Thursday 10 August last week, NACCHO hosted a two-day workshop with our Aboriginal Community-Controlled Registered Training Organisations (ACCHRTOs) in Canberra. The aim of the workshop was to identify resource gaps and prioritise development of National Training Resources for the Aboriginal Health Worker and Health Practitioner qualifications and key skill sets.

The development of National Training Resources will support the capacity of our ACCHRTOs as part of the rollout of the First Nations Health Worker Traineeship Program which will deliver 500 new Aboriginal Health Workers and Health Practitioners over the next four years into our sector. Our ACCHRTOs will work with our ACCHOs to grow a highly qualified local workforce to progress Closing the Gap in Aboriginal and Torres Strait Islander health.

ACCHRTOs resource mapping workshop at NACCHO 10.8.23

Participants of ACCHRTOs resource mapping workshop at NACCHO, Canberra on 10 August 2023.

Western diet disastrous effect on kidney health

One of the drivers of health problems that disproportionately affect Indigenous people is the Western diet. Balgo, also known as Wirrimanu, in WA, is a community so remote it’s home to people who lived in the bush until the 1980s, and others who worked in cattle stations on rations. The strong contrast between eating bush turkey and kangaroo, and the introduction of white sugar and white flour is in living memory, and it’s had an impact on kidney health in the community.

When your kidneys fail, often from diabetes 2, dialysis machines do the kidneys’ job and remove water and toxins from the blood. You’ve got to get treated two to three times a week and it takes around five hours each time. It means people in communities like Balgo with no dialysis care have to leave home to get the treatment that will keep them alive. Indigenous people in remote communities have one of the highest rates of chronic kidney disease in the world.

In 2000, locals from Kiwirrkura were forced to leave their country and families for dialysis treatment. So artists from their communities, including the Pintubi Nine (a family group who remained unaware of European colonisation of Australia and lived a traditional desert-dwelling life in Australia’s Gibson Desert until 1984), made four enormous paintings, which were auctioned off at the Art Gallery of NSW. They raised enough money to start a remote dialysis care organisation called Purple House, and they’ve just got funding to bring dialysis to Balgo. The four-chair unit will be ready next year. But for locals it couldn’t come sooner.

You can listen to the ABC RN Health Report episode Balgo – I want my people to come back home in full and/or read the transcript in full here.

Eric Moora, Balgo WA

Eric Moora, Wirrimanu (Balgo), WA. Photo: Elsa Siberstein. Image source: ABC Radio National.

Aboriginal-led responses the ‘best way’

Professor Fiona Stanley AC is an epidemiologist and one of Australia’s most prominent health advocates. Professor Stanley has been awarded the Centenary Medal, was named Australian of the Year in 2003, is a Companion of the Order of Australia, and has more than ten honorary doctorates in Australia and abroad for her research into child and maternal health. She was also the first to identify the Gap in First Nations health and wellbeing using data.

“This is what’s has driven me in 50 years of research,” said Professor Stanley. “And I now have this wonderful information about why the [Indigenous Voice [to Parliament] will make a difference.” Professor Stanley said that she has seen Aboriginal community controlled health systems produce good outcomes for First Nations’ health, while she said programs without Aboriginal and Torres Strait Islander control do not close the gap. “There are two main reasons that we have failed to close the gap,” Professor Stanley said.

“The first is that successive governments have poured money into non-Indigenous bureaucratic programs without consultation, which at best haven’t had any impact, and at worst had a major negative impact. The second is the underfunding and defunding of the Aboriginal controlled services and organisations. And yet, when Aboriginal communities are called on to do the job, they do it better than anyone in the world,” she said, referring to the Aboriginal Community Controlled coronavirus disease 2019 (COVID-19) response, which was internationally recognised as global best practice. Voting Yes on the Voice is the most cost-effective thing we can do. But it will also have the extraordinary impact of increasing First Nations self-esteem,” Professor Stanley said.

To view the AMA InSight+ article Aboriginal-led responses the ‘best way’ for self-determination in full click here.

Professor Fiona Stanley speaking at panel discussion in Perth 10.7.23

Fiona Stanley says there were fewer COVID cases in the Indigenous community as they “had a voice”. Photo: Daryna Zadvirna. Image source: ABC News.

Deaths in custody just keep rising

Content warning: This article contains reference to suicide. Please refer to the services at the bottom of this article for support.

Two Indigenous men died in custody last week – one in NSW and the other in WA. In NSW, Wiradjuri man TJ Dennis died by suicide in his prison cell at Silverwater Correctional Complex last weekend. Reports suggest that the ACT Government transferred TJ Dennis against advice from the Winnunga Nimmityjah Aboriginal Health and Community Service. The health service was advocating for his transfer to a specialist forensic mental health facility where he could receive treatment for his complex mental health issues, which were related to childhood trauma, as well as be monitored carefully, because he had previously attempted suicide multiple times at AMC.

Winnunga Nimmityjah CEO Julie Tongs told media that in her opinion Mr Dennis’s death was “not only predictable, it was avoidable” had the ACT State Government heeded the service’s advice and provided Mr Dennis with care appropriate to his mental health condition. She is calling for a joint inquiry into TJ Dennis’ death (meaning an inquiry which will include both the ACT and NSW) and also a separate investigation into the AMC, which has been the subject of some serious complaints regarding human rights concerns.

National death in custody statistics (including those in youth detention centres) are recorded by the National Deaths in Custody Program (NDICP) which has kept records since 1980. Since the Royal Commission into Indigenous deaths in Custody in 1991, there have been 516 recorded deaths of Indigenous people who died in custody. Last year’s NDICP Annual Report showed that between July 2021 and June 2022  there was an increase of 23 deaths recorded in the previous year. Of the total of 106 recorded deaths in custody, 24 were deaths of Indigenous people. According to the national 2023 figures, 48 people have died in custody this year – 8 of them have been Indigenous. Deaths in custody are tragic, particularly when they are preventable, but they are only one part of the story. Australia’s history of systemic racism and human rights abuses of Indigenous people are also very serious issues across the spectrum of the justice system (and society as a whole) which need urgent attention and have done for way too long.

To read the Sydney Criminal Lawyers article Black deaths in custody continue decades after the Royal Commission in full click here.

banner 'Stop Black Deaths in Custody' image of black hands on jail bars

Photo: Jack Fisher, ABC News. Image source: Sydney Criminal Lawyers.

If this article brought up anything for you or someone you love, please reach out to, call or visit the online resources listed below for support:

13YARN – 13 92 76, 13yarn.org.au

Lifeline – 13 11 14, lifeline.org.au

Beyond Blue – 1300 224 636, beyondblue.org.au/forums

MensLine – 1300 789 978

Kids Helpline – 1800 551 800

Suicide Call Back Service – 1300 659 467

Economic development needs healthy people

The World Health Organisation defines ‘health’ as not merely the absence of disease or infirmity, but a state of complete physical, mental and social wellbeing. Health underpins the peace, security and prosperity of communities and nations. Remote northern Australia has among the highest rates of preventable deaths and potentially preventable hospitalisations in the country. Young Aboriginal and Torres Strait Islander people living in the north have among the highest reported rates of youth-onset type 2 diabetes in the world.

A healthy population underpins economic development. A 2020 situational analysis of health service delivery in northern Australia noted several strengths, such as the innovative service models led by AACCHOs that deliver culturally safe service models for comprehensive primary health care. It also identified challenges, including health workforce shortages and high rates of turnover, along with barriers to healthcare access and poor care continuity. Building up the region’s health workforce is pivotal. Better local training and support, tailored to local health needs and supplemented by attraction and retention strategies and improved liveability for families, are critical.

The second priority area is support for cross-sectoral approaches. Persisting inequities highlight the importance of the social, cultural, commercial and environmental determinants of health. These include housing, employment, education, healthy environments, climate change and nutrition. Culture and connection to Country are also key health determinants for many Aboriginal and Torres Strait Islander people. The ‘one health’ approach also recognises that interconnections between people, animals and the environment shape health outcomes and responses to global health threats such as COVID-19.

Social determinants are reflected in many government policies, but there are often gaps between policy intent and implementation. Connecting sectors to improve health requires joint planning and innovative governance models that support effective co-design and collaboration. The success of the northern Australia development agenda hinges most on governance models—they must be designed to allow policy intentions to be linked with evidence and action, building on learnings from past successes and failures.

To read The Strategist article Economic development requires healthy people and communities in full click here.

ATSI man receiving treatment at Mala'la Health Service Aboriginal Corporation, Maningrida, NT

Mala’la Health Service Aboriginal Corporation, Maningrida, NT. Photo: Felicity James. Image source: ABC News.

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